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Abstract: 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.

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 sport activity (NSA) and gym attendees with low (GAL, FM%18) FM%. Food consumption was monitored by 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. Conclusions: 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.

(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.

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.

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.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.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.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)-K10In 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.

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.

(1) Background: In recent years, the EAT-Lancet Commission has suggested the inclusion of nuts among proteins from vegetable sources, but this inclusion would imply a higher consumption of nuts compared with a healthy Mediterranean diet. (2) Objective: In this work, we sought to provide a comparison between the macronutrient intakes and environmental impacts of two different types of diet: a diet including nuts and a diet without nuts. (3) Methods: In this pilot study, we recruited 89 Italians divided into two groups: nut consumers (44 individuals) and non-consumers (45 individuals). Food consumption was monitored by a seven-day diary, while the Mediterranean diet scores, habitual physical activity scores, and orthorexia nervosa scores were evaluated through standardized questionnaires. (4) Results: We found that nut consumers had higher physical activity and energy intake levels. High consumption of fat (p &lt, 0.001) and protein (p &lt, 0.001) was observed among nut consumers compared with the levels observed among non-consumers. Moreover, a higher environmental impact of total dietary intake was observed among nut consumers, in terms of carbon (p &lt, 0.05) and land (p &lt, 0.05) footprints, impacts on the water footprint was almost significant (p = 0.06). (5) Conclusions: We suggest that, among plant food proteins, the consumption of complementary proteins from legumes and cereals should be preferred to the consumption of proteins from nuts.

Background: Diet impacts both human and environmental health and must be designed to optimize the training and performance of athletes. The aim of this study was to quantify the effect of dietary advice (DA) on the food intake of wheelchair basketball athletes (WBA) and the environmental impact longitudinally. Methods: DA were provided to WBA of the Italian national team (DAM-T1). Nutritional assessment and evaluation of the environmental impact of diet were performed two months (DAM-T2) and one year later (DAM-T3), when a post-COVID-19 survey was performed also in WBA who did not receive counselling (men: NDAM-T3, women: NDAW-T3). Results: After DA, WBA showed a reduced percentage of energy derived from sugars and fats. Athletes adjusted their protein intake according to the personalized recommendations. The intake of some micronutrients improved after DA and was higher compared to NDAM-T3 and NDAW-T3. Despite the lower impact of diet in NDAW-T3, they presented more nutritional deficiency than men. The mean intake of vegetables was in the range of the EAT-Lancet Commission suggestion only two months after DA. After DA, fiber intake increased and adapted to the tolerated level. Conclusions: WBA improved their diet after DA but did not comply with the EAT-Lancet suggestion for red meat and legumes.

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 β-hydroxybutyrate (βHB) 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 Conclusions:: 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.

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.

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.

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 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.

Neutrophil-to-lymphocyte ratio (NLR) has been proposed as a bone loss index in postmenopausal women and as a marker of inflammation in coeliac patients. The aims of this work were to evaluate the effect of gluten-free diet (GFD) on NLR retrospectively and study the relationship between NLR and Mediterranean diet adherence and selected food groups (fruits, vegetables, red meat, potatoes, and unrefined and refined cereals). Adult individuals (n=50), who had been on a strict GFD by at least 6 months, were recruited. The degree of adherence to the Mediterranean diet was calculated with two different scores: the Mediterranean Diet Score (MDS-14), assessed through the validated 14-item questionnaire of the PREDIMED study, and the MEDScore (Score-55) proposed by Panagiotakos. The latter includes the consumption of unrefined cereals (UC). High percentages of osteopenia and osteoporosis were found within the recruited subjects, who furnished the reports of bone mineral density (BMD), in particular in postmenopausal (Post-M) women. Recent NLR was higher in subjects with osteoporosis compared to osteopenia and normal BMD. However, retrospective analysis showed both increase and decrease in NLR after GFD, with no significant differences between Marsh grade, anemia, and BMD status. Moreover, premenopausal previous pregnancy (Pre-MPP) and Post-M had higher NLR at diagnosis compared to Men and premenopausal (Pre-M), but higher differences were observed in recent NLR between Pre-MPP and Men only. Chocolate consumption was associated with lower recent NLR, whereas the latter was correlated with Score-55, but not with MDS-14. Moreover, refined cereal consumption was correlated with recent NLR. Although large prospective studies are needed in order to clarify the relationship between UC and NLR in coeliac patients, in this pilot study, we have investigated for the first time the relationship between NLR, dietary habit, and osteoporosis in coeliac disease.

