Effects of a hypoenergetic diet associated with açaí (Euterpe oleracea Mart.) pulp consumption on antioxidant status, oxidative stress and inflammatory biomarkers in overweight, dyslipidemic individuals

doi:10.1016/j.clnu.2019.06.008

Clinical Nutrition

Volume 39, Issue 5, May 2020, Pages 1464-1469

https://doi.org/10.1016/j.clnu.2019.06.008 Get rights and content

Highlights

•
The addition of 200 g of açaí to hypoenergetic diet (HD) reduced IFN-γ and IL-6.
•
There was also significant reduction in plasma 8-isoprostane concentrations levels.
•
Açai and HD had a significant reduction in body mass and BMI.

Summary

Objective

To evaluate the effects of a hypoenergetic diet (HD)associated with açaí pulp consumption on oxidative stress, antioxidant status and inflammatory biomarkers in overweight, dyslipidemic individuals.

Research methods & procedures

A randomized, double-blind, placebo-controlled clinical trial was conducted for 90 days. The study began with a 30-day run-in period, during which the intervention was exclusively a HD. Following this period, volunteers were randomized into 2 groups, and 200 g of either açaí pulp or placebo were added to the HD for 60 days. Anthropometric measurements, arterial pressure, oxidative stress and antioxidant status biomarkers, inflammatory and biochemical biomarkers were evaluated.

Results

Sixty-nine volunteers completed the clinical trial, 30 of which were in the HD + açaí group and 39 in HD + placebo group. Plasma 8-isoprostane concentrations significantly reduced 60 days after the intervention in the açaí group (p = 0.000), and there was a significant difference between the groups (açaí versus placebo; p = 0.037). Regarding inflammatory status parameters, a significant reduction in IL-6 was observed in the HD + açaí group (p = 0.042), and IFN-γ decreased significantly in both groups, HD + açaí (p = 0.001) and HD + placebo (p = 0.008); there were, however, no differences between the groups. Lipid profile parameters and blood glucose levels did not show change, regardless of nutritional intervention.

Conclusion

The addition of açaí to a HD, for 60 days, reduced oxidative stress and improved inflammation in overweight, dyslipidemic individuals.

Graphical abstract

Introduction

The prevalence of obesity has increased worldwide. In the year 2017, elevated body mass index (BMI) ranked fourth among risk factors for mortality, mainly due to its effects on cardiovascular diseases (CVD) [1]. In Brazil, 2016 research data from the Telephone-based Surveillance of Chronic Diseases (VIGITEL) revealed that more than half of the population was overweight, with 18.9% of Brazilians being classified as obese [2]. Obesity influences the development of many risk factors associated with CVD, such as dyslipidemia, systemic arterial hypertension (SAH), insulin resistance, and type 2 diabetes mellitus [3]. Oxidative stress and inflammation also contribute to the development of these diseases [4].

The accumulation of adipose tissue promotes changes in adipokine secretion, as well as infiltration and activation of macrophages within the tissue [5]. There is a resulting increase in the expression of pro-inflammatory cytokines, such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α), and in the production of reactive oxygen species (ROS) by the infiltrated macrophages [5]. The main enzymatic antioxidants system includes superoxide dismutase, catalase, glutathione peroxidase, and reduced glutathione; whereas dietary antioxidant compounds, such as vitamin E, vitamin C, carotenoids, uric acid, and polyphenols, are part of the non-enzymatic system. Together, they act through mechanisms to prevent and control ROS formation [5], [6].

Dietary patterns characterized by higher consumption of fruits, vegetables, whole grains, low-fat dairy products, and lean meats are associated with a lower risk of all-cause morbidity and mortality [7]. Bioactive compounds, such as polyphenols found in fruits and vegetables, are also associated with beneficial effects on improvements in CVD risk factors, inhibiting inflammation and platelet aggregation, regulating lipid metabolism and intestinal microbiota, and eliminating free radicals [8].

Açaí (Euterpe oleracea Mart.), is a typical fruit from the Amazon Region of Brazil, which is rich in polyphenols, such as anthocyanins (cyanidin-3-glucoside and cyanidin 3-rutinoside), oleic acid, fibers, and phytosterols. It has attracted interest due to its antioxidant potential [9], [10], [11]. In vitro studies in experimental models have demonstrated that açaí has antioxidant [9], [12], anti-inflammatory [13], and lipid-profile-improving effects [14]. Studies with humans, however, are still limited [15], [16], [17].

