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Effects of the pure flavonoids epicatechin and quercetin on vascular function and cardiometabolic health: a randomized, double-blind, placebo-controlled, crossover trial.
Am J Clin Nutr 2015; 101(5):914-21AJ

Abstract

BACKGROUND

Prospective cohort studies showed inverse associations between the intake of flavonoid-rich foods (cocoa and tea) and cardiovascular disease (CVD). Intervention studies showed protective effects on intermediate markers of CVD. This may be due to the protective effects of the flavonoids epicatechin (in cocoa and tea) and quercetin (in tea).

OBJECTIVE

We investigated the effects of supplementation of pure epicatechin and quercetin on vascular function and cardiometabolic health.

DESIGN

Thirty-seven apparently healthy men and women aged 40-80 y with a systolic blood pressure (BP) between 125 and 160 mm Hg at screening were enrolled in a randomized, double-blind, placebo-controlled, crossover trial. CVD risk factors were measured before and after 4 wk of daily flavonoid supplementation. Participants received (-)-epicatechin (100 mg/d), quercetin-3-glucoside (160 mg/d), or placebo capsules for 4 wk in random order. The primary outcome was the change in flow-mediated dilation from pre- to postintervention. Secondary outcomes included other markers of CVD risk and vascular function.

RESULTS

Epicatechin supplementation did not change flow-mediated dilation significantly (1.1% absolute; 95% CI: -0.1%, 2.3%; P = 0.07). Epicatechin supplementation improved fasting plasma insulin (Δ insulin: -1.46 mU/L; 95% CI: -2.74, -0.18 mU/L; P = 0.03) and insulin resistance (Δ homeostasis model assessment of insulin resistance: -0.38; 95% CI: -0.74, -0.01; P = 0.04) and had no effect on fasting plasma glucose. Epicatechin did not change BP (office BP and 24-h ambulatory BP), arterial stiffness, nitric oxide, endothelin 1, or blood lipid profile. Quercetin-3-glucoside supplementation had no effect on flow-mediated dilation, insulin resistance, or other CVD risk factors.

CONCLUSIONS

Our results suggest that epicatechin may in part contribute to the cardioprotective effects of cocoa and tea by improving insulin resistance. It is unlikely that quercetin plays an important role in the cardioprotective effects of tea. This study was registered at clinicaltrials.gov as NCT01691404.

Authors+Show Affiliations

From Top Institute Food and Nutrition, Wageningen, The Netherlands (JID, JMG, LG, PLZ, and PCHH); the Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands (JID, JMG, LG, DK, and PCHH); and Nutrition and Health Department, Unilever R&D Vlaardingen, Vlaardingen, The Netherlands (PLZ).From Top Institute Food and Nutrition, Wageningen, The Netherlands (JID, JMG, LG, PLZ, and PCHH); the Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands (JID, JMG, LG, DK, and PCHH); and Nutrition and Health Department, Unilever R&D Vlaardingen, Vlaardingen, The Netherlands (PLZ).From Top Institute Food and Nutrition, Wageningen, The Netherlands (JID, JMG, LG, PLZ, and PCHH); the Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands (JID, JMG, LG, DK, and PCHH); and Nutrition and Health Department, Unilever R&D Vlaardingen, Vlaardingen, The Netherlands (PLZ).From Top Institute Food and Nutrition, Wageningen, The Netherlands (JID, JMG, LG, PLZ, and PCHH); the Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands (JID, JMG, LG, DK, and PCHH); and Nutrition and Health Department, Unilever R&D Vlaardingen, Vlaardingen, The Netherlands (PLZ).From Top Institute Food and Nutrition, Wageningen, The Netherlands (JID, JMG, LG, PLZ, and PCHH); the Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands (JID, JMG, LG, DK, and PCHH); and Nutrition and Health Department, Unilever R&D Vlaardingen, Vlaardingen, The Netherlands (PLZ).From Top Institute Food and Nutrition, Wageningen, The Netherlands (JID, JMG, LG, PLZ, and PCHH); the Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands (JID, JMG, LG, DK, and PCHH); and Nutrition and Health Department, Unilever R&D Vlaardingen, Vlaardingen, The Netherlands (PLZ).

