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Strawberry Consumption, Cardiometabolic Risk Factors, and Vascular Function: A Randomized Controlled Trial in Adults
Leailin Huang1, Di Xiao1, Xuhuiqun Zhang1
1Department of Food Science and Nutrition, Center for Nutrition Research, Institute for Food Safety and Health, Illinois Institute of Technology, Chicago, IL, USA.
Insights
Strawberry consumption may enhance vascular health in adults with hypercholesterolemia by improving endothelial function and blood pressure. These benefits may stem from changes in microbial-derived phenolic metabolites, supporting strawberries in heart-healthy diets.
Area of Science:
- Cardiovascular health and nutrition science.
- Metabolomics and endothelial function research.
Background:
- Certain fruits, like strawberries, contain phytochemicals that may offer cardiometabolic advantages.
- Adults with moderate hypercholesterolemia often seek dietary strategies to manage cardiovascular risk factors.
Purpose of the Study:
- To evaluate the impact of strawberry intake on cardiometabolic risk factors.
- To assess the effects of strawberries on vascular endothelial function in adults with hypercholesterolemia.
Main Methods:
- A randomized, controlled, double-blinded crossover trial involving 34 adults with moderate hypercholesterolemia.
- Participants consumed daily beverages with freeze-dried strawberry powder or a control powder for 4 weeks, followed by a 4-week washout period.
- Primary outcome was LDL cholesterol; secondary outcomes included metabolic markers, inflammation, metabolomics, flow-mediated dilation (FMD), and blood pressure (BP).
Main Results:
- No significant changes were observed in LDL cholesterol or other primary metabolic markers.
- A significant increase in flow-mediated dilation (FMD) was noted 1 hour after strawberry consumption.
- Blood pressure was attenuated at 2 hours post-consumption, and specific phenolic metabolites correlated with improved FMD.
Conclusions:
- Strawberry intake may improve vascular health and endothelial function, potentially through microbial-derived phenolic metabolites.
- These findings support the inclusion of strawberries in heart-healthy dietary recommendations for individuals with moderate hypercholesterolemia.
Background:
Certain fruits, such as strawberries, may impart cardiometabolic benefits due to their phytochemical content.
Objectives:
Study aims were to assess the effects of strawberry intake on cardiometabolic risk factors and vascular endothelial function in adults with moderate hypercholesterolemia.
Methods:
This study was a randomized, controlled, double-blinded, 2-arm, 2-period (4-wk/period) crossover trial. Adults (n = 34; male/female 1:1; mean ± SEM age, 53 ± 1 y; BMI, 31 ± 1 kg/m2; LDL cholesterol, 133 ± 3 mg/dL) were 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 × 25 g) or energy-, 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 h and 2 h after a 50-g bolus strawberry or control beverage. Mixed-model analysis of repeated measures via PROC MIXED, PC-SAS was performed on primary and secondary outcome variables.
Results:
LDL cholesterol did not differ after the 4-wk interventions (P > 0.05), nor did fasting total cholesterol, triglycerides, glucose, insulin, high-sensitivity C-reactive protein, FMD, or BP (all P > 0.05). Significant intervention-by-hour interaction for FMD (P = 0.03) and BP (P = 0.05) revealed increased FMD at 1 h after strawberry compared with control by 1.5 ± 0.38% (P = 0.0008) and attenuated systolic BP at 2 h by 3.1 ± 0.99 mmHg (P = 0.02). Select phenolic metabolites increased significantly (P < 0.05) 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 < 0.05).
Conclusion:
Strawberries 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.
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