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Aspects of anthocyanin absorption, metabolism and pharmacokinetics in humans

Published online by Cambridge University Press:  14 December 2007

Colin D Kay*
Affiliation:
Pennsylvania State University, College of Health and Human Development, 315 Health and Human Development Building East, University Park, PA 16802, USA
*
Corresponding author: Dr Colin D. Kay, fax +1 814 863 7525, email [email protected]
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Abstract

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Interest in the health-promoting properties of berry anthocyanins is intensifying; however, findings are primarily based on in vitro characteristics, leaving mechanisms associated with absorption, metabolism and pharmacokinetics largely unexplored. The present review integrates the available anthocyanin literature with that of similar flavonoids or polyphenols in order to form hypotheses regarding absorption, metabolism and clearance in humans. Of the limited available literature regarding the absorption and clearance kinetics of anthocyanins, maximum plasma concentrations are reported anywhere between 1·4 and 592 nmol/l and occur at 0·5–4 h post-consumption (doses; 68–1300 mg). Average urinary excretion is reported between 0·03 and 4 % of the ingested dose, having elimination half-lives of 1·5–3 h. In addition, much is unknown regarding the metabolism of anthocyanins. The most commonly cited conjugation reactions involved in the metabolism of other flavonoids include glucuronidation, methylation and sulfation. It is reasonable to suspect that anthocyanins are metabolised in much the same manner; however, until recently, there was little evidence to suggest that anthocyanins were metabolised to any significant extent. New evidence now suggests that anthocyanins are absorbed and transported in human serum and urine primarily as metabolites, with recent studies documenting as much as 68–80 % of anthocyanins as metabolised derivatives in human urine. Further research is required to resolve mechanisms associated with the absorption, metabolism and clearance of anthocyanins in order to establish their true biological activities and health effects. The presented evidence will hopefully focus future research, refining study design and propagating a more complete understanding of anthocyanins' biological significance in humans.

Type
Research Article
Copyright
Copyright © The Author 2006

References

Andriambeloson, E, Magnier, C, Haan-Archipoff, G, Lobstein, A, Anton, R, Beretz, A, Stoclet, JC & Andriantsitohaina, R (1998) Natural dietary polyphenolic compounds cause endothelium-dependent vasorelaxation in rat thoracic aorta. Journal of Nutrition 128, 23242333.CrossRefGoogle ScholarPubMed
Aura, AM, Martin-Lopez, P, O'Leary, KA, Williamson, G, Oksman-Caldentey, KM, Poutanen, K & Santos-Buelga, C (2004) In vitro metabolism of anthocyanins by human gut microflora. European Journal of Nutrition 28, 110.Google Scholar
Aziz, AA, Edwards, CA, Lean, ME & Crozier, A (1998) Absorption and excretion of conjugated flavonols, including quercetin-4′-O-beta-glucoside and isorhamnetin-4′-O-beta-glucoside by human volunteers after the consumption of onions. Free Radical Research 29, 257269.CrossRefGoogle ScholarPubMed
Balant, L, Burki, B, Wermeille, M & Golden, G (1979) Comparison of some pharmacokinetic parameters of (+)-cyanidanol-3 obtained with specific and non-specific analytical methods. Arzneimittelforschung 29, 17581762.Google ScholarPubMed
Bitsch, I, Janssen, M, Netzel, M, Strass, G & Frank, T (2004 a) Bioavailability of anthocyanidin-3-glycosides following consumption of elderberry extract and blackcurrant juice. International Journal of Clinincal Pharmacology and Therapeutics 42, 293300.CrossRefGoogle ScholarPubMed
