[Barriers and facilitators of the EfiKroniK exercise program for people with chronic diseases in Primary Care]. / Barreras y facilitadores del programa de ejercicio EfiKroniK para pacientes con enfermedad crónica en atención primaria.

OBJECTIVE: Explore patients' perceptions during a supervised exercise program and detect the barriers and facilitators that influence exercise adherence after the supervision period. DESIGN: A qualitative observational study with three focus groups as the main data collection technique was conducted. SITE: Primary Health centers of Bizkaia. PARTICIPANTS: Out of the 175 randomized patients in the hybrid effectiveness-implementation trial, a sample of 19 patients from the intervention group were included in the qualitative study (12 advanced-stage onco-haematological patients and seven with severe mental disorders). METHODS: Content analysis of the generated transcripts was performed by combining a deductive approach, based on the domains of the PRACTIS theoretical framework, and an inductive one, based on the postulates of the Grounded Theory. RESULTS: The data analysis showed that participants were satisfied with the EfiKroniK program and that the main identified benefits were discovery of the benefits of physical exercise, the psychological and emotional management of the disease, the benefits from peer communication and emotional support, and the break from routine of their illness. Participants decreased the levels of physical exercise at the end of the supervision6 due to the confluence of several barriers. CONCLUSION: A supervised exercise program carried out in Primary Care contributed to the improvement of the quality of life as well as the emotional and social well-being of patients with advanced-stage diseases. Our study identified potential barriers and facilitators associated with exercise participation and its continuity, however, it is necessary to encourage inter-sectoral coordination within the socio-health system to promote integrated and continuous care for chronic patients.

Effects of combined application of high-pressure processing and active coatings on phenolic compounds and microbiological and physicochemical quality of apple cubes.

BACKGROUND: In recent years the use of high-pressure processing (HPP) of fruit products has steadily increased due to its antimicrobial effectiveness and the retention of nutritional and quality attributes compared to conventional thermal technologies. Edible coatings are already being used to enhance the quality of minimally processed fruits. Thus, apple cubes (AC) and alginate-vanillin-coated apple cubes (AVAC) were subjected to HPP (400 MPa/5 min/35 °C). The microbiological and physicochemical parameters were evaluated and the bioactive compounds were monitored before and after HPP of apple cubes. Also, an in vitro gastrointestinal digestion (GID) was conducted. RESULTS: HPP left L. monocytogenes counts below the detection limit (2 log UFC g-1 ), regardless of the presence of coating. For E. coli, HPP + active coating showed a synergism affording the greatest reduction (>5 log) for AVAC-HPP. Firmness was maintained in AVAC-HPP samples, while AC-HPP samples suffered reductions of 35%. Colour attributes were also better retained in AVAC-HPP samples. In general, HPP led to a decrease in phenolic compounds. Regarding the effects of GID, vanillin-based active coating exerted a protective effect on some phenolics. Thus, p-coumaroylquinic acid concentration was maintained for AVAC and AVAC-HPP during GID. Epigallocatechin, the compound with the highest concentration in apple cubes, increased for AVAC (106%) and AVAC-HPP (57%). Also, phloridzin concentration increased for AVAC-HPP (17%). At the end of GID, procyanidin B1 and epigallocatechin were the main phenolic compounds for all samples, AVAC showing the highest concentration. CONCLUSIONS: This work demonstrates that the combined application of HPP and active coatings on apple cubes could be used to obtain a safe and good-quality product. © 2021 Society of Chemical Industry.

Effectiveness of physical exercise for people with chronic diseases: the EFIKRONIK study protocol for a hybrid, clinical and implementation randomized trial.

