Dietary flavonoids: Nano delivery and nanoparticles for cancer therapy.

Application of nanotechnologies to cancer therapy might increase solubility and/or bioavailability of bioactive compounds of natural or synthetic origin and offers other potential benefits in cancer therapy, including selective targeting. In the present review we aim to evaluate in vivo studies on the anticancer activity of nanoparticles (NPs) obtained from food-derived flavonoids. From a systematic search a total of 60 studies were identified. Most of the studies involved the flavanol epigallocatechin-3-O-gallate and the flavonol quercetin, in both delivery and co-delivery (with anti-cancer drugs) systems. Moreover, some studies investigated the effects of other flavonoids, such as anthocyanins aglycones anthocyanidins, flavanones, flavones and isoflavonoids. NPs inhibited tumor growth in both xenograft and chemical-induced animal models of cancerogenesis. Encapsulation improved bioavailability and/or reduced toxicity of both flavonoids and/or co-delivered drugs, such as doxorubicin, docetaxel, paclitaxel, honokiol and vincristine. Moreover, flavonoids have been successfully applied in molecular targeted nanosystems. Selectivity for cancer cells involves pH- and/or reactive oxygen species-mediated mechanisms. Furthermore, flavonoids are good candidates as drug delivery for anticancer drugs in green synthesis systems. In conclusion, although human studies are needed, NPs obtained from food-derived flavonoids have promising anticancer effects in vivo.

Total and Plant Protein Consumption: The Role of Inflammation and Risk of Non-Communicable Disease.

Background: Inflammatory cytokine levels are associated with Non-Communicable Diseases (NCDs) and can be influenced by a person's macronutrient profile. This work aims to evaluate the relationship between the compliance with the age-specific recommended protein intake and the levels of inflammatory markers related to the risk of NCDs. Methods: The study participants included 347 participants (119 men and 228 women), ages 18 to 86 years. Cardio-metabolic risk evaluations, including an assessment of the prevalence of Metabolic Syndrome, were performed. Leptin, IL-15, IL-6, and TNF-α levels were measured. Results: The adequacy of the total protein (TP) intake was lower in old people compared to individuals aged <60 years, and only few volunteers consumed the suggested 50% plant protein (PP) for a healthy and sustainable diet. A lower risk of NCDs with a PP consumption above at least 40% was observed only in old individuals. A differential effect on TNF-α and IL-6 was observed for both TP and PP intake by gender and age class, whereas for leptin and IL-15 only significant interactions among sex and the class of age were found. Conclusion: Although our data suggest that consuming more than 40% of PP can reduce the risk of NCDs, the effect of gender differences on cytokine levels should be considered in larger studies.

A Brief Review on Vitamin B12 Deficiency Looking at Some Case Study Reports in Adults.

In the era of evidence-based medicine, the randomized clinical trial corresponds to the top step in the qualitative scale of the evidence available in the literature, while small series of cases or the description of individual cases occupy the last place. However, the latter represent an important part of clinical practice and have significantly influenced the evolution of medicine, contributing significantly to the advancement of scientific knowledge. Vitamin B12 deficiency shares several common symptoms that affect several tissues and organs with health aliments, so its diagnosis could be unobvious for the broad array of its effects and investigation methods used. In this review, we focused our attention on some case reports related to the vitamin B12 deficiency associated to anemia, neurologic disorders, and hyperhomocysteinemia. B12 deficiency reversal is simply achieved by prompt therapy, even though it is not the same for several disorders.

Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity.

The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.

Fruit juice drinks prevent endogenous antioxidant response to high-fat meal ingestion.

