Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease-FLAVURS

A randomized controlled trial

Anna L. Macready, Trevor W. George, Mary F. Chong, Dauren S. Alimbetov, Yannan Jin, Alberto Vidal, Jeremy P E Spencer, Orla B. Kennedy, Kieran M. Tuohy, Anne Marie Minihane, Michael H. Gordon, Julie A. Lovegrove

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Background: Observed associations between increased fruit and vegetable (F&V) consumption, particularly those F&Vs that are rich in flavonoids, and vascular health improvements require confirmation in adequately powered randomized controlled trials. Objective: This study was designed to measure the dose-response relation between high-flavonoid (HF), low-flavonoid (LF), and habitual F&V intakes and vascular function and other cardiovascular disease (CVD) risk indicators. Design: A single-blind, dose-dependent, parallel randomized controlled dietary intervention study was conducted. Male and female low-F&V consumers who had a &gt1.5-fold increased risk of CVD (n = 174) were randomly assigned to receive an HF F&V, an LF F&V, or a habitual diet, with HF and LF F&V amounts sequentially increasing by 2, 4, and 6 (+2, +4, and +6) portions/d every 6 wk over habitual intakes. Microvascular reactivity (laser Doppler imaging with iontophoresis), arterial stiffness [pulse wave velocity, pulse wave analysis (PWA)], 24-h ambulatory blood pressure, and biomarkers of nitric oxide (NO), vascular function, and inflammation were determined at baseline and at 6, 12, and 18 wk. Results: In men, the HF F&V diet increased endothelium-dependent microvascular reactivity (P = 0.017) with +2 portions/d (at 6 wk) and reduced C-reactive protein (P = 0.001), E-selectin (P = 0.0005), and vascular cell adhesion molecule (P = 0.0468) with +4 portions/d (at 12 wk). HF F&Vs increased plasma NO (P = 0.0243) with +4 portions/d (at 12 wk) in the group as a whole. An increase in F&Vs, regardless of flavonoid content in the groups as a whole, mitigated increases in vascular stiffness measured by PWA (P = 0.0065) and reductions in NO (P = 0.0299) in the control group. Conclusion: These data support recommendations to increase F&V intake to >6 portions daily, with additional benefit from F&Vs that are rich in flavonoids, particularly in men with an increased risk of CVD. This trial was registered at www.controlled-trials.com as ISRCTN47748735.

Original languageEnglish
Pages (from-to)479-489
Number of pages11
JournalAmerican Journal of Clinical Nutrition
Volume99
Issue number3
DOIs
Publication statusPublished - Mar 1 2014
Externally publishedYes

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Flavonoids
Vegetables
Fruit
Cardiovascular Diseases
Randomized Controlled Trials
Pulse Wave Analysis
Blood Vessels
Nitric Oxide
Vascular Stiffness
Diet
Iontophoresis
E-Selectin
Vascular Cell Adhesion Molecule-1
C-Reactive Protein
Endothelium
Lasers
Biomarkers
Blood Pressure
Inflammation
Control Groups

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease-FLAVURS : A randomized controlled trial. / Macready, Anna L.; George, Trevor W.; Chong, Mary F.; Alimbetov, Dauren S.; Jin, Yannan; Vidal, Alberto; Spencer, Jeremy P E; Kennedy, Orla B.; Tuohy, Kieran M.; Minihane, Anne Marie; Gordon, Michael H.; Lovegrove, Julie A.

In: American Journal of Clinical Nutrition, Vol. 99, No. 3, 01.03.2014, p. 479-489.