BACKGROUND: Chronic illnesses are the leading cause of morbidity and mortality and threaten the sustainability of healthcare systems worldwide. There is limited evidence in terms of the best modality and intensity of physical activity for improving cardiorespiratory capacity and quality of life in patients with chronic conditions. The objective of the EfiKroniK study is to estimate the common effect of innovative, individualized and supervised physical exercise, on cardiorespiratory functional capacity and quality of life across people with different chronic conditions. METHODS/DESIGN: This is a multicentre clinical trial with a type I hybrid effectiveness-implementation design, including 370 patients each with one of four different chronic illnesses: solid cancer, blood cancer, chronic obstructive pulmonary disease or schizophrenia. Patients will be randomly divided into two parallel groups, stratified by illness type. Patients in both groups will receive a standard healthy life prescription (PVS, from the Spanish "Prescribe Vida Saludable") and additionally, the EfiKroniK group will be prescribed a physical exercise programme tailored to each patient in terms of intensity in each session. The primary outcome variables will be cardiorespiratory functional capacity and quality of life. The secondary outcome variables will be signs and symptoms, psychological and social factors and specific laboratory parameters. We will also analyse the dose-response effect of the physical exercise programme. Qualitative variables will describe patients' perception of the utility and suitability of the EfiKroniK programme, as well as their expectations and satisfaction, identifying barriers to and facilitators of the EfiKroniK implementation process through discussion groups. The study will be carried out on an intention-to-treat basis, comparing changes throughout the 1-year follow-up between groups, adjusting for baseline, by performing mixed-effect analysis of covariance. We will estimate the effect of time on repeated measures in each subject and changes in the EfiKroniK and PVS groups over time. DISCUSSION: The study will provide the data necessary to allow us to prescribe physical exercise in a similar way to a drug and as a key part of the treatment of chronic illnesses within our healthcare system. TRIAL REGISTRATION: NCT03810755 . Date and version identifier: October 9, 2020. Version2.0.

Metabolomic Fingerprinting in the Comprehensive Study of Liver Changes Associated with Onion Supplementation in Hypercholesterolemic Wistar Rats.

The consumption of functional ingredients has been suggested to be a complementary tool for the prevention and management of liver disease. In this light, processed onion can be considered as a source of multiple bioactive compounds with hepatoprotective properties. The liver fingerprint of male Wistar rats (n = 24) fed with three experimental diets (control (C), high-cholesterol (HC), and high-cholesterol enriched with onion (HCO) diets) was obtained through a non-targeted, multiplatform metabolomics approach to produce broad metabolite coverage. LC-MS, CE-MS and GC-MS results were subjected to univariate and multivariate analyses, providing a list of significant metabolites. All data were merged in order to figure out the most relevant metabolites that were modified by the onion ingredient. Several relevant metabolic changes and related metabolic pathways were found to be impacted by both HC and HCO diet. The model highlighted several metabolites (such as hydroxybutyryl carnitine and palmitoyl carnitine) modified by the HCO diet. These findings could suggest potential impairments in the energy-lipid metabolism, perturbations in the tricarboxylic acid cycle (TCA) cycle and ß-oxidation modulated by the onion supplementation in the core of hepatic dysfunction. Metabolomics shows to be a valuable tool to evaluate the effects of complementary dietetic approaches directed to hepatic damage amelioration or non-alcoholic fatty liver disease (NAFLD) prevention.

Multiplatform metabolomic fingerprinting as a tool for understanding hypercholesterolemia in Wistar rats.

PURPOSE: The aim was to investigate the impact of hypercholesterolemic diet on the metabolome of male Wistar rats by a multiplatform metabolomic fingerprinting. METHODS: Male Wistar rats were fed with two different diets [control (C) and high-cholesterol diet (HC)-containing 2 % cholesterol and 0.5 % cholic acid]. After 7 weeks of experimental feeding, the rats were euthanized for blood collection and plasma recovery. The metabolite fingerprint was then achieved by applying a multiplatform comprising LC-MS, GC-MS and CE-MS. RESULTS: Multivariate statistical analysis showed a clear separation between the C and HC groups. Individual differences in metabolites were evaluated using univariate statistical analysis, and multiple metabolites were identified and confirmed in the plasma. A global profiling integrates for the first time pathways affected by high-cholesterol diet intake and allowed us to elucidate some of the associated alterations underlying the hypercholesterolemia event in Wistar rats. CONCLUSIONS: HC feeding stimulated the alteration of multiple pathways in Wistar rats, warning of the risk of developing important diseases, which can be modulated by the diet. Further studies are required to investigate the possibilities to revert or ameliorate the negative effects triggered by HC intake.

An association between liraglutide treatment and reduction in excessive daytime sleepiness in obese subjects with type 2 diabetes.

