Interventionsstudie zur Wirkung von moderatem Rotweinkonsum auf ausgewählte redoxsensitive Immunfunktionen bei T-Lymphozyten und Phagozytenpopulationen

Problemstellung: Polyphenole sind sekundäre Pflanzenstoffe, die in allen pflanzlichen Nahrungsmitteln vorkommen, in besonders hoher Konzentration im Rotwein. Ihnen werden zahlreiche biologische Wirkungen zugeschrieben, u.a. auch immunmodulierende und antiinflammatorische Effekte. Letztere wurden bisher fast ausschließlich in vitro nachgewiesen. Ziel dieser Arbeit war es daher zu prüfen, ob eine einmalige oder wiederholte nutritive Polyphenolaufnahme durch Konsum von Rotwein (RW) redoxsensitive Immunfunktionen ex vivo beeinflusst, und ob entalkoholisierter Rotwein (ERW) vergleichbare Effekte hat wie RW. Methoden: A) 27 gesunde Nichtraucher tranken nüchtern einmalig 200 mL RW, 175 mL ERW oder 200 mL Wasser (Kontrolle). Bestimmt wurde der Anteil apoptotischer T-Lymphozyten (Annexin V-Bindungstest) und der Anteil phagozytierender und burstaktiver Granulozyten und Monozyten (Phago-, Bursttest®) vor, 90 und 360 min nach der Intervention. Alle Untersuchungen erfolgten mittels Durchflusszytometrie. B) 49 gesunde Nichtraucher nahmen 6 Wochen lang täglich 200 mL RW oder 175 mL ERW zusätzlich zur gewohnten Kost auf. Eine Kontrollgruppe mit 25 Probanden erhielt kein Getränk. Blutproben wurden morgens nüchtern vor und nach der 6 wöchigen Intervention entnommen und dieselben Parameter untersucht wie bei A). Ergebnisse: Immunmodulierende Wirkungen, die mit der Intervention in Verbindung gebracht werden können, wurden nur nach einmaligem, nicht aber nach wiederholtem Konsum von RW oder ERW festgestellt. Der Anteil phagozytierender Monozyten stieg 90 min nach Konsum von RW an, aber nicht nach Konsum von ERW, was durch den Alkohol oder die höhere Polyphenolaufnahme mit RW im Vergleich zu ERW bedingt sein könnte. Der Anteil burstaktiver Granulozyten nahm 360 min nach Konsum von ERW ab, während der Anteil burstaktiver Monozyten 90 und 360 min nach Konsum von ERW gegenüber dem Ausgangswert anstieg. Dass diese Veränderungen nur nach Konsum von ERW auftraten, aber nicht nach Konsum von RW, deutet darauf hin, dass der Alkohol im RW die Wirkungen der Polyphenole kompensiert, möglicherweise durch prooxidative Wirkungen oder einer beschleunigten Elimination der Polyphenole. Alle übrigen Parameter blieben unverändert.Schlussfolgerung: Immunmodulierende Wirkungen wurden nur nach einmaligem Verzehr von RW und ERW bei der unspezifischen zellulären Abwehr festgestellt. Warum nach regelmäßigem Konsum von RW und ERW keine immunmodulierende Wirkungen auftraten, ist unklar. Da die immunmodulierenden Wirkungen der Polyphenole in vitro dosisabhängig sind, ist es denkbar, dass die Polyphenolkonzentration nach 6 wöchigem Konsum im Nüchternblut zu gering war, um den Phagozytoseprozess zu modulieren. Möglicherweise werden aber auch Adaptationsmechanismen aktiviert, um langfristig die Homöostase aufrecht zu halten. Ob eine erhöhte nutritive Aufnahme von anderen Flavonoiden, z.B. Flavonolen, ähnliche Wirkungen auslösen wie die Polyphenole im Rotwein, müsste in Hinblick auf einen möglichen präventiven oder therapeutischen Nutzen bei chronisch-degenerativen, entzündlichen Erkrankungen in weiteren Interventionsstudien überprüft werden.Intervention study to investigate the effect of moderate red wine consumption on selected redoxsensitive immune functions from T-lymphocytes and phagocyte populations Background: Polyphenols are secondary plant products occurring in plant foods, in especially high concentrations in red wine. They have many biological properties, among them immunomodulatory and antiinflammatory effects. These effects have almost exclusively been observed in vitro. Hence the aim of this study was to investigate if single or repeated dietary polyphenol intake by means of red wine (RW) affects redox sensitive immune functions ex vivo, and if dealcoholized red wine (DRW) induces similar effects. Methods: A) 27 healthy non-smokers consumed a single dose of 200 mL RW, 175 mL DRW or 200 mL water (controls). The percentage of apoptotic T lymphocytes was determined with annexin V labelling and phagocytosis and burst of granulocytes and monocytes with testkits (Phago-, Bursttest®) before, 90 and 360 min after intervention. All investigations were done by flow cytometry. B) 49 healthy non-smokers ingested either 200 mL RW or 175 mL DRW daily for 6 weeks in addition to their usual diet. A control group including 25 participants did not receive any study drink. Blood samples were taken after an overnight fast before and after 6 weeks of intervention and the same parameters were investigated as in A). Results: A) Immunomodulatory effects related to intervention could only be observed after single, but not after repeated ingestion of either RW or DRW. The percentage of phagocytic monocytes increased 90 min after consumption of RW, but not after consumption of DRW, probably due to the alcohol or the higher polyphenol intake with RW in comparison to DRW. The percentage of burstpositive granulocytes decreased 360 min after consumption of DRW and increased progressively in monocytes compared to baseline values. As these effects occurred only after consumption of DRW, but not after consumption of RW, the alcohol seems to compensate the polyphenols¡¦ effects, probably by prooxidative effects or by increased polyphenol elimination. Further parameter did not change in any group. Conclusion: Immunomodulating effects occurred only after a single ingestion of RW or DRW within the unspecific defense. It is not clear why immunomodulatory effects did not occur after repeated consumption of RW or DRW. As immunomodulatory effects of polyphenols are concentration-dependent in vitro, the polyphenol concentration in blood after an overnight fast might have been too low after 6 weeks of intervention to modulate phagocytosis. Another explanation might concern compensatory mechanisms which might have been activated to maintain homeostasis. Regarding the potential protection against chronic-degenerative, inflammatory diseases, it should be investigated in further intervention studies whether an increased nutritional intake of other flavonoids, e.g. flavonols, may induce similar effects as polyphenols from red wine