High-fat meals (HFM) induce metabolic stress, leading to the activation of protective mechanisms, including inflammation and endogenous antioxidant defences. In the present study, we investigated the effects of antioxidant-rich fruit juice drinks on the endogenous antioxidant response induced by HFM. In a double-blind, cross-over design (10 d washout), fourteen overweight volunteers were randomly assigned to one of the following interventions: HFM+500 ml placebo beverage (HFM-PB, free from fruit); HFM+500 ml antioxidant beverage 1 (HFM-AB1; apple, grape, blueberry and pomegranate juices and grape skin, grape seed and green tea extracts); HFM+500 ml antioxidant beverage 2 (HFM-AB2; pineapple, black currant and plum juices). HFM-PB consumption increased the plasma levels of thiols (SH) (4 h, P< 0·001) and uric acid (UA) (2 h, P< 0·01) and total radical-trapping antioxidant parameter (TRAP) (4 h, P< 0·01). Following the consumption of drinks, UA production was significantly reduced with respect to placebo beverage consumption 8 h after HFM-AB2 consumption (P< 0·05). SH levels were reduced 0·5 (P< 0·05), 1 (P< 0·05) and 2 h (P< 0·01) after HFM-AB1 consumption and 2, 4 and 8 h (P< 0·05) after HFM-AB2 consumption. Plasma TRAP (2 h, P< 0·001) and urinary ferric reducing antioxidant power (0-8 h, P< 0·01) were increased by HFM-AB1 consumption, the drink with the highest in vitro antioxidant capacity, but not by HFM-AB2 consumption. In urine, UA levels were significantly increased from basal levels after the consumption of HFM-PB and HFM-AB2. However, neither of the beverages increased the urinary excretion of UA with respect to the placebo beverage. In conclusion, the increase in UA and SH levels induced by HFM as part of an endogenous antioxidant response to postprandial stress can be prevented by the concomitant ingestion of antioxidant-rich fruit juice drinks.

Upper-Limb Muscle Fatigability in Para-Athletes Quantified as the Rate of Force Development in Rapid Contractions of Submaximal Amplitude.

This study aimed to compare neuromuscular fatigability of the elbow flexors and extensors between athletes with amputation (AMP) and athletes with spinal cord injury (SCI) for maximum voluntary force (MVF) and rate of force development (RFD). We recruited 20 para-athletes among those participating at two training camps (2022) for Italian Paralympic veterans. Ten athletes with SCI (two with tetraplegia and eight with paraplegia) were compared to 10 athletes with amputation (above the knee, N = 3; below the knee, N = 6; forearm, N = 1). We quantified MVF, RFD at 50, 100, and 150 ms, and maximal RFD (RFDpeak) of elbow flexors and extensors before and after an incremental arm cranking to voluntary fatigue. We also measured the RFD scaling factor (RFD-SF), which is the linear relationship between peak force and peak RFD quantified in a series of ballistic contractions of submaximal amplitude. SCI showed lower levels of MVF and RFD in both muscle groups (all p values ≤ 0.045). Despite this, the decrease in MVF (Cohen's d = 0.425, p < 0.001) and RFDpeak (d = 0.424, p = 0.003) after the incremental test did not show any difference between pathological conditions. Overall, RFD at 50 ms showed the greatest decrease (d = 0.741, p < 0.001), RFD at 100 ms showed a small decrease (d = 0.382, p = 0.020), and RFD at 150 ms did not decrease (p = 0.272). The RFD-SF decreased more in SCI than AMP (p < 0.0001). Muscle fatigability impacted not only maximal force expressions but also the quickness of ballistic contractions of submaximal amplitude, particularly in SCI. This may affect various sports and daily living activities of wheelchair users. Early RFD (i.e., ≤50 ms) was notably affected by muscle fatigability.

PAR level mediates the link between ROS and inflammatory response in patients with type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by disrupted glucose homeostasis and metabolic abnormalities, with oxidative stress and inflammation playing pivotal roles in its pathophysiology. Poly(ADP-ribosyl)ation (PARylation) is a post-translational process involving the addition of ADP-ribose polymers (PAR) to target proteins. While preclinical studies have implicated PARylation in the interplay between oxidative stress and inflammation in T2DM, direct clinical evidence in humans remains limited. This study investigates the relationship between oxidative stress, PARylation, and inflammatory response in T2DM patients. METHODS: This cross-sectional investigation involved 61 T2DM patients and 48 controls. PAR levels were determined in peripheral blood cells (PBMC) by ELISA-based methodologies. Oxidative stress was assessed in plasma and PBMC. In plasma, we monitored reactive oxygen metabolites (d-ROMs) and ferric-reducing antioxidant power. In PBMC, we measured the expression of antioxidant enzymes SOD1, GPX1 and CAT by qPCR. Further, we evaluated the expression of inflammatory mediators such as IL6, TNF-α, CD68 and MCP1 by qPCR in PBMC. RESULTS: T2DM patients exhibited elevated PAR levels in PBMC and increased d-ROMs in plasma. Positive associations were found between PAR levels and d-ROMs, suggesting a link between oxidative stress and altered PAR metabolism. Mediation analysis revealed that d-ROMs mediate the association between HbA1c levels and PAR, indicating oxidative stress as a potential driver of increased PARylation in T2DM. Furthermore, elevated PAR levels were found to be associated with increased expression of pro-inflammatory cytokines IL6 and TNF-α in the PBMC of T2DM patients. CONCLUSIONS: This study highlights that hyperactivation of PARylation is associated with poor glycemic control and the resultant oxidative stress in T2DM. The increase of PAR levels is correlated with the upregulation of key mediators of the inflammatory response. Further research is warranted to validate these findings and explore their clinical implications.

