Nicole R. Stendell-Hollis

Cherries and Health: A Review

Cherries, and in particular sweet cherries, are a nutritionally dense food rich in anthocyanins, quercetin, hydroxycinnamates, potassium, fiber, vitamin C, carotenoids, and melatonin. UV concentration, degree of ripeness, postharvest storage conditions, and processing, each can significantly alter the amounts of nutrients and bioactive components. These constituent nutrients and bioactive food components support the potential preventive health benefits of cherry intake in relation to cancer, cardiovascular disease, diabetes, inflammatory diseases, and Alzheimers disease. Mechanistically, cherries exhibit relatively high antioxidant activity, low glycemic response, COX 1 and 2 enzyme inhibition, and other anti-carcinogenic effects in vitro and in animal experiments. Well-designed cherry feeding studies are needed to further substantiate any health benefits in humans.

Plasma and dietary carotenoids are associated with reduced oxidative stress in women previously treated for breast cancer.

Dietary carotenoids show numerous biological activities, including antioxidant activity, induction of apoptosis, and inhibition of mammary cell proliferation. Studies examining the role of carotenoid consumption in relation to breast cancer recurrence are limited and report mixed results. We tested the hypothesis that breast cancer survivors with high dietary and plasma carotenoids would show significantly lower levels of oxidative stress than breast cancer survivors with low dietary and plasma carotenoid levels. Two hundred seven postmenopausal breast cancer survivors from the Womens Healthy Eating and Living Study volunteered for this ancillary study. Dietary data were analyzed by the Arizona Food Frequency Questionnaire and plasma carotenoids α-carotene, β-carotene, lutein plus zeaxanthin, lycopene, and β-cryptoxanthin and quantified with high-performance liquid chromatography, and immunoaffinity chromatography-monoclonal antibody–based ELISAs were used to analyze the urine samples for 8-hydroxy-2′-deoxyguanosine (8-OhdG) and 8-iso-prostaglandin-F2α (8-iso-PGF2α). The correlations between dietary and plasma carotenoids were 0.34 for β-carotene, 0.46 for α-carotene, 0.39 for β-cryptoxanthin, 0.27 for lycopene, 0.30 for lutein plus zeaxanthin, and 0.30 for total carotenoids. The 8-OHdG oxidative stress biomarker was significantly reduced at the highest quartile of total plasma carotenoid concentrations (P = 0.001) and 8-iso-PGF2α was moderately reduced (P = 0.088). Dietary carotenoid levels were not significantly associated with oxidative, stress indicators, although dietary lycopene and lutein/zeaxanthin were modestly associated with 8-OHdG levels (P = 0.054 and 0.088, respectively). Key findings include a significant inverse association between total plasma carotenoid concentrations and oxidative stress as measured by urinary 8-OHdG and a moderately significant inverse association with 8-iso-PGF2α, a protective association that was not shown for dietary carotenoid intake. (Cancer Epidemiol Biomarkers Prev 2007;16(10):2008–15)

Green tea improves metabolic biomarkers, not weight or body composition: a pilot study in overweight breast cancer survivors.

BACKGROUND Overweight status after breast cancer treatment may increase a womans risk for recurrent disease and/or early onset cardiovascular disease. Green tea has been proposed to promote weight loss and favourably modify glucose, insulin and blood lipids. This pilot study tested the effect of daily decaffeinated green tea consumption for 6 months on weight and body composition, select metabolic parameters and lipid profiles in overweight breast cancer survivors. METHODS The effect of daily decaffeinated green tea intake on weight, body composition and changes in resting metabolic rate, energy intake, glucose, insulin, homeostasis model assessment--insulin resistance (HOMA-IR) and lipids was evaluated in overweight breast cancer survivors. Participants had a mean weight of 80.2 kg; body mass index (BMI) 30.1 kg m⁻²; and body fat 46.4%. Participants (n = 54) were randomised to 960 mL of decaffeinated green or placebo tea daily for 6 months. RESULTS Mean (SD) tea intake among study completers (n = 39) was 5952 (1176) mL week⁻¹ and was associated with a significant reduction in energy intake (P = 0.02). Change in body weight of -1.2 kg (green tea) versus +0.2 kg (placebo) suggests a weight change effect, although this was not statistically significant. Decaffeinated green tea intake was associated with elevated high-density lipoprotein (HDL) levels (P = 0.003) and nonsignificant improvements in the HDL/LDL ratio and HOMA-IR (-1.1 ± 5.9: green tea; +3.2 ± 7.2: herbal). CONCLUSIONS Intake of decaffeinated green tea for 6 months was associated with a slight reduction in body weight and improved HDL and glucose homeostasis in overweight breast cancer survivors.

