The Journal of nutrition | 2021
Strawberry Consumption, Cardiometabolic Risk Factors, and Vascular Function: A Randomized Controlled Trial in Adults with Moderate Hypercholesterolemia.
Abstract
BACKGROUND\nCertain fruits, such as strawberries, may impart cardiometabolic benefits due to their phytochemical content.\n\n\nOBJECTIVES\nStudy aims were to assess the effects of strawberry intake on cardiometabolic risk factors and vascular endothelial function in adults with moderate hypercholesterolemia.\n\n\nMETHODS\nThis study was a randomized, controlled, double-blinded, 2-arm, 2-period (4-wk/period) crossover trial. Adults (n\xa0=\xa034; male/female 1:1; mean\xa0±\xa0SEM age, 53\xa0±\xa01\xa0y; BMI, 31\xa0±\xa01\xa0kg/m2; \xa0LDL cholesterol, 133\xa0±\xa03\xa0mg/dL)\xa0were randomly allocated to 1 of 2 study sequences in a 1:1 ratio. Participants drank study beverages twice daily containing freeze-dried strawberry powder (2\xa0× 25 g)\xa0or\xa0energy-, volume-matched control powder for 4 wk separated by a 4-wk washout. The primary outcome variable was the difference in fasting LDL cholesterol after 4-wk interventions. Secondary outcomes were metabolic markers, inflammation, quantitative (poly)phenolic metabolomics, flow-mediated dilation (FMD), and blood pressure (BP), with the latter (FMD, BP) also assessed acutely at 1\xa0h and 2\xa0h after a 50-g\xa0bolus strawberry or control beverage. Mixed-model analysis of repeated measures via PROC MIXED, PC-SAS was performed on primary and secondary outcome variables.\n\n\nRESULTS\nLDL cholesterol did not differ after the 4-wk interventions (P\xa0>\xa00.05), nor did fasting total cholesterol, triglycerides, glucose, insulin, high-sensitivity C-reactive protein, FMD, or BP (all P >\xa00.05). Significant intervention-by-hour interaction for FMD (P\xa0=\xa00.03) and BP (P\xa0=\xa00.05) revealed increased FMD at 1\xa0h after strawberry compared with control by 1.5\xa0±\xa00.38%\xa0(P\xa0=\xa00.0008) and attenuated systolic BP at 2\xa0h by 3.1\xa0±\xa00.99\xa0mmHg\xa0(P\xa0=\xa00.02). Select phenolic metabolites increased significantly (P\xa0<\xa00.05) in blood following strawberry consumption while others decreased, including 3-(4-methoxyphenyl)propanoic acid-3-O-glucuronide, which was significantly correlated with increased FMD (P\xa0<\xa00.05).\n\n\nCONCLUSION\nStrawberries may improve vascular health, independent of other metabolic changes. The effect may be related to changes in microbial-derived phenolic metabolites after strawberry consumption influencing endothelial function. Data support inclusion of strawberries in a heart-healthy diet in adults with moderate hypercholesterolemia.This trial was registered at clinicaltrials.gov as NCT02612090.