Bitsch, R, Netzel, M, Frank, T, Strass, G & Bitsch, I (2004 b) Bioavailability and biokinetics of anthocyanins from red grape juice and red wine. Journal of Biomedicine and Biotechnology 5, 293298.CrossRefGoogle Scholar
Bitsch, R, Netzel, M, Sonntag, S, Strass, G, Frank, T & Bitsch, I (2004 c) Urinary excretion of cyanidin glucosides and glucuronides in healthy humans after elderberry juice ingestion. Journal of Biomedicine and Biotechnology 5, 343345.CrossRefGoogle Scholar
Boulton, DW, Walle, UK & Walle, T (1999) Fate of the flavonoid quercetin in human cell lines: chemical instability and metabolism. Journal of Pharmacy and Pharmacology 51, 353359.CrossRefGoogle ScholarPubMed
Bravo, L, Abia, R, Eastwood, MA & Saura-Calixto, F (1994) Degradation of polyphenols (catechin and tannic acid) in the rat intestinal tract. Effect on colonic fermentation and faecal output. British Journal of Nutrition 71, 933946.CrossRefGoogle ScholarPubMed
Brown, JE, Khodr, H, Hider, RC & Rice-Evans, CA (1998) Structural dependence of flavonoid interactions with Cu2+ ions: implications for their antioxidant properties. Biochemistry Journal 330, 11731178.CrossRefGoogle ScholarPubMed
Bub, A, Watzl, B, Heeb, D, Rechkemmer, G & Briviba, K (2001) Malvidin-3-glucoside bioavailability in humans after ingestion of red wine, dealcoholized red wine and red grape juice. European Journal of Nutrition 40, 113120.CrossRefGoogle ScholarPubMed
Cao, G, Muccitelli, HU, Sanchez-Moreno, C & Prior, RL (2001) Anthocyanins are absorbed in glycated forms in elderly women: a pharmacokinetic study. American Journal of Clinical Nutrition 73, 920926.CrossRefGoogle ScholarPubMed
Cheng, Z, Radominska-Pandya, A & Tephly, TR (1999) Studies on the substrate specificity of human intestinal UDP-lucuronosyltransferases 1A8 and 1A10. Drug Metabolism and Disposition 27, 11651170.Google ScholarPubMed
Coughtrie, MH, Sharp, S, Maxwell, K & Innes, NP (1998) Biology and function of the reversible sulfation pathway catalysed by human sulfotransferases and sulfatases. Chemico-biological Interactions 109, 327.CrossRefGoogle ScholarPubMed
Crespy, V, Morand, C, Manach, C, Besson, C, Demigne, C & Remesy, C (1999) Part of quercetin absorbed in the small intestine is conjugated and further secreted in the intestinal lumen. American Journal of Physiology 277, G120–G126Google ScholarPubMed
Das, NP & Sothy, SP (1971) Studies on flavonoid metabolism. Biliary and urinary excretion of metabolites of (+)-(U- 14 C) catechin. Biochemistry Journal 125, 417423.CrossRefGoogle ScholarPubMed
Day, AJ, Canada, FJ, Diaz, JC, Kroon, PA, Mclauchlan, R, Faulds, CB, Plumb, GW, Morgan, MR & Williamson, G (2000) Dietary flavonoid and isoflavone glycosides are hydrolysed by the lactase site of lactase phlorizin hydrolase. FEBS Letters 468, 166170.CrossRefGoogle ScholarPubMed
Day, AJ, DuPont, MS, Ridley, S, Rhodes, M, Rhodes, MJ, Morgan, MR & Williamson, G (1998) Deglycosylation of flavonoid and isoflavonoid glycosides by human small intestine and liver beta-glucosidase activity. FEBS Letters 436, 7175.CrossRefGoogle ScholarPubMed
Day, AJ & Williamson, G (2001) Biomarkers for exposure to dietary flavonoids: a review of the current evidence for identification of quercetin glycosides in plasma. British Journal of Nutrition 86, S105–S110CrossRefGoogle ScholarPubMed
Donovan, JL, Crespy, V, Manach, C, Morand, C, Besson, C, Scalbert, A & Remesy, C (2001) Catechin is metabolized by both the small intestine and liver of rats. Journal of Nutrition 131, 17531757.CrossRefGoogle ScholarPubMed
Dutton, GJ (1980) Glucuronidation of Drugs and other Compounds. Boca Raton: FL CRC Press.Google Scholar
