Fruit-Based Beverages Contain a Wide Range of Phytochemicals and Intervention Targets Should Account for the Individual Compounds Present and Their Availability.

Benefits from micronutrients within fruit juice and smoothies are well documented, but fewer studies research the role of phytochemicals. Well-controlled human studies are essential to evaluate their impact, particularly on glucose and lipid regulation but also gastrointestinal health. Planning these studies requires data on the potential molecular targets. Here we report a comprehensive metabolomic (LC-MS) analysis of the phytochemical composition of four commonly consumed beverages, including data on whether they are free to be absorbed early in the gastrointestinal tract or bound to other plant components. Smoothies contained a wide range of phenolics (free and bound), whereas the fruit juices contained higher amounts of fewer compounds. Orange juice was rich in bound hesperidin (1.97 ± 0.39 mg/100 mL) and hydroxycinnamic acids, likely to be delivered to the colon with the potential to have an impact on gut health. Apple juice contained free chlorogenic acid (3.11 ± 1.03 mg/100 mL), phloridzin (0.40 ± 0.03 mg/100 mL), catechin (0.090 ± 0.005 mg/100 mL), and epicatechin (0.38 ± 0.02 mg/100 mL), suggesting potential roles in glucose uptake reduction or positive effects on systemic blood flow. Redox screening established that differences in chemical composition impacted on bioactivity, highlighting the importance of availability from the matrix. This suggests that fruit-based beverage interventions should target specific mechanisms depending on the fruits from which they are comprised and in particular, the availability of the individual constituents.

Caspase-independence and characterization of bisnaphthalimidopropyl spermidine induced cytotoxicity in HL60 cells.

Bisnaphthalimides are DNA intercalators of potential use as chemotherapeutics but for which the range of mechanism of action is only gradually being elucidated. Using human promyelocytic HL-60 cells, we extend characterization of the cytotoxicity of bisnaphthalimidopropylspermidine (BNIPSpd) and examine the relationship with caspase-activity. Within 4 h exposure, BNIPSpd (1-10 µM) induced significant DNA strand breakage. Evidence of apoptosis was progressive through the experimental period. Within 6 h, BNIPSpd increased the proportion of cells exhibiting plasma membrane phosphatidylserine exposure. Within 12 h, active caspase expression increased and was sustained with 5 and 10 µM BNIPSpd. Flow cytometric analysis revealed caspase activity in cells with and without damaged membranes. By 24 h, 5 and 10 µM BNIPSpd increased hypodiploid DNA content and internucleosomal DNA fragmentation (DNA ladders) typical of the later stages of apoptosis. 1 µM BNIPSpd exposure also increased hypodiploid DNA content by 48 h. Polyamine levels decreased by 24 h BNIPSpd exposure. The pan-caspase inhibitor, z-VAD-fmk, significantly decreased DNA degradation (hypodiploid DNA and DNA ladders) and cytotoxicity. Despite this, cell growth and viability remained significantly impaired. We propose that BNIPSpd cytotoxicity arises through DNA damage and not polyamine depletion and that cytotoxicity is dominated by but not dependent upon caspase driven apoptosis.

Effect of increasing fruit and vegetable intake by dietary intervention on nutritional biomarkers and attitudes to dietary change: a randomised trial.

