Anthocyanins do not influence long-chain n-3 fatty acid status:Studies in cells, rodents and humans

Increased tissue status of the long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) is associated with cardiovascular and cognitive benefits. Limited epidemiological and animal data suggest that flavonoids, and specifically anthocyanins, may increase EPA and DHA levels, potentially by increasing their synthesis from the shorter-chain n-3 PUFA, α-linolenic acid. Using complimentary cell, rodent and human studies we investigated the impact of anthocyanins and anthocyanin-rich foods/extracts on plasma and tissue EPA and DHA levels and on the expression of fatty acid desaturase 2 (FADS2), which represents the rate limiting enzymes in EPA and DHA synthesis. In experiment 1, rats were fed a standard diet containing either palm oil or rapeseed oil supplemented with pure anthocyanins for 8 weeks. Retrospective fatty acid analysis was conducted on plasma samples collected from a human randomized controlled trial where participants consumed an elderberry extract for 12 weeks (experiment 2). HepG2 cells were cultured with α-linolenic acid with or without select anthocyanins and their in vivo metabolites for 24 h and 48 h (experiment 3). The fatty acid composition of the cell membranes, plasma and liver tissues were analyzed by gas chromatography. Anthocyanins and anthocyanin-rich food intake had no significant impact on EPA or DHA status or FADS2 gene expression in any model system. These data indicate little impact of dietary anthocyanins on n-3 PUFA distribution and suggest that the increasingly recognized benefits of anthocyanins are unlikely to be the result of a beneficial impact on tissue fatty acid status

New Zealand Blackcurrant Extract Improves Cycling Performance and Fat Oxidation in Cyclists

PURPOSE: Blackcurrant intake increases peripheral blood flow in humans, potentially by anthocyanin-induced vasodilation which may affect substrate delivery and exercise performance. We examined the effects of New Zealand blackcurrant (NZBC) extract on substrate oxidation, cycling time-trial performance and plasma lactate responses following the time-trial in trained cyclists. METHODS: Using a randomized, double-blind, crossover design, fourteen healthy men (age: 38 ± 13 years, height: 178 ± 4 cm, body mass: 77 ± 9 kg, V?O2max: 53 ± 6 ml·kg-1·min-1, mean ± SD) ingested NZBC extract (300 mg?day-1 CurraNZ™ containing 105 mg anthocyanin) or placebo (PL, 300 mg microcrystalline cellulose M102) for 7-days (washout 14-days). On day 7, participants performed 30 min of cycling (3x10 min at 45, 55 and 65% V?O2max), followed by a 16.1 km time-trial with lactate sampling during a 20-minute passive recovery. RESULTS: NZBC extract increased fat oxidation at 65% V?O2max by 27% (P < 0.05) and improved 16.1 km time-trial performance by 2.4% (NZBC: 1678 ± 108 s, PL: 1722 ± 131 s, P < 0.05). Plasma lactate was higher with NZBC extract immediately following the time-trial (NZBC: 7.06 ± 1.73 mmol?L-1, PL: 5.92 ± 1.58 mmol?L-1 P < 0.01). CONCLUSIONS: Seven days intake of New Zealand blackcurrant extract improves 16.1 km cycling time-trial performance and increases fat oxidation during moderate intensity cycling

Common Phenolic Metabolites of Flavonoids, but Not Their Unmetabolized Precursors, Reduce the Secretion of Vascular Cellular Adhesion Molecules by Human Endothelial Cells