Felgines, C, Talavera, S, Gonthier, MP, Texier, O & Scalbert, A, Lamaison, JL & Remesy, C (2003) Strawberry anthocyanins are recovered in urine as glucuro- and sulfoconjugates in humans. Journal of Nutrition 133, 12961301.CrossRefGoogle ScholarPubMed
Frank, T, Janssen, M, Netzel, M, Strass, G, Kler, A, Kriesl, E & Bitsch, I (2005) Pharmacokinetics of anthocyanidin-3-glycosides following consumption of Hibiscus sabdariffa L. extract. Journal of Clinical Pharmacology 45, 203210.CrossRefGoogle ScholarPubMed
Frank, T, Netzel, M, Strass, G, Bitsch, R & Bitsch, I (2003) Bioavailability of anthocyanidin-3-glucosides following consumption of red wine and red grape juice. Canadian Journal of Physiology and Pharmacology 81, 423435.CrossRefGoogle ScholarPubMed
Galvano, F, La Fauci, L, Lazzarino, G, Fogliano, V, Ritieni, A, Ciappellano, S, Battistini, NC, Tavazzi, B, Galvano, G (2004) Cyanidins: metabolism and biological properties. Journal of Nutritional Biochemistry 15, 211.CrossRefGoogle ScholarPubMed
Gee, JM, DuPont, MS, Day, AJ, Plumb, GW, Williamson, G & Johnson, IT (2000) Intestinal transport of quercetin glycosides in rats involves both deglycosylation and interaction with the hexose transport pathway. Journal of Nutrition 130, 27652771.CrossRefGoogle ScholarPubMed
Gregus, Z & Klassen, CD (1986) Enterohepatic circulation of toxicants Gastrointestinal Toxicology, pp5799 [Rozman, K and Hänninen, O editors] New York: Elsevier.Google Scholar
Hackett, AM (1986) The metabolism of flavonoid compounds in mammals. In Plant Flavonoids in Biology and Medicine, pp. 177194 [Cody, V, Middleton, E and Harborne, JB, editors]. New York: Alan R Liss Inc.Google Scholar
Hollman, PC, Bijsman, MN, van Gameren, Y, Cnossen, EP, de Vries, JH & Katan, MB (1999) The sugar moiety is a major determinant of the absorption of dietary flavonoid glycosides in man. Free Radical Research 31, 569573.CrossRefGoogle Scholar
Hollman, PC, de Vries, JH, van Leeuwen, SD, Mengelers, MJ & Katan, MB (1995) Absorption of dietary quercetin glycosides and quercetin in healthy ileostomy volunteers. American Journal of Clinical Nutrition 62, 12761282.CrossRefGoogle ScholarPubMed
Hollman, PC & Katan, MB (1998 a) Bioavailability and health effects of dietary flavonols in man. Archives of Toxicology Supplement 20, 237248.CrossRefGoogle ScholarPubMed
Hollman, PC & Katan, MB (1998 b) Absorption, metabolism and bioavailability of flavonoids. In Flavonoids in Health and Disease, pp. 483522 [Rice-Evans, CA and Packer, L, editors]. New York: Marcel Dekker, Inc.Google Scholar
Hollman, PC & Katan, MB (1999) Health effects and bioavailability of dietary flavonols. Free Radical Research 31, S75–S80CrossRefGoogle ScholarPubMed
Hollman, PC, van der Gaag, M, Mengelers, MJ, van Trijp, JM, de Vries, JH & Katan, MB (1996) Absorption and disposition kinetics of the dietary antioxidant quercetin in man. Free Radical Biology and Medicine 21, 703707.CrossRefGoogle ScholarPubMed
Hollman, PC, van Trijp, JM, Buysman, MN, van der Gaag, MS, Mengelers, MJ, de Vries, JH & Katan, MB (1997) Relative bioavailability of the antioxidant flavonoid quercetin from various foods in man. FEBS Letters 418, 152156.CrossRefGoogle ScholarPubMed
Hollman, PCH (2001) Evidence for health benefits of plant phenols: local or systemic effects? Journal of the Science of Food and Agriculture 81, 842852.CrossRefGoogle Scholar
Kamei, H, Kojima, T, Hasegawa, M, Koide, T, Umeda, T, Yukawa, T & Terabe, K (1995) Suppression of tumor cell growth by anthocyanins in vitro. Cancer Investigation 13, 590594.CrossRefGoogle ScholarPubMed
Karakaya, S (2004) Bioavailability of phenolic compounds. Critical Reviews in Food Science and Nutrition 44, 453464.CrossRefGoogle ScholarPubMed
Kay, CD, Mazza, G & Holub, BJ (2005) Anthocyanins exist in the circulation primarily as metabolites in adult men. Journal of Nutrition 135, 25822588.CrossRefGoogle ScholarPubMed
