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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dc.contributor.authorHollands, Wendy J.
dc.contributor.authorTapp, Henri
dc.contributor.authorDefernez, Marianne
dc.contributor.authorPerez Moral, Natalia
dc.contributor.authorWinterbone, Mark S.
dc.contributor.authorPhilo, Mark
dc.contributor.authorLucey, Alice J.
dc.contributor.authorKiely, Mairead E.
dc.contributor.authorKroon, Paul A.
dc.date.accessioned2018-12-17T11:58:05Z
dc.date.available2018-12-17T11:58:05Z
dc.date.issued2018-11-23
dc.date.updated2018-12-17T11:46:52Z
dc.description.abstractBackground: 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.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationHollands, 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/nqy139en
dc.identifier.doi10.1093/ajcn/nqy139
dc.identifier.endpage1014en
dc.identifier.issn0002-9165
dc.identifier.issn1938-3207
dc.identifier.issued5en
dc.identifier.journaltitleAmerican Journal of Clinical Nutritionen
dc.identifier.startpage1006en
dc.identifier.urihttps://hdl.handle.net/10468/7229
dc.identifier.volume108en
dc.language.isoenen
dc.publisherOxford University Press on behalf of the American Society for Nutritionen
dc.relation.uriwww.clinicaltrials.gov as NCT02013856.
dc.rights© 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/nqy139en
dc.subjectCardiovascular diseaseen
dc.subjectPolyphenolsen
dc.subjectFlavonoidsen
dc.subjectPulse-wave velocityen
dc.subjectMetabolite profilingen
dc.subjectEndogenous metabolismen
dc.subjectLipid metabolismen
dc.titleLack 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 trialen
dc.typeArticle (peer-reviewed)en
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