Although it is a highly caloric fruit, açaí may be part of a healthy balanced diet, and it may be useful in weight-loss programs. As previously shown, this fruit is rich in monounsaturated fatty acids and fibers which may act by stimulating metabolism, promoting satiety, and improving bowel function. Furthermore, the anthocyanins present in açaí may have antioxidant and anti-inflammatory effects and be beneficial to individuals who are overweight.

Considering the presence of a high quantity and variety of compounds present in açaí and their possible effects on protecting against oxidative stress and inflammation, the objective of this study was to evaluate the effects of a hypoenergetic diet associated with açaí consumption on oxidative stress and antioxidant status and inflammatory biomarkers in overweight, dyslipidemic individuals.

Section snippets

Population

Two hundred and twenty-four volunteers were recruited at the Clinical Nutrition Research and Extension Center of the Clementino Fraga Filho University Hospital of the Federal University of Rio de Janeiro (Rio de Janeiro, RJ, Brazil), from October 2016 to February 2018. Of the 224 individuals screened, 131 were eligible to participate in the study. Selection criteria were: adults with BMI ≥25 kg/m² [18], both sexes, ages 20 to 59, and at least one lipid profile alteration according to the

Results

Two hundred and twenty-four volunteers were recruited, 93 (41.5%) of which did not meet eligibility criteria. One hundred and twenty-five volunteers, with an average age of 39.8 ± 10.7, 76% (n = 95) of which were women and 24% (n = 30) of which were men, participated in the run-in period. Table 1 shows the anthropometric, arterial pressure, biochemical characteristics of the volunteers who participated in the run in. Significant reductions in body mass and BMI were observed. There was a

Discussion

With the aim of reducing loss of follow-up during the clinical trial and adapting volunteers to the study, a 30-day run in period was conducted, during which volunteers received HD only. Notwithstanding the implementation of this period, we were unable to avoid a 34.3% loss of follow-up. High withdrawal rates have similarly been observed in dietary intervention studies. In a retrospective clinical trial, Inelmen et al. [26] observed a 1-year-drop-out rate of 77.3% in a sample of 383 overweight

Conclusion

This study showed that the addition of 200 g of açaí to a hypoenergetic diet, reduced oxidative stress and improved inflammatory status in overweight individuals with dyslipidemia.

Author contributions

Gláucia Maria Moraes de Oliveira and Glorimar Rosa were responsible for study design, analyzed and interpretation of the results and writing of the manuscript. Luciana Nicolau Aranha was responsible for recruiting and care of patients, laboratory analysis, analyzed and interpretation of the results and the writing of the manuscript. Mariana Gomes Silva and Sofia Kimi Uehara assisted in recruiting and care of patients. Ronir Raggio Luiz assisted interpretation of the results. José Firmino

Conflicts of interest

The authors declare no conflict of interest.

Acknowledgements

This study was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES).

References (30)

M.E. Piché et al.
Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update
Prog Cardiovasc Dis
(2018)
A.H. de Mello et al.
Mitochondrial dysfunction in obesity
Life Sci
(2018)
E. Birben et al.
Oxidative stress and antioxidant defense
World Allergy Organ J
(2012)
B.E. Harmon et al.
Associations of key diet-quality indexes with mortality in the multiethnic cohort: the dietary patterns methods project
Am J Clin Nutr
(2015)
L.A. Pacheco-Palencia et al.
Phytochemical composition and thermal stability of two commercial acai species, Euterpe oleracea and Euterpe precatória
Food Chem
(2009)
M. Heinrich et al.
Açai (Euterpe oleracea Mart): a phytochemical and pharmacological assessment of the species' health claims
Phytochem Lett
(2011)
C. Xie et al.
The açaí flavonoid velutin is a potent anti-inflammatory agent: blockade of LPS-mediated TNF-á and IL-6 production through inhibiting NF-êB activation and MAPK pathway
J Nutr Biochem
(2012)
P.O. Barbosa et al.
Açai (Euterpe Oleracea Mart.) pulp dietary intake improves cellular antioxidant enzymes and biomarkers of serum in healthy women
Nutrition
(2016)
D. Pala et al.
Açai (Euterpe oleracea Mart.) dietary intake affects plasma lipids, apolipoproteins, cholesteryl ester transfer to high-density lipoproteinand redox metabolism: a prospective study in women
Clin Nutr
(2018)
M. Wishnofsky
Caloric equivalentes of gained or lost weight
Am J Clin Nutr
(1958)

Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden on Disease Study

Lancet

(2018)

Ministério da Saúde

Vigitel Brasil 2016: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico dos 26 estados brasileiros e no Distrito Federal em 2016/Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde

(2017)

M. Matsudo et al.

Increased oxidative stress in obesity: implications for metabolic syndrome, diabetes, hypertension, dyslipidemia, atherosclerosis, and câncer

Obes Res Clin Pract

(2013)

G. Chiva-Blanch et al.

Polyphenols and health: moving beyond antioxidants

J Berry Res

(2012)

A.G. Schauss et al.

Phytochemical and nutrient composition of the freeze-dried amazonian palm berry, Euterpe oleraceae Mart. (acai)

J Agric Food Chem

(2006)

Cited by (20)

A polyphenol-rich açaí seed extract protects against 5-fluorouracil-induced intestinal mucositis in mice through the TLR-4/MyD88/PI3K/mTOR/NF-κBp65 signaling pathway
2024, Nutrition Research
Açaí seed extract (ASE) is obtained from Euterpe oleracea Mart. (açaí) plant (Amazon region) has high nutritional and functional value. ASE is rich in polyphenolic compounds, mainly proanthocyanidins. Proanthocyanidins can modulate the immune system and oxidative stress by inhibiting the toll-like receptor-4 (TLR-4)/myeloid differentiation primary response 88 (MyD88)/nuclear factor-κB (NF-κB) pathway. A great deal of evidence suggests that inflammatory cytokines and oxidative stress contribute to the pathogenesis of intestinal mucositis, and these events can lead to intestinal dysmotility. We hypothesized that ASE acts as an anti-inflammatory and antioxidant compound in intestinal mucositis induced by 5-fluorouracil (5-FU) through modulation of the TLR-4/MyD88/phosphatidylinositol-3-kinase α/mechanistic target of rapamycin/NF-κBp65 pathway. The animals were divided into linear 5-FU (450 mg/kg) and 5-FU + ASE (10, 30, and 100 mg/kg) groups. The weight loss of the animals was evaluated daily. Samples from duodenum, jejunum, and ileum were obtained for histopathological, biochemical, and functional analyses. ASE reduced weight loss, inflammatory parameters (interleukin-1β; tumor necrosis factor-α; myeloperoxidase activity) and the gene expression of mediators involved in the TLR-2/MyD88/NF-κB pathway. ASE prevented histopathological changes with beneficial effects on gastrointestinal transit delay, gastric emptying, and intestinal absorption/permeability. In conclusion, ASE protects the integrity of the intestinal epithelial barrier by inhibiting the TLR/MyD88/PI3K/mechanistic target of rapamycin/NF-κBp65 pathway.
Exploring strategies to enhance anthocyanin bioavailability and bioaccessibility in food: A literature review
2023, Food Bioscience
Anthocyanins are phenolic compounds with remarkable antioxidant capacity, known for their wide range of health benefits for consumers. However, its instability is a challenge during digestion, resulting in losses in the gastrointestinal tract. To effectively harness the health potential of anthocyanins, it is essential to improve their bioaccessibility and bioavailability. This review explores strategies that can be employed to improve the stability of anthocyanins in food systems and during digestion. The article investigates how co-ingestion, processing, and different microencapsulation techniques mainly affect the in vitro bioaccessibility of anthocyanins. Co-ingestion with matrices rich in lipids and carotenoids improved the bioaccessibility of some anthocyanins, while the presence of pectin and casein affected them in variable ways. Cooking processing can lead to softening of the food matrix, resulting in increased bioaccessibility. Encapsulation techniques stand out, supported by several studies that show promising results, presenting themselves as a solution to these challenges. However, most studies have been limited to in vitro experiments, emphasizing the need for additional in vivo investigations to fully understand the impact of these strategies in the physiological context.
Influence of spontaneous and inoculated fermentation of açai on simulated digestion, antioxidant capacity and cytotoxic activity
2023, Food Research International
This work describes the kinetic study of different types (spontaneous, lactic and alcoholic) of açai fermentation in terms of total phenolics and total anthocyanins, as well as antioxidant capacity, before and after simulated digestion (SD). Cytotoxicity (A549, HCT8 and IMR90 cells) and formation of reactive oxygen species (A549 cells) were also evaluated. The results revealed that spontaneous fermentation (SF) for 24 h, followed by SD, generated a product with greater bioaccessibility of phenolics (52.68%) and cyanidin-3-glucoside (27.01%) than unfermented açai. Likewise, lactic fermentation (LF) for 72 h improved the bioavailability of phenolics (64.49%) and cyanidin-3-rutinoside (20.00%). On the other hand, alcoholic fermentation (AF) decreased the bioaccessibility of phenolic compounds and anthocyanins after SD. The SF 24 h (10.16 ± 1.25 μmol Trolox /g) and LF 72 h (15.90 ± 0.51 μmol Trolox /g) significantly increased the antioxidant capacity after SD, when compared to unfermented açai (SF 0 h, 4.00 ± 0.09 μmol Trolox /g; LF 0 h, 10.57 ± 0.91 μmol Trolox /g). It was concluded that the samples did not show cytotoxicity in the cell lines tested and, in addition, AF 24 h showed antioxidant and antimutagenic effects in vitro, reducing about 40% of chromosomal aberrations. The results obtained provide important information that can be used to produce foods with greater bioaccessibility of bioactive compounds.
Amazon-derived nutraceuticals: Promises to mitigate chronic inflammatory states and neuroinflammation
2021, Neurochemistry International
Citation Excerpt :
Recent studies have been performed in order to assess the potential beneficial role of açaí consumption by human individuals. The work of Aranha et al. (2020) investigated whether the intake of açaí (200 g) added to an individualized hypoenergetic diet, for 60 days, could positively modulate anthropometric indicators and markers associated with oxidative stress and pro-inflammatory states in overweight, dyslipidemic individuals. Overall, besides the hypoenergetic diet and açaí decreasing body mass index (BMI) and body mass, the association was also able to reduce oxidative stress and pro-inflammatory cytokines (IFN-γ and IL-6), thus exerting some anti-inflammatory and antioxidant potential.
