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Mol Nutr Food Res. 2018 Feb;62(3). doi: 10.1002/mnfr.201700674. Epub 2017 Dec 19.

Flavonoid-Rich Apple Improves Endothelial Function in Individuals at Risk for Cardiovascular Disease: A Randomized Controlled Clinical Trial.

Author information

1
School of Medicine, University of Western Australia, Royal Perth Hospital, Perth, Western Australia, Australia.
2
School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.
3
School of Molecular Sciences, and the School of Agriculture and Environment, University of Western Australia, Perth, Australia.
4
The UWA Institute of Agriculture, University of Western Australia, Perth, Australia.
5
Irrigated Agriculture Division, Department of Primary Industries and Regional Development, South Perth, Australia.
6
Vascular Biology Division, Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia.
7
St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, NSW, Australia.
8
Centre for Epidemiology and Biostatistics, School of Public Health, Flinders University of South Australia, Adelaide, South Australia, Australia.
9
School of Biomedical Sciences and Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.

Abstract

SCOPE:

The cardioprotective effects of apples are primarily attributed to flavonoids, found predominantly in the skin. This study aimed to determine if acute and/or chronic (4 weeks) ingestion of flavonoid-rich apples improves endothelial function, blood pressure (BP), and arterial stiffness in individuals at risk for cardiovascular diseases (CVD).

METHODS AND RESULTS:

In this randomized, controlled cross-over trial, acute and 4 week intake of apple with skin (high flavonoid apple, HFA) is compared to intake of apple flesh only (low flavonoid apple, LFA) in 30 participants. The primary outcome is endothelial function assessed using flow-mediated dilation (FMD) of the brachial artery, while main secondary outcomes are 24 h ambulatory BP and arterial stiffness. Other outcomes include fasting serum glucose and lipoprotein profile, plasma heme oxygenase-1 (Hmox-1), F2 -isoprostanes, flavonoid metabolites, and plasma and salivary nitrate (NO3- ) and nitrite (NO2- ) concentrations. Compared to LFA control, the HFA results in a significant increase in FMD acutely (0.8%, p < 0.001) and after 4 weeks chronic intake (0.5%, p < 0.001), and in plasma flavonoid metabolites (p < 0.0001). Other outcomes are not altered significantly.

CONCLUSION:

A lower risk of CVD with higher apple consumption could be mediated by the beneficial effect of apple skin on endothelial function, both acutely and chronically.

KEYWORDS:

apples; blood pressure; endothelial function; flavonoids; randomized controlled trial

PMID:
29086478
DOI:
10.1002/mnfr.201700674
[Indexed for MEDLINE]

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