Abstract Antioxidants are chemical compounds that bind the free radicals in human body preventing the development of many diseases and reducing the severity of degenerative diseases and cancer. Antioxidants are found in fruits, vegetables, grains, nuts, spices etc. Antioxidants are ranked for concentration in specifi c food using a method called the ORAC-Oxygen Radical Absorbance Capacity. The ORAC measures the antioxidant strength in foods assigning each food with a numerical value. Recent studies concluded that berries, such as blueberries, blackberries, strawberries, cranberries, and raspberries, contain some of the highest levels of antioxidants. The acai berry and pomegranates has high ORAC level also. Current clinical studies showed that antioxidants in these fruits are benefi cial in preventing the development of breast, prostate, lung, colon and skin cancers, atherosclerosis, dementia and many other diseases. The healthy properties of berries, pomegranates and other fruits are studied for everything from cancer prevention to skin care. We are presenting a summaries and conclusions of several recent studies concerning the protective antioxidant eff ect of some fruits with high ORAC levels, hoping that this would initiate a future closer collaboration between food producers and clinicians

Goran Kolevski

Snezana Ivic-Kolevska

CiteSeerX

Journal of Hygienic Engineering and Design
271
Review paper
UDC 634.6/.7:612.015.3
ANTIOXIDANTS IN FRUITS AND HUMAN MEDICAL RESEARCH:
AN OVERVIEW
Goran Kolevski 1*, Snezana Ivic-Kolevska2
1Clinic of Neurology, Vodnjanska bb, 1000 Skopje, Republic of Macedonia
2Institute for Public Health, 50 Divizija, 6, Skopje, Republic of Macedonia
*e-mail: gogomk@hotmail.com
Abstract
Antioxidants are chemical compounds that bind 
the free radicals in human body preventing the 
development of many diseases and reducing the 
severity of degenerative diseases and cancer.
Antioxidants are found in fruits, vegetables, grains, nuts, 
spices etc. Antioxidants are ranked for concentration in 
specifi c food using a method called the ORAC-Oxygen 
Radical Absorbance Capacity. The ORAC measures the 
antioxidant strength in foods assigning each food with 
a numerical value. 
Recent studies concluded that berries, such as 
blueberries, blackberries, strawberries, cranberries, 
and raspberries, contain some of the highest levels 
of antioxidants. The acai berry and pomegranates 
has high ORAC level also. Current clinical studies 
showed that antioxidants in these fruits are benefi cial 
in preventing the development of breast, prostate, 
lung, colon and skin cancers, atherosclerosis, dementia 
and many other diseases. The healthy properties of 
berries, pomegranates and other fruits are studied for 
everything from cancer prevention to skin care.
We are presenting a summaries and conclusions of 
several recent studies concerning the protective 
antioxidant eff ect of some fruits with high ORAC 
levels, hoping that this would initiate a future closer 
collaboration between food producers and clinicians. 
Key words: Antioxidants, ORAC, fruits. 
1. Introduction
Oxygen free radicals (or reactive oxygen species 
(ROS)) are active bimolecular which are formed during 
normal metabolism and through external factors 
such as x-rays, ultra-violet radiation and pollution. 
Oxygen free radicals are involved in the development 
of many degenerative diseases and pathological 
conditions, including atherosclerosis, dementia, 
Parkinson’s disease, cancers, cardiovascular diseases 
etc, highlighting the need to consider the level of 
consummation of antioxidants in our body (Harman 
[1]). 
Antioxidants are bimolecular that help to counteract 
the detrimental eff ects of oxygen free radicals, 
preventing the development of many diseases and 
reducing the severity of degenerative diseases and 
cancer. These substances act as “free radical scavengers” 
and hence prevent and repair damage done by oxygen 
free radicals (Ames et al. [2]). 
Antioxidants are mostly found in fruits and vegetables, 
but in diff erent levels and concentrations. Concerning 
this, the benefi t and healthy eff ects of consumed food 
depends on quality and concentration of antioxidants 
in consumed nutrients, especially fruits. 
Foods are ranked by their antioxidant potency using 
a method called the ORAC-Oxygen Radical Absorbance 
Capacity (Ou et al. [3]). The ORAC measures the 
antioxidant strength in foods assigning each food with 
a numerical value (Table 1). 
Table 1. ORAC levels of some fruits
Fruits (100 g) ORAC level
Açaí berries 18,400
Pomegranates 10,500
Blackberries 5,100
Bilberry 4,200 
Blueberries 3,200
Plums 2,800
Raspberries 2,700
Strawberries 2,600
Oranges 2,400
Grapes, Red 739
Cherries 670
Grapefruit, pink 495
Grapes, white 460
Banana 210
Apple 207
Peach 170
Watermelon 100
