Lorna Fyfe

The effect of polyphenol-rich dark chocolate on fasting capillary whole blood glucose, total cholesterol, blood pressure and glucocorticoids in healthy overweight and obese subjects

Numerous studies indicate that polyphenol-rich chocolate reduces fasting blood glucose, blood pressure (BP) and total cholesterol in healthy individuals and hypertensives with or without glucose intolerance. The aim of the present study was to investigate the effect of two doses of polyphenol-rich dark chocolate (DC) on fasting capillary whole blood glucose, total cholesterol and BP and to examine whether improvements in these parameters are associated with changes in adrenocorticoid excretion in overweight and obese individuals. The study used a randomised, single-blind, cross-over design where fourteen overweight and obese subjects were randomised to either take 20 g DC with 500 mg polyphenols then 20 g DC with 1000 mg polyphenols or vice-versa. Participants followed each diet for 2 weeks separated by a 1-week washout period. It was observed that the 500 mg polyphenol dose was equally effective in reducing fasting blood glucose levels, systolic BP (SBP) and diastolic BP (DBP) as the 1000 mg polyphenol dose suggesting that a saturation effect might occur with increasing dose of polyphenols. There was also a trend towards a reduction in urinary free cortisone levels with both groups although it did not reach statistical significance. No changes in anthropometrical measurements were seen. We suggest that more research is required to investigate the mechanism(s) by which polyphenol-rich foods influence health.

Differential effect of polyphenol-rich dark chocolate on biomarkers of glucose metabolism and cardiovascular risk factors in healthy, overweight and obese subjects: a randomized clinical trial

The association between excess cortisol and various parameters of metabolic syndrome including hypertension, insulin resistance and dyslipidaemia is increasingly recognised. The present single-blind randomised placebo-controlled cross-over study compared the effect of polyphenol-rich dark chocolate (DC) on biomarkers of glucose metabolism, lipid profile, and blood pressure (BP) in females with BMI ≥ 25 kg m(-2) (n = 21) and females with BMI < 25 kg m(-2) (n = 21). Volunteers consumed 20 g of DC containing 500 mg polyphenols or a placebo DC with negligible polyphenol-content daily for 4 weeks, separated by a 2-week washout period. Systolic BP and diastolic BP decreased after 4 weeks of polyphenol-rich DC. Placebo raised fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and salivary cortisol, an effect that was significantly different from polyphenol-rich DC which had a negligible effect on fasting insulin, HOMA-IR and salivary cortisol. Females with BMI ≥ 25 kg m(-2) responded less favourably to placebo than lean females and consequently had higher fasting insulin and HOMA-IR, in addition to a lower quantitative sensitivity check index (QUICKI) after ingestion of placebo compared to polyphenol-rich DC. No significant changes in lipid profile were observed. This study provides evidence for the metabolic benefits of consuming polyphenol-rich dark chocolate while demonstrating the possibility of adverse effects occurring with polyphenol-poor chocolate placebo.

Dark chocolate: an obesity paradox or a culprit for weight gain?

Obesity remains a major public health challenge, and its prevalence is dramatically increasing. Diet and exercise are typically recommended to prevent and manage obesity; however, the results are often conflicting. Polyphenols, a class of phytochemicals that have been shown to reduce the risk factors for diabetes type II and cardiovascular diseases, are recently suggested as complementary agents in the management of obesity through several mechanisms such as decreasing fat absorption and/or fat synthesis. Dark chocolate, a high source of polyphenols, and flavanols in particular, has lately received attention for its possible role in modulating obesity because of its potential effect on fat and carbohydrate metabolism, as well as on satiety. This outcome was investigated in animal models of obesity, cell cultures and few human observational and clinical studies. The research undertaken to date has shown promising results, with the possible implication of cocoa/dark chocolate in the modulation of obesity and body weight through several mechanisms including decreasing the expression of genes involved in fatty acid synthesis, reducing the digestion and absorption of fats and carbohydrates and increasing satiety. Copyright

Anti‐Microbial Activity and Composition of Manuka and Portobello Honey

Recently renewed interest in the therapeutic properties of honey has led to the search for new antimicrobial honeys. This study was undertaken to assess the antimicrobial activity and composition of a locally produced Portobello honey (PBH) on three bacteria known to infect wounds. Manuka honey (MH) was used for comparative purposes. Broth culture and agar disc diffusion assays were used to investigate the antimicrobial properties of honey. The honeys were tested at four concentrations: 75%, 50%, 10% and 1% (v/v) and compared with an untreated control. The composition of honey was determined by measuring: polyphenol content by Folin Ciocalteau method, antioxidant capacity by ferric ion reducing power assay, hydrogen peroxide (H2O2) by catalase test, pH and sugar content by pH strips and refractometer, respectively. Both honeys at 75% and 50% inhibited the majority of the three bacteria tested. 10% PBH exhibited antimicrobial activity to the lesser extent than 10% MH. The difference was very significant (p ≤ 0.001). Both honeys were acidic with pH 4, and both produced H2O2. The sugar content of PBH was higher than MH, but the difference was not significant. The MH had significantly higher levels of the polyphenols and antioxidant activity than PBH. Copyright

Honey: A realistic antimicrobial for disorders of the skin

Resistance of pathogenic microorganisms to antibiotics is a serious global health concern. In this review, research investigating the antimicrobial properties of honeys from around the world against skin relevant microbes is evaluated. A plethora of in vitro studies have revealed that honeys from all over the world have potent microbicidal activity against dermatologically important microbes. Moreover, in vitro studies have shown that honey can reduce microbial pathogenicity as well as reverse antimicrobial resistance. Studies investigating the antimicrobial properties of honey in vivo have been more controversial. It is evident that innovative research is required to exploit the antimicrobial properties of honey for clinical use and to determine the efficacy of honey in the treatment of a range of skin disorders with a microbiological etiology.