Despite tea increased plasma nonenzymatic antioxidant capacity, the European Food Safety Administration (EFSA) denied claims related to tea and its protection from oxidative damage. Furthermore, the Supplement Information Expert Committee (DSI EC) expressed some doubts on the safety of green tea extract (GTE). We performed a pilot study in order to evaluate the effect of a single dose of two capsules of a GTE supplement (200 mg × 2) on the peroxidation of leukocytes index ratio (PLIR) in relation to uric acid (UA) and ferric reducing antioxidant potential (FRAP), as well as the sample size to reach statistical significance. GTE induced a prooxidant effect on leukocytes, whereas FRAP did not change, in agreement with the EFSA and the DSI EC conclusions. Besides, our results confirm the primary role of UA in the antioxidant defences. The ratio based calculation of the PLIR reduced the sample size to reach statistical significance, compared to the resistance to an exogenous oxidative stress and to the functional capacity of oxidative burst. Therefore, PLIR could be a sensitive marker of redox status.

In western societies where most of the day is spent in the postprandial state, the existence of oxidative and inflammatory stress conditions makes postprandial stress an important factor involved in the development of cardiovascular risk factors. A large body of evidence have been accumulated on the anti-inflammatory effects of probiotics, but no information is available on the mechanisms through which intestinal microbiota modulates redox unbalance associated with inflammatory stress. Here, we aimed to investigate the ability of Lactobacillus casei Shirota (LS) to induce an antioxidant response to counteract oxidative and inflammatory stress in an in vitro model of enterocytes. Our results show that pretreatment of enterocytes with LS prevents membrane barrier disruption and cellular reactive oxygen species (ROS) accumulation inside the cells, modulates the expression of the gastro-intestinal glutathione peroxidase (GPX2) antioxidant enzyme, and reduces p65 phosphorylation, supporting the involvement of the Nfr2 and nuclear factor kappa B pathways in the activation of antioxidant cellular defenses by probiotics. These results suggest, for the first time, a redox mechanism by LS in protecting intestinal cells from AAPH-induced oxidative and inflammatory stress.

In western societies where most of the day is spent in the postprandial state, the existence of oxidative and inflammatory stress conditions makes postprandial stress an important factor involved in the development of cardiovascular risk factors. A large body of evidence have been accumulated on the anti-inflammatory effects of probiotics, but no information is available on the mechanisms through which intestinal microbiota modulates redox unbalance associated with inflammatory stress. Here, we aimed to investigate the ability of Lactobacillus casei Shirota (LS) to induce an antioxidant response to counteract oxidative and inflammatory stress in an in vitro model of enterocytes. Our results show that pretreatment of enterocytes with LS prevents membrane barrier disruption and cellular reactive oxygen species (ROS) accumulation inside the cells, modulates the expression of the gastro-intestinal glutathione peroxidase (GPX2) antioxidant enzyme, and reduces p65 phosphorylation, supporting the involvement of the Nfr2 and nuclear factor kappa B pathways in the activation of antioxidant cellular defenses by probiotics. These results suggest, for the first time, a redox mechanism by LS in protecting intestinal cells from AAPH-induced oxidative and inflammatory stress.

High intakes of vegetables have been associated with a lower incidence of cardiovascular diseases (CVD). However, the effect of vegetables on immune function and antioxidant status in human studies have provided contrasting results. In the present study, after a week of run-in period, 38 subjects at risk of CVD were randomly assigned to one of the following 4-week interventions: low vegetable consumption (800 g of vegetables/week) or high vegetable consumption (4200 g of vegetables/week). Vegetables included carrots, topinambur (Jerusalem artichoke, Helianthus tuberosus), tomatoes, red cabbage, and sweet peppers. Blood and salivary samples were collected before and after intervention periods. In addition to clinical, immunological, and antioxidant markers, leukocyte and lymphocyte expression of the gut-homing β7 integrin was evaluated. No significant changes were detected in clinical, immunological, and antioxidant markers in biological samples, except for an increase in white blood cell count for the low vegetable consumption group (p<0.05). The study provides additional evidence about the uncertainty of providing a clear evidence for vegetables in modulating markers of immune function and antioxidant status. Further studies are needed in order to unravel the mechanism of effect of vegetable consumption in cardiovascular prevention.

