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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.
Am J Clin Nutr. 2018 11 01; 108(5):1006-1014.AJ

Abstract

Background

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.

Authors+Show Affiliations

Quadram Institute Bioscience, Norwich, United Kingdom.Quadram Institute Bioscience, Norwich, United Kingdom.Quadram Institute Bioscience, Norwich, United Kingdom.Quadram Institute Bioscience, Norwich, United Kingdom.Quadram Institute Bioscience, Norwich, United Kingdom.Quadram Institute Bioscience, Norwich, United Kingdom.Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.Quadram Institute Bioscience, Norwich, United Kingdom.

Pub Type(s)

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

Language

eng

PubMed ID

30475960

Citation

Hollands, Wendy J., et al. "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." The American Journal of Clinical Nutrition, vol. 108, no. 5, 2018, pp. 1006-1014.
Hollands WJ, Tapp H, Defernez M, et al. 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. Am J Clin Nutr. 2018;108(5):1006-1014.
Hollands, W. J., Tapp, H., Defernez, M., Perez Moral, N., Winterbone, M. S., Philo, M., Lucey, A. J., Kiely, M. E., & 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. The American Journal of Clinical Nutrition, 108(5), 1006-1014. https://doi.org/10.1093/ajcn/nqy139
Hollands WJ, et al. 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. Am J Clin Nutr. 2018 11 1;108(5):1006-1014. PubMed PMID: 30475960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Hollands,Wendy J, AU - Tapp,Henri, AU - Defernez,Marianne, AU - Perez Moral,Natalia, AU - Winterbone,Mark S, AU - Philo,Mark, AU - Lucey,Alice J, AU - Kiely,Mairead E, AU - Kroon,Paul A, PY - 2018/03/19/received PY - 2018/05/18/accepted PY - 2018/11/27/entrez PY - 2018/11/27/pubmed PY - 2019/9/10/medline SP - 1006 EP - 1014 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 108 IS - 5 N2 - Background: 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. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/30475960/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_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqy139 DB - PRIME DP - Unbound Medicine ER -