Oxidative DNA damage in humans: comparison between high and low habitual fruit and vegetable consumption

We investigated whether men with a habitual high consumption of vegetables and fruit have a lower excretion of 8 oxo 7,8 dihydro 2 deoxyguanosine 8 oxodG , a urinary marker for oxidative DNA damage, than men with a low consumption of vegetables and fruit. Ten pairs of healthy non smoking males aged between 28 and 59 years, matched for age 10 years and body mass index 2 kg m 2 were selected from a dietary validation study. Habitual food intake was estimated with 12 monthly 24 h recalls. Men in the high vegetable and fruit group consumed an average of 224 g day 1 range 101-330 g day 1 more vegetables and fruit than men in the low vegetable and fruit group. Excretion of 8 oxodG was 95 pmol kg 1 day 1 95 CI-29, 219 higher in the high vegetable and fruit group than in the low vegetable and fruit group paired t test, P = 0.11 . Excretion of 8 oxodG was not correlated with intake of vitamins, energy, fat, nor with blood concentrations of antioxidant pro vitamins, but it was inversely correlated with age. The present findings do not suggest that humans with a habitual high fruit and vegetables consumption have less oxidative DNA damage as measured by 8 oxodG excretion than men with low consumption of fruit and vegetables.     

Randomised controlled trial of effect of fruit and vegetable consumption on plasma concentrations of lipids and antioxidants.

OBJECTIVES: To determine the extent to which plasma antioxidant concentrations in people with habitual low intake of fruit and vegetables respond to increased intakes of these foods. To examine whether advice to increase fruit and vegetables will result in reduction of concentrations of total and low density lipoprotein cholesterol. DESIGN: Randomised controlled trial in which intervention and control groups were followed up for eight weeks. The intervention group was asked to consume eight servings of fruit and vegetables a day. SETTING: Dunedin, New Zealand. SUBJECTS: Eighty seven subjects with normal lipid concentrations who ate three or fewer servings of fruit and vegetables daily. MAIN OUTCOME MEASURES: Plasma concentrations of vitamin C, retinol, alpha and beta carotene, alpha tocopherol, lipids, and lipoproteins. Dietary intake assessed with diet records over four days. RESULTS: The mean plasma vitamin C, alpha carotene, and beta carotene concentrations increased in parallel with increased dietary intake of fruit and vegetables in the intervention group. Concentrations of retinol, alpha tocopherol, lipids, and lipoproteins remained unchanged despite some increase in dietary vitamin E and a small reduction in saturated fat intake. CONCLUSIONS: Following a recommendation to increase fruit and vegetable consumption produces change in plasma concentrations of vitamin C, alpha carotene, and beta carotene likely to reduce incidence of cancer. More specific dietary advice to modify fat intake may be necessary to reduce the risk of cardiovascular disease mediated by lipoprotein and vitamin E.     

Cognition and Indicators of Dietary Habits in Older Adults from Southern Brazil

Objective

To assess the association between unhealthy dietary habits and cognition in older adults from Southern Brazil.

Methods

This cross-sectional study analyzed data from the second wave of a population- and household-based epidemiological survey (2013–2014) conducted in the city of Florianópolis. A total of 1,197 older adults (778 women) over 60 years old participated in the study. Cognition, the dependent variable, was measured by the Mini-Mental State Examination (MMSE). The independent variables were the following indicators of unhealthy dietary habits: low intake of fruits and vegetables (≤ 4 servings/day); fish (< 1 serving/week); and habitual fatty meat intake (yes/no). Adjustments were made for age, education level, income, smoking status, alcohol intake, leisure-time physical activity, depression symptoms, chronic diseases, and body mass index. Simple and multiple linear regression analyses were performed, considering sampling weights and stratification by gender.

Results

The mean MMSE scores for men and women were 25.15 ± 5.56 and 24.26 ± 5.68, respectively (p = 0.009). After adjustments, in women low fruit and vegetable intake (≤ 4 servings/day) was independently associated with the lowest MMSE scores. No associations were found in men. Additionally, women’s mean MMSE scores increased as their daily frequency of fruit and vegetable intake increased (p = 0.001).

Conclusion

Women with low fruit and vegetable intake according to the World Health Organization (WHO) have lower cognition scores. Regular intake of fruits, vegetables, and fish in exchange of fatty meats may be a viable public policy strategy to preserve cognition in aging.     

