Effects of long-term consumption of two plant-based dietary supplements on cardiovascular health and low-grade inflammation in middle-aged and elderly people: study protocol for a randomised, controlled trial.

BACKGROUND: Ageing is a process characterised by chronic low-grade inflammation and oxidative stress which could lead to increased prevalence of both physical and mental age-related chronic conditions. A healthy balanced diet, rich in fruit and vegetables as well as omega-3 polyunsaturated fatty acids (n3 PUFA), could reduce oxidative stress and improve markers of low-grade inflammation. Nonetheless, considering that a large part of the population struggles to meet current guidelines on fruit and vegetable and n3 PUFA recommendations, fruit and vegetable concentrate supplements and mixed omega fatty acid supplements could be an effective strategy to bridge the gap between actual and recommended intakes. METHODS: In this randomised, controlled, open-labelled, parallel-grouped clinical trial, 112 participants will be allocated to one of four arms (n = 28 on each arm): an encapsulated juice powder concentrate, a plant-based omega fatty acid supplement, both or a control group. We aim to investigate whether long-term separate or combined ingestion of the two can affect biomarkers of cardiovascular health, low-grade inflammation and indicators of ageing, including cognitive function, in middle-aged and elderly people. We will additionally explore the effect of the different supplementations on plasma levels of vitamins, carotenoids and fatty acids. Intervention will last 2 years and participants will be assessed at baseline and at follow-up visits at 6, 12, 18 and 24 months. DISCUSSION: This study will provide evidence whether long-term, plant-based dietary supplementation can support cardiovascular health, anti-inflammatory processes, immunity and nutritional status in ageing. Trial registration This trial was registered at ClinicalTrials.gov (NCT04763291) on February 21, 2021.

An encapsulated fruit, vegetable and berry juice powder concentrate increases plasma values of specific carotenoids and vitamins.

Vitamins and carotenoids are organic compounds that are important for vital functions of the human organism. Since the human body is not able to synthesize most of these micronutrients, they need to be supplied by the intake of food or supplements. The aim of this study was to analyze whether a whole food based, encapsulated fruit, berry, and vegetable juice powder concentrate provides bioavailable carotenoids and vitamins A (all-trans retinol), E and C. Eighteen healthy subjects received 6 capsules a day for 8 weeks, which provided 2.91 mg ß-carotene, 490 µg vitamin A, 18.7 mg vitamin E, 159 mg vitamin C, 6.1 mg lutein and 1 mg lycopene. Plasma concentrations of several carotenoids and vitamins before and after supplementation were measured. After 8 weeks of supplementation, the plasma concentration of the following carotenoids increased significantly: α-carotene increased from 59.6 ± 22.4 nmol/L to 85.7 ± 24.2 nmol/L (p = 0.002), ß-cryptoxanthin from 106.7 ± 39.8 nmol/L to 151.9 ± 57.9 nmol/L (p = 0.017), and lycopene from 1.2 ± 0.5 µmol/L to 1.7 ± 0.5 µmol/L (p = 0.005). Significant increases were also observed for plasma concentrations of vitamin C from 70 ± 20 µmol/L to 90 ± 10 µmol/L (p < 0.001), all-trans retinol from 1.99 ± 0.24 µmol/L to 2.30 ± 0.66 µmol/L (p = 0.015), and α-tocopherol from 27 ± 6 µmol/L to 32 ± 6 µmol/L (p = 0.008). For those micronutrients with accepted plasma reference ranges, all observed increases levelled off around the upper limit of the individual reference range. The data demonstrate that the investigated supplement is able to increase plasma concentrations of certain carotenoids and vitamins of healthy subjects within 8 weeks.

Effects of a plant-based fatty acid supplement and a powdered fruit, vegetable and berry juice concentrate on omega-3-indices and serum micronutrient concentrations in healthy subjects.