Kay, CD, Mazza, G, Holub, BJ & Wang, J (2004) Anthocyanin metabolites in human urine and serum. British Journal of Nutrition 91, 933942.CrossRefGoogle ScholarPubMed
Kuhnle, G, Spencer, JP, Schroeter, H, Shenoy, B, Debnam, ES, Srai, SK, Rice-Evans, C & Hahn, U (2000) Epicatechin and catechin are O-methylated and glucuronidated in the small intestine. Biochemical and Biophysical Research Communications 277, 507512.CrossRefGoogle ScholarPubMed
Laitinen, M & Watkins, JB (1986) Mucosal biotransformations. In Gastrointestinal Toxicology, pp. 169192 [Rozman, K and Hänninen, O, editors]. New York: Elsevier.Google Scholar
Lapidot, T, Harel, S, Granit, R & Kanner, J (1998) Bioavailiblity of red wine anthocyanins as detected in human urine. Journal of Agricultural and Food Chemistry 46, 42974302.CrossRefGoogle Scholar
Laplaud, PM, Lelubre, A & Chapman, MJ (1997) Antioxidant action of Vaccinium myrtillus extract on human low density lipoproteins in vitro: initial observations. Fundamental and Clinical Pharmacology 11, 3540.CrossRefGoogle ScholarPubMed
Manach, C & Donovan, JL (2004) Pharmacokinetics and metabolism of dietary flavonoids in humans. Free Radical Research 38, 771785.CrossRefGoogle ScholarPubMed
Manach, C, Morand, C, Crespy, V, Demigne, C, Texier, O, Regerat, F & Remesy, C (1998) Quercetin is recovered in human plasma as conjugated derivatives which retain antioxidant properties. FEBS Letters 426, 331336.CrossRefGoogle ScholarPubMed
Manach, C, Williamson, G, Morand, C, Scalbert, A & Remesy, C (2005) Bioavailability and bioefficacy of polyphenols in humans. I. Review of 97 bioavailability studies. American Journal of Clinical Nutrition 81, S230–S242.CrossRefGoogle ScholarPubMed
Matsumoto, H, Hanamura, S, Kawakami, T, Sato, Y, Hirayama, M (2001) Preparative-scale isolation of four anthocyanin components of black currant (Ribes nigrum L.) fruits. Journal of Agricultural and Food Chemistry 49, 15411545.CrossRefGoogle ScholarPubMed
Mazza, G (2000) Health aspects of natural colors. In Natural Food Colorants: Science and Technology, pp. 289314 [Lauro, GJ and Francis, FJ, editors]. New York: Marcel Dekker Inc.Google Scholar
Mazza, G, Cacace, JE & Kay, CD (2004) Methods of analysis for anthocyanins in plants and biological fluids. Journal of AOAC International 87, 129145.CrossRefGoogle ScholarPubMed
Mazza, G, Kay, CD, Cottrell, T & Holub, BJ (2002) Absorption of anthocyanins from blueberries and serum antioxidant status in human subjects. Journal of Agricultural and Food Chemistry 50, 77317737.CrossRefGoogle ScholarPubMed
Miyazawa, T, Nakagawa, K, Kudo, M, Muraishi, K & Someya, K (1999) Direct intestinal absorption of red fruit anthocyanins, cyanidin-3-glucoside and cyanidin-3,5-diglucoside, into rats and humans. Journal of Agricultural and Food Chemistry 47, 10831091.CrossRefGoogle ScholarPubMed
Mizuma, T, Ohta, K & Awazu, S (1994) The beta-anomeric and glucose preferences of glucose transport carrier for intestinal active absorption of monosaccharide conjugates. Biochimica et Biophysica Acta 1200, 117122.CrossRefGoogle ScholarPubMed
Mojarrabi, B & Mackenzie, PI (1998) Characterization of two UDP glucuronosyltransferases that are predominantly expressed in human colon. Biochemical and Biophysical Research Communications 247, 704709.CrossRefGoogle ScholarPubMed
Morand, C, Crespy, V, Manach, C, Besson, C, Demigne, C & Remesy, C (1998) Plasma metabolites of quercetin and their antioxidant properties. American Journal of Physiology 275, 212219.Google ScholarPubMed
Mülleder, U, Murkovic, M & Pfannhauser, W (2002) Urinary excretion of cyanidin glycosides. Journal of Biochemical and Biophysical Methods 53, 6166.CrossRefGoogle ScholarPubMed
Murkovic, M, Adam, U & Pfannhauser, W (2000) Analysis of anthocyanin glycosides in human serum. Fresenius' Journal of Analytical Chemistry 366, 379381.CrossRefGoogle ScholarPubMed