Raw and processed fruit and vegetable consumption and 10-year coronary heart disease incidence in a population-based cohort study in the Netherlands

Background

Prospective cohort studies have shown that high fruit and vegetable consumption is inversely associated with coronary heart disease (CHD). Whether food processing affects this association is unknown. Therefore, we quantified the association of fruit and vegetable consumption with 10-year CHD incidence in a population-based study in the Netherlands and the effect of processing on these associations.

Methods

Prospective population-based cohort study, including 20,069 men and women aged 20 to 65 years, enrolled between 1993 and 1997 and free of cardiovascular disease at baseline. Diet was assessed using a validated 178-item food frequency questionnaire. Hazard ratios (HR) were calculated for CHD incidence using multivariable Cox proportional hazards models.

Results

During a mean follow-up time of 10.5y, 245 incident cases of CHD were documented, which comprised 211 non-fatal acute myocardial infarctions and 34 fatal CHD events. The risk of CHD incidence was 34% lower for participants with a high intake of total fruit and vegetables (>475 g/d; HR: 0.66; 95% CI: 0.45–0.99) compared to participants with a low total fruit and vegetable consumption (≤241 g/d). Intake of raw fruit and vegetables (>262 g/d vs ≤92 g/d; HR: 0.70; 95% CI: 0.47–1.04) as well as processed fruit and vegetables (>234 g/d vs ≤113 g/d; HR: 0.79; 95% CI: 0.54–1.16) were inversely related with CHD incidence.

Conclusion

Higher consumption of fruit and vegetables, whether consumed raw or processed, may protect against CHD incidence.     

Intake of fruits and vegetables,and risk of endometrial cancer in the NIH-AARP Diet and Health Study

Background: Fruits and vegetables contain a wide variety of phytochemicals which may have anti-carcinogenic effects. Although the results of case–control studies have suggested a possible protective effect of fruit and vegetable intake on the risk of endometrial carcinoma, few cohort studies have examined this association. Materials and methods: We used data from the NIH-AARP Diet and Health Study to assess the association of fruit and vegetable consumption, as well as intake of specific botanical groupings of fruits and vegetables, with endometrial cancer risk among 112,088 women who completed a food-frequency questionnaire at baseline, in 1995–1996. During 8 years of follow-up 1142 incident cases of endometrial cancer were ascertained. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results: After adjustment for covariates, HRs for the highest compared to the lowest quintile of total fruit and total vegetable intake were 1.30 (95% CI 1.04–1.61, P for trend 0.05) and 1.09 (95% CI 0.90–1.33, P for trend 0.55), respectively. No inverse associations were observed for intake of any of 13 botanical groupings of fruits and vegetables. Conclusions: Results from this large prospective study do not support a protective role of a high intake of fruits or vegetables on the risk of endometrial cancer in older women.     

Fruit and Vegetable Consumption and Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Background

Randomized controlled trials provide conflicting results on the effects of increased fruit and vegetable consumption on changes in body weight. We aimed to perform a systematic review and meta-analysis of prospective cohort studies on fruit and vegetable consumption in relation to changes in anthropometric measures.

Methods

PubMed and EMBASE were searched up to July 2015 for prospective studies reporting on habitual fruit and/or vegetable consumption in relation to changes in body weight or waist circumference or to risk of weight gain/overweight/obesity in adults. Random-effects meta-analysis was applied to pool results across studies.

Findings

Seventeen cohort studies (from 20 reports) including 563,277 participants met our inclusion criteria. Higher intake of fruits was inversely associated with weight change (decrease) (beta-coefficient per 100-g increment, -13.68 g/year; 95% CI, -22.97 to -4.40). No significant changes could be observed for combined fruit and vegetable consumption or vegetable consumption. Increased intake of fruits was inversely associated with changes (decrease) in waist circumference (beta: -0.04 cm/year; 95% CI, -0.05 to -0.02). Comparing the highest combined fruit & vegetable, fruit, and vegetable intake categories were associated with a 9%, 17%, and 17% reduced risk of adiposity (odds ratio [OR]: 0.91, 95% CI, 0.84 to 0.99), (OR: 0.83, 95% CI, 0.71 to 0.99), and (OR: 0.83, 95% CI, 0.70 to 0.99), respectively.