The major aim of this controlled, randomised, open-labelled, parallel-grouped, clinical trial was to investigate whether supplementation with different dosages of omega-3 fatty acids (0.5 g/d and 1 g/d) from a plant-based fatty acid supplement affected omega-3-indices (O3I) in well-nourished, healthy people. In addition, the combined ingestion of the plant-based fatty acid supplement, together with an encapsulated fruit, vegetable and berry (FVB) juice powder concentrate, was applied in order to observe the absorption of certain micronutrients and to examine some aspects related to the safe consumption of the products. The data demonstrate that the intake of only 0.5 g/day of omega-3 fatty acids from of a vegan supplement was able to increase the O3I significantly after 8 and 16 weeks. The combined ingestion with the FVB supplement concurrently increased serum concentrations of specific vitamins and carotenoids without effects on hepatic, kidney and thyroid function or changes in blood lipids.

Definition of a tolerable upper intake level of niacin: a systematic review and meta-analysis of the dose-dependent effects of nicotinamide and nicotinic acid supplementation.

Context: Nicotinic acid and nicotinamide are soluble compounds of the vitamin B group, widely used to regulate the lipid profile in hyperlipidemic individuals. Higher doses of nicotinic acid are associated with adverse effects, especially flushing. A unique tolerable upper intake level (UL) of nicotinic acid has not been defined. Objective: This meta-analysis aims to evaluate adverse effects and their incidence after supplementation with different doses of nicotinic acid and nicotinamide, comparing results with current ULs in Europe and the United States. Data Sources: PubMed was searched for articles providing detailed information about nicotinic acid or nicotinamide supplementation and related outcomes. Study Selection: A total of 2670 citations were selected for screening. Two primary outcomes were considered: occurrence of adverse effects following nicotinic acid or nicotinamide supplementation, and dose at which adverse effects occurred. Data extraction: Details on study population, type and duration of treatment, dosage of vitamins, association with lipid-influencing drugs, length of follow-up, and incidence and type of adverse events were extracted. Results: After screening, 47 articles involving 11 741 individuals were included. Meta-analysis was based on estimation of benchmark doses for the probability of adverse effects after supplementation. In individuals with dyslipidemia or cardiovascular disease, nicotinic acid monotherapy seems to be protective against any adverse effects considered, as adverse events occurred at doses above those used with other treatments. In healthy individuals treated with nicotinic acid alone, major adverse effects occurred at doses below 1000 mg/d. Conclusions: Results may indicate a high degree of conservativeness in the UL of nicotinic acid, fixed at 35 mg/d in United States and 10 mg/d in Europe. Reconsideration of the UL of nicotinic acid for nutritional supplements, possibly differentiating between ULs in healthy and unhealthy individuals, may be warranted.

Absorption Profile of (Poly)Phenolic Compounds after Consumption of Three Food Supplements Containing 36 Different Fruits, Vegetables, and Berries.

The market of plant-based nutraceuticals and food supplements is continuously growing due to the increased consumer demand. The introduction of new products with relevant nutritional characteristics represents a new way of providing bioactive compounds and (poly)phenols to consumers, becoming a strategy to ideally guarantee the health benefits attributed to plant foodstuffs and allowing the increase of daily bioactive compound intake. A paramount step in the study of nutraceuticals is the evaluation of the bioavailability and metabolism of their putatively active components. Therefore, the aim of the present study was to investigate the absorption profile of the (poly)phenolic compounds contained in three different plant-based food supplements, made of 36 different plant matrices, which were consumed by 20 subjects in an open one-arm study design. Blood samples were collected at baseline and 1, 2, 5, and 10 h after capsule intake. Twenty quantifiable metabolites deriving from different (poly)phenolic compounds were identified. Results showed that the consumption of the three capsules allowed the effective absorption of several (poly)phenolic compounds and metabolites appearing at different times in plasma, thereby indicating different absorption profiles. The capsules thus ensured potential health-promoting molecules to be potentially available to target tissues and organs.

Effects of zeolite supplementation on parameters of intestinal barrier integrity, inflammation, redoxbiology and performance in aerobically trained subjects.