PURPOSE: Low fruit and vegetable consumption is linked with an increased risk of death from vascular disease and cancer. The benefit of eating fruits and vegetables is attributed in part to antioxidants, vitamins and phytochemicals. Whether increasing intake impacts on markers of disease remains to be established. This study investigates whether increasing daily intake of fruits, vegetables and juices from low (approx. 3 portions), to high intakes (approx. 8 portions) impacts on nutritional and clinical biomarkers. Barriers to achieving the recommended fruit and vegetable intakes are also investigated. METHOD: In a randomised clinical trial, the participants [19 men and 26 women (39-58 years)] with low reported fruit, juice and vegetable intake (<3 portions/day) were randomised to consume either their usual diet or a diet supplemented with an additional 480 g of fruit and vegetables and fruit juice (300 ml) daily for 12 weeks. Nutritional biomarkers (vitamin C, carotenoids, B vitamins), antioxidant capacity and genomic stability were measured pre-intervention, at 4-, 8- and 12 weeks throughout the intervention. Samples were also taken post-intervention after a 6-week washout period. Glucose, homocysteine, lipids, blood pressure, weight and arterial stiffness were also measured. Intake of fruit, fruit juice and vegetables was reassessed 12 months after conducting the study and a questionnaire was developed to identify barriers to healthy eating. RESULTS: Intake increased significantly in the intervention group compared to controls, achieving 8.4 portions/day after 12 weeks. Plasma vitamin C (35%), folate (15%) and certain carotenoids [α-carotene (50%) and ß-carotene (70%) and lutein/zeaxanthin (70%)] were significantly increased (P < 0.05) in the intervention group. There were no significant changes in antioxidant capacity, DNA damage and markers of vascular health. Barriers to achieving recommended intakes of fruits and vegetables measured 12 months after the intervention period were amount, inconvenience and cost. CONCLUSION: While increasing fruit, juice and vegetable consumption increases circulating level of beneficial nutrients in healthy subjects, a 12-week intervention was not associated with effects on antioxidant status or lymphocyte DNA damage. TRIAL REGISTRATION: This trial was registered at Controlled-Trials.com; registration ISRCTN71368072.

Breads Fortified with Freeze-Dried Vegetables: Quality and Nutritional Attributes. Part 1: Breads Containing Oil as an Ingredient.

There is increasing emphasis on reformulating processed foods to make them healthier. This study for the first time comprehensively investigated the effects of fortifying bread (containing oil as an ingredient) with freeze-dried vegetables on its nutritional and physico-chemical attributes. Breads fortified with carrot, tomato, beetroot or broccoli were assessed for nutrition, antioxidant potential, storage life, shelf stability, textural changes and macronutrient oxidation. Furthermore, using an in vitro model the study for the first time examined the impact of vegetable addition on the oxidative stability of macronutrients during human gastro-intestinal digestion. As expected, adding vegetables improved the nutritional and antioxidant properties of bread. Beetroot and broccoli significantly improved bread storage life. None of the vegetables significantly affected bread textural changes during storage compared to the control. Lipid oxidation in fresh bread was significantly reduced by all four types of vegetables whilst protein oxidation was lowered by beetroot, carrot and broccoli. The vegetables demonstrated varying effects on macronutrient oxidation during gastro-intestinal digestion. Beetroot consistently showed positive effects suggesting its addition to bread could be particularly beneficial.

Breads Fortified with Freeze-Dried Vegetables: Quality and Nutritional Attributes. Part II: Breads Not Containing Oil as an Ingredient.

The present article describes the second part of a study investigating the effect of adding vegetables on the nutritional, physico-chemical, and oxidative properties of wheat bread, and specifically focuses on bread that does not contain oil as an added ingredient. Wheat flour breads fortified with freeze-dried carrot, tomato, beetroot or broccoli were developed and assessed for their nutritional composition, antioxidant potential, oxidative stability, and storage properties. Using a simulated in vitro model, the study also examined the impact of vegetable addition on the oxidative stability of macronutrients during gastro-intestinal digestion. Adding vegetables improved the nutritional and functional attributes of the oil-free breads. However, they demonstrated a lower antioxidant potential compared to their oil-containing counterparts. Similarly, the textural and storage properties of the oil-free vegetable breads were poorer compared to the oil-containing breads. As expected, in the absence of oil the oil-free breads were associated with lower lipid oxidation both in their fresh form and during gastro-intestinal digestion. Adding vegetables reduced protein oxidation in the fresh oil-free breads but had no effect during gastro-intestinal digestion. The impact of vegetables on macronutrient oxidation in the oil-free breads during digestion appears to be vegetable-specific with broccoli exacerbating it and the others having no effect. Of the evaluated vegetables, beetroot showed the most promising nutritional and physico-chemical benefits when incorporated into bread that does not contain added oil.

