Terrence M. Vance

Dietary Antioxidants and Prostate Cancer: A Review

Prostate cancer is the most common noncutaneous cancer in men in the United States. Several studies have examined the relationship between prostate cancer and antioxidants; however, the results of these studies are inconsistent. This article provides a systematic review of studies on prostate cancer and antioxidant intake from diet and supplements. Tea and coffee appear to offer protection against advanced prostate cancer. Different forms of vitamin E appear to exert different effects on prostate cancer, with alpha-tocopherol potentially increasing and gamma-tocopherol potentially decreasing risk of the disease. There is no strong evidence for a beneficial effect of selenium, vitamin C, or beta-carotene, whereas lycopene appears to be negatively associated with risk of the disease. The effect of dietary antioxidants on prostate cancer remains undefined and inconclusive, with different antioxidants affecting prostate cancer risk differentially. Further studies are needed to clarify the relationship between antioxidants and prostate cancer risk and to delineate the underlying mechanisms.

Bioavailability of anthocyanins and colonic polyphenol metabolites following consumption of aronia berry extract.

A single-dose pharmacokinetic trial was conducted in 6 adults to evaluate the bioavailability of anthocyanins and colonic polyphenol metabolites after consumption of 500mg aronia berry extract. UHPLC-MS methods were developed to quantitate aronia berry polyphenols and their metabolites in plasma and urine. While anthocyanins were bioavailable, microbial phenolic catabolites increased ∼10-fold more than anthocyanins in plasma and urine. Among the anthocyanins, cyanidin-3-O-galactoside was rapidly metabolized to peonidin-3-O-galactoside. Aronia polyphenols were absorbed and extensively metabolized with tmax of anthocyanins and other polyphenol catabolites from 1.0h to 6.33h in plasma and urine. Despite significant inter-individual variation in pharmacokinetic parameters, concentrations of polyphenol metabolites in plasma and urine at 24h were positively correlated with total AUC in plasma and urine (r=0.93, and r=0.98, respectively). This suggests that fasting blood and urine collections could be used to estimate polyphenol bioavailability and metabolism after aronia polyphenol consumption.

Greater Total Antioxidant Capacity from Diet and Supplements Is Associated with a Less Atherogenic Blood Profile in U.S. Adults

Evidence from epidemiologic studies has shown that total antioxidant capacity (TAC) in the diet might be inversely associated with stroke, heart failure, and inflammatory biomarkers. However, studies on the association of TAC from both diet and supplements with cardiovascular disease (CVD) risk factors in the U.S. population are lacking. This cross-sectional population-based study aimed to investigate the association of TAC with both diet and supplements with CVD risk factors among 4039 U.S. adults in National Health and Nutrition Examination Survey (NHANES) 2007–2012. TAC from both food sources and dietary supplements was estimated from two 24-h dietary recalls using the NHANES supplement ingredient database, United States Department of Agriculture (USDA) proanthocyanidin, flavonoid, and isoflavone databases. Top contributors to TAC were tea, antioxidant supplements, vegetable mixture, orange juice, berries, and wine. Antioxidant supplement users had 1.6 times higher TAC than non-users. Greater TAC was associated with reduced triglycerides (TG) (−1.39% change; 95% CI = −2.56 to −0.21), TG to high-density lipoprotein cholesterol (HDL-C) ratio (−2.03% change; 95% CI = −3.45 to −0.60), HDL-C (0.65% change; 95% CI = 0.07 to 1.23), insulin (−1.37% change; 95% CI = −2.64 to −0.09), homeostasis model assessment of insulin resistance (HOMA-IR) (−1.57% change; 95% CI = −3.02 to −0.09) and C-reactive protein (CRP) (−0.83% change; 95% CI = −1.29 to −0.38) after adjusting for potential confounders. There was no significant association between TAC and waist circumference, BMI, blood pressure, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and fasting glucose. The findings of this study support the hypothesis that an antioxidant-rich diet and intake of supplements are beneficial to reduce CVD risk.

Estimated Flavonoid Intake of the Elderly in the United States and Around the World

The aging population has been growing fast in the United States and worldwide. The morbidity of age-related chronic degenerative diseases has also been increasing in parallel. Numerous studies have reported that consumption of flavonoid-rich fruits and vegetables is inversely associated with such chronic diseases as Alzheimers disease, age-related macular degeneration, cardiovascular disease, and osteoporosis. In establishing flavonoids as one of the contributors to the protective effects, the very first step is to estimate flavonoid intake from various dietary sources. Estimation of flavonoid intake from dietary sources has been feasible since 2003 when the U.S. Department of Agriculture (USDA) released the database for the flavonoid content of selected foods. Since then, several articles have been published in which flavonoid intake in various subpopulation groups was estimated from relatively large, current databases of flavonoid concentration data. However, information is still limited on the intake by seniors in the United States and worldwide. This review summarizes the most current estimates of flavonoid intake by seniors in the United States and elsewhere.