Antioxidant and inflammatory response following high-fat meal consumption in overweight subjects.

PURPOSE: Postprandial metabolic stress as a consequence of ingestion of high-energy meals is recognized as an important risk factor for cardiovascular disease. The objective of this study was to evaluate the inflammatory and antioxidant response of the body to the acute ingestion of a high-fat meal (HFM). METHODS: Fifteen healthy overweight subjects were recruited for the study. After HFM consumption, plasma glucose, insulin, uric acid (UA), triglycerides (TG), total cholesterol (TC), thiols (SH), inflammatory cytokines (IL-6 and TNF-α) and dietary antioxidants were measured at 0, 0, 5, 1, 2, 4, 6 and 8 h points from ingestion. RESULTS: The ingestion of HFM induced significant increases in both TG and TC, with peaks at 4 h (p < 0.001) and 8 h (p < 0.01), respectively. IL-6 and TNF-α significantly increased postprandially, reaching maximum concentrations 8 h after meal consumption (p < 0.001). Whereas plasma concentrations of vitamins and carotenoids were not changed by HFM, SH and UA increased, peaking 2-4 h postingestion (p < 0.001 and 0.01, respectively). Increments of SH and UA were positively correlated with AUC for TG (Pearson coefficient 0.888, p < 0.001 and 0.923, p < 0.001, respectively). CONCLUSIONS: Present results indicate that as a consequence of an excess of dietary fat, the body responds through an inflammatory reaction, which is accompanied by an increment of endogenous antioxidant defenses, mediated by UA and SH, but not by vitamins C and E and carotenoids. Although further studies are needed, results of the current investigation represent novel findings on endogenous strategies of redox defense from fat overloads.

The Potential Role of Naringin and Naringenin as Nutraceuticals Against Metabolic Syndrome.

Metabolic syndrome, an increasing problem in western society, is a cluster of conditions that affect cardiovascular health, lipid and glucose management, increasing the risk of heart diseases, stroke and diabetes. Bioactive flavonoids are a great resource of compounds with proven antiinflammatory activities. Naringin, a natural flavanone found in citrus fruits, and its aglycone have demonstrated to ameliorate obesity, dyslipidemia, and insulin resistance in animal models. The principal mechanisms by which these flavonoids exert their action involve AMPK and PPARα up-regulation and the down-regulation of genes involved in lipid metabolism. Although different studies have been carried out to define the pharmacological effects of these flavonoids, their therapeutic use is still limited.

Overlap of orthorexia, eating attitude and psychological distress in some Italian and Spanish university students.