Staff perspectives of barriers to women accessing birthing services in Nepal: a qualitative study.

BACKGROUND: Nepal has made significant progress with regard to reducing the maternal mortality ratio but a major challenge remains the under-utilisation of skilled birth attendants who are predominantly facility based. Studies have explored women's views of the barriers to facility birth; however the voices of staff who offer services have not been studied in detail. This research explores the views of staff as to the key reasons why pregnant women do not give birth in a maternity-care facility. METHODS: This mixed methods study comprised qualitative interviews and non-participant observation. The study was conducted in two small non-governmental hospitals, one semi-rural and one urban, in Kathmandu Valley. Twenty interviews were conducted with health care providers and other staff in these hospitals. The interviews were undertaken with the aid of a Nepali translator, with some interviews being held in English. Twenty-five hours of non-participant observation was conducted in both maternity hospitals . Both observation and interview data were analysed thematically. Ethical approval was granted by the Nepal Research Health Council and Bournemouth University's Ethics Committee. RESULTS: Key themes that emerged from the analysis reflected barriers that women experience in accessing services at different conceptual levels and resembled the three phases of delay model by Thaddeus and Maine. This framework is used to present the barriers. First Phase Delays are: 1) lack of awareness that the facility/services exist; 2) women being too busy to attend; 3) poor services; 4) embarrassment; and 5) financial issues. Themes for the second Phase of Delay are: 1) birthing on the way; and 2) by-passing the facility in favour of one further away. The final Phase involved: 1) absence of an enabling environment; and 2) disrespectful care. CONCLUSION: This study highlights a multitude of barriers, not all of the same importance or occuring at the same time in the pregnancy journey. It is clear that staff are aware of many of the barriers for women in reaching the facility to give birth, and these fit with previous literature of women's views. However, staff had limited insight into barriers occuring within the facility itself and were more likely to suggest that this was a problem for other institutions and not theirs.

The influence of bisnaphthalimidopropyl polyamines on DNA instability and repair in Caco-2 colon epithelial cells.

Bisnaphthalimido compounds bis-intercalate to DNA via the major groove and are potentially potent cancer therapeutics. Previously, we incorporated natural polyamines as linkers connecting the two naphthalimido ring moieties to create a series of soluble bisnaphthalimidopropyl polyamines (BNIPPs). Here, extending earlier work on bisnaphthalimidopropylspermidine (BNIPSpd)-induced apoptosis in colon adenocarcinoma Caco-2 cells, we compare the cytotoxicity and genotoxicity of BNIPSpd relative to the spermine and oxaspermine derivatives, bisnaphthalimidopropylspermine (BNIPSpm) and bisnaphthalimidopropyloxaspermine (BNIPOSpm). The order of cytotoxicity after 24 h was BNIPSpd (IC(50) = 0.47 µM) > BNIPSpm (IC(50) = 10.04 µM) > BNIPOSpm (IC(50) >50 µM). After a 72-h BNIPOSpm exposure, an IC(50) = 10.25 µM was achieved. With 4-h exposure to BNIPSpd or BNIPSpm or 12-h exposure to BNIPOSpm, concentrations ≥1 µM induced a significant dose-dependent increase in DNA damage as measured by alkaline single-cell gel electrophoresis. The longer incubation times required for BNIPOSpm to induce DNA strand breaks reflect a slower rate of BNIPOSpm cellular distribution as monitored via BNIPP fluorescence within the cells. Moreover, exposure to a non-genotoxic concentration of BNIPSpd, BNIPSpm (0.1 µM for 4 h) or BNIPOSpm (0.1 µM for 12 h) induced a significant decrease in repair of oxidative DNA damage induced by hydrogen peroxide. In conclusion, BNIPP exposure in Caco-2 cells is associated with significant induction of DNA damage and inhibition of DNA repair at non-genotoxic concentrations. The latter is a novel consequence of BNIPP-cell interactions which adds to the spectrum of therapeutically relevant activities that may be exploited for the design and development of naphthalimide-based therapeutics.