Green Tea Extract and Catechol-O-Methyltransferase Genotype Modify Fasting Serum Insulin and Plasma Adiponectin Concentrations in a Randomized Controlled Trial of Overweight and Obese Postmenopausal Women

BACKGROUND Green tea consumption has been associated with favorable changes in body weight and obesity-related hormones, although it is not known whether these changes result from green tea polyphenols or caffeine. OBJECTIVE We examined the impact of decaffeinated green tea extract (GTE) containing 843 mg of (-)-epigallocatechin-3-gallate on anthropometric variables, obesity-associated hormones, and glucose homeostasis. METHODS The Minnesota Green Tea Trial was a 12-mo randomized, double-blind, placebo-controlled clinical trial of 937 healthy postmenopausal women assigned to either decaffeinated GTE (1315 mg total catechins/d) or a placebo, stratified by catechol-O-methyltransferase (COMT) genotype. This study was conducted in a subset of 237 overweight and obese participants [body mass index (BMI) ≥25 kg/m(2)]. RESULTS No changes in energy intake, body weight, BMI, or waist circumference (WC) were observed over 12 mo in women taking GTE (n = 117) or placebo (n = 120). No differences were seen in circulating leptin, ghrelin, adiponectin, or glucose concentrations at month 12. Participants randomly assigned to GTE with baseline insulin ≥10 μIU/mL (n = 23) had a decrease in fasting serum insulin from baseline to month 12 (-1.43 ± 0.59 μIU/mL), whereas those randomly assigned to placebo with baseline insulin ≥10 μIU/mL (n = 19) had an increase in insulin over 12 mo (0.55 ± 0.64 μIU/mL, P < 0.01). Participants with the homozygous high-activity (G/G) form of COMT had significantly lower adiponectin (5.97 ± 0.50 compared with 7.58 ± 0.53 μg/mL, P = 0.03) and greater insulin concentrations (7.63 ± 0.53 compared with 6.18 ± 0.36 μIU/mL, P = 0.02) at month 12 compared with those with the low-activity (A/A) genotype, regardless of treatment group. CONCLUSIONS Decaffeinated GTE was not associated with reductions in body weight, BMI, or WC and did not alter energy intake or mean hormone concentrations in healthy postmenopausal women over 12 mo. GTE decreased fasting insulin concentrations in those with elevated baseline fasting concentrations. The high-activity form of the COMT enzyme may be associated with elevations in insulin and a reduction in adiponectin concentrations over time. This trial was registered at http://www.clinicaltrials.gov as NCT00917735.

A Comparison of Mediterranean-Style and MyPyramid Diets on Weight Loss and Inflammatory Biomarkers in Postpartum Breastfeeding Women

BACKGROUND Of postpartum women, 15%-20% retain ≥ 5 kg of their gestational weight gain, increasing risk for adult weight gain. Postpartum women are also in a persistent elevated inflammatory state. Both factors could increase the risk of obesity-related chronic disease. We hypothesized that breastfeeding women randomized to a Mediterranean-style (MED) diet for 4 months would demonstrate significantly greater reductions in body weight, body fat, and inflammation than women randomized to the U.S. Department of Agricultures (USDA) MyPyramid diet for Pregnancy and Breastfeeding (comparison diet). METHODS A randomized, controlled dietary intervention trial was conducted in 129 overweight (body mass index [BMI] 27.2 ± 4.9 kg/m(2)), mostly exclusively breastfeeding (73.6%) women who were a mean 17.5 weeks postpartum. Dietary change was assessed using a validated Food Frequency Questionnaire (FFQ) before and after intervention as well as plasma fatty acid measures (gas chromatography/flame ionization detector [GC/FID]). Anthropometric measurements and biomarkers of inflammation, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), also were assessed at baseline and 4 months via enzyme-linked immunosorbent assay (ELISA). RESULTS Participants in both diet groups demonstrated significant (p<0.001) reductions in body weight (-2.3 ± 3.4 kg and -3.1 ± 3.4 kg for the MED and comparison diets, respectively) and significant (p ≤ 0.002) reductions in all other anthropometric measurements; no significant between-group differences were shown as hypothesized. A significant decrease in TNF-α but not IL-6 was also demonstrated in both diet groups, with no significant between-group difference. CONCLUSIONS Both diets support the promotion of postpartum weight loss and reduction in inflammation (TNF-α) in breastfeeding women.

Investigating the Association of Lactation History and Postmenopausal Breast Cancer Risk in the Women's Health Initiative

Prolonged lactation (≥24 mo) has been associated with reduced breast cancer risk. This research examined this association in postmenopausal women in the Womens Health Initiative (WHI) Hormone Trial (HT) and Observational Study (OS). This retrospective cohort analysis included 69,358 predominantly overweight (65.4%), white (83.2%) postmenopausal women without breast cancer. Women in the HT were randomized to 0.625 mg conjugated equine estrogen (CEE), 0.625 CEE + 2.5 mg medroxyprogesterone acetate (CEE/MPA), or placebo. OS participants had no restrictions on hormone use. Lactation history was assessed via WHI Reproductive History Questionnaire. Most women breastfed at least 1 mo (58.0%); 35.4% breastfed 1–2 children; and 6.5% stated having breastfed ≥24mo. Women in the HT–CEE who breastfed their first child between 20–24 yr of age demonstrated a nonsignificant decreased risk of breast cancer (HR: 0.62; 95% CI: 0.38, 1.01). OS participants who reported CEE/MPA hormone use and age of first breastfeeding ≥30 yr showed a significant increased risk of breast cancer (HR: 1.66; 95% CI: 1.14, 2.41). Risk was increased if age of last breastfeeding was ≥35yr (HR: 1.50; 95% CI: 1.05, 2.14). This research did not demonstrate a significantly decreased risk of postmenopausal breast cancer in women who breastfed for ≥24 mo during their lifetime.

Mediterranean Diet and Breast Cancer

Breast cancer remains the most commonly diagnosed cancer in women. Whereas some epidemiological studies generally support the role of diet in breast cancer prevention, conflicting evidence exists, making it challenging to provide a definitive answer on these risks that can be effectively translated to clinical practice and public health recommendations.