BACKGROUND: The main purpose of the present study is to evaluate whether treatment with long-acting human glucagon-like peptide-1 liraglutide was associated with an improvement of excessive daytime sleepiness (EDS) in obese subjects with type-2 diabetes. METHODS: This single-centre retrospective study included 158 obese (body mass index [BMI] ≥ 30 kg/m(2)) adult subjects with type-2 diabetes who were initiated with liraglutide treatment at least 3 months before study inclusion. Data of the Epworth Sleepiness Scale (ESS), anthropometric parameters, glucose-control and metabolic parameters were collected at liraglutide initiation (baseline) and at months 1 and 3 after liraglutide initiation. RESULTS: Significant reductions in ESS score were achieved at months 1 (-1.3 ± 2.8, p < 0.001) and 3 (-1.5 ± 3.0, p < 0.001) after liraglutide introduction. After 3 months of treatment with liraglutide, significant changes in body weight (p < 0.001), BMI (p < 0.001), waist (p < 0.001) and neck circumferences (p < 0.005), HbA1c (p < 0.001), mean blood glucose (p < 0.001), fasting plasma glucose (p < 0.001), triglycerides (p < 0.01) and total cholesterol (p < 0.001) were achieved. CONCLUSIONS: After 3 months of treatment with liraglutide a significant reduction in EDS was observed in obese subjects with type-2 diabetes. Besides this, significant changes in body weight and metabolic parameters of diabetes control were also accomplished. Further investigation is required to determine whether liraglutide could improve other abnormal sleep patterns and obstructive sleep apnoea.

Sustainable extraction methods of carotenoids from mango (Mangifera indica L. 'Kent') pulp: Ultrasound assisted extraction and green solvents.

Mango is a good source of carotenoids for use in food, cosmetic, and pharmaceutical products because of their organoleptic and health-promoting properties. Safe and sustainable methods for their extraction is required. The present investigation was aimed to study concentration and carotenoid profile of 'Kent' mango pulp through a conventional extraction (CE) and ultrasound-assisted extraction (UAE) using traditional solvents (tetrahydrofuran-THF and diethyl ether: petroleum ether-DE:PE) and green solvents (GS) (2-metiltetrahydrofuran, 2 m-THF; cyclopentyl methyl ether, CPME). Mango showed (µg/g d.w.) ß-carotene (29.4), zeaxanthin (1.28), ß-cryptoxanthin (2.8), phytoene (18.68) and phytofluene (7.45) in a CE using DE:PE. Similar results were obtained applying DE:PE in UAE and GS in a CE, so CPME and 2-mTHF seem suitable solvents to replace DE:PE in CE. The yield of total carotenes, xanthophylls and carotenoids using GS combined with UAE was lower than with CE, but important enough to be used as a sustainable procedure for obtaining carotenoids from mango pulp.

Bile Acids and Short-Chain Fatty Acids Are Modulated after Onion and Apple Consumption in Obese Zucker Rats.

Gut microorganisms are involved in the development and severity of different cardiovascular diseases, and increasing evidence has indicated that dietary fibre and polyphenols can interact with the intestinal microbiota. The study objective was to investigate the effect of onion and apple intake on the major types of microbial-derived molecules, such as short-chain fatty acids (SCFAs) and bile acids (BAs). Obese Zucker rats were randomly assigned (n = eight rats/group) to a standard diet (OC), a standard diet/10% onion (OO), or a standard diet/10% apple (OA). Lean Zucker rats fed a standard diet served as a lean control (LC) group. Faecal samples were collected at baseline, and 8 weeks later, the composition of the microbial community was measured, and BA and SCFA levels were determined using high-performance liquid chromatography-mass spectrometry (HPLC-MS) and gas chromatography-mass spectrometry (GC-MS), respectively. Rats fed onion- and apple-enriched diets had increased abundance of beneficial bacteria, such as Bifidobacterium spp. and Lactobacillus spp., enhanced SCFAs (acetic, propionic, isobutyric, and valeric acids), decreased excretion of some BAs, mainly of the primary (CA, α-MCA, and ß-MCA) and secondary type (ω-MCA, HDCA, NCA, DCA, and LCA), and increased amount of taurine- and glycine-conjugated BAs compared to the OC group. The contribution of specific bioactive compounds and their metabolites in the regulation of the microbiome and the pathways linked to SCFA and BA formation and their relationship with some diseases needs further research.

Enhanced extraction of phenolic compounds from mango by-products using deep eutectic solvents.

