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Lack of acute or chronic effects of epicatechin-rich and procyanidin-rich apple extracts on blood pressure and cardiometabolic biomarkers in adults with moderately elevated blood pressure: a randomized, placebo-controlled crossover trial
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Date
2018-11-23
Authors
Hollands, Wendy J.
Tapp, Henri
Defernez, Marianne
Perez Moral, Natalia
Winterbone, Mark S.
Philo, Mark
Lucey, Alice J.
Kiely, Mairead E.
Kroon, Paul A.
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press on behalf of the American Society for Nutrition
Published Version
Abstract
Background: The reported effects of flavanol-rich foods such as cocoa, dark chocolate, and apples on blood pressure and endothelial function may be due to the monomeric flavanols [mainly (–)-epicatechin (EC)], the oligomeric flavanols [procyanidins (PCs)], or other components. Reports of well-controlled intervention studies that test the effects of isolated oligomeric flavanols on biomarkers of cardiovascular health are lacking. Objective: We studied the acute and chronic effects of an EC-rich apple flavanol extract and isolated apple PCs on systolic blood pressure (BP) and other cardiometabolic biomarkers. Design: Forty-two healthy men and women with moderately elevated BP completed this randomized, double-blind, placebo-controlled, 4-arm crossover trial. Participants ingested a single dose of an apple flavanol extract (70 mg monomeric flavanols, 65 mg PCs), a double dose of this extract (140 mg monomeric flavanols, 130 mg PCs), an apple PC extract (130 mg PCs, 6.5 mg monomeric flavanols), or placebo capsules once daily for 4 wk, in random order. Biomarkers of cardiovascular disease risk and vascular function were measured before and 2 h after ingestion of the first dose and after the 4-wk intervention. Results: Compared with placebo, none of the isolated flavanol treatments significantly (P < 0.05) changed systolic or diastolic BP (peripheral and aortic), plasma nitric oxide (NO) reaction products, or measures of arterial stiffness (carotid femoral pulse-wave velocity, brachial-ankle pulse-wave velocity, or Augmentation Index) after 2 h or 4 wk of the intervention. There were no changes in plasma endogenous metabolite profiles or circulating NO; endothelin 1; total, HDL, or LDL cholesterol; triglycerides; fasting glucose; fructosamine; or insulin after 4 wk of the intervention. Conclusions: Our data suggest that, in isolation, neither monomeric flavanols nor PCs affect BP, blood lipid profiles, endothelial function, or glucose control in individuals with moderately elevated BP. The reported benefits of consuming flavanol-rich cocoa, chocolate, and apple products appear to be dependent on other components, which may work in combination with monomeric flavanols and PCs. This trial was registered at www.clinicaltrials.gov as NCT02013856.
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Keywords
Cardiovascular disease , Polyphenols , Flavonoids , Pulse-wave velocity , Metabolite profiling , Endogenous metabolism , Lipid metabolism
Citation
Hollands, W. J., Tapp, H., Defernez, M., Perez Moral, N., Winterbone, M. S., Philo, M., Lucey, A. J., Kiely, M. E. and Kroon, P. A. (2018) 'Lack of acute or chronic effects of epicatechin-rich and procyanidin-rich apple extracts on blood pressure and cardiometabolic biomarkers in adults with moderately elevated blood pressure: a randomized, placebo-controlled crossover trial', American Journal of Clinical Nutrition, 108(5), pp. 1006-1014. doi:10.1093/ajcn/nqy139
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Copyright
© 2018, American Society for Nutrition. This is a pre-copyedited, author-produced version of an article accepted for publication in American Journal of Clinical Nutrition following peer review. The version of record is available online at: https://doi.org/10.1093/ajcn/nqy139