Background: Flavonoids have been implicated in the prevention of cardiovascular disease; however, their mechanisms of action have yet to be elucidated, possibly because most previous in vitro studies have used supraphysiological concentrations of unmetabolized flavonoids, overlooking their more bioavailable phenolic metabolites. Objective: We aimed to explore the effects of phenolic metabolites and their precursor flavonoids at physiologically achievable concentrations, in isolation and combination, on soluble vascular cellular adhesion molecule-1 (sVCAM-1). Method: Fourteen phenolic acid metabolites and 6 flavonoids were screened at 1 μM for their relative effects on sVCAM-1 secretion by human umbilical vein endothelial cells stimulated with tumor necrosis factor alpha (TNF-α). The active metabolites were further studied for their response at different concentrations (0.01 μM–100 μM), structure-activity relationships, and effect on vascular cellular adhesion molecule (VCAM)-1 mRNA expression. In addition, the additive activity of the metabolites and flavonoids was investigated by screening 25 unique mixtures at cumulative equimolar concentrations of 1 μM. Results: Of the 20 compounds screened at 1 μM, inhibition of sVCAM-1 secretion was elicited by 4 phenolic metabolites, of which protocatechuic acid (PCA) was the most active (−17.2%, P = 0.05). Investigations into their responses at different concentrations showed that PCA significantly reduced sVCAM-1 15.2–36.5% between 1 and 100 μM, protocatechuic acid-3-sulfate and isovanillic acid reduced sVCAM-1 levels 12.2–54.7% between 10 and 100 μM, and protocatechuic acid-4-sulfate and isovanillic acid-3-glucuronide reduced sVCAM-1 secretion 27.6% and 42.8%, respectively, only at 100 μM. PCA demonstrated the strongest protein response and was therefore explored for its effect on VCAM-1 mRNA, where 78.4% inhibition was observed only after treatment with 100 μM PCA. Mixtures of the metabolites showed no activity toward sVCAM-1, suggesting no additive activity at 1 μM. Conclusions: The present findings suggest that metabolism of flavonoids increases their vascular efficacy, resulting in a diversity of structures of varying bioactivity in human endothelial cells

Cardiovascular Function During Supine Rest in Endurance Trained Males with New Zealand Blackcurrant: A Dose-Response Study

Purpose Blackcurrant contains anthocyanins that could alter cardiovascular function and reduce cardiovascular disease risk. We examined dose responses of New Zealand blackcurrant (NZBC) extract on cardiovascular function during supine rest. Methods Fifteen endurance trained male cyclists (age: 38±12 years, height: 178±5 cm, body mass: 76±10 kg, V?O2max: 56±8 mL?kg-1?min-1, mean±SD) were randomly assigned using a counterbalanced Latin square design to complete four conditions, a control of no NZBC, or one of three doses (300, 600 or 900 mg?day-1) of NZBC extract (CurraNZTM) for seven-days with a fourteen-day washout. Cardiovascular function (i.e. blood pressure, heart rate, ejection time, cardiac output, stroke volume and total peripheral resistance) during supine rest was examined (Portapres® Model 2). Results Systolic and diastolic blood pressure, heart rate and ejection time were unchanged by NZBC. A dose effect (P<0.05) was observed for cardiac output, stroke volume and total peripheral resistance. A trend for a dose effect was observed for mean arterial blood pressure. Cardiac output increased by 0.6±0.6 L·min-1 (15%) and 1.0±1.0 L·min-1 (28%) and stroke volume by 5±8 mL (7%) and 6±17 mL (18%) between control and 600, and 900 mg?day-1, respectively. Total peripheral resistance decreased by 4±3 mmHg·L-1·min-1 (20%) and 5±9 mmHg·L-1·min-1 (20%) for 600, and 900 mg?day-1. Conclusion Seven-days intake of New Zealand blackcurrant extract demonstrated dose-dependent changes on some cardiovascular parameters during supine rest in endurance-trained male cyclists

Creation and implementation of an electronic health record note for quality improvement in pediatric epilepsy: Practical considerations and lessons learned.

ObjectiveTo describe the development of the Pediatric Epilepsy Outcome-Informatics Project (PEOIP) at Alberta Children's Hospital (ACH), which was created to provide standardized, point-of-care data entry; near-time data analysis; and availability of outcome dashboards as a baseline on which to pursue quality improvement.MethodsStakeholders involved in the PEOIP met weekly to determine the most important outcomes for patients diagnosed with epilepsy, create a standardized electronic note with defined fields (patient demographics, seizure and syndrome type and frequency and specific outcomes- seizure type and frequency, adverse effects, emergency department visits, hospitalization, and care pathways for clinical decision support. These were embedded in the electronic health record from which the fields were extracted into a data display platform that provided patient- and population-level dashboards updated every 36&nbsp;hours. Provider satisfaction and family experience surveys were performed to assess the impact of the standardized electronic note.ResultsIn the last 5&nbsp;years, 3,245 unique patients involving 13, 831 encounters had prospective, longitudinal, standardized epilepsy data accrued via point-of-care data entry into an electronic note as part of routine clinical care. A provider satisfaction survey of the small number of users involved indicated that the vast majority believed that the note makes documentation more efficient. A family experience survey indicated that being provided with the note was considered "valuable" or "really valuable" by 86% of respondents and facilitated communication with family members, school, and advocacy organizations.SignificanceThe PEOIP serves as a proof of principle that information obtained as part of routine clinical care can be collected in a prospective, standardized, efficient manner and be used to construct filterable process/outcome dashboards, updated in near time (36&nbsp;hours). This information will provide the necessary baseline data on which multiple of QI projects to improve meaningful outcomes for children with epilepsy will be based

Creation and implementation of an electronic health record note for quality improvement in pediatric epilepsy: Practical considerations and lessons learned.