Conclusion

This meta-analysis showed several inverse associations between fruit and vegetable intake and prospective improvements in anthropometric parameters, and risk of adiposity. The present meta-analysis seems to be limited by low study quality. Nevertheless, when combined with evolutionary nutrition and epidemiological modeling studies, these findings have public health relevance and support all initiatives to increase fruit and vegetable intake.     

Products of DNA, protein and lipid oxidative damage in relation to vitamin C plasma concentration

Oxidative stress plays an important role in the pathogenesis of numerous chronic age-related free radical-induced diseases. Improved antioxidant status minimizes oxidative damage to DNA, proteins, lipids and other biomolecules. Diet-derived antioxidants such as vitamin C, vitamin E, carotenoids and related plant pigments are important in antioxidative defense and maintaining health. The results of long-term epidemiological and clinical studies suggest that protective vitamin C plasma concentration for minimum risk of free radical disease is higher than 50 micromol/l. Products of oxidative damage to DNA (DNA strand breaks with oxidized purines and pyrimidines), proteins (carbonyls) and lipids (conjugated dienes of fatty acids, malondialdehyde) were estimated in a group of apparently healthy adult non-smoking population in dependence on different vitamin C plasma concentrations. Under conditions of protective plasma vitamin C concentrations (>50 micromol/l) significantly lower values of DNA, protein and lipid oxidative damage were found in comparison with the vitamin C-deficient group (<50 micromol/l). The inhibitory effect of higher fruit and vegetable consumption (leading to higher vitamin C intake and higher vitamin C plasma concentrations) on oxidation of DNA, proteins and lipids is also expressed by an inverse significant correlation between plasma vitamin C and products of oxidative damage. The results suggest an important role of higher and frequent consumption of protective food (fruit, vegetables, vegetable oils, nuts, seeds and cereal grains) in prevention of free radical disease.     

Behavioural counselling to increase consumption of fruit and vegetables in low income adults: randomised trial

ObjectiveTo measure the effect of brief behavioural counselling in general practice on patients'' consumption of fruit and vegetables in adults from a low income population.DesignParallel group randomised controlled trial.SettingPrimary health centre in a deprived, ethnically mixed inner city area.Participants271 patients aged 18-70 years without serious illness.InterventionBrief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling.ResultsConsumption of fruit and vegetables increased from baseline to 12 months by 1.5 and 0.9 portions per day in the behavioural and nutrition groups (mean difference 0.6 portions, 95% confidence interval 0.1 to 1.1). The proportion of participants eating five or more portions a day increased by 42% and 27% in the two groups (mean difference 15%, 3% to 28%). Plasma β carotene and α tocopherol concentrations increased in both groups, but the rise in β carotene was greater in the behavioural group (mean difference 0.16 μmol/l, 0.001 μmol/l to 1.34 μmol/l). There were no changes in plasma ascorbic acid concentrations or urinary potassium excretion. Differences were maintained when analysis was restricted to the 177 participants with incomes ≤£400 (€596, $640) a week.ConclusionsBrief individual counselling in primary care can elicit sustained increases in consumption of fruit and vegetables in low income adults in the general population.

What is already known on this topic

Brief interventions can be effective in increasing consumption of fruit and vegetablesBiomarkers and intention to treat analyses have seldom been used in such interventions, and few studies have targeted low income populations

What this study adds

Compared with nutritional counselling, brief behavioural counselling carried out by nurses in primary care led to greater increases in fruit and vegetable intake and in plasma β carotene concentrationFavourable effects were observed in low income adults living in a deprived inner city area     

Supplementation with a combination of antioxidants does not affect glycaemic control, oxidative stress or inflammation in type 2 diabetes subjects

The present clinical trial examined the influence of a supplement, containing a combination of antioxidants extracted from fruit, berries and vegetables, on levels of plasma antioxidants (tocopherols, carotenoids and ascorbate), glycaemic control (blood glucose, HbA1c, insulin), oxidative stress biomarkers (F(2)-isoprostane, malondialdehyd, nitrotyrosine, 8-oxo-7, 8-dihydro-2'-deoxyguanosine, formamidopyrimidine glycosylase sites, frequency of micronucleated erythrocytes) and inflammatory markers (interleukin-6, C-reactive protein, prostaglandin F(2α)-metabolite) in type 2 diabetes. Forty subjects were randomly assigned to control, single or double dose group and completed the study. In summary, 12 weeks of antioxidant supplementation did neither affect glycaemic control nor the levels of biomarkers of oxidative stress or inflammation, despite substantially increased plasma concentrations of antioxidants. The absence of an effect may be explained by the selected study subjects with relatively well-controlled diabetes, a high intake of fruit and vegetable and levels of plasma antioxidants, biomarkers of oxidative stress and inflammatory markers comparable to those found in healthy subjects.     