This study aims at investigating the effect of an experimental period of intake of whole grain foods rich in lignans as part of an habitual diet on the plasma and urinary excretion of enterolignans, the biomarkers of lipid metabolism and the immunological and antioxidant status in a group of postmenopausal women with moderate serum cholesterol. A randomized double-blind crossover study was completed on 13 subjects in 12-weeks after protocol approval of an ethical committee. The subjects consumed whole grain foods high in lignans (30 g/d of breakfast cereals or biscuits, etc., 80 g/d of whole grain pasta) or refined grain foods for 4 weeks, separated by a 2-weeks wash-out period. A modest hypocholesterolemic effect (p

The aim of this work was to evaluate the effect of long term supplementation with two moderate dose of Zn on plasma and cellular red-ox status markers in elderly volunteers.In a double blind study 108 healthy volunteers, aged 70-85 years, were enrolled. They were randomly divided in 3 groups of treatment, receiving placebo, 15 mg/day and 30 mg/day of Zn for 6 months. Red-ox status markers were assessed at baseline and after 6 months evaluating carotenoids, vitamin A and E in plasma; glutathione (GSH), thiol groups (RSH), malondialdehyde (MDA), percentage of haemolysis and methemoglobin in erythrocytes.Zn supplementation had no significant effects on red-ox status markers except for vitamin A levels (from 1.94±0.44 to 2.18±0.48 μM in volunteers receiving 15 mg of Zn and from 1.95±0.46 to 2.26±0.56 μM in volunteers receiving 30 mg of Zn), which increased proportionally to zinc dose.It appears that, differently from unhealthy populations, long-term supplementation with two moderate doses of Zn in a healthy elderly population, with an adequate Zn nutritive status and macro and micronutrients intakes in the range of normality, is an inefficient way to increase antioxidant defences.

Wild rocket [ Diplotaxis tenuifolia (L.) DC.] belongs to the Brassicaceae family and has its origin in the Mediterranean region. The effect of conventional and integrated cultivation practices on the nutritional properties and benefits of wild rocket [ Diplotaxis tenuifolia (L.) DC.] were studied. Bioactive molecules content (vitamin C, quercetin, lutein), antioxidant properties and bioactivity of polyphenolic extracts from the edible part of rocket in Caco-2 cells were determined. Regarding antioxidant properties, FRAP (Ferric Reducing Antioxidant Power) values ranged from 4.44 ± 0.11 mmol/kg fw to 9.92 ± 0.46 mmol/kg fw for conventional rocket and from 4.13 ± 0.17 fw mmol/kg to 11.02 ± 0.45 mmol/kg fw for integrated rocket. The characteristics of wild rocket as a dietary source of antioxidants have been pointed out. Significant differences in the quality of conventional and integrated rocket have been shown, while no influence of agronomic practice on biological activity was reported. A significant accumulation of cells in G1 phase and a consequent reduction in the S and G2 + M phases were observed in Caco-2 cells treated with rocket polyphenol extract.

Lettuce belongs to the Asteraceae family and it is native of the Mediterranean region. In our research, the effect of cultivation practices (organic versus conventional) on antioxidants in Italian head lettuce (Lactuca sativa var. capitata L.) grown in greenhouse was investigated. Bioactive molecule levels, antioxidant properties and the cytotoxicity of polyphenolic extracts from the edible part of head lettuce in Caco-2 cells were determined. FRAP values are 5.33 ± 0.35 and 6.35 ± 0.08 mmol/kg in organic products and 4.83 ± 0.16 and 1.80 ± 0.04 mmol/kg in conventional products. FRAP values differ significantly (P