Evidence-based guideline of the German Nutrition Society: fat intake and prevention of selected nutrition-related diseases

As nutrition-related chronic diseases have become more and more frequent, the importance of dietary prevention has also increased. Dietary fat plays a major role in human nutrition, and modification of fat and/or fatty acid intake could have a preventive potential. The aim of the guideline of the German Nutrition Society (DGE) was to systematically evaluate the evidence for the prevention of the widespread diseases obesity, type 2 diabetes mellitus, dyslipoproteinaemia, hypertension, metabolic syndrome, coronary heart disease (CHD), stroke, and cancer through the intake of fat or fatty acids. The main results can be summarized as follows: it was concluded with convincing evidence that a reduced intake of total and saturated fat as well as a larger intake of polyunsaturated fatty acids (PUFA) at the expense of saturated fatty acids (SFA) reduces the concentration of total and low-density lipoprotein cholesterol in plasma. Furthermore, there is convincing evidence that a high intake of trans fatty acids increases risk of dyslipoproteinaemia and that a high intake of long-chain polyunsaturated n-3 fatty acids reduces the triglyceride concentration in plasma. A high fat intake increases the risk of obesity with probable evidence when total energy intake is not controlled for (ad libitum diet). When energy intake is controlled for, there is probable evidence for no association between fat intake and risk of obesity. A larger intake of PUFA at the expense of SFA reduces risk of CHD with probable evidence. Furthermore, there is probable evidence that a high intake of long-chain polyunsaturated n-3 fatty acids reduces risk of hypertension and CHD. With probable evidence, a high trans fatty acid intake increases risk of CHD. The practical consequences for current dietary recommendations are described at the end of this article

Single and repeated moderate consumption of native or dealcoholized red wine show different effects on antioxidant parameters in blood and DNA strand breaks in peripheral leukocytes in healthy volunteers: a randomized controlled trial [ISRCTN68505294]