BACKGROUND: Zeolites are crystalline compounds with microporous structures of Si-tetrahedrons. In the gut, these silicates could act as adsorbents, ion-exchangers, catalysts, detergents or anti-diarrheic agents. This study evaluated whether zeolite supplementation affects biomarkers of intestinal wall permeability and parameters of oxidation and inflammation in aerobically trained individuals, and whether it could improve their performance. METHODS: In a randomized, double-blinded, placebo controlled trial, 52 endurance trained men and women, similar in body fat, non-smokers, 20-50 years, received 1.85 g of zeolite per day for 12 weeks. Stool samples for determination of intestinal wall integrity biomarkers were collected. From blood, markers of redox biology, inflammation, and DNA damage were determined at the beginning and the end of the study. In addition, VO2max and maximum performance were evaluated at baseline and after 12 weeks of treatment. For statistical analyses a 2-factor ANOVA was used. RESULTS: At baseline both groups showed slightly increased stool zonulin concentrations above normal. After 12 weeks with zeolite zonulin was significantly (p < 0.05) decreased in the supplemented group. IL-10 increased tendentially (p < 0.1) in the zeolite group. There were no significant changes observed in the other measured parameters. CONCLUSIONS: Twelve weeks of zeolite supplementation exerted beneficial effects on intestinal wall integrity as indicated via decreased concentrations of the tight junction modulator zonulin. This was accompanied by mild anti-inflammatory effects in this cohort of aerobically trained subjects. Further research is needed to explore mechanistic explanations for the observations in this study.

Supplementation with a juice powder concentrate and exercise decrease oxidation and inflammation, and improve the microcirculation in obese women: randomised controlled trial data.

Obesity and sedentary lifestyle are associated with increased oxidative stress, inflammation and vessel dysfunction. Previous research has shown that an encapsulated fruit/berry/vegetable juice powder (FBV) supplement or controlled exercise training improve the markers of redox biology, low-grade inflammation and circulation. The aim of the present study was to assess the effects of 8 weeks of supplementation with FBV or placebo, and a single bout of controlled walking on the markers of oxidation, inflammation and skin capillary microcirculation in forty-two obese pre-menopausal women (41 (SD 5) years, non-smokers and BMI 34·5 (SD 3·8) kg/m(2)) using a randomised, double-blind, placebo-controlled design. All assessments were made before and after 8 weeks of capsule supplementation, and pre- and post-30 min of controlled treadmill walking at 70 % of VO2max. Venous blood was collected for the determination of carbonyl proteins (CP), oxidised LDL (ox-LDL), total oxidation status (TOS) of lipids, malondialdehyde, TNF-α and IL-6. Capillary blood flow, O2 saturation of Hb (SO2Hb) and the relative concentration of Hb (rHb) were assessed at a 2 mm skin depth. Following 8 weeks of supplementation, compared with placebo, the FBV group had a significant (P< 0·05) reduction in CP, ox-LDL, TOS and TNF-α, and a significant increase in blood flow, SO2Hb and rHb. Independent of supplementation, moderate exercise significantly increased blood flow and rHb, with a trend towards increased SO2Hb. Compared with placebo, 8 weeks of supplementation with FBV decreased the markers of systemic oxidation and inflammation. Both FBV supplementation and a single walking bout improved the markers of the microcirculation in these obese women.

Exercise, intestinal barrier dysfunction and probiotic supplementation.

Athletes exposed to high-intensity exercise show an increased occurrence of gastrointestinal (GI) symptoms like cramps, diarrhea, bloating, nausea, and bleeding. These problems have been associated with alterations in intestinal permeability and decreased gut barrier function. The increased GI permeability, a so-called 'leaky gut', also leads to endotoxemia, and results in increased susceptibility to infectious and autoimmune diseases, due to absorption of pathogens/toxins into tissue and the bloodstream. Key components that determine intestinal barrier function and GI permeability are tight junctions, protein structures located in the paracellular channels between epithelial cells of the intestinal wall. The integrity of tight junctions depends on sophisticated interactions between the gut residents and their expressed substances, the intestinal epithelial cell metabolism and the activities of the gut-associated lymphoid tissue. Probiotic supplements are an upcoming group of nutraceuticals that could offer positive effects on athlete's gut and entire health. Some results demonstrate promising benefits for probiotic use on the athlete's immune system. There is also evidence that probiotic supplementation can beneficially influence intestinal barrier integrity in acute diseases. With regard to exercise-induced GI permeability problems, there is still a lack of studies with appropriate data and a gap to understand the underlying mechanisms to support such health beneficial statements implicitly. This article refers (i) to exercise-induced intestinal barrier dysfunction, (ii) provides suggestions to estimate increased gut barrier permeability in athletes, and (iii) discusses the potential of probiotic supplementation to counteract an exercise-induced leaky gut.