Lowering of oxidative stress improves endothelial function in healthy subjects with habitually low intake of fruit and vegetables: A randomized controlled trial of antioxidant- and polyphenol-rich blackcurrant juice

Inadequate intake of the recommended five-a-day fruit and vegetable portions might contribute to increased cardiovascular disease risk. We assessed the effects of dietary intake of a blackcurrant juice drink, rich in vitamin C and polyphenols, on oxidative stress and vascular function. This was a double-blind, placebo-controlled, parallel group study of 66 healthy adults who habitually consume <2 portions of fruit and vegetables per day. Participants were randomly allocated to consume 250 ml of placebo (flavored water) or low or high blackcurrant juice drink four times a day for 6 weeks. Flow-mediated dilation (FMD) and plasma concentrations of F₂-isoprostanes and vitamin C were measured. In the high blackcurrant juice drink group FMD increased significantly (5.8±3.1 to 6.9±3.1%, P=0.022) compared with the placebo group (6.0±2.2 to 5.1±2.4%). Plasma vitamin C concentration increased significantly in the low (38.6±17.6 to 49.4±21.0 µmol/L, P<0.001) and high (34.6±20.4 to 73.8±23.3 µmol/L, P<0.001) blackcurrant juice drink groups compared with the placebo group (38.1±21.0 to 29.0±17.6 µmol/L). F₂-isoprostane concentrations were significantly lower in the high blackcurrant juice drink group (225±64 pg/ml) compared with the low blackcurrant juice drink (257±69 pg/ml, P=0.002) and placebo group (254±59 pg/ml, P=0.003). At follow-up, changes in plasma vitamin C correlated significantly with changes in FMD (r=0.308, P=0.044). Consumption of blackcurrant juice drink high in vitamin C and polyphenols can decrease oxidative stress and improve vascular health in individuals with habitually low dietary fruit and vegetable intake.     

Increasing Fruit and Vegetable Intake and Decreasing Fat and Sugar Intake in Families at Risk for Childhood Obesity

Objective: The goal of this study was to evaluate the effect of a parent‐focused behavioral intervention on parent and child eating changes and on percentage of overweight changes in families that contain at least one obese parent and a non‐obese child. Research Methods and Procedures: Families with obese parents and non‐obese children were randomized to groups in which parents were provided a comprehensive behavioral weight‐control program and were encouraged to increase fruit and vegetable intake or decrease intake of high‐fat/high‐sugar foods. Child materials targeted the same dietary changes as their parents without caloric restriction. Results: Changes over 1 year showed that treatment influenced targeted parent and child fruit and vegetable intake and high‐fat/high‐sugar intake, with the Increase Fruit and Vegetable group also decreasing their consumption of high‐fat/high‐sugar foods. Parents in the increased fruit and vegetable group showed significantly greater decreases in percentage of overweight than parents in the decreased high‐fat/high‐sugar group. Discussion: These results suggest that focusing on increasing intake of healthy foods may be a useful approach for nutritional change in obese parents and their children.     

Intake of fruits and vegetables in relation to 10-year weight gain among Spanish adults