BACKGROUND: Orthorexia nervosa (ON) is the persistent concern of maintaining the self-imposed diet to improve one's health. Many factors have been associated to ON in univ-ersity students. AIM: To assess the prevalence of ON in Italian and Spanish university students in relation to eating attitude and psychological distress, and the possible overlaps between ON (evaluated with different scored questionnaires from the originally proposed ORTO-15), distress and risk of eating disorders. METHODS: This study was carried out on 160 students recruited at La Sapienza University of Rome and at the Catholic University of Murcia. Questionnaires were administered to evaluate ON (ORTO-15 and sub-scores), body concerns (Multidimensional Body-Self Relations Questionnaire, MBSRQ, and Body Uneasiness test, BUT), psychological distress (Kessler Psychological Distress Scale, K10), physical activity (International Physical Activity Questionnaire, IPAQ), eating attitude (Eating Attitudes Test, EAT-26) and malnutrition (Starvation Symptom Inventory, SSI). Sex differences, within the same country, and differences between Italian and Spanish students, within the same sex, were evaluated. RESULTS: The ORTO-15 positive subjects, assessed with the originally proposed cut-off, were above 70% in both Italian and Spanish students, with a higher prevalence in the Spanish sample (Italian females 76.3%, Italian males 70.7%; Spanish females 97.0%, Spanish males 96.3%). According to ORTO-7, about 30% of Italian and 48% of Spanish students were positive to ON with no significant sex differences. When excluding students underweight (UW), overweight (OW) or obese (OB), as well as those potentially at risk of eating disorders or presenting mild, moderate and severe distress, in the resultant normal weight (NW)-K10neg-EAT-26neg subgroup, we did not find many correlations observed in the whole sample, including those between ORTO scores and BUT, SSI, Total MBSRQ and some of its components. Moreover, ORTO-7 resulted in the only ON score unrelated with Body Mass Index, MBSRQ components and IPAQ-assessed intense activity, in the NW-K10neg-EAT-26neg subgroup. After this sort of "exclusion diagnosis", the prevalence of ON of these students on the overall sample resulted in 16.9%, 12.2%, 15.2% and 25.9% for Italian females, Italian males, Spanish females and Spanish males, respectively. CONCLUSION: In some university students ON could be a symptom of other conditions related to body image concerns and distress, as well as to high physical activity and appearance, fitness, health or illness orientation (from MBSRQ). However, ORTO-7 became independent from these confounding variables, after the exclusion of UW, OW, OB and students positive to EAT-26 and K10, suggesting the possibility of identifying orthorexic subjects with this specific questionnaire.

Dietary Intakes and Food Habits of Wheelchair Basketball Athletes Compared to Gym Attendees and Individuals who do not Practice Sport Activity.

BACKGROUND: Mediterranean diet (Med-D) has been previously suggested for athletes, but Paralympics usually have a low intake of plant foods. Orthorexia nervosa (ON) can drive dietary intake of both athletes and gym attendees. OBJECTIVE: We aimed to compare dietary intakes and food habits of elite wheelchair basketball athletes (WBA) and able-bodied individuals who practice or not sport activity and with different fat mass percentage (FM%). METHODS: We recruited 15 WBA from the Italian National team and 3 control groups (15 each group): healthy individuals who do not practice any sports activity (NSA) and gym attendees with low (GAL, FM%<17) and high (GAH, FM%>18) FM%. Food consumption was monitored by a 3- d diary, while Med-D scores and ON score were evaluated through standardized questionnaires. In WBA we also assessed Neurogenic Bowel Dysfunction (NBD), GastroEsophageal Reflux Disease (GERD), allergy questionnaire for athletes (AQUA) and Starvation Symptoms Inventory (SSI). RESULTS: In WBA, ON correlated with GERD and SSI. WBA and GAH with eating behavior of ON had higher adherence to Med-D, whereas NSA had less adherence to Med-D. Sub-score, including fruits, vegetables and legumes, was higher in the GAL and GAH groups compared to the WBA and NSA groups. Med-D was inversely related to animal protein intake (PRO-AN) in NSA and GAL. FM% was inversely related to PRO-AN in WBA and GAH, and to ON only in GAH. In WBA, PRO-AN and vegetable protein intake correlated with both carbohydrate and energy intakes. CONCLUSION: In WBA, commitment to wellness (ON and Med-D adherence) could be a response to gastrointestinal and starvation symptoms. WBA should be involved in setting their own individualized dietary strategies.

Mediterranean Diet Effect: an Italian picture.