Supplementation with mixed fruit and vegetable concentrates in relation to athlete's health and performance: scientific insight and practical relevance.

Regular consumption of fruits and vegetables (FV) is widely regarded as an important contributor to a healthy diet. Inadequate consumption of plant foods is associated with an inadequate supply of important micronutrients like vitamins, phytochemicals and minerals. In athletes a deficit of these micronutrients can lead to excessive production of reactive oxygen and nitrogen species that induce tissue damage, a higher frequency of inflammatory processes, decreased immunity, increased susceptibility to injury, and prolonged recovery. But many athletes rarely achieve the recommended intake of FV due to difficult coordination of training activities and food intake, or due to problems with digestion of FV. Therefore, in recent years more and more sports people have adopted supplemental FV concentrates to work around timing problems with uptake and the detrimental digestive effects during training of high FV intake. It is thought that supplementation of an athlete's basic diet with mixed FV concentrates can promote stable health and immunity, in order to provide a basis for optimal adaptation and performance. The intention of this article is to build a bridge between the science behind FV supplementation in exercise on the one hand and the practical relevance of its application on the other. For that purpose this paper addresses three questions: Is supplementation with a mixed FV concentrate to the athlete's diet appropriate to ensure stable health and immunity? Can supplementation with a mixed FV concentrate improve performance? Counseling guidance: how can sport nutrition advisors decide whether or not to supplement with mixed FV concentrates?

Does vitamin C and E supplementation impair the favorable adaptations of regular exercise?

The detrimental outcomes associated with unregulated and excessive production of free radicals remains a physiological concern that has implications to health, medicine and performance. Available evidence suggests that physiological adaptations to exercise training can enhance the body's ability to quench free radicals and circumstantial evidence exists to suggest that key vitamins and nutrients may provide additional support to mitigate the untoward effects associated with increased free radical production. However, controversy has risen regarding the potential outcomes associated with vitamins C and E, two popular antioxidant nutrients. Recent evidence has been put forth suggesting that exogenous administration of these antioxidants may be harmful to performance making interpretations regarding the efficacy of antioxidants challenging. The available studies that employed both animal and human models provided conflicting outcomes regarding the efficacy of vitamin C and E supplementation, at least partly due to methodological differences in assessing oxidative stress and training adaptations. Based on the contradictory evidence regarding the effects of higher intakes of vitamin C and/or E on exercise performance and redox homeostasis, a permanent intake of non-physiological dosages of vitamin C and/or E cannot be recommended to healthy, exercising individuals.

Increased lipid peroxidation in trained men after 2 weeks of antioxidant supplementation.