Background and aim A complex relationship between immune system and metabolic pathway exists and can induce oxidative stress. The objective of this study was to design a new methodology allowing the measurement of oxidative status of leukocytes. Methods and results We developed a flow cytometry technique, based on C11-BODIPY 581/591 staining, to evaluate peroxidation in leukocytes. We defined the Peroxidation of Leukocytes Index Ratio (PLIR) as the ratio between the damage after AAPH-induced and PMA-induced peroxidation, using Trolox as standard antioxidant. Sensitivity of the method was assessed by correlating results with plasma antioxidant capacity (TRAP and FRAP), levels of endogenous antioxidants (uric acid and sulfhydryls) and markers of metabolic status (cholesterol, triglycerides, glucose and insulin). PLIR measures the ratio between the resistance to exogenous and endogenous ROS injury, independently from baseline level of oxidation, which was directly correlated with plasma cholesterol on lymphocytes (0.738, p = 0.029), monocytes (0.691, p = 0.047) and neutrophils (0.690, p = 0.047). PLIR of lymphocytes was inversely correlated with uric acid (− 0.810, p = 0.009) and FRAP (− 0.738, p = 0.029) levels. On the other hand, PLIR of monocytes was directly correlated with the total scavenger antioxidant capacity attributable to nutritional antioxidants (0.738, p = 0.029), calculated as the difference between TRAP and the contribution of uric acid and sulfhydryls to its value. Conclusions This study reports a feasible and reproducible new flow cytometry assay for assessing the leukocytes redox status. PLIR discriminates between reducing and scavenger activities and is able to appreciate the potentially dangerous effect of uric acid on innate immune response.

In this study, we have explored the relationship between the cultivation method and the concentration of major flavonoid aglycones, hydroxycinnamic acids, carotenoids and the total antioxidant activity of tomato (Lycopersicon esculentum cv Perfectpeel); in addition, we have investigated the bioactivity of polyphenol extracts from tomato. The main polyphenols in extracts were quercetin (33.90 ± 6.31 mg kg -1 and 17.92 ± 1.09 mg kg -1 in conventional and organic extracts), chlorogenic acid (3.52 ± 0.74 mg kg -1 and 2.82 ± 0.92 mg kg -1 in conventional and organic extracts) and caffeic acid (3.61 ± 0.71 mg kg -1 and 3.29 ± 0.33 mg kg -1 in conventional and organic extracts). Although statistical differences were found between organic and conventional extracts in several target compounds, no difference in biological effect was observed using cell models. The observed Trans Epithelial Electrical Resistance values were not significantly different between organic and conventional tomato extracts, but we have observed, in both samples, a decrease in tight-junction permeability at 17 μM of polyphenol concentrations. Antioxidant compounds entering within the cell could exert an antioxidant action, nevertheless at concentrations > 17 μM could have a pro-oxidant effect.

Overweight and obesity are associated with low grade of inflammation and chronic inflammatory response characterized by abnormal production and activation of some pro-inflammatory signalling pathways. Taking into account that obesity is the direct result of an imbalance between energy intake and energy expenditure, the nutritional factors in the diet, with particular focus on zinc, may play a pivotal role in the development of obesity-associated comorbidities. Considering the potential interactions among zinc nutritional status, inflammation, overweight/obesity and insulin secretion, the aim of the present work was to clarify the influence of zinc dietary intake on some metabolic, inflammatory and zinc status parameters in adult overweight/obese subjects. We found a close interrelationship between nutritional zinc and obesity. In particular, subjects with a lower zinc dietary intake display a deeper inflammatory status, general impairment of the zinc status, an altered lipid profile and increased insulin production with respect to obese subjects with normal zinc dietary intake. Moreover, in the presence of low dietary zinc intake, the obese subjects are less capable to respond to oxidative stress and to inflammation leading to the development of obesity or to a worsening of already preexisting obesity status. In conclusion, a possible zinc supplementation in obese subjects with a deeper inflammatory status and more altered zinc profile may be suggested in order to limit or reduce the inflammation, taking also into account that zinc supplementation normalizes "inflammaging" as well as zinc profile leading to a correct intra- and extracellular zinc homeostasis.

