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Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents and Oxidative Stress in Adolescents. Erica M. Holt, MPH : University of Minnesota (UM) Lyn M. Steffen, PhD, MPH, RD: UM Antoinette Moran, MD: UM - PowerPoint PPT Presentation
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Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and
Oxidative Stress in Adolescentsand Oxidative Stress in Adolescents
Erica M. Holt, MPH : University of Minnesota (UM)Lyn M. Steffen, PhD, MPH, RD: UM
Antoinette Moran, MD: UMSamar Basu, PhD: Uppsala University
Julia Steinberger, MD: UMJulie A. Ross, PhD: UM
Ching-Ping Hong, MS: UMAlan R. Sinaiko, MD: UM
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Background
• Fruits and vegetables, foods rich in flavonoids and antioxidants, have been associated with lower risk of stroke, coronary heart disease, and markers of inflammation and oxidative stress in adults
• Markers of inflammation and oxidative stress are predictors of coronary heart disease risk
• It is unknown whether these markers are related to dietary flavonoid and antioxidant intake in youth.
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Study Objective
To determine whether greater intakes of fruit and vegetables, antioxidants, and total flavonoids are inversely associated with
markers of inflammation and oxidative stress in adolescent boys and girls.
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Study Methods
• Study Design
– Cross-sectional study conducted in 1996-2000
• Study Population
– 304 adolescent girls and boys
– Exclusions for analysis:
• 19 students without dietary data
– 285 adolescents included in analysis
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Data Collection
• Tanner stage assessed (I, II, III, IV, V)• Height and weight measured
– Body mass index (BMI) calculated kg/m2
• Fasting blood sample obtained– Analyzed for markers of inflammation (C-reactive protein
[CRP], tumor necrosis factor-alpha [TNF-a], interleukin-6 [IL-6], 15-keto-dihydro-PGF2a [PGF2a] and oxidative stress, 8-iso-F2a [F2-isoprostane])
• Dietary intake assessment – Willett 127-item food frequency questionnaire
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Food Groups
• Food intakes were grouped into selected food categories for these analyses
– Fruit: 10 different fruits
– Fruit juice: apple, orange, grapefruit juice
– Vegetables: 24 vegetables
– French fried potatoes
– Legumes
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Statistical Methods
• All analyses were conducted using SAS, version 9.1• Variables with skewed distributions were log transformed to
achieve normality; means were back transformed and reported as geometric means.
• Spearman partial correlation analyses evaluated the relation of dietary intake with markers of inflammation and oxidative stress, adjusting for age, sex, race, Tanner stage, energy intake, and body mass index.
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Results
Characteristic Boys
(n=155)
Girls
(n=130)
p-value
Age 15.1 (1.2) 14.9 (1.2) 0.13
Tanner Stage, n (%) 4.5 (0.8) 4.6 (0.6) 0.22
BMI, kg/m2 23.3 (5.0) 24.0 (5.3) 0.21
SD = standard deviation BMI = Body mass index
Mean (SD) physical and clinical characteristics of adolescent boys and girls, N=285
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Mean (SD) markers of inflammation and oxidative stress among adolescent boys and girls, N=285
Characteristic Boys
(n=155)
Girls
(n=130)
p-value
CRP 0.77 (1.9) 0.85 (1.9) 0.12
TNF-a 4.01 (1.9) 4.33 (2.2) 0.33
IL-6 2.16 (2.1) 2.41 (1.9) 0.17