Nutraceuticals have been the focus of numerous research in recent years and accumulating data support their use for promoting some health benefits. Several nutraceuticals have been widely studied as supplements due to their functional properties ameliorating symptoms associated with neurological disorders, such as oxidative stress and chronic inflammatory states. This seems to be the case of some fruits and seeds from the Amazon Biome consumed since the pre-Columbian period that could have potential beneficial impact on the human nervous system. The beneficial activities of these food sources are possibly related to a large number of bioactive molecules including polyphenols, carotenoids, unsaturated fatty acids, vitamins, and trace elements. In this context, this review compiled the research on six Amazonian fruits and seeds species and some of the major nutraceuticals found in their composition, presenting brief mechanisms related to their protagonist action in improving inflammatory responses and neuroinflammation.
Durability of coating mortars containing açaí fibers
2020, Case Studies in Construction Materials
Citation Excerpt :
Açaí (Euterpe oleracea Mart.) is considered one of the most important species of the genus Euterpe, considering those registered in Brazil [1], being inserted in the genus Euterpe [2]. Visually the arbor of açaí is an elegant palm tree where its fruits have an inflorescence that is infrafolliar [3,4], as can be seen in Fig. 1.
Mortars with external coating are often subjected to situations of sudden degradation, such as heat stroke, salt attack in coastal environments, or rain. Therefore, the objective of this work was to evaluate the results of durability of mortars with external coating in the proportion 1: 1: 6: 1.5 (cement: hydrated lime: sand: water), containing incorporation of 0, 1.5, 3.0 and 5% of fiber of açaí treated with NaOH solution. The main importance of this work is to improve the understanding of the durability of cementitious mortars containing natural fibers, especially açai fiber. After characterizing the fibers using SEM-EDS, 50 × 100 m cylindrical specimens were cured at room temperature for 28 days and tests were carried out on compressive strength and mass loss in mortars subjected to degradation by wetting cycles and drying, salt spray exposure and thermal shock. It was proven that mortars containing up to 3.0 % of açaí fiber underwent reinforcement with the incorporation, presenting an increase in compressive strength from 6.23 to 8.41 MPa, but that mortars containing 5.0 % suffered a drop in resistance due to the excess of fibers, which compromised the wetness of the cementitious matrix. In addition, the durability results proved that the presence of fibers in a percentage of up to 3.0 % created an adhesion and stress transfer bridge that reduced the drop in strength and the loss of mass of the material when subjected to durability in tests wetting and drying and thermal shock tests. This fact is proven by comparing the compressive strength of mortars after the wetting and drying cycle in which the reference composition showed resistance of only 4.37 MPa against 6.65 MPa for the composition with 3%. The same is observed in mortars after thermal shock tests, with a resistance of only 5.82 MPa for the reference composition and 7.02 MPa for the composition with 3% açai fiber. The exception occurred in salt spray tests, where mortars performed very poorly due to the rotting of the açaí fibers, which because they are organic deteriorated in the presence of salts. Even so, it was found that mortars with 1.5 % fiber show a better behavior than the reference mortar in all situations, including in salt spray attack.
Açaí seed extract prevents the renin-angiotensin system activation, oxidative stress and inflammation in white adipose tissue of high-fat diet–fed mice
2020, Nutrition Research
Citation Excerpt :
Although possible divergences could derive from methodological differences (rodent species, mode, duration of treatment) among the studies, as well as the variance of molecular characterization and physiological function between rodents and humans, the few studies describing the effect of the açaí (Euterpe oleracea Mart.) pulp but not seed extract consumption by humans showed a reduction of the oxidative stress and improvement of inflammation in overweight, dyslipidemic individuals [53]. Considering the translational limitations of this study, the consumption of ASE could be an alternative dietary strategy to prevent the abnormalities that occur in obese individuals, but future studies should address these limitations.
The role of the renin-angiotensin system (RAS), oxidative stress, and inflammation on the development of obesity and its comorbidities has been extensively addressed. Euterpe oleracea Mart. (açaí) seed extract (ASE), with antioxidant and anti-inflammatory properties and capable to modulate plasma renin levels, has been evidenced as a potential regulator of body mass. We hypothesized that the supplementation with ASE might exert beneficial effects on obesity-related white adipose tissue changes and metabolic disorders by interfering with the local adipose tissue overexpression of RAS, inflammation, and oxidative stress in C57BL/6 mice fed a high-fat (HF) diet. The animals were fed a standard diet (10% fat, control), 60% fat (HF), HF + ASE (300 mg/kg per day) and HF + ENA (enalapril, 30 mg/kg per day) for 12 weeks. ASE and ENA prevented weight gain and adiposity, adipocyte hypertrophy, dyslipidemia, and insulin resistance. In adipose tissue, ASE increased the insulin receptor expression and reduced renin and AT1 receptor expression, which was associated with decreased plasma levels of renin and angiotensin II. Differently, ENA increased the expression of angiotensin-conversing enzyme 2, AT2, B2, and Mas receptors in adipose tissue. Also, ASE but not ENA decreased malondialdehyde and 8-isoprostane levels in adipose tissue. Finally, ASE and ENA reduced the adipose tissue inflammatory markers tumor necrosis factor alpha and interleukin 6. These results demonstrate that ASE prevented the adipocyte hypertrophy, obesity, hyperlipidemia, hyperglycemia, and insulin resistance in HF diet–fed mice. The downregulation of RAS in adipose tissue, reducing oxidative stress and inflammation, may contribute to the prevention of obesity-related disorders.