Bisnaphthalimidopropyl spermidine induces apoptosis within colon carcinoma cells.

Bisnaphthalimido compounds bisintercalate to DNA via the major groove and are potentially potent cancer therapeutics. We incorporated natural polyamines as linkers connecting the two-naphthalimido ring moieties to create a series of novel soluble cytotoxic bisnaphthalimidopropyl polyamines (BNIPPs). Here, we determined the cytotoxicity of bisnaphthalimidopropyl spermidine (BNIPSpd) towards Caco-2 and HT-29 colon adenocarcinoma cells revealing an IC(50) value of 0.15 and 1.64 microM after 48h exposure within Caco-2 and HT-29 cells, respectively. After 4h, >/=0.5 microM BNIPSpd treatment-induced significant DNA damage. After 24h exposure a concentration-dependent increase in active caspase-3 expression, chromatin condensation and internucleosomal DNA fragmentation identified apoptosis as the principal manifestation for the cytotoxicity within both cell lines. By 24h exposure, there was also a significant decline in cellular spermine and spermidine levels. It is concluded that bisnaphthalimidopropyl spermidine (BNIPSpd) toxicity primarily results from apoptosis and that BNISpd has potential to be further developed as an anti-tumour agent.

Kaempferol induced inhibition of HL-60 cell growth results from a heterogeneous response, dominated by cell cycle alterations.

Dietary flavonoids may be exploitable as chemotherapeutics and preventatives for critical health conditions, including cancer. Antiproliferative effects are commonly ascribed to such compounds but ambiguity exists as to the principal mechanism of action and the universal benefit of exposure, particularly at high concentrations. Here, we identify heterogeneous responses within HL-60 promyelocytic leukaemia cells that explain contradictions in the reported origin of the antiproliferative action of kaempferol, a dietary abundant flavonoid. At > or =10 microM, kaempferol exposure is predominantly characterised by cell cycle alterations, notably a significant increase in S-phase and a progressive accumulation in G2-M with 10 and > or =20 microM kaempferol, respectively. However, a limited but consistent membrane damage is observed across the 1-100 microM exposure and at 1 microM occurs devoid from indices of apoptosis which are only consistently observed with > or =10 microM kaempferol treatment. At the most cytotoxic exposures, multiparametric flow cytometric analysis revealed distinct sub populations of cells. Cells with decreased size, typical of apoptosis and necrosis, possessed heightened caspase-3 activity, decreased anti-apoptotic Bcl-2 expression and changes to membrane asymmetry and integrity. The remaining population had elevated active caspase-3 but no change or a moderate increase in Bcl-2 expression and no plasma membrane alterations. Differentiation was not a significant factor in HL-60 growth inhibition. In conclusion, kaempferol-induced growth inhibition is dominated by cell cycle changes but involves a limited cytotoxicity, which we propose results from a membrane damage centred as well as an apoptotic process. This heterogeneity of response may confound the disease-preventative role and pharmacological application of this flavonoid.

Biphasic effect of falcarinol on caco-2 cell proliferation, DNA damage, and apoptosis.

The polyacetylene falcarinol, isolated from carrots, has been shown to be protective against chemically induced colon cancer development in rats, but the mechanisms are not fully understood. In this study CaCo-2 cells were exposed to falcarinol (0.5-100 microM) and the effects on proliferation, DNA damage, and apoptosis investigated. Low-dose falcarinol exposure (0.5-10 microM) decreased expression of the apoptosis indicator caspase-3 concomitantly with decreased basal DNA strand breakage. Cell proliferation was increased (1-10 microM), whereas cellular attachment was unaffected by <10 microM falcarinol. At concentrations above 20 microM falcarinol, proliferation of CaCo-2 cells decreased and the number of cells expressing active caspase-3 increased simultaneously with increased cell detachment. Furthermore, DNA single-strand breakage was significantly increased at concentrations above 10 microM falcarinol. Thus, the effects of falcarinol on CaCo-2 cells appear to be biphasic, inducing pro-proliferative and apoptotic characteristics at low and high concentrations of falcarinol, respectively.