BACKGROUND: Red wine (RW) is rich in antioxidant polyphenols that might protect from oxidative stress related diseases, such as cardiovascular disease and cancer. Antioxidant effects after single ingestion of RW or dealcoholized RW (DRW) have been observed in several studies, but results after regular consumption are contradictory. Thus, we examined if single or repeated consumption of moderate amounts of RW or DRW exert antioxidant activity in vivo. METHODS: Total phenolic content and concentration of other antioxidants in plasma/serum, total antioxidant capacity (TEAC) in plasma as well as DNA strand breaks in peripheral leukocytes were measured in healthy non-smokers A) before, 90 and 360 min after ingestion of one glass of RW, DRW or water; B) before and after consumption of one glass of RW or DRW daily for 6 weeks. DNA strand breaks (SB) were determined by single cell gel electrophoresis (Comet Assay) in untreated cells and after induction of oxidative stress ex vivo with H(2)O(2 )(300 μM, 20 min). RESULTS: Both RW and DRW transiently increased total phenolic content in plasma after single consumption, but only RW lead to a sustained increase if consumed regularly. Plasma antioxidant capacity was not affected by single or regular consumption of RW or DRW. Effects of RW and DRW on DNA SB were conflicting. DNA strand breaks in untreated cells increased after a single dose of RW and DRW, whereas H(2)O(2 )induced SB were reduced after DRW. In contrast, regular RW consumption reduced SB in untreated cells but did not affect H(2)O(2 )induced SB. CONCLUSION: The results suggest that consumption of both RW and DRW leads to an accumulation of phenolic compounds in plasma without increasing plasma antioxidant capacity. Red wine and DRW seem to affect the occurrence of DNA strand breaks, but this cannot be referred to antioxidant effects

Impact of Cocoa Consumption on Inflammation Processes—A Critical Review of Randomized Controlled Trials

Background: Cocoa flavanols have strong anti-inflammatory properties in vitro. If these also occur in vivo, cocoa consumption may contribute to the prevention or treatment of diseases mediated by chronic inflammation. This critical review judged the evidence for such effects occurring after cocoa consumption. Methods: A literature search in Medline was performed for randomized controlled trials (RCTs) that investigated the effects of cocoa consumption on inflammatory biomarkers. Results: Thirty-three RCTs were included, along with 9 bolus and 24 regular consumption studies. Acute cocoa consumption decreased adhesion molecules and 4-series leukotrienes in serum, nuclear factor κB activation in leukocytes, and the expression of CD62P and CD11b on monocytes and neutrophils. In healthy subjects and in patients with cardiovascular diseases, most regular consumption trials did not find any changes except for a decreased number of endothelial microparticles, but several cellular and humoral inflammation markers decreased in patients suffering from type 2 diabetes and impaired fasting glucose. Conclusions: Little evidence exists that consumption of cocoa-rich food may reduce inflammation, probably by lowering the activation of monocytes and neutrophils. The efficacy seems to depend on the extent of the basal inflammatory burden. Further well-designed RCTs with inflammation as the primary outcome are needed, focusing on specific markers of leukocyte activation and considering endothelial microparticles as marker of vascular inflammation

Cocoa, Chocolate and Human Health

This book entitled “Cocoa, Chocolate, and Human Health” presents the most recent findings about cocoa and health in 14 peer-reviewed chapters including nine original contributions and five reviews from cocoa experts around the world. Bioavailability and metabolism of the main cocoa polyphenols, i.e., the flavanols like epicatechin, are presented including metabolites like valerolactones that are formed by the gut microbiome. Many studies, including intervention studies or epidemiological observations, do not focus on single compounds, but on cocoa as a whole. This proves the effectiveness of cocoa as a functional food. A positive influence of cocoa on hearing problems, exercise performance, and metabolic syndrome is discussed with mixed results; the results about exercise performance are contradictive. Evidence shows that cocoa flavanols may modulate some risk factors related to metabolic syndrome such as hypertension and disorders in glucose and lipid metabolism. However, several cardiometabolic parameters in type 2 diabetics were not affected by a flavanol-rich cocoa powder as simultaneous treatment with pharmaceuticals might have negated the effect of cocoa. The putative health-promoting components of cocoa are altered during processing like fermentation, drying, and roasting of cocoa beans. Chocolate, the most popular cocoa product, shows remarkable losses in polyphenols and vitamin E during 18 months of storage