In this study the antioxidant composition of fresh and stored strawberries and the bioavailability of the main strawberry bioactive compounds were determined in humans. In addition we have investigated plasma total antioxidant capacity. On 13 healthy volunteers, blood samples were collected before and after acute ingestion of fresh and stored strawberries, 300g respectively. Ferric Reducing Antioxidant Power (FRAP) values after consumption of fresh and stored strawberries showed a significant increase (P < 0.05) at 5 and 8 hours time interval, while significantly decreased TRAP (Total Radical-Trapping Antioxidant Parameter) values (P < 0.05) were found at 8 hours respect to baseline after stored strawberries consumption. After consuming fresh strawberries, plasma levels of α-carotene increased significantly (P < 0.05) respect to stored ones. Moreover, consumption of fresh and stored strawberries resulted in a significant increase of vitamin C at 2, 3 and 5 hours (P < 0.05). The bioavailable amount of strawberries antioxidant compounds reflects the variations observed in fresh and stored fruits. We could summarize that the global food quality is related to both native quantity of bioactive compounds and storage treatments.

Total Antioxidant Capacity (TAC) is a biomarker often used in order to investigate oxidative stress in many pathological conditions. Saliva and urine can be collected noninvasively and represent attractive diagnostic fluids for detecting biomarkers of various pathological conditions. The reviewed case-control and intervention studies that measured salivary or urinary TAC revealed that diseases, antioxidant foods, or supplements and age, gender, and lifestyle factors influenced salivary or urinary TAC. Salivary and urinary TAC were particularly affected by oral or renal status, respectively, as well as by infection; therefore these factors must be taken into account in both case-control and intervention studies. Furthermore, some considerations on sample collection and normalization strategies could be made. In particular, unstimulated saliva could be the better approach to measure salivary TAC, whereas 24 h or spontaneous urine collection should be chosen on the basis of the study outcome and of the creatinine clearance. Finally, the uric acid-independent TAC could be the better approach to evaluate red-ox status of body, in particular after nutritional interventions and in diseases associated with hyperuricaemia.

To report selected dietary intake and vitamin status at baseline of volunteers participating in the ZENITH study and the correlation of vitamin status with zinc.A multicentre prospective intervention study employing a randomised double-blind design.Clermont-Ferrand, Theix (France), Coleraine (Northern Ireland), Grenoble (France), Rome (Italy).In total, 387 healthy middle-aged (55-70 y) and older (70-87 y) men and women participated in the study.Dietary intake was assessed by means of a validated 4-d recall record. Fasting blood samples were simultaneously analysed for retinol and alpha-tocopherol by the HLPC method. Erythrocyte folates were measured by a competitive immunoassay with direct chemiluminescence detection on an automatised immunoanalyser.In all centres, men had a significantly (P0.0001) higher mean nutrient intake than women. Comparison between age-groups showed that older individuals had significantly lower intakes of macro- and selected micronutrients than middle-aged subjects (P0.0001). A high fat intake (from 36 to 40% of total energy) was observed in all examined groups. In relation to biochemical measures of vitamin status, all parameters were above their respective cut-off values for normality and, thus, none of the subjects had biochemical evidence of deficiency of these selected vitamins. A moderate correlation was found with plasma vitamin A and serum zinc (r = 0.12, P0.05) or red blood cell zinc (r = 0.12, P0.01) and with erythrocyte folates and red blood cell zinc (r = 0.11, P0.05).There were only moderate differences in the nutrient intake of the ZENITH study volunteers among the four European centres. Their biochemical status for retinol, alpha-tocopherol and folate appeared adequate.

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, PPPPPPPPPPin 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.