European Hygienic Engineering & Design Group 
272
Developed by scientists at the USDA Human Nutrition 
Research Center on Aging, the ORAC test is considered 
one of the most sensitive and reliable methods 
for measuring the ability of antioxidants to absorb 
free radicals, because of its biological relevance to 
antioxidant action in vivo (in living organisms) (Weller 
[4]). This method measures both the degree and 
speed with which a certain food inhibits the action 
of an oxidizing agent, and then integrates these two 
measurements into a single value, producing an 
accurate assessment of diff erent types of antioxidants 
of diff erent strengths. The ORAC value of a food is 
proportional to its polyphenol content. Fruits with a 
higher ORAC value or richer color - have been shown 
to suppress free radicals more eff ectively than lightly 
pigmented foods (Dávalos et al. [5]).
2. SCIENTIFIC SEARCH FOR BEST FRUITS
2.1 Anthocyanins
The most powerful antioxidants that some fruits, 
such as berries, contain in its composition are a 
class of polyphenols (or biofl avonoids) known as 
anthocyanins (Zafra-Stone et al. [6]). These nutrients 
produce the deep red, blue, and purple plant 
pigments. Anthocyanins are distributed widely among 
nature’s most brightly colored fruits (Aiyer et al. [7]). 
Fruits bearing these colors-blueberries, cranberries, 
pomegranates, black currants, beets, and açaí-are 
especially rich in anthocyanins. Although present only 
in minimal quantities, they are readily absorbed into 
the blood upon ingestion, where they counteract the 
pathological eff ects of free radical activity (Seeram et al. 
[8]). Anthocyanins express a broad spectrum of health 
benefi ts, including (Lee et al. [9] and Shin et al. [10]): 
inhibiting cancer cell growth and inducing apoptosis 
(programmed cell death) in several cancer cell lines, 
reducing the risk of cardiovascular disease, improving 
eye function, limiting cellular oxidative DNA damage.
2.2 Açaí 
The açaí (Euterpe oleraceae Mart.) is a species of palm 
tree indigenous to the area surrounding the Amazon 
in South America. Modern scientifi c analysis revealed 
the value of açaí’s antioxidant capability in several 
recent scientifi c studies (Marcason [11]). 
A study designed to evaluate total free radical 
scavenging capacity among various antioxidant foods 
revealed that when compared to common European 
fruit and vegetable juices, the açaí samples ranked 
in the top class of peroxyl radical scavengers. The 
authors found the samples to be so high in antioxidant 
capacity that the numbers could only be estimated 
(Mertens-Talcott et al. [12]). Another study found that 
human plasma antioxidant activity is signifi cantly 
increased after the consumption of açaí fruit and juice, 
observing individual increases in plasma antioxidant 
activity of up to 2.3-3-fold, respectively (Lichtenthaler 
et al. [13]). Its potent antioxidant properties endow 
açaí with a singular ability to combat cellular aging 
and oxidative damage (Schauss et al. [14]). There is a 
scientifi c evidence that açaí is a major cancer fi ghter. 
Polyphenolic mixtures of açaí pulp, juice and oil 
extracts inhibited the proliferation of human colon 
cancer cells in the lab by up to 90.7% and a study on 
human leukemia cells found açaí polyphenols reduced 
cell proliferation from 56-86% (Del Pozo-Insfran et al. 
[15]). Açaí’s high antioxidant capacity also improves 
brain function, with potential for the treatment of 
neurological disorders, including Alzheimer’s disease 
and Parkinson’s disease. 
2.3 Pomegranate 
The pomegranate (Punica granatum) is a subtropical 
fruit originating from Asia. It has been cultivated 
and naturalized over the Mediterranean region 
since ancient times. Pomegranates are mentioned in 
Egyptian papyrus scrolls dating back to 1550 BC, and 
pomegranate branches form part of the decorative 
motif on the pillars of King Solomon’s temple. 
Pomegranate is absorbed into the bloodstream far 
more effi  ciently than other fruit extracts. One study 
showed a pomegranate extract to be 95% absorbed, 
which is far greater than any polyphenol-containing 
fruit extract of its kind (Seeram et al. [16]). Dozens of 
recent studies concluded that pomegranates contain 
powerful antioxidants that inhibit the process of 
atherosclerosis (Gil et al. [17]). The scientists found that 
pomegranate concentrated juice signifi cantly reduce 
oxidative stress in blood and atherosclerotic plaques, 
resulting in modestly lower blood pressure and 
reducing the risk of cardiovascular and cerebrovascular 
diseases (Aviram et al. [18]). The fact that pomegranate 
was shown to reverse carotid artery atherosclerosis 
indicates that even aged humans might be able to 
lower their risks of stroke and heart attack (Aviram 
and Dornfeld [19]). Pomegranate extract also has 