Objective: Despite the alarming increase in the prevalence of obesity, epidemiologic studies that prospectively examine the fruit and vegetable consumption and other lifestyle factors in relation to weight gain (WG) are still insufficient. We explored the associations between fruit and vegetable intake and WG over a 10‐year period in an adult Mediterranean population. Methods and Procedures: We performed a 10‐year follow‐up study with healthy participants (n = 206) aged 15–80 years at baseline in 1994, who participated in a nutrition survey in Valencia, Spain. Data on diet, lifestyle factors, and body weight were obtained in 1994 and 2004 using a food frequency questionnaire (FFQ) and direct measurements. Results: The average WG over the study period was 3.41 (s.d. 6.9) kg. In multivariate analyses, participants in the third quartile of fruit intake at baseline in 1994 had lower risk of WG ≥ 3.41 kg compared to those in the lowest quartile (oddsratio (OR) = 0.31, 95% confidence interval (CI), 0.11–0.85; P trend = 0.044). Regarding vegetable intake, the risk of WG was lowest in participants of the fourth quartile (>333 g/day), which had an 84% reduced risk of gaining 3.41 kg weight (OR = 0.18, 95% CI, 0.05–0.66; P trend = 0.017). When the intake of fruits and vegetables was combined, the risk of WG decreased across quartiles, with the lowest risk among those in the fourth quartile (OR = 0.22, 95% CI, 0.06–0.81; P trend = 0.022). Further adjustment for an increased intake of fruits and vegetables over the past 10 years reported by participants in 2004 did not appreciably alter the observed ORs. Discussion: Dietary patterns associated with a high intake of fruits and vegetables in Mediterranean populations may reduce long‐term risk of subsequent WG and obesity among adults.     

Effect of ascorbic acid and green tea on endogenous formation of N-nitrosodimethylamine and N-nitrosopiperidine in humans.

Many constituents present in the human diet may inhibit endogenous formation of N-nitroso compounds (NOC). Studies with human volunteers showed inhibiting effects of intake of ascorbic acid and green tea consumption on nitrosation using the N-nitrosoproline test. The aim of the present study was to evaluate the effects of ascorbic acid and green tea on urinary excretion of carcinogenic N-nitrosodimethylamine (NDMA) and N-nitrosopiperidine (NPIP) in humans. Twenty-five healthy female volunteers consumed a fish meal rich in amines as nitrosatable precursors in combination with intake of nitrate-containing drinking water at the Acceptable Daily Intake level during 7 consecutive days. During 1 week before and after nitrate intake a diet low in nitrate was consumed. Using the same protocol, the effect of two different doses of ascorbic acid (250 mg and 1 g/day) and two different doses of green tea (2 g and 4 g/day) on formation of NDMA and NPIP was studied. Mean nitrate excretion in urine significantly increased from control (76+/-24) to 167+/-25 mg/24 h. Intake of nitrate and fish resulted in a significant increase in mean urinary excretion of NDMA compared with the control weeks: 871+/-430 and 640+/-277 ng/24 h during days 1-3 and 4-7, respectively, compared with 385+/-196 ng/24 h (p<0.0002). Excretion of NPIP in urine was not related to nitrate intake and composition of the diet. Intake of 250 mg and 1 g of ascorbic acid per day resulted in a significant decrease in urinary NDMA excretion during days 4-7 (p=0.0001), but not during days 1-3. Also, consumption of four cups of green tea per day (2 g) significantly decreased excretion of NDMA during days 4-7 (p=0.0035), but not during days 1-3. Surprisingly, consumption of eight cups of green tea per day (4 g) significantly increased NDMA excretion during days 4-7 (p=0.0001), again not during days 1-3. This increase is probably a result of catalytic effects of tea polyphenols on nitrosation, or of another, yet unknown, mechanism. These results suggest that intake of ascorbic acid and moderate consumption of green tea can reduce endogenous NDMA formation.     

Attributable causes of esophageal cancer incidence and mortality in china

Background

To estimate the contribution of tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake to esophageal cancer mortality and incidence in China.

Methodology/Principal Findings

We calculated the proportion of esophageal cancer attributable to four known modifiable risk factors [population attributable fraction (PAF)]. Exposure data was taken from meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were also from meta-analyses and large-scale prospective studies. Esophageal cancer mortality and incidence came from the 3^rd national death cause survey and population-based cancer registries in China. We estimated that 87,065 esophageal cancer deaths (men 67,686; women: 19,379) and 108,206 cases (men: 83,968, women: 24,238) were attributable to tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake in China in 2005. About 17.9% of esophageal cancer deaths among men and 1.9% among women were attributable to tobacco smoking. About 15.2% of esophageal cancer deaths in men and 1.3% in women were caused by alcohol drinking. Low vegetable intake was responsible for 4.3% esophageal cancer deaths in men and 4.1% in women. The fraction of esophageal cancer deaths attributable to low fruit intake was 27.1% in men and 28.0% in women. Overall, 46% of esophageal cancers (51% in men and 33% in women) were attributable to these four modifiable risk factors.

