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Fruit and Vegetable Consumption and Its Relation to Markers of Inflammation and Oxidative Stress in Adolescents

https://doi.org/10.1016/j.jada.2008.11.036Get rights and content

Abstract

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; however, it is unknown whether these markers are related to dietary flavonoid and antioxidant intake in youth.

Objective

To determine whether greater intakes of fruit and vegetables, antioxidants, folate, and total flavonoids were inversely associated with markers of inflammation and oxidative stress in 285 adolescent boys and girls aged 13 to 17 years.

Design

In this cross-sectional study conducted between February 1996 and January 2000, diet was assessed by a 127-item food frequency questionnaire. Height and weight measurements were obtained and a fasting blood sample drawn. Spearman partial correlation analyses evaluated the relation of intakes of fruit and vegetables, antioxidants, folate, and flavonoids with markers of inflammation (C-reactive protein, interleukin-6, tumor necrosis factor-α, and 15-keto-dihydro-PGF metabolite and oxidative stress (urinary 8-iso prostaglandin F, an F2-isoprostane), adjusting for age, sex, race, Tanner stage, energy intake, and body mass index.

Results

Urinary F2-isoprostane was inversely correlated with intakes of total fruit and vegetables, vitamin C, beta carotene, and flavonoids. Serum C-reactive protein was significantly inversely associated with intakes of fruit (r=−0.19; P=0.004), vitamin C (r=−0.13, P=0.03), and folate (r=−0.18; P=0.004). Serum interleukin-6 was inversely associated with intakes of legumes, vegetables, beta carotene, and vitamin C. Serum tumor necrosis factor-α was inversely associated with beta carotene (r=−0.14, P=0.02) and luteolin (r=−0.15, P=0.02).

Conclusion

Study results show that the beneficial effects of fruit and vegetable intake on markers of inflammation and oxidative stress are already present by early adolescence and provide support for the Dietary Guidelines for Americans “to consume five or more servings per day” of fruits and vegetables to promote beneficial cardiovascular health.

Section snippets

Study Population

Approval for this study was obtained from the University of Minnesota Institutional Review Board Human Subjects Committee. Consent for participation was obtained from all participants and their parents or guardians.

Participant recruitment and study methods have been described in detail previously (30). Briefly, after blood pressure screening of 12,043 fifth- to eighth-grade Minneapolis, MN, public school students, 500 study participants were randomly selected by strata of sex, race (black or

Results

The cohort included 155 boys and 130 girls, aged 15±1.2 years; 20% were African American. Physical characteristics and laboratory data are shown in Table 1. Tanner stage and BMI were similar for boys and girls and no significant differences were found between sexes for CRP, TNF-α, and IL-6. However, PGF metabolite, and F2-isoprostanes were significantly greater in girls than boys (P=0.003 and P=0.004, respectively).

Study participants consumed an average of 5.5±0.3 servings (about 2.75 cups)

Discussion

In this study of adolescents, a diet high in fruit and vegetables and, therefore, rich in antioxidants, folate, and flavonoids, was associated with lower levels of markers for inflammation and oxidative stress. These results show that increased consumption of fruit and vegetables and, therefore, antioxidant and flavonoid intake, begin to have an effect on markers of inflammation and oxidative stress early in life, and suggest that with an ongoing similar pattern of consumption, these beneficial

Conclusion

Evidence is accumulating that suggests low-grade inflammation and oxidative stress predicts an increased risk for chronic disease in adults (29, 46, 47, 48, 49, 50, 51, 52, 53, 54) and adolescence (26, 78). As shown in the present study, fruit and vegetable intake was associated with lower concentrations of systemic oxidative stress and inflammation in adolescents, which is similar to studies in adults (1, 2, 3, 4, 5). Anti-inflammatory mechanisms, such as dietary antioxidants, may inhibit

E. M. Holt is an epidemiologist, Hennepin County Public Health Department, Hopkins, MN; at the time of the study, she was a student in the Master of Public Health Program, Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis

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    E. M. Holt is an epidemiologist, Hennepin County Public Health Department, Hopkins, MN; at the time of the study, she was a student in the Master of Public Health Program, Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis

    L. M. Steffen is an associate professor of epidemiology and C.-P. Hong is a senior analyst/programmer, Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis

    A. Moran is professor and division chief, Pediatric Endocrinology and Diabetes, J. Steinberger is an associate professor of pediatrics and chair of Pediatric Cardiology, J. A. Ross is professor and director, Division of Pediatric Epidemiology & Clinical Research, and A. R. Sinaiko is a professor, all with the Department of Pediatrics, University of Minnesota Medical School, Minneapolis

    S. Basu is an associate professor, Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden

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