BACKGROUND: The purpose of this study was to evaluate the overall diet quality effects, mainly on antioxidant nutritional status and some cytokines related to the cellular immune response as well as oxidative stress in a healthy Italian population group. METHODS: An observational study was conducted on 131 healthy free-living subjects. Dietary intake was assessed by dietary diary. Standardised procedures were used to make anthropometric measurements. On blood samples (serum, plasma and whole blood) were evaluated: antioxidant status by vitamin A, vitamin E, carotenoids, vitamin C, uric acid, SH groups, SOD and GPx activities; lipid blood profile by total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides; total antioxidant capacity by FRAP and TRAP; the immune status by TNF-α, and IL-10 cytokines; the levels of malondialdehyde in the erythrocytes as marker of lipid peroxidation. RESULTS: The daily macronutrients intake (g/day) have shown a high lipids consumption and significant differences between the sexes with regard to daily micronutrients intake. On total sample mean Mediterranean Diet Score (MDS) was 4.5 ± 1.6 and no significant differences between the sexes were present. A greater adherence to a Mediterranean dietary pattern increases the circulating plasma levels of carotenoids (lutein plus zeaxanthin, cryptoxanthin, α and ß-carotene), vitamin A and vitamin E. The levels of endogenous antioxidants were also improved. We observed higher levels in anti-inflammatory effect cytokines (IL-10) in subjects with MDS ≥ 6, by contrast, subjects with MDS ≤ 3 show higher levels in sense of proinflammatory (TNF α P < 0.05). Lower levels of MDA were associated with MDS > 4. Our data suggest a protective role of vitamin A against chronic inflammatory conditions especially in subjects with the highest adherence to the Mediterranean-type dietary pattern. CONCLUSIONS: Mediterranean dietary pattern is associated with significant amelioration of multiple risk factors, including a better cardiovascular risk profile, reduced oxidative stress and modulation of inflammation.

Differential effect of cheese fatty acid composition on blood lipid profile and redox status in normolipidemic volunteers: a pilot study.

The present study investigated the effect of the consumption of two cheese varieties differing for fat quality on blood lipid profile and redox status biomarkers in 30 selected healthy volunteers, consuming either the experimental cheese (from milk produced by cows fed a grass and maize silage based diet with 5% of linseed oil added) or the control cheese (from normal cows' milk) for 4 weeks according to a crossover design. The experimental cheese had a lower content of medium-chain saturated fatty acids and a higher content of stearic acid and polyunsaturated fatty acids; its consumption led to higher levels of vitamins C and E and stearic acid in blood, while myristic acid and oxidized low-density lipoprotein concentrations were significantly lower. As myristic acid and oxidized low-density lipoprotein are highly correlated with increased atherogenic risk and vitamins C and E with antioxidant activity, the enrichment of cows' diet with linseed oil could provide a dietary option to prevent cardiovascular diseases risk.

Dietary Habits and Musculoskeletal Pain in Statin and Red Yeast Rice Users: A Pilot Study.

(1) Background: Diet and statins are commonly used to treat high cholesterol (CHOL) levels. (2) Aim: To compare adherence to Mediterranean diet (Med-D), orthorexia nervosa (ON), and musculoskeletal pain in individuals in treatment with statins metabolized by CYP3A4, not metabolized by CYP3A4 or red yeast rice (RYR, containing monacolin K: MON-K). (3) Methods: starting from 80 individuals, after the exclusion of those with other causes of possible pain, 56 individuals were selected and divided into three groups according to the type of statin (CYP3A4, NO-CYP3A4 and MON-K). Adherence to the Med-D was evaluated with the MEDScore and a sub-score was calculated for fruit and vegetables consumption (MEDScore-FV). ON and musculoskeletal pain were assessed with the ORTO-15 and with the Nordic Musculoskeletal questionnaires, respectively. A retrospective analysis of CHOL decrease after treatment was conducted. (4) Results: CHOL levels were lower in CYP3A4 and NO-CYP3A4 after treatment (182.4 ± 6.3 and 177.0 ± 7.8 mg/dL, respectively), compared with MON-K (204.2 ± 7.1 mg/dL, p < 0.05). MON-K and CYP3A4 groups had a high prevalence of reported knee pain (33.3% and 18.8%, respectively) than NO-CYP3A4 group (0%, p < 0.05). A high percentage of individuals in MON-K take supplements and nutraceuticals (87.5%), whereas MEDScore-FV was higher in CYP3A4 (9.4 ± 0.2) compared to NO-CYP3A4 (7.6 ± 0.5, p < 0.05). (5) Conclusions: This study suggests that individuals receiving treatment with statins and RYR should be monitored from the perspective of plant foods' consumption and nutraceutical use, to prevent musculoskeletal pain.

Post-Exercise Ketosis, Salivary Uric Acid and Interleukin-6 after a Simulated Wheelchair Basketball Match.