Zinc Intake Is Associated with Lower Cadmium Burden in US Adults

BACKGROUND Cadmium is a toxic transition metal whose absorption and accumulation might depend on zinc intake. OBJECTIVE We sought to determine whether zinc intake and serum zinc would be inversely associated with cadmium exposure. METHODS This study used data from NHANES 2003-2012, from which there were 6678 and 6488 participants with urinary and blood cadmium data, respectively, and 1195 participants with serum zinc data. Mean blood and urinary cadmium were reported by quintiles of zinc intake and by the dose and duration of zinc supplement use. The associations between zinc intake from diet and supplements, serum zinc, and blood and urinary cadmium were determined using multiple regression. Analyses were adjusted for age, body mass index, race/ethnicity, gender, income-to-poverty ratio, education, smoking status, and mean intakes of energy, calcium, and iron. RESULTS Urinary cadmium concentrations were 0.04 μg/g creatinine lower among participants in the highest compared with lowest quintile of total zinc intake (P-trend = 0.0041). Zinc supplement dose and duration were inversely associated with blood cadmium (P = 0.0372) and serum zinc (P-trend = 0.0017), respectively. In adjusted regression models, a 10% increase in total zinc intake corresponded to a predicted decrease in blood cadmium of 0.42% (95% CI: -0.79%, -0.06%; P = 0.0260) and in urinary cadmium of 0.42% (95% CI: -0.81%, -0.04%; P = 0.0340). A 10% increase in serum zinc was associated with a predicted 1.99% (95% CI: -3.17%, -0.81%; P = 0.0012) decrease in blood cadmium and a predicted 4.09% (95% CI: 2.14%, 6.04%, P = 0.0001) increase in urinary cadmium. CONCLUSIONS Dietary and serum zinc in US adults are associated with cadmium exposure, presumably by influencing the absorption and accumulation of cadmium. Whether the degree of reduction in cadmium exposure from greater zinc intake and status is causal or relevant from a public health perspective needs further investigation.

Greater flavonoid intake is associated with improved CVD risk factors in US adults.

Epidemiological studies have reported that diets high in flavonoids are associated with a reduced risk of CVD. However, evidence on the association of dietary flavonoid intake with CVD risk factors is still scarce. The present study aimed to investigate the association of dietary flavonoid intake with CVD risk factors among US adults in the National Health and Nutrition Examination Survey (NHANES) 2007-2012. A total of 4042 US adults aged 19 years and older from the NHANES 2007-2012 participated in this cross-sectional, population-based study. Intakes of total and individual flavonoids were estimated from 2-d 24-h diet recall data by matching with the expanded US Department of Agriculture flavonoid, isoflavone and proanthocyanidin databases. After adjusting for covariates, increased HDL-cholesterol was associated with higher total flavonoid intake (0·54 % change). TAG and TAG:HDL-cholesterol ratio were inversely associated with anthocyanidin (-1·25 % change for TAG; -1·60 % change for TAG:HDL-cholesterol ratio) and total flavonoid intakes (-1·31 % change for TAG; -1·83 % change for TAG:HDL-cholesterol ratio), respectively. Insulin and homoeostasis model assessment for insulin resistance (HOMA-IR) were inversely associated with flavone (for insulin, -3·18 % change; 95 % CI -5·85, -0·44; for HOMA-IR, -3·10 % change; 95 % CI -5·93, -0·19) and isoflavone intakes (for insulin, -3·11 % change; 95 % CI -5·46, -0·70; for HOMA-IR, -4·01 % change; 95 % CI -6·67, -1·27). BMI was negatively associated with anthocyanidin intake (-0·60 % change). This study showed that higher flavonoid intake was associated with improved CVD risk factors. Further research is warranted to confirm the findings from this study as these associations were moderate in strength.

Intake of dietary antioxidants is inversely associated with biomarkers of oxidative stress among men with prostate cancer.

Prostate cancer is the most common non-cutaneous cancer and the second leading cause of cancer-related mortality among men in the USA. Growing evidence suggests that oxidative stress is involved in the development and progression of prostate cancer. In this study, the association between antioxidants from diet and supplements and biomarkers of oxidative stress in blood (n 278), urine (n 298) and prostate tissue (n 55) were determined among men from the North Carolina-Louisiana Prostate Cancer Project. The association between antioxidant intake and oxidative stress biomarkers in blood and urine was determined using linear regression, adjusting for age, race, prostate cancer aggressiveness and smoking status. Greater antioxidant intake was found to be associated with lower urinary 8-isoprostane concentrations, with a 10% increase in antioxidant intake corresponding to an unadjusted 1·1% decrease in urinary 8-isoprostane levels (95% CI -1·7, -0·3%; P value<0·01) and an adjusted 0·6% decrease (95% CI -1·4, 0·2%; P value=0·16). In benign prostate tissue, thioredoxin 1 was inversely associated with antioxidant intake (P=0·02). No significant associations were found for other blood or urinary biomarkers or for malignant prostate tissue. These results indicate that antioxidant intake may be associated with less oxidative stress among men diagnosed with prostate cancer.

