Applied nutritional investigationNatural antioxidant ice cream acutely reduces oxidative stress and improves vascular function and physical performance in healthy individuals
Introduction
Oxidative stress promotes aging and related chronic diseases. A healthy diet, rich in fruits and vegetables, is protective against oxidative stress, thus reducing the risk for several conditions (i.e., myocardial infarction, stroke, diabetes, and cancer) [1]. Most scientific studies suggest that the cardiometabolic effects of a healthy diet are due to the polyphenol content; these chemicals have powerful antioxidant activities [2], [3]. Two reviews showed an inverse association between the dietary intake of polyphenols and the risk for cardiovascular disease (CVD), with ≤65% reduction in cardiovascular mortality in clinical trials [4], [5]. Studies tested the effect of antioxidant foods rich in polyphenols, such as cocoa, nuts, tea, and red wine, on the endothelial response in terms of the capacity to acutely increase and maintain the endothelium-dependent vasodilation over time in healthy individuals [6], [7], [8], [9], [10], [11], [12], [13]. For cocoa consumption, these studies mostly evaluated derivatives, such as chocolate [6]. Cocoa derivatives contain a high amount of caffeine, theobromine, and fats. Caffeine and theobromine can induce arrhythmias and even stimulate the central nervous system, causing restlessness and agitation [14]. When cocoa consumption becomes habitual, these effects cannot be tolerated and are potentially harmful in people suffering from heart disease or hypertension [15]. Consequently, habitual consumption of only cocoa as an antioxidant cannot be recommended. Furthermore, cocoa derivatives contain a considerable amount of fat (55% of the total) as butter [16]. Therefore, consumption of cocoa derivatives may be harmful in overweight and obese individuals [17]. A mixture of cocoa and other natural foods rich in polyphenols can, however, be more efficient as an antioxidant than cocoa alone while also reducing its side effects.
Moderate physical exercise is considered an essential component of a healthy lifestyle. Nevertheless, exercise, particularly exhaustive exercise, causes the organism to adapt to different stresses. Thus, exercise induces acute oxidative stress, inflammation, and muscle damage [18]. Data from the literature do not clearly show whether a diet can prevent or reduce oxidative stress and mitigate the muscle damage induced by physical exercise [19], [20].
The aim of this controlled, single-blind, crossover study was to evaluate the acute effect of on oxidative stress, endothelial function and physical performance by ingesting 100 g natural ice cream that is rich in polyphenols rather than a control ice cream.
Section snippets
Methods
We estimated serum markers of oxidative stress (determination of reactive oxygen metabolites [d-ROMs] and hydrogen peroxide [H2O2]), serum antioxidant status (ferric-reducing ability of plasma [FRAP]), nitric oxide (NO) bioavailability (NOx), endothelium flow-mediated vasodilation (FMD), variation in reactive hyperemia index (RHI by Endopat 2000), and exercise tolerance as measured by the peak double product (heart rate × systolic blood pressure, after cycloergometer stress test).
Fourteen
Measurement of hydroperoxides with the plasma d-ROMs test
The d-ROMs measurement is a photometric test for the measurement of plasma hydroperoxides (ROOH), which represent the main oxidized molecules of the organism and thus are an efficient indirect marker of oxidative stress. The test is based on the Fenton reaction and the formation of oxygen radicals (RLO) during lipid peroxidation; the RLO quantity is directly proportional to the amount of peroxide in plasma. The analytical imprecision of this method is between 2.25 and 4.5%. The results are
Statistical analysis
The primary endpoint of the study was the FMD change after the ingestion of the antioxidant ice cream. Data from a pilot study were used to calculate the sample size. For a 40% increase from the baseline FMD after intake of the antioxidant ice cream (FMD baseline 2.6 ± 1.3 versus 3.7 ± 1.3), 14 participants were needed to provide a power of 92% with α = 0.05.
The variables were tested for a normal distribution using histograms and/or the Kolmogorov–Smirnov test. Normally distributed variables
Results
All 14 volunteers completed the study. The clinical characteristics of the study population are reported in (Table 2). The total and single polyphenol contents were significantly higher (P < 0.001) in the antioxidant ice cream than in the control ice cream (Table 3).
Two h after the ingestion of the antioxidant ice cream, the serum level of polyphenols (Fig. 3A) increased significantly (P < 0.001); the oxidative stress decreased, as indicated by the average d-ROMs and H2O2 values (Fig. 3B, C; P
Discussion
To our knowledge, this is the first study to demonstrate the acute antioxidant effects of a mixture of cocoa, hazelnuts, and green tea—items with high polyphenol contents—that has been incorporated into ice cream. After the ingestion of the antioxidant ice cream, there was a significant reduction in the levels of circulating markers of oxidative stress (serum hydroperoxides and H2O2) and an increased bioavailability of NO. The antioxidant status, as measured by the FRAP, improved significantly.
Conclusions
The present study suggests that the ingestion of an antioxidant ice cream consisting of a mixture of selected foods with high polyphenol contents strongly improves the vascular function and physical performance, probably through an oxidative stress-mediated mechanism.
The ice cream is potentially effective in counteracting oxidative stress in healthy individuals, athletes, elderly, and even in patients suffering from many chronic and degenerative diseases because of the powerful antioxidant
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VS participated in the design of the study, performed experimental work, and contributed to the manuscript preparation. MM contributed to the interpretation of data and the manuscript preparation. RS performed statistical analysis and contributed to the manuscript preparation. LG contributed to the interpretation of data and to the manuscript preparation. DF performed experimental work and contributed to the manuscript preparation. The authors have no conflicts of interest to declare.