Influence of galangin on HL-60 cell proliferation and survival.

The effect of galangin, a flavonol component of India root spice and the 'herbal' medicine propolis, on HL-60 human leukaemia cell survival is characterised. Galangin (1-100 microM) exerted an antiproliferative effect that, with dose and exposure longevity, was progressively associated with an elevated hypodiploid DNA content and expression of the active form of caspase-3, principally prior to membrane damage. At >or=50 microM, plasmamembrane phosphatidylserine exposure was observed. There was no evidence for intracellular oxidative stress as an orchestrator of cytotoxicity and significant phagocyte-like differentiation was not detected. We discuss whether such cytotoxicity will be therapeutically exploitable or contribute to cancer prevention within a pharmacological or dietary context.

The effect of short-term kaempferol exposure on reactive oxygen levels and integrity of human (HL-60) leukaemic cells.

Flavonoids may be a principal contributor to the cancer preventative activity of fruit- and vegetable-rich diets and there is interest in their use as dietary supplements. However, there is potential conflict between the cytoprotective and cytotoxic activities of flavonoids, and their efficacy as anti-cancer agents is unresolved. Here, the integrity and survival of HL-60 promyelocytic leukaemia cells following short-term (90 min) exposure to the dietary abundant flavonoid kaempferol (1-100 microM) is reported. Supplementation initially decreased reactive oxygen levels but, paradoxically, a dose-dependent increase in single-strand DNA breakage occurred. However, there was no increase in oxidised DNA purines or membrane damage. Following a 24-h recovery period in non-kaempferol supplemented media, DNA single-strand breakage had declined and kaempferol exposed and control cultures possessed similar reactive oxygen levels. A reduction in (3)H-thymidine incorporation occurred with > or =10 microM kaempferol. One hundred micromolar kaempefrol increased the proportion of cells in G(2)-M phase, the proportion of cells with a sub-G(1) DNA content and enhanced 'active' caspase-3 expression but only induced a loss of mitochondrial membrane potential within a minority of cells. The relevance of induced DNA damage within a non-overtly oxidatively stressed environment to the disease preventative and therapeutic use of kaempferol is discussed.

DNA stability and lipid peroxidation in vitamin E-deficient rats in vivo and colon cells in vitro--modulation by the dietary anthocyanin, cyanidin-3-glycoside.