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25934864

Citation

Dower, James I., et al. "Effects of the Pure Flavonoids Epicatechin and Quercetin On Vascular Function and Cardiometabolic Health: a Randomized, Double-blind, Placebo-controlled, Crossover Trial." The American Journal of Clinical Nutrition, vol. 101, no. 5, 2015, pp. 914-21.
Dower JI, Geleijnse JM, Gijsbers L, et al. Effects of the pure flavonoids epicatechin and quercetin on vascular function and cardiometabolic health: a randomized, double-blind, placebo-controlled, crossover trial. Am J Clin Nutr. 2015;101(5):914-21.
Dower, J. I., Geleijnse, J. M., Gijsbers, L., Zock, P. L., Kromhout, D., & Hollman, P. C. (2015). Effects of the pure flavonoids epicatechin and quercetin on vascular function and cardiometabolic health: a randomized, double-blind, placebo-controlled, crossover trial. The American Journal of Clinical Nutrition, 101(5), pp. 914-21. doi:10.3945/ajcn.114.098590.
Dower JI, et al. Effects of the Pure Flavonoids Epicatechin and Quercetin On Vascular Function and Cardiometabolic Health: a Randomized, Double-blind, Placebo-controlled, Crossover Trial. Am J Clin Nutr. 2015;101(5):914-21. PubMed PMID: 25934864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of the pure flavonoids epicatechin and quercetin on vascular function and cardiometabolic health: a randomized, double-blind, placebo-controlled, crossover trial. AU - Dower,James I, AU - Geleijnse,Johanna M, AU - Gijsbers,Lieke, AU - Zock,Peter L, AU - Kromhout,Daan, AU - Hollman,Peter C H, Y1 - 2015/02/25/ PY - 2014/08/28/received PY - 2015/01/27/accepted PY - 2015/5/3/entrez PY - 2015/5/3/pubmed PY - 2015/7/29/medline KW - CVD KW - clinical trial KW - cocoa KW - epicatechin KW - flavonoids KW - flow-mediated dilation KW - insulin resistance KW - quercetin KW - tea KW - vascular function SP - 914 EP - 21 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 101 IS - 5 N2 - BACKGROUND: Prospective cohort studies showed inverse associations between the intake of flavonoid-rich foods (cocoa and tea) and cardiovascular disease (CVD). Intervention studies showed protective effects on intermediate markers of CVD. This may be due to the protective effects of the flavonoids epicatechin (in cocoa and tea) and quercetin (in tea). OBJECTIVE: We investigated the effects of supplementation of pure epicatechin and quercetin on vascular function and cardiometabolic health. DESIGN: Thirty-seven apparently healthy men and women aged 40-80 y with a systolic blood pressure (BP) between 125 and 160 mm Hg at screening were enrolled in a randomized, double-blind, placebo-controlled, crossover trial. CVD risk factors were measured before and after 4 wk of daily flavonoid supplementation. Participants received (-)-epicatechin (100 mg/d), quercetin-3-glucoside (160 mg/d), or placebo capsules for 4 wk in random order. The primary outcome was the change in flow-mediated dilation from pre- to postintervention. Secondary outcomes included other markers of CVD risk and vascular function. RESULTS: Epicatechin supplementation did not change flow-mediated dilation significantly (1.1% absolute; 95% CI: -0.1%, 2.3%; P = 0.07). Epicatechin supplementation improved fasting plasma insulin (Δ insulin: -1.46 mU/L; 95% CI: -2.74, -0.18 mU/L; P = 0.03) and insulin resistance (Δ homeostasis model assessment of insulin resistance: -0.38; 95% CI: -0.74, -0.01; P = 0.04) and had no effect on fasting plasma glucose. Epicatechin did not change BP (office BP and 24-h ambulatory BP), arterial stiffness, nitric oxide, endothelin 1, or blood lipid profile. Quercetin-3-glucoside supplementation had no effect on flow-mediated dilation, insulin resistance, or other CVD risk factors. CONCLUSIONS: Our results suggest that epicatechin may in part contribute to the cardioprotective effects of cocoa and tea by improving insulin resistance. It is unlikely that quercetin plays an important role in the cardioprotective effects of tea. This study was registered at clinicaltrials.gov as NCT01691404. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/25934864/Effects_of_the_pure_flavonoids_epicatechin_and_quercetin_on_vascular_function_and_cardiometabolic_health:_a_randomized_double_blind_placebo_controlled_crossover_trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.114.098590 DB - PRIME DP - Unbound Medicine ER -