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The primary aim of this placebo-controlled study is to determine whether flavonoids beneficially affect markers of cardiovascular disease risk in healthy subjects at elevated cardiovascular risk.
The underlying mechanisms of action of flavonoids will be assessed on blood biomarkers and we will assess the effects of the food matrix, and aspects of isoflavone metabolism.
The study population will be healthy males (aged 50-75 years) at elevated risk of cardiovascular (CV) disease.
A target of 60 participants will be required to complete the study and a total of 70 subjects will be targeted (n=70 subjects * ~85% anticipated completion rate = 60 subjects to complete the study).
This placebo-controlled study will test the relative efficacy of 4 different flavonoid sub-classes ((i) flavan-3-ol, (ii) anthocyanin, (iii) flavanone and (iv) isoflavone).
Accordingly, subjects will be randomised to one of the four flavonoid study groups ((i) to (iv) outlined above), and then will consume each of the following treatments in random order:
Additionally, an isoflavone metabolite will be fed to establish potential vascular effects.
Each sub-class will be assessed separately and a 1 week wash-out period between treatments will be observed.
At each assessment visit, vascular function will be assessed pre- and post-intervention, with subsequent assessments made to coincide with anticipated peak plasma concentrations.
Dietary intake will be monitored during the study and participants will be required to adhere to a range of dietary and lifestyle restrictions within 3 days of each assessment to reduce potential confounding of the data assessment of interest.
A standard battery of vascular function tests will be performed on all intervention groups, with each assessment visit performed in an identical manner.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group A: flavanones | Experimental | All experimental days will be exactly the same. All volunteers will attend the clinical research and trial unit in a fasted state. Prior to test administration, baseline vascular function will be assessed and biological samples taken by a trained and qualified research nurse. Subsequently, assessments will be repeated at times corresponding to anticipated peak plasma concentration of the flavonoid of interest. |
|
| Intervention group B: isoflavones | Experimental | All experimental days will be exactly the same. All volunteers will attend the clinical research and trial unit in a fasted state. Prior to test administration, baseline vascular function will be assessed and biological samples taken by a trained and qualified research nurse. Subsequently, assessments will be repeated at times corresponding to anticipated peak plasma concentration of the flavonoid of interest. |
|
| Intervention group C: Flavan-3-ols | Experimental | All experimental days will be exactly the same. All volunteers will attend the clinical research and trial unit in a fasted state. Prior to test administration, baseline vascular function will be assessed and biological samples taken by a trained and qualified research nurse. Subsequently, assessments will be repeated at times corresponding to anticipated peak plasma concentration of the flavonoid of interest. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Flavanone - supplement | Dietary Supplement | acute single optimal dose |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in blood vessel control (pressure and endothelial function) at time points coinciding with postprandial [anticipated] peak plasma flavonoid concentration. | Assessment of vascular function | acute postprandial; up to 24 hours, dependent on flavonoid sub-classification studied |
| Measure | Description | Time Frame |
|---|---|---|
| Differences in effects of flavonoids introduced by food matrix | acute postprandial; up to 24 hours dependent on flavonoid sub-classification studied |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aedin Cassidy, PhD | University of East Anglia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Nutrition, Norwich Medical School | Norwich | Norfolk | NR4 7TJ | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26843154 | Derived | Hazim S, Curtis PJ, Schar MY, Ostertag LM, Kay CD, Minihane AM, Cassidy A. Acute benefits of the microbial-derived isoflavone metabolite equol on arterial stiffness in men prospectively recruited according to equol producer phenotype: a double-blind randomized controlled trial. Am J Clin Nutr. 2016 Mar;103(3):694-702. doi: 10.3945/ajcn.115.125690. Epub 2016 Feb 3. | |
| 25788001 |
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| Intervention group D: Anthocyanins | Experimental | All experimental days will be exactly the same. All volunteers will attend the clinical research and trial unit in a fasted state. Prior to test administration, baseline vascular function will be assessed and biological samples taken by a trained and qualified research nurse. Subsequently, assessments will be repeated at times corresponding to anticipated peak plasma concentration of the flavonoid of interest. |
|
| Flavanone - food |
| Other |
acute single dose |
|
| Flavanone - placebo | Other | acute single dose (flavanone free) |
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| Isoflavone - supplement | Dietary Supplement | acute single optimal dose |
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| Isoflavone - food | Other | acute single optimal dose |
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| Isoflavone - placebo | Other | acute single dose (isoflavone free) |
|
| Isoflavone - metabolite supplement | Dietary Supplement | acute single optimal dose of commercial product |
|
| Flavan-3-ol - supplement | Dietary Supplement | acute single optimal dose |
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| Flavan-3-ol - food | Other | acute single optimal dose |
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| Flavan-3-ol - placebo | Other | acute single dose (flavan-3-ol free) |
|
| Anthocyanin - supplement | Dietary Supplement | acute single optimal dose |
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| Anthocyanin - food | Other | acute single optimal dose |
|
| Anthocyanin - placebo | Other | acute single dose (anthocyanin free) |
|
| Schar MY, Curtis PJ, Hazim S, Ostertag LM, Kay CD, Potter JF, Cassidy A. Orange juice-derived flavanone and phenolic metabolites do not acutely affect cardiovascular risk biomarkers: a randomized, placebo-controlled, crossover trial in men at moderate risk of cardiovascular disease. Am J Clin Nutr. 2015 May;101(5):931-8. doi: 10.3945/ajcn.114.104364. Epub 2015 Mar 18. |