BACKGROUND: Interleukin (IL)-6, total antioxidant capacity (TAC) and uric acid (UA) increase after exercise in able-bodied individuals. Wheelchair Basketball Athletes (WBA), having low muscle mass, could be at risk of post-exercise ketosis. OBJECTIVE: This study aimed to evaluate the post-exercise ketosis, IL-6, and antioxidant response, in WBA of the Italian National team, after a simulated match. METHODS: Dietary intakes, Starvation Symptoms Inventory (SSI), percentage of fat mass (FM%) and basal Respiratory Exchange Ratio (RER) and Basal Energy Expenditure (BEE), were evaluated. Salivary TAC, UA and IL-6 were measured: before (PreM), at the end (EM) and 20 minutes after (PostM) the match. Capillary glucose and ß-hydroxybutyrate (ßHB) were monitored. Percentage of Heart Rate Reserve (%HRR) was measured to evaluate exercise intensity. RESULTS: WBA had low carbohydrates (43.5% of daily energy intake (En)) and high fat (36.3% En) intakes. The increase in UA at PostM correlated with En (0.810, p<0.01) and was inversely related to ßHB at EM (-0.719, p<0.05). Furthermore, at PostM growing IL-6 levels correlated with BEE (0.778, p<0.05) and inversely related to FM% (-0.762, p<0.5) were found, which in turn was correlated to SSI (0.781, p<0.05). Also ßHB PostM correlated with SSI (0.761, p<0.05) but was inversely related to RER (-0.745, p<0.05) and En (-0.826, p<0.01). CONCLUSION: Our study suggests that some WBA should improve their dietary habit in order to prevent post-exercise ketosis and ameliorate the endogenous antioxidant response after exercise.

Hormetic Effects of Bioactive Compounds from Foods, Beverages, and Food Dressing: The Potential Role in Spinal Cord Injury.

Spinal cord injury (SCI) is a damage or trauma to the spinal cord resulting in a total or partial loss of motor and sensory function. SCI is characterized by a disequilibrium between the production of reactive oxygen species and the levels of antioxidant defences, causing oxidative stress and neuroinflammation. This review is aimed at highlighting the hormetic effects of some compounds from foods, beverages, and food dressing that are able to reduce oxidative stress in patients with SCI. Although curcumin, ginseng, and green tea have been proposed for SCI management, low levels of antioxidant vitamins have been reported in individuals with SCI. Mediterranean diet includes food rich in vitamins and antioxidants. Moreover, food dressing, including spices, herbs, and extra virgin olive oil (EVOO), contains multiple components with hormetic effects. The latter involves the activation of the nuclear factor erythroid-derived 2, consequently increasing the antioxidant enzymes and decreasing inflammation. Furthermore, EVOO improves the bioavailability of carotenoids and could be a delivery system for bioactive compounds. In conclusion, Mediterranean dressing in addition to plant foods can have an important effect on redox balance in individuals with SCI.

Bioavailability of strawberry antioxidants in human subjects.

Strawberries contain many antioxidant phytochemicals such as vitamin C, carotenoids and phenolic compounds including anthocyanins (ACN). In the present study, antioxidant composition of fresh strawberries (FS) and stored strawberries (SS) and the bioavailability of the main strawberry bioactive compounds were determined in human subjects. Thirteen healthy volunteers consumed 300 g of FS and SS on two separate occasions. Blood, before and at different time points from meal consumption, as well as 24 h urine, was collected, and parent compounds and metabolites of the different compounds were determined by HPLC or LC/MS/MS. A reduction in α-carotene plasma concentrations v. baseline values was recorded after the consumption of FS, although the amount of this carotenoid was higher in the SS. On the contrary, a significant increase of plasma vitamin C after 2, 3 and 5 h (P < 0.05) of FS and SS consumption was recorded. No quercetin and ACN were found in plasma, while coumaric acid, 4-hydroxybenzoic acid (4HBA, 56 and 54% of pelargonidin-3-glucoside (Pel-glc) ingested with FS and SS, respectively) and protocatechuic acid (59 and 34% of cyanidin-3-glucoside ingested with FS and SS, respectively) over 8 h from strawberry consumption were retrieved in the plasma. Pelargonidin glucuronide, pelargonidin glucoside and pelargonidin aglycone peaked in urine within 2 h of strawberry consumption, and the 24 h amount excreted was always approximately 0.9% of the Pel-glc dose ingested. The data indicated that the content of phytochemicals in strawberries may influence the bioavailability of individual compounds. Furthermore, in the present study, the metabolism of Pel-glc was elucidated, and, for the first time, 4HBA was suggested to be a major human metabolite of Pel-glc.