ObjectiveTo describe the development of the Pediatric Epilepsy Outcome-Informatics Project (PEOIP) at Alberta Children's Hospital (ACH), which was created to provide standardized, point-of-care data entry; near-time data analysis; and availability of outcome dashboards as a baseline on which to pursue quality improvement.MethodsStakeholders involved in the PEOIP met weekly to determine the most important outcomes for patients diagnosed with epilepsy, create a standardized electronic note with defined fields (patient demographics, seizure and syndrome type and frequency and specific outcomes- seizure type and frequency, adverse effects, emergency department visits, hospitalization, and care pathways for clinical decision support. These were embedded in the electronic health record from which the fields were extracted into a data display platform that provided patient- and population-level dashboards updated every 36&nbsp;hours. Provider satisfaction and family experience surveys were performed to assess the impact of the standardized electronic note.ResultsIn the last 5&nbsp;years, 3,245 unique patients involving 13, 831 encounters had prospective, longitudinal, standardized epilepsy data accrued via point-of-care data entry into an electronic note as part of routine clinical care. A provider satisfaction survey of the small number of users involved indicated that the vast majority believed that the note makes documentation more efficient. A family experience survey indicated that being provided with the note was considered "valuable" or "really valuable" by 86% of respondents and facilitated communication with family members, school, and advocacy organizations.SignificanceThe PEOIP serves as a proof of principle that information obtained as part of routine clinical care can be collected in a prospective, standardized, efficient manner and be used to construct filterable process/outcome dashboards, updated in near time (36&nbsp;hours). This information will provide the necessary baseline data on which multiple of QI projects to improve meaningful outcomes for children with epilepsy will be based

Dietary anthocyanin intake and age-related decline in lung function: longitudinal findings from the VA Normative Aging Study

Background: It is unknown if habitual intake of dietary flavonoids, known for their antioxidative and anti-inflammatory properties, affects longitudinal change in lung function. Objective: We investigated if different flavonoid subclasses present in the habitual diet were associated with beneficial changes in lung function over time in the elderly. Design: This longitudinal analysis included 839 participants from the VA Normative Aging Study whose lung function (FEV1 and FVC) was measured at two and up to five visits between 1992 and 2008 (n = 2,623 measurements). Yearly average intake of major flavonoid subclasses (anthocyanins, flavanones, flavan-3-ols, flavonols, flavones, and polymers) was calculated from food-frequency questionnaires at each visit. We estimated adjusted differences in annual change in lung function associated with each flavonoid subclass, categorized into quartiles, in linear mixed-effect regression models after adjustment for lifestyle and dietary confounders. Results: Strong inverse associations were found between anthocyanin intake and age related decline in lung function. Independent of dietary and non-dietary risk factors, slower rates of FEV1 and FVC decline by 23.6 mL/y (95% confidence interval [CI]: 16.6,30.7) and 37.3 mL/y (95%CI: 27.8, 46.8), respectively, were observed in participants in the fourth quartile of intake compared with participants in the first quartile (Ptrend &lt;0.0001). The protective associations observed for anthocyanin intake were present in both current/former and never smokers. Compared with no or very low intake, intake of ≥ 2servings/week of anthocyanin-rich blueberries was associated with slower decline in FEV1 and FVC by 22.5 mL/y (95%CI: 10.8, 34.2) and 37.9 mL/y (95%CI: 22.1, 53.7),respectively. To a lesser extent, higher flavan-3-ol intake 92 was also associated with slowerlung function decline. Conclusion: Attenuation of age-related lung function decline was associated with higher dietary anthocyanin intake in this longitudinal sample of predominantly elderly men.Further prospective studies are needed to confirm these novel associations.