Conclusions/Significance

Tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake were responsible for 46% of esophageal cancer mortality and incidence in China in 2005. These findings provide useful data for developing guidelines for esophageal cancer prevention and control in China.     

Health Risk Assessment of Heavy Metals in Soils and Vegetables from a Typical Greenhouse Vegetable Production System in China

There is growing concern about food safety and environmental contamination due to potential health risks to consumers. The aims of this study are to elucidate the accumulation status, influencing factors, and potential risk of selected heavy metals in soils and vegetables from a typical greenhouse vegetable production system in China. The potential health risks of heavy metals through soil contact and vegetable consumption were evaluated for greenhouse and corresponding open field production. The results indicated that the mean concentrations of Hg, Pb, Cu, and Zn in greenhouse vegetable soils were greater than those in open field soils. Leaf vegetables had relatively higher concentrations and transfer factors of heavy metals than root and fruit vegetables, especially for Cd. The target hazard quotient of heavy metals through vegetable consumption was greater than 1 for leaf vegetables, and was also higher for greenhouse vegetables than those from open field. The risk of exposure to heavy metals through direct contact with soil and vegetable consumption was higher for children than for adults and seniors. Planting patterns with different vegetable types and soil properties can affect bioavailability and crop accumulation of heavy metals.     

Urinary excretion of 8-oxo-7,8-dihydroguanine as biomarker of oxidative damage to DNA

Oxidatively damaged DNA may be important in carcinogenesis. 8-Oxo-7,8-dihydroguanine (8-oxoGua) is an abundant and mutagenic lesion excised by oxoguanine DNA glycosylase 1 (OGG1) and measurable in urine or plasma by chromatographic methods with electrochemical or mass spectrometric detectors, reflecting the rate of damage in steady state. A common genetic OGG1 variant may affect the activity and was associated with increased levels of oxidized purines in leukocytes without apparent effect on 8-oxoGua excretion or major change in cancer risk. 8-OxoGua excretion has been associated with exposure to air pollution, toxic metals, tobacco smoke and low plasma antioxidant levels, whereas fruit and vegetable intake or dietary interventions showed no association. In rodent studies some types of feed may be source of 8-oxoGua in collected urine. Of cancer therapies, cisplatin increased 8-oxoGua excretion, whereas radiotherapy only showed such effects in experimental animals. Case-control studies found high excretion of 8-oxoGua in relation to cancer, dementia and celiac disease but not hemochromatosis, although associations could be a consequence rather than reflecting causality of disease. One prospective study found increased risk of developing lung cancer among non-smokers associated with high excretion of 8-oxoGua. Urinary excretion of 8-oxoGua is a promising biomarker of oxidatively damaged DNA.     

High dietary intake of phytosterol esters decreases carotenoids and increases plasma plant sterol levels with no additional cholesterol lowering

The objective of this study was to measure the effects on serum lipids and plasma phytosterols of 6.6 g/day phytosterols from three foods (bread, breakfast cereal, and spread) consumed for 12 weeks compared with a diet that was not enriched with phytosterols. Thirty-five subjects undertook a nonrandomized, single-blind study consisting of a 2 week baseline period, 6 weeks on high-phytosterol intake, 6 weeks on high-phytosterol intake plus increased fruit and vegetable intake, and a final 2 week washout period. Serum total cholesterol decreased by 8.3% from 6.59 to 6.04 mmol/l, and LDL cholesterol decreased by 12.6% from 4.44 to 3.88 mmol/l. Plasma phytosterol levels increased by 45% (sitosterol) and 105% (campesterol). Cholesterol-adjusted plasma alpha- and beta-carotene levels decreased by 19-23%, lutein by 14%, and lycopene by 11%. Levels of alpha-carotene and lutein increased with extra fruit and vegetables. Only lycopene failed to increase during the washout phase. There were no significant changes in biochemical parameters. Serum LDL cholesterol lowering with 6.6 g/day ingested phytosterols was in the range seen with 1.6-3.2 g/day phytosterols. Lowering of plasma carotenoids was greater than that seen with lower phytosterol intake and was partially reversed by increased fruit and vegetable intake.     