Cranberry for Bacteriuria in Individuals with Spinal Cord Injury: A Systematic Review and Meta-Analysis.

BACKGROUND: Urinary tract infection (UTI) is common in individuals with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD) and in veterans with SCI who use antibiotics improperly for asymptomatic bacteriuria. Cranberry (CB) has been suggested for UTI prevention. METHODS: We performed a systematic search up to May 2020 in the following databases: AccessMedicine, BioMed Central, CINAHL, Cochrane Library, ProQuest, and PubMed. Quality assessment was performed using a specifically designed quality score. Risk ratio was calculated with both random effect model analysis (DerSimonian-Laird method) and quality effect model analysis (Doi Thalib method). RESULTS: Six studies on bacteriuria and SCI were reviewed. From the four studies available for meta-analysis, two of which with individuals taking both CB and control, 477 data from 415 participants were analysed (241 CB and 236 control). No significant differences were detected with meta-analysis. However, bias, limitations, and incompleteness were observed in the reviewed studies. CONCLUSION: Although further studies are needed, we suggest an accurate monitoring of diet and fluid intake, the evaluation of risk for potential food or nutraceutical interactions with drugs, and the inclusion of inflammatory markers among the outcomes in addition to UTI.

Evaluation of adherence to Mediterranean diet and association with clinical and biological markers in an Italian population.

OBJECTIVES: The purpose of this study was to evaluate the overall diet quality of an Italian population through the use of the Mediterranean Diet Serving Score (MDSS) and its relation to clinical and biochemical nutritional markers. METHODS: The study was conducted on healthy participants ages 18 to 86 y living in central Italy. Adherence to the Mediterranean food pattern was evaluated by a semiquantitative food frequency, using the MDSS. Anthropometric measurements and biochemical analyses of nutritional interest were performed according to the standardized procedure. RESULTS: The sample included a total of 349 participants (121 men and 228 women) with an average age of 54 ± 15 y and a body mass index of 27.4 ± 4.8 kg/m2, underlining an overweight status in both men and women. The mean educational level was medium-high in both sexes, whereas the occupation level was higher in women than in men (P = 0.001). The mean MDSS score was 14.4 ± 4.1 out of a total of 24 points. The adherence was higher in women (score 14.7 ± 3.9) than men (score 13.9 ± 4.4), although there were no significant differences (P = 0.25). No statistical differences in MDSS were found in relation to body mass index and educational level, whereas a higher MDSS score was observed in the older age group (P < 0.05). A positive correlation among MDSS, high-density lipoprotein cholesterol, and vitamin C has been found (P < 0.05), whereas there was a negative correlation with uric acid and triacylglycerols (P < 0.05). A logistic regression analysis highlighted smoking habit as the only predictive factor for a high adherence to MDSS (P < 0.05). CONCLUSIONS: MDSS has a low adherence to the Mediterranean diet, particularly in the youngest age group and smokers. The index shows a correlation with some parameters of nutritional interest and further larger cohorts studies are needed to confirm our findings.

Chocolate Consumers and Lymphocyte-to-Monocyte Ratio: A Working Hypothesis from a Preliminary Report of a Pilot Study in Celiac Subjects.

BACKGROUND AND AIM: The aim of this work was to evaluate the relationship between platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) with habitual consumption of dark chocolate in a group of celiac subjects in which chocolate consumption and lower neutrophil-to-lymphocyte ratio (NLR) association had already been observed. Additionally, due to the known anti-nutrient effect on iron absorption, we evaluated red blood cell count (RBC), mean corpuscular volume (MCV) and hemoglobin (Hb) values. METHODS: Chocolate consumers and non-consumers were matched for sex, menopausal status, NLR values over the previously suggested cut off (2.32) for celiac patients, and co-morbidities. RESULTS: Chocolate consumers had high LMR compared to non-consumers, whereas no differences were observed between chocolate consumers and non-consumers in RBC, MCV, Hb and PLR. However, similar number of subjects had PLR higher than the previously suggested cut off (143.7) for celiac disease. CONCLUSIONS: This preliminary report suggests a working hypothesis for larger studies aimed at establishing cut off values for LMR in celiac patients and the modulation of this marker by dietary antioxidants.