PURPOSE: To assess the effects of an encapsulated antioxidant concentrate (EAC) and exercise on lipid peroxidation (LIPOX) and the plasma antioxidant enzyme glutathione peroxidase (Pl-GPx). METHODS: Eight trained male cyclists (VO2max > 55 ml x kg(-1) x min(-1)) participated in this randomized, placebo-controlled, double-blinded, crossover study and undertook 4 cycle-ergometer bouts: 2 moderate exercise bouts over 90 min at 45% of individual VO2max and 2 strenuous exercise bouts at 75% of individual VO2max for 30 min. The first 2 exercise tests--1 moderate and 1 strenuous-were conducted after 4 weeks wash-out and after 12 and 14 days of EAC (107 IU vitamin E, 450 mg vitamin C, 36 mg beta-carotene, 100 microg selenium) or placebo treatment. After another 4 weeks wash-out, participants were given the opposite capsule treatment and repeated the 2 exercise tests. Physical exercise training was equal across the whole study period, and nutrition was standardized by a menu plan the week before the tests. Blood was collected before exercise, immediately postexercise, and 30 min and 60 min after each test. Plasma samples were analyzed for LIPOX marker malondialdehyde (MDA) and the antioxidant enzyme pl-GPx. RESULTS: MDA concentrations were significantly increased after EAC supplementation at rest before exercise and after moderate exercise (p < .05). MDA concentrations showed no differences between treatments after strenuous exercise (p > .1). Pl-GPx concentrations decreased at all time points of measurement after EAC treatment (p < .05). CONCLUSIONS: The EAC induced an increase of LIPOX as indicated by MDA and decreased pl-GPx concentrations pre- and postexercise.

Protein modification responds to exercise intensity and antioxidant supplementation.

PURPOSE: To assess the effects of different exercise intensities and antioxidant supplementation on plasma protein modification. METHODS: Trained men (n = 41) from a homogenous population were randomly assigned to perform cycle ergometer exercise either at 70% or 80% of individual .VO2max. Each intensity group was randomly assigned to receive either juice powder concentrate (JPC 70%, n = 11; JPC 80%, n = 10) or placebo (Plac 70%, n = 10; Plac 80%, n = 10) capsules for 28 wk. Four controlled exercise bouts and blood collections were conducted at baseline and study weeks 4, 16, and 28. Blood samples were drawn before (BE), immediately after (IE), and 30 min (30M) and 30 h (30H) postexercise. These samples were analyzed to estimate concentrations of carbonyl groups on plasma proteins (CP) and the redox state of human serum albumin (HSA). RESULTS: In the Plac group, CP concentrations increased at 80% of .VO2max IE and 30M, returning to preexercise concentrations by 30H (P < 0.05). At both 16 and 28 wk, the Plac groups had significantly higher BE and 30H CP concentrations than the JPC groups (P < 0.05). The reduced fraction of HSA, human mercaptalbumin (HMA), decreased at all four exercise tests at both exercise intensities IE and 30M, returning to preexercise values by 30H (P < 0.05). Supplementation had no influence on HSA. CONCLUSIONS: These results indicate that CP concentrations increase with 80% .VO2max intensity. The JPC group had lower baseline CP levels after 16 and 28 wk and no exercise-induced CP increase. HSA is reversibly shifted to a more oxidized state by recent intense exercise.

Several indicators of oxidative stress, immunity, and illness improved in trained men consuming an encapsulated juice powder concentrate for 28 weeks.

Phytonutrients from plant foods provide numerous antioxidants. We hypothesized that supplementation for 28 wk with a commercially available encapsulated juice powder concentrate (JPC) could influence indicators of oxidative stress, immunity, and illness. Trained men (n = 41; 34 +/- 5 y; maximum oxygen uptake = 55 +/- 7 mL x kg(-1) x min(-1)) from a homogenous police Special Forces unit were randomly assigned in a double blind manner to either JPC (n = 21) or placebo (n = 20). We used multiple 7-d food records to assess dietary intake and found inadequate mean daily fruit and vegetable consumption (3.2 +/- 1.2 servings). The group physician documented all duty days lost due to illness. We collected plasma at baseline and study wk 4, 8, 16, and 28 for analysis of carbonyl groups on protein (CP) and TNFalpha. Over the 28-wk investigation, CP was lower in the JPC group, with both a treatment and a time x treatment interaction (P < 0.05). Concentrations of both CP and TNFalpha at 16 and 28 wk were lower in the JPC than in the placebo group (P < 0.001). TNFalpha increased during the first 8 wk followed by a decrease in both groups for the following 20 wk (P < 0.001). Over the final 20 wk of the study, the placebo group tended to have more days of illness than the JPC group (P = 0.068). These data suggest beneficial JPC effects with regard to reduction of duty days lost due to illness and reduction of CP and TNFalpha concentrations in this group of trained men over 28 wk.