Aronia berry polyphenol consumption reduces plasma total and low-density lipoprotein cholesterol in former smokers without lowering biomarkers of inflammation and oxidative stress: a randomized controlled trial

Former smokers are at increased risk for cardiovascular disease. We hypothesized that dietary aronia polyphenols would reduce biomarkers of cardiovascular disease risk, inflammation, and oxidative stress in former smokers. We also determined the extent these effects were associated with polyphenol bioavailability. A 12-week, randomized, placebo-controlled trial was conducted in 49 healthy adult former smokers (n = 24/placebo, n = 25/aronia) to evaluate if daily consumption of 500 mg aronia extract modulated plasma lipids, blood pressure, biomarkers of inflammation and oxidative stress, and lipid transport genes of peripheral blood mononuclear cells. The primary outcome was change in low-density lipoprotein cholesterol (LDL-C) from baseline, and multivariate correlation analysis was performed to determine if changes in lipids were associated with urinary polyphenol excretion. Aronia consumption reduced fasting plasma total cholesterol by 8% (P = .0140), LDL-C by 11% (P = .0285), and LDL receptor protein in peripheral blood mononuclear cells (P = .0036) at 12 weeks compared with the placebo group. Positive changes in the urinary polyphenol metabolites peonidin-3-O-galactoside, 3-(4-hydroxyphenyl) propionic acid, and unmetabolized anthocyanin cyanidin-3-O-galactoside were associated with lower plasma total cholesterol and LDL-C in the aronia group. Aronia consumption did not change blood pressure or biomarkers of inflammation and oxidative stress. Aronia polyphenols reduced total and LDL-C in former smokers but did not improve biomarkers of oxidative stress and chronic inflammation. The cholesterol-lowering activity of aronia extract was most closely associated with urinary levels of cyanidin-3-O-galactoside and peonidin-3-O-galactoside, its methylated metabolite. This trial was registered at ClinicalTrials.gov as NCT01541826.

Dietary Total Antioxidant Capacity is Inversely Associated with Prostate Cancer Aggressiveness in a Population-Based Study

ABSTRACT The purpose of this study was to determine the relationship between total antioxidant capacity (TAC) from diet and supplements and prostate cancer aggressiveness among 855 African Americans (AA) and 945 European Americans (EA) in the North Carolina–Louisiana Prostate Cancer Project (PCaP). Cases were classified as either high aggressive, low aggressive, or intermediate aggressive. TAC was calculated from the vitamin C equivalent antioxidant capacity of 42 antioxidants measured via food frequency questionnaire. EA reported greater dietary TAC from diet and supplements combined (P < 0.0001). In both minimally and fully adjusted logistic regression models, TAC from diet and supplements combined was associated with a reduced odds of high aggressive prostate cancer in all men, AA and EA: odds ratios for highest vs. lowest level (>1500 vs. <500 mg vitamin C equivalent/day): 0.31 [95% confidence interval (CI): 0.15, 0.67; P-trend < 0.01], 0.28 (95% CI: 0.08, 0.96; P-trend < 0.001), and 0.36 (95% CI: 0.15, 0.86; P-trend = 0.58), respectively. These associations did not appear to differ between AA and EA. These data suggest that greater intake of antioxidants is associated with less aggressive prostate cancer. Additional research is needed to confirm these results and determine the underlying mechanisms.

Development of a comprehensive analytical method for furanocoumarins in grapefruit and their metabolites in plasma and urine using UPLC-MS/MS: a preliminary study

Abstract To develop a comprehensive analytical method for photoactive furanocoumarins, grapefruit (whole, flesh, peel and juice) was extracted using QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) method. Seven furanocoumarins: bergaptol, psoralen, 8-methoxypsoralen, bergapten, 6′,7′-dihydroxybergamottin (6′,7′-DHB), epoxybergamottin and bergamottin were determined in grapefruit using UPLC-MS/MS. The concentrations of furanocoumarins in the plasma and urine of six healthy young adults before and after ingestion of grapefruit or grapefruit juice were also determined. Recovery rates of furanocoumarins by QuEChERS method from matrix spike sample and laboratory calibrate sample were 125.7 ± 25.4% and 105.7 ± 6.3%, respectively. Bergamottin and 6′,7′-DHB were predominant compounds in grapefruit flesh, juice and plasma, while bergaptol and 6′,7′-DHB were major compounds detected in the urine. The results demonstrated that bergamottin and 6′,7′-DHB were metabolized to bergaptol. Overall, the analytical methods developed in the present study can be applied to the analysis of various furanocoumarins in plant sources and biological samples.