demonstrated anticarcinogenic properties that are 
eff ective in suppressing a variety of cancers, including 
prostate, lung, skin, breast, and colon cancers (Kim 
et al. [20]). This fruit has also been shown to reduce 
infl ammation in colitis and suppress infl ammation and 
joint damage in rheumatoid arthritis. 
Medical scientists conducted a study on heart disease 
patients to ascertain pomegranate’s eff ects on 
inducible angina and the rate of blood fl ow through 
the coronary arteries. The entire group was subjected 
to a baseline stress test to induce angina and to an 
advanced tomography technique to measure coronary 
Journal of Hygienic Engineering and Design
273
blood fl ow. This study showed for the fi rst time that 
daily consumption of pomegranate can improve blood 
fl ow to the heart in coronary artery disease patients in 
a relatively short period of time. Scientists attributed 
the anti-atherosclerotic benefi ts of pomegranate 
to the high levels of polyphenols, tannins, and 
anthocyanidins contained in the fruit. They pointed 
out that while grape juice/red wine contain some of 
these extracts, neither grape juice nor red wine has 
been shown to improve coronary blood low in patients 
with established heart disease (Ross [21]). In 2010, 23 
clinical trials were registered in the National Institutes 
of Health of USA to examine eff ects of pomegranate 
extracts or juice consumption on following diseases: 
prostate cancer and hyperplasia, diabetes, lymphoma, 
coronary artery disease etc.
2.4 Berries
Recent studies confi rm that blackberries appear 
to be extremely benefi cial in the management 
of infl ammation, suppressing pro-infl ammatory 
cytokines. Blackberry extracts also show potential in 
inhibiting the growth of human colon cancer cells in 
the laboratory, suggesting a potential role in cancer 
prevention (Dai et al. [22]). 
Over the past year, a record number of independent 
studies have confi rmed the health eff ects of 
blueberries. Scientists tested blueberries against an 
array of common disorders and discovered signifi cant 
results (Yi et al. [23]). One of the most studied and 
benefi cial eff ect of Blueberries is the ability to improve 
memory and cognitive performance by reducing the 
degenerative changes in aging neurons. Blueberries 
are abundant in polyphenols that can cross the blood-
brain barrier and localize in regions critical to learning 
and memory (Galli et al. [24]). Blueberries protect the 
myocardium from ischemic damage and prevent post-
myocardial infarction heart failure. They have also been 
found to improve insulin resistance and thus glucose 
control in pre-clinical models. 
Cranberries are probably best known for the benefi cial 
eff ect in the urinary tract, by inhibiting the adherence 
of E. coli to the urethra and bladder (Gupta et al. [25]). 
They’re also proven fi ghters of oxidative stress. A double-
blind, placebo-controlled trial involving 65 healthy 
women found that 1,200 mg of cranberry extract per 
day prompted a signifi cant decrease in serum levels of 
advanced oxidation protein products—a key measure 
of oxidative stress (Valentova et al. [26]). Cranberries 
also display anti-proliferative activity against several 
types of cancer in vitro and in vivo, including gastric 
cancer and esophageal adenocarcinoma. 
Grapes and grape seeds are best known for their 
cardio protective features, by decreasing LDL oxidation 
and platelet aggregation (Leifert and Abeywardena 
[27]). Also, grapes and grape seeds have been shown to 
inhibit colon cancer cell invasion and. Grapes also may 
help combat Parkinson’s and other neurodegenerative 
diseases. 
Strawberry extracts have been shown to inhibit the 
growth of oral, colon, and prostate cancer cells (Zhang 
et al. [28]), improve lipid profi les and peroxidation 
(Basu et al. [29]) and lower the risk of coronary artery 
disease (Jenkins et al. [30]).
3. Conclusions
 – Recent years, in scientifi c community there is 
growing evidence that antioxidant properties of 
some fruits with high ORAC levels can interfere with 
development and severity of many degenerative 
diseases, cancers, as well as atherosclerosis and 
cognitive impairment. Consuming these fruits 
would help modern humans to improve their 
health and quality of their life. 
 – Presented summaries and conclusions of studies 
concerning the protective antioxidant eff ect of 
some fruits will arouse the interest in public, hoping 
that this would initiate a future closer collaboration 
between food producers and clinicians. 
4. References
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ANTIOXIDANTS IN FRUITS AND HUMAN MEDICAL RESEARCH: AN OVERVIEW

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ANTIOXIDANTS IN FRUITS AND HUMAN MEDICAL RESEARCH: AN OVERVIEW

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