Postprandial stress induced by acute consumption of meals with a high fat content results in an increase of markers of cardiometabolic risk. Repeated acute dietary stress may induce a persistent low-grade inflammation, playing a role in the pathogenesis of functional gut diseases. This may cause an impairment of the complex immune response of the gastrointestinal mucosa, which results in a breakdown of oral tolerance. We investigated the effect of ingestion of a fruit-juice drink (FJD) composed by multiple fruit juice and extracts, green tea extracts and vitamin C on postprandial stress induced by a High Fat Meal (HFM) in healthy overweight subjects. Following a double blind, placebo controlled, cross-over design, 15 healthy overweight subjects were randomized to a HFM providing 1334 Kcal (55% fat, 30% carbohydrates and 15% proteins) in combination with 500 mL of a placebo drink (HFM-P) or a fruit-juice drink (HFM-FJD). Ingestion of HFM-P led to an increase in circulating levels of cholesterol, triglycerides, glucose, insulin, TNF-α and IL-6. Ingestion of HFM-FJD significantly reduced plasma levels of cholesterol and triglycerides, decreasing inflammatory response mediated by TNF-α and IL-6. Ingestion of a fruit-juice drink reduce markers of postprandial stress induced by a HFM.

Epidemiological or in vitro evidence suggests a potential role for flavonoids as anti-inflammatory agents; we investigated the effect of flavonoids-rich foods or supplements on tumor necrosis factor- alpha (TNF-α) and interleukin-6 (IL-6) in long-term placebo-controlled human intervention trials. From 110 human intervention studies selected (MEDLINE, EMBASE, CHORANE, and FSTA databases), 32 long-term placebo-controlled trials were suitable for meta-analysis. After sensitivity analysis, seven studies imputed of bias were excluded and 25 studies were analyzed (TNF-α, n = 2404; IL-6, n = 2174). Levels of TNF-α decreased after flavonoid consumption in the fixed model only (mean difference (MD) (95% CI): -0.098 (-0.188, -0.009), p = 0.032), but metaregression results showed that neither higher dose, nor a longer duration of intervention were associated with a greater effect size. Subgroup analysis did not reveal any significant effect for quercetin and soy, but other sources (red wine, pomegranate, and tea extracts) showed a significant effect size both in fixed (MD (95% CI): TNF-α -0.449 (-0.619, -0.280), p < 0.001; IL-6 -0.346 (-0.612, -0.079), p = 0.011) and random (MD (95% CI): TNF-α -0.783 (-1.476, -0.090), p = 0.027; IL-6, -0.556 (-1.062, -0.050), p = 0.031) effect models. High-quality placebo-controlled trials are needed in order to identify flavonoids as the active ingredients.

It has been suggested that flavonoids, secondary metabolites widely present in the vegetable kingdom, are involved in the role played by plant foods in disease prevention. The immune-modulating action of flavonoids in vitro suggests a specific role in modulating cytokines and transcription factors such as nuclear factor kappa B (NFκB). However, the majority of studies have been conducted with non-physiological concentrations of flavonoids and without considering the nature of the metabolites found in the bloodstream. In humans, the number of studies is limited and the results are contrasting, leaving open the debate about the role of flavonoids as modulators of immune response.

This descriptive, cross-sectional study reports the anti-oxidant activities of a population sample of 736 individuals, randomly selected from residents of two small towns of the Latina province of Italy (an area at low frequency of cancer). The circulating levels of vitamins A, C and E, ceruloplasmin, carotenoids (lutein + zeaxanthin, lycopene, alpha- and beta-carotene, cryptoxanthin), cholesterol, high-density lipoprotein cholesterol and triglycerides, as well as anthropometric measurements (skin-folds, height, weight) were evaluated. A dietary interview was also performed by means of a semi-quantitative questionnaire. All the anti-oxidants were above the cut-off points for normality, whereas body mass index, % fat and serum lipids were not clearly suggestive of a protected population. The data obtained could be useful to estimate the baseline values of protective microelements and to assess dietary profiles in populations following a Mediterranean diet.