Effect of the Intake of Oyster Mushrooms (Pleurotus ostreatus) on Cardiometabolic Parameters—A Systematic Review of Clinical Trials

Cardiometabolic diseases are a leading global health challenge. Their incidence as well as progression is strongly affected by diet. Consumption of Pleurotus ostreatus (P. ostreatus), an edible oyster mushroom rich in functional ingredients (e.g., β-glucans), may improve glucose and lipid metabolism, blood pressure, body weight and appetite sensations. Hence, this systematic review aimed to provide an overview on the effects of P. ostreatus intake on cardiometabolic parameters from clinical trials, taking into account risk of bias (RoB). Relevant studies were investigated for details with consideration of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The Cochrane Collaboration’s tool was used to assess the RoB. In total, eight trials included observed beneficial effects of P. ostreatus intake on glucose metabolism (reduction in fasting and/or 2 h postprandial glucose) and lipids (decrease in total cholesterol, LDL-cholesterol and/or triglycerides), and some found a reduction in blood pressure. In contrast, body weight did not change. Appetite sensations were not assessed. In most studies, the RoB was high or unclear due to methodological weaknesses and/or inadequate reporting. Thus, P. ostreatus intake may improve cardiometabolic health, but evidence for this is low. Hence, further clinical trials with an adequate study design are warranted to validate these suggestions

Impact of Cocoa Consumption on Inflammation Processes—A Critical Review of Randomized Controlled Trials

Background: Cocoa flavanols have strong anti-inflammatory properties in vitro. If these also occur in vivo, cocoa consumption may contribute to the prevention or treatment of diseases mediated by chronic inflammation. This critical review judged the evidence for such effects occurring after cocoa consumption. Methods: A literature search in Medline was performed for randomized controlled trials (RCTs) that investigated the effects of cocoa consumption on inflammatory biomarkers. Results: Thirty-three RCTs were included, along with 9 bolus and 24 regular consumption studies. Acute cocoa consumption decreased adhesion molecules and 4-series leukotrienes in serum, nuclear factor κB activation in leukocytes, and the expression of CD62P and CD11b on monocytes and neutrophils. In healthy subjects and in patients with cardiovascular diseases, most regular consumption trials did not find any changes except for a decreased number of endothelial microparticles, but several cellular and humoral inflammation markers decreased in patients suffering from type 2 diabetes and impaired fasting glucose. Conclusions: Little evidence exists that consumption of cocoa-rich food may reduce inflammation, probably by lowering the activation of monocytes and neutrophils. The efficacy seems to depend on the extent of the basal inflammatory burden. Further well-designed RCTs with inflammation as the primary outcome are needed, focusing on specific markers of leukocyte activation and considering endothelial microparticles as marker of vascular inflammation

Effect of the Intake of Isoflavones on Risk Factors of Breast Cancer—A Systematic Review of Randomized Controlled Intervention Studies

Epidemiological studies suggest that high intake of soy isoflavones may protect against breast cancer, but causal relationships can only be established by experimental trials. Thus, we aimed to provide a systematic review of randomized controlled trials (RCTs) on the effect of an isoflavone intake on risk factors of breast cancer in healthy subjects. After a systematic literature search in PubMed, 18 different RCTs with pre- and/or postmenopausal women were included and investigated for details according to the PRISMA guideline. In these studies, isoflavones were provided by soy food or supplements in amounts between 36.5–235 mg/d for a period of 1–36 months. Breast density, estrogens including precursors, metabolites, estrogen response such as length of menstrual cycle, and markers of proliferation and inflammation were considered. However, in most studies, differences were not detectable between isoflavone and control/placebo treatment despite a good adherence to isoflavone treatment, irrespective of the kind of intervention, the dose of isoflavones used, and the duration of isoflavone treatment. However, the lack of significant changes in most studies does not prove the lack of effects as a sample size calculation was often missing. Taking into account the risk of bias and methodological limitations, there is little evidence that isoflavone treatment modulates risk factors of breast cancer in pre- and postmenopausal women. Future studies should calculate the sample size to detect possible effects and consider methodological details to improve the study quality