Deep eutectic solvents (DESs) potential for the extraction of polyphenolic compounds (PC) from mango by-products (peel and seed) was evaluated. Ultrasound (US) and agitation were applied to evaluate the effects of solvent and extraction methodology. The extracts were characterized with antioxidant capacity and HPLC-DAD profile. A theoretical study was performed using density functional theory and the QTAIM approach. ß-alanine and choline chloride based DESs were effective to extract PC from peel and seed. Some DES increased PC extraction up to three times for peel (23.05 ± 1.22 mg/g DW) and up to five time for seeds (60.01 ± 1.40 mg/g DW). The PC profile varied with the solvent (DES vs EtOH/MeOH), procedure (US vs agitation) and material (peel or seed). Mangiferin extraction from peels was significantly increased with ß-alanine based DES (676.08 ± 20.34 µg/gDW). The strength of H-bonds had a determining effect on the viscosity of DESs. The solute-solvent solvation energy was suitable to estimate the strength of H-bond interactions between DES and target compounds. This study demonstrates the remarkable capacity of DESs to extract PC from mango by-products and provides insights into the factors controlling extraction properties.

Mango 'criollo' by-products as a source of polyphenols with antioxidant capacity. Ultrasound assisted extraction evaluated by response surface methodology and HPLC-ESI-QTOF-MS/MS characterization.

Ultrasound assisted extraction (UAE) was evaluated as a green procedure for the recovery of phenolic compounds with antioxidant capacity from underutilized mango 'criollo' (peel, pulp and seed). Magnetic stirred was performed as conventional extraction. Response surface methodology using a three-factor (% ethanol, amplitude and time) central composite design was used to maximize the extraction for total phenolic compounds (TPC), total flavonoids and antioxidant capacity. The operational conditions to maximize extraction were: peel, 46% ethanol/amplitude 60% (36 µm)/6.5 min; pulp, 25% ethanol/amplitude 75% (45 µm)/30 min; seed 49% ethanol/100% (60 µm) amplitude/20 min. The phenolic composition of the optimized extracts was characterized by HPLC-QTOF-MS/MS and 45 compounds were tentatively identified as xanthones (mangiferin), flavonoids (quercetin), ellagic acid, benzophenones (maclurin), gallate derivatives and gallotannins. UAE increased TPC extraction (33%); interestingly mangiferin extraction increased 53% in peel, similarly, ellagic acid increased up to 2.5 and 4.4 times in peel and seed extracts.

Onion and Apple Functional Ingredients Intake Improves Antioxidant and Inflammatory Status and Vascular Injury in Obese Zucker Rats.

The objective of this study was to investigate the effects of onion and apple functional ingredients in homozygous (fa/fa) obese Zucker rats. Rodents were fed three diets: standard diet [obese control (OC) group], standard diet containing 10% onion [obese onion 10% (OO) group] and standard diet containing 10% apple [obese apple 10% (OA) group] for 8 weeks. Food intake and body weight gain were higher in obese than in lean rats. Food efficiency was lower in OO and AO groups compared with OC group. Within the obese groups, total cholesterol, LDL-cholesterol, triacylglycerols, glucose, insulin and triglyceride-glucose index were lower in OO group than in OC group, and HDL-cholesterol was higher in OO group than in OC group. In general, antioxidant activity (ABTS•+ and FRAP), antioxidant enzyme activities (CAT, SOD, GPx), GSH/GSSG ratio, nitrate/nitrite and GLP-1 increased in OO and OA groups compared with OC. Oxidative stress biomarkers, namely protein carbonyls, 8-hydroxy-2'-deoxyguanosine, 8-epi-prostaglandin F2α, inflammatory and vascular injury biomarkers (PAI-1, TIMP-1, VEGF, sICAM-1, sE-Selectin, MCP-1) and leptin, were lower in OO and OA groups than in OC group. Endothelial impairment was partially reversed, and superoxide content and gene expression of NLRP3, NFKß1 and COX2 decreased, in OO and OA groups with respect to OC group. The study demonstrates that high pressure-processed onion and apple functional ingredients administration to obese Zucker rats causes beneficial effects on metabolic health, in particular through improving food efficiency ratio; exerting pronounced lipid-lowering effects; reducing glycemia, insulinemia, and biomarkers of hepatic injury (ALT, AST); improving antioxidant, oxidative stress, inflammatory and vascular injury biomarkers, metabolic hormones, and endothelial function; and decreasing proinflammatory gene expression of NLRP3, NFKß1 and COX2.