The urinary excretion of endogenous creatinine (CRTN) and 3-methylhistidine (3-MH) has been proposed as a predictor of fat-free mass (FFM) in healthy subjects. In this study, we report the relationship between FFM, estimated by densitometry plus deuterium dilution, and daily urinary excretion of CRTN and 3-MH in a sample of 20 healthy adult subjects of both sexes. 3-MH and CRTN were measured in 2 days of urine collection, which followed 4 days of meat-free diet. Meat-free diet was maintained throughout the period of urine collection. The mean of 2 days of excretion of 3-MH was 237.7 +/- 87.3 (SD) and 138.9 +/- 31.2 mumol/day in men and women, respectively. The mean CRTN excretion was 1.51 +/- 0.22 and 0.98 +/- 0.15 g/day in men and women, respectively. CRTN excretion was found well associated with FFM (R2 = 0.89; P < 0.0001), whereas 3-MH was lightly associated with FFM (R2 = 0.33; P < 0.01). Residuals from the regression of 3-MH vs. FFM were found to be correlated with CRTN excretion and FFM (R2 = 0.57 and 0.67, respectively), suggesting that muscularity and the absolute amount of lean mass are relevant for the error in predicting FFM from 3-MH excretion. Data confirm that urinary CRTN excretion can be an expedient indirect method for evaluating body composition in healthy adult subjects. Data also suggest that the relationship between 3-MH and FFM is complex, limiting the possibility of predicting body composition from the excretion of this metabolite.

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 β-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.

An emerging role of IL-17 in the inflammatory response associated with pathogenesis of neurodegeneration has been recently suggested. However, though diet represents a key factor in the modulation of inflammatory processes, evidence is not currently available on the nutritional regulation of IL-17 in humans. In a double blind, randomized, placebo controlled, crossover study, we investigated the effect of High Fat Meal (HFM) on IL-17 circulating levels in presence of a placebo (HFM-P) or with a Fruit Juice Drink (HFM-FJD) composed of pineapple, blackcurrant and plum in fourteen healthy overweight humans. Fasting in the morning subjects ingested a test meal providing 1344 Kcal. Ingestion of HFM-P induced an inflammatory response mediated by TNF-α (p < 0.001), IL-6 (p < 0.001) and IL-17 (p < 0.01). Plasma IL-17 concentration significantly increased at 1 h (+2.6 ± 1.1 pg/ml), remaining high at 4 h (+2.98 ± 1.2 pg/ml), 6 h (+2.38 ± 0.6 pg/ml) and 8 h (+2.8 ± 0.9 pg/ml) (ANOVA for time-course p=0.009). When the HFM was consumed in the presence of the FJD a marked inhibition of IL-17 response to the HFM was observed (ANOVA between treatment p=0.037). We provided, for the first time, evidence on the role of diet in modulating IL-17 production in healthy overweight subjects.

International audience; 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.

The aim of the study was to assess the effect of drinking rooibos tea (Aspalathus linearis) on total antioxidant capacity (TAC), lipid triacylglycerols, cholesterol and glycaemia plasma levels in humans. In vitro, unfermented rooibos tea displayed a 28% higher value of TRAP than did the fermented beverage. An acute intervention study, cross-over design, was performed, with 15 healthy volunteers who consumed 500ml of either water, unfermented or fermented rooibos teas. Plasma antioxidant capacity increased significantly with both teas, reaching a peak at 1h post-consumption (+6.6%, p

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 concentrationsv.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

To assess the effects of zinc supplementation on vitamin status in middle-aged and older volunteers.Three hundred and eighty-seven healthy middle-aged (55-70 years) and older (70-85 years) men and women, randomly allocated to three groups to receive 15 or 30 mg Zn/day or placebo for 6 months. Dietary intake was assessed by means of a validated 4-day recall record. Fasting blood samples were simultaneously analysed for levels of plasma retinol and alpha-tocopherol by high-performance liquid chromatography. Erythrocyte folates were measured by a competitive immunoassay with direct chemiluminescence detection on an automatized immunoanalyser. Biochemical measurements were performed at baseline and after 3 and 6 months of zinc supplementation.Plasma vitamin A levels were significantly increased proportionally with zinc dose and period of treatment, particularly at 6 months (for 15 mg Zn/day, P0.05; for 30 mg Zn/day, P0.0001); no significant changes were observed in the placebo group. There was no effect of zinc supplementation on vitamin E/cholesterol ratio and erythrocyte folates.Our results show that a long-term zinc supplementation increases plasma vitamin A levels in middle-aged and older people of similar characteristics to those involved in this study. Moreover, supplementation influences serum zinc levels but does not affect erythrocyte zinc concentration and both plasma vitamin E and erythrocyte folate status.