BACKGROUND: Fruit and vegetable consumption protects against cancer. This is attributed in part to antioxidants such as vitamin E combating oxidative DNA damage. Anthocyanins are found in significant concentrations in the human diet. However, it remains to be established whether they are bioactive in vivo. AIM: To investigate the consequence both of vitamin E deficiency on oxidative damage to DNA and lipids and the cytoprotective effect of nutritionally relevant levels of cyanidin-3-glycoside both in vivo in rats and in vitro in human colonocytes. METHODS: Male Rowett Hooded Lister rats were fed a diet containing less than 0.5 mg/kg vitamin E or a vitamin E supplemented control diet containing 100 mg d alpha-tocopherol acetate/kg. Half of the controls and vitamin E-deficient rats received cyanidin-3-glycoside (100 mg/kg). After 12 weeks endogenous DNA stability in rat lymphocytes (strand breaks and oxidised bases) and response to oxidative stress ex vivo (H2O2; 200 microM) was measured by single cell gel electrophoresis (SCGE). Tissue levels of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-Oxo-dG) were measured by HPLC with EC detection. D alpha-tocopherol and lipid peroxidation products (thiobarbituric acid reactive substances; TBARS) were measured by HPLC. Rat plasma pyruvate kinase and the production of reactive oxygen by phagocytes were detected spectrophotometrically and by flow cytometry respectively. Immortalised human colon epithelial cells (HCEC) were preincubated in vitro with the anthocyanins cyanidin and cyanidin-3-glycoside and the flavonol quercetin (all 50 microM) before exposure to H2O2 (200 microM). DNA damage was measured by SCGE as above. RESULTS: Plasma and liver d alpha-tocopherol declined progressively over 12 weeks in rats made vitamin E deficient. Lipid peroxidation was increased significantly in plasma, liver and red cells. Reactive oxygen levels in phagocytes and plasma pyruvate kinase were increased. Vitamin E deficiency did not affect DNA stability in rat lymphocytes, liver or colon. Cyanidin-3-glycoside did not alter lipid peroxidation or DNA damage in rats. However, it was chemoprotective against DNA damage in human colonocytes.DNA strand breakage was decreased 38.8 +/- 2.2% after pretreatment with anthocyanin. CONCLUSION: While it is accepted that vitamin E alters lipid oxidation in vivo, its role in maintaining DNA stability remains unclear. Moreover, whereas cyanidin-3-glycoside protects against oxidative DNA damage in vitro, at nutritionally relevant concentrations it is ineffective against oxidative stress in vivo.

Synthesis and biological activities of bisnaphthalimido polyamines derivatives: cytotoxicity, DNA binding, DNA damage and drug localization in breast cancer MCF 7 cells.

New bisoxynaphthalimidopolyamines (BNIPOPut, BNIPOSpd and BNIPOSpm) were synthesized. Their cytotoxic properties were evaluated against breast cancer MCF 7 cells and compared with bisnaphthalimidopolyamines BNIPSpd and BNIPSpm. Among the bisoxynaphthalimido polyamines, BNIPOSpm and BNIPOSpd exhibited cytotoxic activity with an IC50 f 29.55 and 27.22 microM, respectively, while BNIPOPut failed to exert significant cytotoxicity after 48-h drug exposure. DNA binding was determined by midpoint of thermal denaturation (Tm) measurement, ethidium bromide displacement and DNA gel mobility. Both BNIPOSpm and BNIPOSpd exhibited strong binding affinities with DNA. BNIPOPut had the least effect. The results were compared with other cytotoxic bisnaphthalimido compounds (BNIPSpm and BNIPSpd) previously reported by us. Using the single cell gel electrophoresis assay, it was found that BNIPSpm and BNIPSpd caused substantial DNA damage to MCF 7 treated cells while BNIPOSpm showed no significant effect over a range of drug concentrations after 4-h drug exposure. However, after 12-h drug exposure, BNIPOSpm had induced significant DNA damage similar to that of BNIPSpm (after 4-h drug exposure). Fluorescence microscopic analysis revealed that at 1 microM drug concentration and after 6-h drug exposure, both BNIPSpm and BNIPSpd were located within the cell while the presence of BNIPOSpm, was not observed. Therefore, we conclude that BNIPSpd, BNIPSpm and BNIPOSpm induce DNA damage consistent with their rate of uptake into the cells.

Safe motherhood program evaluation: theory and practice.

Debate on the evaluation of safe motherhood programs has mainly focused on the outcome or process measure to be used. Less attention is paid to the application of different approaches to evaluation. This article reviews current theories of evaluation and provides examples of the extent to which these theories have been applied in the actual practice of evaluation. Most evaluations use multiple methods and approaches, but the rationale and intention behind these choices are often not made explicit. Factors are identified that need to be taken into consideration when planning and conducting safe motherhood program evaluations. Safe motherhood programs are complex interventions, requiring evaluation by different theoretical approaches and multiple methods. Awareness of these approaches will allow health professionals to plan for evaluation and to use evaluation findings more effectively. If cognizant of the different approaches to evaluation, evaluation frameworks can be developed to improve assessment of the effectiveness of these programs.