Differential effectiveness of berry polyphenols as anti-giardial agents

SUMMARY Following previous work on the anti-giardial effect of blueberry polyphenols, a range of polyphenol-rich extracts from berries and other fruits was screened for their ability to kill Giardia duodenalis, an intestinal parasite of humans. Polyphenol-rich extracts were prepared from berries using solid-phase extraction and applied to trophozoites of Giardia duodenalis grown in vitro. All berry extracts caused inhibition at 166 μg gallic acid equivalents (GAE)/ml phenol content but extracts from strawberry, arctic bramble, blackberry and cloudberry were as effective as the currently used drug, metronidazole, causing complete trophozoite mortality in vitro. Cloudberry extracts were found to be the most effective causing effectively complete trophozoite mortality at 66 μg GAE/ml. The polyphenol composition of the more effective berry extracts suggested that the presence of ellagitannins could be an important factor. However, the potency of cloudberry could be related to high ellagitannin content but also to the presence of substantial amounts of unconjugated p-coumaric acid and benzoic acid. These in vitro effects occur at concentrations easily achievable in the gut after berry ingestion and we discuss the likelihood that berry extracts could be effective anti-giardial agents in vivo.

Honey: an immunomodulatory agent for disorders of the skin

ABSTRACT Studies have shown that honeys from around the world can inhibit the growth of a range of dermatologically important microbes. In addition to reports of the antimicrobial properties of honey, a number of recent in vitro and in vivo studies suggest that honey is able to modulate immunological parameters related to the skin immune system. Paradoxically, both immune-stimulatory and anti-inflammatory effects have been observed. In this review, scientific research investigating the immunomodulatory properties of honeys from around the world, in relation to disorders of the skin, is evaluated. While there is sufficient evidence to suggest that honey does indeed have immunomodulatory properties, which may at least partially explain the ability of honey to promote the healing of wounds, there are still gaps in the scientific knowledge and literature. More research is necessary for a more complete understanding of the immune-modulating properties of honey and to enable the utilisation of honey as an immune-modulating agent in dermatology.

Honey: a therapeutic agent for disorders of the skin

Problems with conventional treatments for a range of dermatological disorders have led scientists to search for new compounds of therapeutic value. Efforts have included the evaluation of natural products such as honey. Manuka honey, for example, has been scientifically recognised for its anti-microbial and wound healing properties and is now used clinically as a topical treatment for wound infections. In this review, scientific evidence for the effectiveness of honey in the treatment of wounds and other skin conditions is evaluated. A plethora of in vitro studies have revealed that honeys from all over the world have potent antimicrobial activity against skin relevant microbes. Moreover, a number of in vitro studies suggest that honey is able to modulate the skin immune system. Clinical research has shown honey to be efficacious in promoting the healing of partial thickness burn wounds while its effectiveness in the treatment of non-burn acute wounds and chronic wounds is conflicted. Published research investigating the efficacy of honey in the treatment of other types of skin disorders is limited. Nevertheless, positive effects have been reported, for example, kanuka honey from New Zealand was shown to have therapeutic value in the treatment of rosacea. Anti-carcinogenic effects of honey have also been observed in vitro and in a murine model of melanoma. It can be concluded that honey is a biologically active and clinically interesting substance but more research is necessary for a comprehensive understanding of its medicinal value in dermatology.

Polyphenol-rich dark chocolate: effect on fasting capillary glucose, total cholesterol, blood pressure and glucocorticoids in healthy overweight and obese subjects

Excess cortisol is associated with various variables of the metabolic syndrome including hypertension, insulin resistance and dyslipidaemia. This relationship is likely to be mediated via cortisol’s ability to regulate NO bioavailability. Since increased NO bioavailability is considered the main mechanism by which polyphenols improve glucose, blood pressure and lipid homeostasis, the present study aimed to investigate the effect of two doses of polyphenol-rich dark chocolate on fasting capillary glucose (FG), total cholesterol (TC), systolic (SBP) and diastolic blood pressure (DBP) and urinary free cortisol (F), cortisone (E) and cortisone:cortisol (E:F) in a group of overweight and obese subjects. The study used a single-blind randomised cross-over design wherein fourteen subjects (eight males, six females; age 36 (SD 11) years; BMI 28 (SD 2.5) kg/m) consumed 20 g dark chocolate containing 500 mg or 1000 mg polyphenols for 2 weeks, separated by a 1-week washout period. This 20g portion corresponds to half a portion of habitual chocolate intake and provides similar concentrations of polyphenols as used in previous studies on healthy and hypertensive volunteers that have reported significant reductions in blood pressure following consumption of dark chocolate . Capillary FG and TC levels were measured using a calibrated Accutrend GC system (Roche Diagnostics, Burgess Hill, West Sussex, UK). Blood pressure was measured using an automated A&D Medical UA-767 BP monitor (A&D Medical, San Jose, CA, USA). Subjects also completed three 3 d diet and physical activity diaries at baseline and during each intervention. Compliance was measured by direct interviewing, returning of empty chocolate foils and assessment of diet diaries. Repeated-measures ANOVA revealed a significant reduction in capillary FG levels, SBP and DBP following both treatments. No significant differences were observed between dark chocolate containing 500 mg and 1000 mg polyphenols, suggesting that both doses were equally effective in improving these variables (P>0.05). No changes in anthropometrical measurements, capillary TC and urinary free glucocorticoids levels were observed.