View all citing articles on Scopus

View full text

Original articleEffects of a hypoenergetic diet associated with açaí (Euterpe oleracea Mart.) pulp consumption on antioxidant status, oxidative stress and inflammatory biomarkers in overweight, dyslipidemic individuals

Highlights

Summary

Objective

Research methods & procedures

Results

Conclusion

Graphical abstract

Introduction

Section snippets

Population

Results

Discussion

Conclusion

Author contributions

Conflicts of interest

Acknowledgements

Prog Cardiovasc Dis

Life Sci

World Allergy Organ J

Am J Clin Nutr

Food Chem

Phytochem Lett

J Nutr Biochem

Nutrition

Clin Nutr

Am J Clin Nutr

Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden on Disease Study

Lancet

Increased oxidative stress in obesity: implications for metabolic syndrome, diabetes, hypertension, dyslipidemia, atherosclerosis, and câncer

Obes Res Clin Pract

Polyphenols and health: moving beyond antioxidants

J Berry Res

Phytochemical and nutrient composition of the freeze-dried amazonian palm berry, Euterpe oleraceae Mart. (acai)

J Agric Food Chem

Original article
Effects of a hypoenergetic diet associated with açaí (Euterpe oleracea Mart.) pulp consumption on antioxidant status, oxidative stress and inflammatory biomarkers in overweight, dyslipidemic individuals