Flavonoid-rich apple improves endothelial function in individuals at risk for cardiovascular disease: a randomised controlled clinical trial: A Randomized Controlled Clinical Trial

Nicola Bondonno, Catherine Bondonno, Lauren Blekkenhorst, Michael Considine, Ghassan Maghzal, Roland Stocker, Richard Woodman, Natalie Ward, Jonathan Hodgson, Kevin Croft

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    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.

    Original languageEnglish
    Article number1700674
    Number of pages10
    JournalMolecular Nutrition and Food Research
    Volume62
    Issue number3
    DOIs
    Publication statusPublished - 2018

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