Greater bioavailability of xanthophylls compared to carotenes from orange juice (high-pressure processed, pulsed electric field treated, low-temperature pasteurised, and freshly squeezed) in a crossover study in healthy individuals.

This study examined the effect of the intake of orange juice provided freshly squeezed (FS) or processed using low-temperature pasteurisation (LP), high-pressure processing (HPP), or pulsed electric field (PEF) treatment on the serum carotenoid concentrations of 12 healthy individuals, aged 20-32 years, enrolled in a crossover study. Participants were instructed to consume 500 ml of orange juice/day for 14 days. Carotenoid concentrations in the orange juice as well as serum samples retrieved on days 7 and 14 were analysed via HPLC. A significant increase in serum xanthophyll concentrations, but not serum carotenes, was observed, with the highest increase in α- and ß-cryptoxanthin. The processing technologies applied appeared to affect serum carotenoid concentrations, with concentrations being similar in the HPP and FS orange juice types. As high variability in serum carotenoid concentrations was observed, the effect of different technologies on serum carotenoid concentration warrants further studies with larger sample sizes.

Impact of High-Pressure Processed Onion on Colonic Metabolism Using a Dynamic Gastrointestinal Digestion Simulator.

Onions are the main dietary source of flavonols that have been associated with important health-promoting properties. Onion treated by high-pressure processing (HPP-treated onion) was subjected to a dynamic gastrointestinal digestion and colon fermentation simulator (DGID-CF) to study the effect on the gut microbiota metabolism in the three colon regions (ascending-AC, transverse-TC, and descending-DC) by means of chronic feeding with 27 g/day for 14 days. HPP-treated onion presented a high content of the flavonols quercetin-3,4'-diglucoside and quercetin-4'-glucoside, and a large percentage of them reached the AC without change. TC and DC progressively increased the total phenolic metabolites 2.5 times respective to day 2, mainly 3-hydroxyphenylacetic, 4-hydroxyphenylacetic, 3-(4-hydroxyphenyl)-propionic, and 3,4-dihydroxyphenylpropionic acids. In addition, the chronic feeding increased the beneficial colon bacteria Bifidobacterium spp. and Lactobacillus spp. and the production of total SCFAs (acetic, propionic, and butyric acids) 9 times (AC), 2.2 times (TC), and 4.4 times (DC) respective to day 1. A multivariate analysis (principal component analysis, PCA) showed a clear separation between the three colon regions based on their phenolic composition (precursors and metabolites). These results showed that HPP-treated onion modulated the human gut microbiota's metabolism and the DGID-CF is a good system to study these changes.

Effect of high-pressure processing applied as pretreatment on carotenoids, flavonoids and vitamin C in juice of the sweet oranges 'Navel' and the red-fleshed 'Cara Cara'.

This work examines the effect of HPP at 200 MPa/25 °C/1 min (HPP-200) as pretreatment on whole-peeled orange fruits from ordinary 'Navel' and red-fleshed 'Cara Cara' sweet oranges before juicing with the aim to improve the extractability of carotenoids, flavonoids, vitamin C and hydrophilic antioxidant activity in the juices. Untreated and HPP-200 juices were subsequently processed at 400 MPa/40 °C/1 min (HPP-400 and HPP-200-400). HPP-200 and HPP-200-400 increased the concentration of hesperidin (25% and 16%), narirutin (27% and 9%), phytoene (40% and 97%) and phytofluene (9- and 12-fold) in Navel-juice and maintained the vitamin C content and the antioxidant activity compared to untreated freshly-prepared juice. However, these two HPP treatments in Cara Cara-juices preserved flavonoids and vitamin C concentration but decreased 16% total carotenoid content mainly lycopene due to its more exposed position in the food matrix. However, a single HPP-400 treatment applied on freshly-prepared orange juices reduced bioactive compounds, mainly in Navel-juices, perhaps due to the mechanical juicing procedure (jar-blender) used or/and with the pressure-induced activation of detrimental food enzymes. All the HP-treated Cara Cara-juices presented higher carotenoid content than the corresponding Navel-juices, and can be considered an excellent dietary source of these compounds. Therefore, HPP applied to whole peeled orange did not modified the profiling of bioactive compounds of Navel- and Cara Cara-juices and increased the concentration of total and individual carotenoids, flavonoids, vitamin C and antioxidant activity depending on the type of bioactive compounds, the orange fruit cultivar and the HPP conditions.