Research output: Contribution to journalArticle

Macready, Anna L. ; George, Trevor W. ; Chong, Mary F. ; Alimbetov, Dauren S. ; Jin, Yannan ; Vidal, Alberto ; Spencer, Jeremy P E ; Kennedy, Orla B. ; Tuohy, Kieran M. ; Minihane, Anne Marie ; Gordon, Michael H. ; Lovegrove, Julie A. / Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease-FLAVURS : A randomized controlled trial. In: American Journal of Clinical Nutrition. 2014 ; Vol. 99, No. 3. pp. 479-489.
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abstract = "Background: Observed associations between increased fruit and vegetable (F&V) consumption, particularly those F&Vs that are rich in flavonoids, and vascular health improvements require confirmation in adequately powered randomized controlled trials. Objective: This study was designed to measure the dose-response relation between high-flavonoid (HF), low-flavonoid (LF), and habitual F&V intakes and vascular function and other cardiovascular disease (CVD) risk indicators. Design: A single-blind, dose-dependent, parallel randomized controlled dietary intervention study was conducted. Male and female low-F&V consumers who had a &gt1.5-fold increased risk of CVD (n = 174) were randomly assigned to receive an HF F&V, an LF F&V, or a habitual diet, with HF and LF F&V amounts sequentially increasing by 2, 4, and 6 (+2, +4, and +6) portions/d every 6 wk over habitual intakes. Microvascular reactivity (laser Doppler imaging with iontophoresis), arterial stiffness [pulse wave velocity, pulse wave analysis (PWA)], 24-h ambulatory blood pressure, and biomarkers of nitric oxide (NO), vascular function, and inflammation were determined at baseline and at 6, 12, and 18 wk. Results: In men, the HF F&V diet increased endothelium-dependent microvascular reactivity (P = 0.017) with +2 portions/d (at 6 wk) and reduced C-reactive protein (P = 0.001), E-selectin (P = 0.0005), and vascular cell adhesion molecule (P = 0.0468) with +4 portions/d (at 12 wk). HF F&Vs increased plasma NO (P = 0.0243) with +4 portions/d (at 12 wk) in the group as a whole. An increase in F&Vs, regardless of flavonoid content in the groups as a whole, mitigated increases in vascular stiffness measured by PWA (P = 0.0065) and reductions in NO (P = 0.0299) in the control group. Conclusion: These data support recommendations to increase F&V intake to >6 portions daily, with additional benefit from F&Vs that are rich in flavonoids, particularly in men with an increased risk of CVD. This trial was registered at www.controlled-trials.com as ISRCTN47748735.",
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T1 - Flavonoid-rich fruit and vegetables improve microvascular reactivity and inflammatory status in men at risk of cardiovascular disease-FLAVURS

T2 - A randomized controlled trial

AU - Macready, Anna L.

AU - George, Trevor W.

AU - Chong, Mary F.

AU - Alimbetov, Dauren S.

AU - Jin, Yannan

AU - Vidal, Alberto

AU - Spencer, Jeremy P E

AU - Kennedy, Orla B.

AU - Tuohy, Kieran M.

AU - Minihane, Anne Marie

AU - Gordon, Michael H.

AU - Lovegrove, Julie A.

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N2 - Background: Observed associations between increased fruit and vegetable (F&V) consumption, particularly those F&Vs that are rich in flavonoids, and vascular health improvements require confirmation in adequately powered randomized controlled trials. Objective: This study was designed to measure the dose-response relation between high-flavonoid (HF), low-flavonoid (LF), and habitual F&V intakes and vascular function and other cardiovascular disease (CVD) risk indicators. Design: A single-blind, dose-dependent, parallel randomized controlled dietary intervention study was conducted. Male and female low-F&V consumers who had a &gt1.5-fold increased risk of CVD (n = 174) were randomly assigned to receive an HF F&V, an LF F&V, or a habitual diet, with HF and LF F&V amounts sequentially increasing by 2, 4, and 6 (+2, +4, and +6) portions/d every 6 wk over habitual intakes. Microvascular reactivity (laser Doppler imaging with iontophoresis), arterial stiffness [pulse wave velocity, pulse wave analysis (PWA)], 24-h ambulatory blood pressure, and biomarkers of nitric oxide (NO), vascular function, and inflammation were determined at baseline and at 6, 12, and 18 wk. Results: In men, the HF F&V diet increased endothelium-dependent microvascular reactivity (P = 0.017) with +2 portions/d (at 6 wk) and reduced C-reactive protein (P = 0.001), E-selectin (P = 0.0005), and vascular cell adhesion molecule (P = 0.0468) with +4 portions/d (at 12 wk). HF F&Vs increased plasma NO (P = 0.0243) with +4 portions/d (at 12 wk) in the group as a whole. An increase in F&Vs, regardless of flavonoid content in the groups as a whole, mitigated increases in vascular stiffness measured by PWA (P = 0.0065) and reductions in NO (P = 0.0299) in the control group. Conclusion: These data support recommendations to increase F&V intake to >6 portions daily, with additional benefit from F&Vs that are rich in flavonoids, particularly in men with an increased risk of CVD. This trial was registered at www.controlled-trials.com as ISRCTN47748735.

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