Seasonal changes in markers of oxidative damage to lipids and DNA; correlations with seasonal variation in diet

We have addressed the question whether the relatively high incidence of cardiovascular disease and certain cancers in countries of central/eastern Europe might be associated with nutritional imbalance, in particular a lack of fresh fruit and vegetables in the diet in winter months. Nutritional parameters and markers of oxidative stress were studied in three Slovak population groups: 46 survivors of myocardial infarction (MI group) and 48 healthy, normolipidemic subjects (NL), living in or near Bratislava; and 70 rural controls (RC group) living a more traditional life style in a country town. Data were collected in February/March and September/October of two consecutive years, representing times of minimum and maximum local availability of fresh fruits and vegetables. Oxidative stress was monitored using two biomarkers; plasma malondialdehyde (MDA, a product of lipid peroxidation), and oxidation of lymphocyte DNA. Dietary antioxidants, folic acid, homocysteine, total antioxidant status (FRAP) and uric acid were measured in plasma. Food frequency questionnaires were administered. Vegetable consumption in summer/autumn was twice as high as in winter/spring. DNA damage did not vary consistently across the seasons. Mean plasma MDA levels for the MI and NL groups showed a clear pattern, with high levels in winter/spring and low levels in summer/autumn. Folic acid showed a reciprocal pattern, similar to the pattern of vegetable consumption. The RC group had the smallest seasonal variations in vegetable consumption, folic acid levels, and MDA. High winter MDA levels are seen in those individuals with relatively low folic acid; they never occur in subjects with high plasma folic acid, implying that folic acid might directly protect against lipid oxidation. This study illustrates the value of the molecular epidemiological approach, while emphasising the need for well characterised population groups and valid biomarkers.     

Cost-effectiveness of interventions to promote fruit and vegetable consumption

Background

Fruits and vegetables are an essential part of the human diet, but many people do not consume the recommended serves to prevent cardiovascular disease and cancer. In this research, we evaluate the cost-effectiveness of interventions to promote fruit and vegetable consumption to determine which interventions are good value for money, and by how much current strategies can reduce the population disease burden.

Methods/Principal Findings

In a review of published literature, we identified 23 interventions for promoting fruit and vegetable intake in the healthy adult population that have sufficient evidence for cost-effectiveness analysis. For each intervention, we model the health impacts in disability-adjusted life years (DALYs), the costs of intervention and the potential cost-savings from averting disease treatment, to determine cost-effectiveness of each intervention over the lifetime of the population, from an Australian health sector perspective. Interventions that rely on dietary counselling, telephone contact, worksite promotion or other methods to encourage change in dietary behaviour are not highly effective or cost-effective. Only five out of 23 interventions are less than an A$50,000 per disability-adjusted life year cost-effectiveness threshold, and even the most effective intervention can avert only 5% of the disease burden attributed to insufficient fruit and vegetable intake.

Conclusions/Significance

We recommend more investment in evaluating interventions that address the whole population, such as changing policies influencing price or availability of fruits and vegetables, to see if these approaches can provide more effective and cost-effective incentives for improving fruit and vegetable intake.     

Metabolism, Intake, and Digestibility of Lambs Supplemented with Organic Chromium

The aim of the present study was to evaluate the metabolism of organic chromium and its effect on digestibility and intake of lambs. Four 4-month-old male lambs, each weighing 28 kg, were used. The animals were kept in metabolic cages for a period of 20 days (15 days of adaptation and 5 days of experimentation), in two experimental phases, with inverted treatments. Organic chromium was administered by intraruminal infusion of 1 mg of chromium-rich yeast (Saccharomyces cerevisiae) throughout the adaptive and experimental period. The dry material rates of the diet and feces of the animals were evaluated to estimate consumption, digestibility, and fecal production. During the experimental period, blood, feces, and urine were collected every 24 h to determine chromium levels. There was no significant difference in the excretion of chromium in the urine, and no mineral remnants were detected in the blood. Excretion was generally fecal. There was greater excretion of chromium in the feces of lambs in the treated group on day 0 and day 3, compared with the control group. The use of organic chromium promoted an increase in the consumption of dry material in the treated animals only at day 0 (P?<?0.05). The production of fecal dry matter was greater among the treated lambs than among the animals of the control group on day 1, day 2, day 3, and day 4 (P?<?0.05). The results obtained showed that organic chromium associated with live yeasts is not absorbed by the body and do not affect the intake time in the dose used.