Impact of high-pressure processing on the stability and bioaccessibility of bioactive compounds in Clementine mandarin juice and its cytoprotective effect on Caco-2 cells.

Mandarin juice is a rich source of antioxidant bioactive compounds. While the content and profile of bioactives are known, the impact of high-pressure processing (HPP) on their stability and bioaccessibility (BA) is unknown, but may allow obtaining safe, nutritious, and fresh-tasting juices with highly extractable bioactive compounds. The stability and BA of bioactive antioxidant compounds in untreated and HPP-treated (400 MPa/40 °C/1 min) Clementine mandarin juices, and the cytoprotective effect of its bioaccessible fractions (BF) obtained after simulated gastrointestinal digestion against H2O2-induced oxidative stress in differentiated Caco-2 cells were investigated. The BF of HPP-treated juices showed a better retention of carotenoids, flavonoids, ascorbic acid, total polyphenols and FRAP value, and slightly higher cytoprotection (mitochondrial membrane potential and ROS) than untreated juices. Therefore, HPP can be recommended as a suitable technology to retain or indeed increase antioxidant bioactives and their cytoprotective activity in mandarin juices after gastrointestinal digestion.

Nutritional approaches and health-related properties of plant foods processed by high pressure and pulsed electric fields.

Consumers are more and more concerned about the nutritional and health-related characteristics of fruits and vegetables, as well as the safety of the food they eat. The processing of foods is becoming more sophisticated and diverse in response to the growing demand for quality foods. Consumers today expect food products to provide fresh-like appearance, convenience, variety, appropriate shelf-life and caloric content, reasonable cost, environmental soundness, high nutritional and functional quality. Nonthermal processing of fruit and vegetable has been revealed as a useful tool to extend their shelf-life and quality as well as to preserve their nutritional and functional characteristics. In the last ten years, there has been an increasing interest in nonthermal technologies as high pressure processing (HPP) and pulsed electric fields (PEF) to preserve fruit and vegetable products without the quality and nutritional damage caused by heat treatments. This review will contribute to inform many of the studies conducted to obtain a better understanding on the effects of some of these nonthermal processing technologies (high hydrostatic pressure and pulsed electric fields) applied to vegetable foods on their nutritional value and bioactive compounds related to health, including the results on micronutrient bioavailability studies and oxidative stress and inflammation biomarkers. These studies could contribute to select the most appropriate processing parameters to obtain safe, high-quality, nutritional, and functional vegetable food.

Effects of an onion by-product on bioactivity and safety markers in healthy rats.

Onions are excellent sources of bioactive compounds including fructo-oligosaccharides (FOS) and polyphenols. An onion by-product was characterised in order to be developed as a potentially bioactive food ingredient. Our main aim was to investigate whether the potential health and safety effects of this onion by-product were shared by either of two derived fractions, an extract containing the onion FOS and polyphenols and a residue fraction containing mainly cell wall materials. We report here on the effects of feeding these products on markers of potential toxicity, protective enzymes and gut environment in healthy rats. Rats were fed during 4 weeks with a diet containing the products or a control feed balanced in carbohydrate. The onion by-product and the extract caused anaemia as expected in rodents for Allium products. No other toxicity was observed, including genotoxicity. Glutathione reductase (GR) and glutathione peroxidase (GPx1) activities in erythrocytes increased when rats were fed with the onion extract. Hepatic gene expression of Gr, Gpx1, catalase, 5-aminolevulinate synthase and NAD(P)H:quinone oxidoreductase was not altered in any group of the onion fed rats. By contrast, gamma-glutamate cysteine ligase catalytic subunit gene expression was upregulated but only in rats given the onion residue. The onion by-products as well as the soluble and insoluble fractions had prebiotic effects as evidenced by decreased pH, increased butyrate production and altered gut microbiota enzyme activities. In conclusion, the onion by-products have no in vivo genotoxicity, may support in vivo antioxidative defence and alter the functionality of the rat gut microbiota.

An exploratory NMR nutri-metabonomic investigation reveals dimethyl sulfone as a dietary biomarker for onion intake.