PGF2-a 0.17 (1.4) 0.20 (1.4) 0.003
F2isoprostane 0.3 (1.6) 0.4 (1.5) 0.004CRP = c-reactive protein TNF-a = Tumor necrosis factor-á IL-6 = Interleukin-6 F2-iso = F2-isoprostane
PGF 2a = Prostaglandin F2a SD = standard deviation
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Mean (SE) daily nutrient intake of adolescent 155 boys and 130 girls, N=285
Nutrient intakea Boys Girls p-value
Energy, kcal 2532 (83) 2234 (94) 0.01
Fiber, g 21.4 (0.4) 22.9 (0.5) 0.03
Vitamin C, mgb 250 (15.2) 251 (17.1) 0.96
Beta-carotene, IU 9047 (565) 9047 (589) 0.31
Folate, mcgb 471 (15.2) 463 (17.3) 0.71
aaAdjusted for age, race, Tanner stage, energy intake b nutrients include food + supplement intake
SE = standard error
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Mean (SE) daily fruit and vegetable intake of adolescent 155 boys and 130 girls, N=285
Food Intake, servingsa Boys Girls p-value
Fruit 1.4 (0.1) 1.4 (0.1) 0.90
Fruit juice 1.7 (0.1) 1.2 (0.1) 0.02
Vegetablesb 2.3 (0.1) 2.6 (0.1) 0.14
French fries 0.5 (0.2) 0.5 (0.3) 0.43
Legumes 0.2 (0.03) 0.2 (0.03) 0.89
Total fruit/vegetable 5.6 (0.3) 5.5 (0.3) 0.79
aaAdjusted for age, race, Tanner stage, energy intake bVegetables exclude french fries
SE = standard error
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Mean (SE) daily flavonoid intake of adolescent 155 boys and 130 girls,
N=285Flavonoid intakea Boys Girls p-value
Myricetin, mg 0.92 (0.07) 1.03 (0.08) 0.27
Kaempferol, mg 2.51 (0.28) 3.06 (0.33) 0.21
Quercetin, mg 10.2 (0.33) 10.8 (0.38) 0.23
Luteolin, mg 0.08 (0.04) 0.04 (0.04) 0.43
Total flavonoids, mg 14.2 (0.58) 15.4 (0.66) 0.16
aaAdjusted for age, race, Tanner stage, energy intake SE = standard error
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Dietary Intakea CRP TNF-a IL-6 PG F2
Vitamin C, mg b -0.13* NS -0.14* NS -0.16*
Beta-carotene, IU NS -0.14* -0.15* NS NS
Folate, mcgb -0.18* NS NS NS -0.21*
Kaempferol, mg NS NS NS NS -0.15*
Quercetin, mg NS NS NS NS -0.15*
Total flavonoids NS NS NS NS -0.14*
Correlation of dietary antioxidants with markers of inflammation and Oxidative Stress in Adolescents, N=285
a = models adjusted for age, sex, race, Tanner stage, energy intake, Body Mass Index
b= nutrients include food and vitamin supplement intake*p<0.05
CRP = c-reactive protein TNF-a = Tumor necrosis factor-á IL-6 = Interleukin-6 F2-iso = F2-isoprostane
PGF 2a = Prostaglandin F2a
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Correlation of food intake with markers of inflammation and oxidative stress in adolescents, N=285
Food Intakea CRP TNF-a IL-6 PG F2
Fruit -0.19* NS -0.13* NS NS
Vegetables NS -0.13* -0.15* NS NS
Legumes NS NS -0.16* NS NS
Fruit and vegetablesb* -0.15* -0.13* -0.16* NS -0.13*
*p<0.05
a = models adjusted for age, sex, race, Tanner stage, energy intake, Body Mass Index (BMI)b = total fruit and vegetables include fruit juice and French fried potatoesCRP = c-reactive protein TNF-a = Tumor necrosis factor-á IL-6 = Interleukin-6 F2-iso = F2-isoprostane
PGF 2a = Prostaglandin F2a
JOURNAL OF THEAMERICAN DIETETICASSOCIATION
Holt E, et al. J Am Diet Assoc. 2009; 109 (Mar).
Fruit and Vegetable Consumption and its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Conclusions
• The beneficial effects of fruit and vegetable intake on markers of inflammation and oxidative stress are already present by early adolescence.
• These findings provide support for the United States Dietary Guideline “to consume five or more servings per day” of fruits and vegetables, which is beneficial for cardiovascular health.
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