The metabolome following intake of onion by-products is evaluated. Thirty-two rats were fed a diet containing an onion by-product or one of the two derived onion by-product fractions: an ethanol extract and the residue. A 24 hour urine sample was analyzed using (1)H NMR spectroscopy in order to investigate the effects of onion intake on the rat metabolism. Application of interval extended canonical variates analysis (ECVA) proved to be able to distinguish between the metabolomic profiles from rats consuming normal feed and rats fed with an onion diet. Two dietary biomarkers for onion intake were identified as dimethyl sulfone and 3-hydroxyphenylacetic acid. The same two dietary biomarkers were subsequently revealed by interval partial least squares regression (PLS) to be perfect quantitative markers for onion intake. The best PLS calibration model yielded a root mean square error of cross-validation (RMSECV) of 0.97% (w/w) with only 1 latent variable and a squared correlation coefficient of 0.94. This indicates that urine from rats on the by-product diet, the extract diet, and the residue diet all contain the same dietary biomarkers and it is concluded that dimethyl sulfone and 3-hydroxyphenylacetic acid are dietary biomarkers for onion intake. Being able to detect specific dietary biomarkers is highly beneficial in the control of nutritionally enhanced functional foods.

Stroke: roles of B vitamins, homocysteine and antioxidants.

In the present review concerning stroke, we evaluate the roles of B vitamins, homocysteine and antioxidant vitamins. Stroke is a leading cause of death in developed countries. However, current therapeutic strategies for stroke have been largely unsuccessful. Several studies have reported important benefits on reducing the risk of stroke and improving the post-stroke-associated functional declines in patients who ate foods rich in micronutrients, including B vitamins and antioxidant vitamins E and C. Folic acid, vitamin B6 and vitamin B12 are all cofactors in homocysteine metabolism. Growing interest has been paid to hyperhomocysteinaemia as a risk factor for CVD. Hyperhomocysteinaemia has been linked to inadequate intake of vitamins, particularly to B-group vitamins and therefore may be amenable to nutritional intervention. Hence, poor dietary intake of folate, vitamin B6 and vitamin B12 are associated with increased risk of stroke. Elevated consumption of fruits and vegetables appears to protect against stroke. Antioxidant nutrients have important roles in cell function and have been implicated in processes associated with ageing, including vascular, inflammatory and neurological damage. Plasma vitamin E and C concentrations may serve as a biological marker of lifestyle or other factors associated with reduced stroke risk and may be useful in identifying those at high risk of stroke. After reviewing the observational and intervention studies, there is an incomplete understanding of mechanisms and some conflicting findings; therefore the available evidence is insufficient to recommend the routine use of B vitamins, vitamin E and vitamin C for the prevention of stroke. A better understanding of mechanisms, along with well-designed controlled clinical trials will allow further progress in this area.

Antioxidant activity and metabolite profile of quercetin in vitamin-E-depleted rats.

Dietary antioxidants interact in a dynamic fashion, including recycling and sparing one another, to decrease oxidative stress. Limited information is available regarding the interrelationships in vivo between quercetin and vitamin E. We investigated the antioxidant activity and metabolism of quercetin (Q) in 65 F-344 rats (n=13 per group) randomly assigned to the following vitamin E (VE)-replete and -deficient diets: (a) VE replete (30 mg alpha-tocopherol acetate/kg diet) control ad libitum (C-AL), (b) VE replete pair fed (C-PF), (c) VE replete+5.0 g Q/kg diet (R-VE+5Q), (d) VE deplete (<1 mg/kg total tocopherols)+5.0 g Q/kg diet (D-VE+5Q) and (e) D-VE. After 12 weeks, blood and tissue were collected for measurement of plasma vitamin E, quercetin and its metabolites, serum pyruvate kinase (PK), plasma protein carbonyls, malondialdehyde (MDA) and oxygen radical absorbance capacity. D-VE diets decreased serum alpha-tocopherol and increased PK activity in a time-dependent manner. The D-VE diet increased plasma protein carbonyls but did not affect MDA. Dietary quercetin supplementation increased quercetin and its metabolites in plasma and liver but did not affect D-VE-induced changes in plasma alpha-tocopherol, PK or protein carbonyls. Plasma isorhamnetin and its disposition in muscle were enhanced by the D-VE diet, as compared to the R-VE diet. Conversely, tamarixetin disposition in muscle was decreased by the D-VE diet. Thus, quercetin did not slow vitamin E decline in vivo; neither did it provide antioxidant activity in vitamin-E-depleted rats. However, vitamin E status appears to enhance the distribution of isorhamnetin into the circulation and its disposition in muscle.