Murkovic, M, Mülleder, U, Adam, U & Pfannhauser, W (2001) Detection of anthocyanins from elderberry juice in human urine. Journal of the Science of Food and Agriculture 81, 934937.CrossRefGoogle Scholar
Nèmeth, K, Plumb, GW, Berrin, JG, Juge, N, Jacob, R, Naim, HY, Williamson, G & Swallow, DM, Kroon, PA (2003) Deglycosylation by small intestinal epithelial cell beta-glucosidases is a critical step in the absorption and metabolism of dietary flavonoid glycosides in humans. European Journal of Nutrition 42, 2942.CrossRefGoogle ScholarPubMed
Netzel, M, Strass, G, Janssen, M, Bitsch, I & Bitsch, R (2001) Bioactive anthocyanins detected in human urine after ingestion of blackcurrant juice. Journal of Environmental Pathology, Toxicology and Oncology 20, 8995.CrossRefGoogle ScholarPubMed
Nielsen, IL, Dragsted, LO, Ravn-Haren, G, Freese, R & Rasmussen, SE (2003) Absorption and excretion of black currant anthocyanins in humans and watanabe heritable hyperlipidemic rabbits. Journal of Agriculture and Food Chemistry 51, 28132820.CrossRefGoogle ScholarPubMed
Oliveira, EJ, Watson, DG & Grant, MH (2002) Metabolism of quercetin and kaempferol by rat hepatocytes and the identification of flavonoid glycosides in human plasma. Xenobiotica 32, 279287.CrossRefGoogle ScholarPubMed
Parthasarathy, S, Khan-Merchant, N, Penumetcha, M & Santanam, N (2001) Oxidative stress in cardiovascular disease. Journal of Nuclear Cardiology 8, 379389.CrossRefGoogle ScholarPubMed
Passamonti, S, Vrhovsek, U, Vanzo, A & Mattivi, F (2003) The stomach as a site for anthocyanins absorption from food. FEBS Letters 544, 210213.CrossRefGoogle ScholarPubMed
Petrakis, P, Kallianos, AG, Wender, SH & Shetlar, MR (1959) Metabolic studies of quercetin labelled with C14. Archives of Biochemistry and Biophysics 85, 264271.CrossRefGoogle ScholarPubMed
Piskula, MK & Terao, J. (1998) Accumulation of (-)-epicatechin metabolites in rat plasma after oral administration and distribution of conjugation enzymes in rat tissues. Journal of Nutrition 128, 11721178.CrossRefGoogle ScholarPubMed
Rechner, AR, Kuhnle, G, Hu, H, Roedig-Penman, A, van den Braak, MH, Moore, KP & Rice-Evans, CA (2002) The metabolism of dietary polyphenols and the relevance to circulating levels of conjugated metabolites. Free Radical Research 36, 12291241.CrossRefGoogle Scholar
Ross, JA & Kasum, CM (2002) Dietary flavonoids: bioavailability, metabolic effects, and safety. Annual Review of Nutrition 22, 1934.CrossRefGoogle ScholarPubMed
Rozman, K (1986) Fecal excretion of toxic substances. In Gastrointestinal Toxicology, pp. 119145 [Rozman, K and Hänninen, O, editors]. New York: Elsevier.Google Scholar
Scalbert, A, Morand, C, Manach, C & Remesy, C (2002) Absorption and metabolism of polyphenols in the gut and impact on health. Biomedicine and Pharmacotherapy 56, 276282.CrossRefGoogle ScholarPubMed
Scalbert, A & Williamson, G (2000) Dietary intake and bioavailability of polyphenols. Journal of Nutrition 130, S2073–S2085.CrossRefGoogle ScholarPubMed
Schneider, H, Schwiertz, A, Collins, MD & Blaut, M (1999) Anaerobic transformation of quercetin-3-glucoside by bacteria from the human intestinal tract. Archives of Microbiology 171, 8191.CrossRefGoogle ScholarPubMed
Shaw, IC & Griffiths, LA (1980) Identification of the major biliary metabolite of (+)-catechin in the rat. Xenobiotica 10, 905911.CrossRefGoogle ScholarPubMed
Shimoi, K, Okada, H, Furugori, M, Goda, T, Takase, S, Suzuki, M, Hara, Y, Yamamoto, H & Kinae, N (1998) Intestinal absorption of luteolin and luteolin 7-O-beta-glucoside in rats and humans. FEBS Letters 438, 220224.CrossRefGoogle ScholarPubMed
Skibola, CF & Smith, MT (2000) Potential health impacts of excessive flavonoid intake. Free Radical Biology and Medicine 29, 375383.CrossRefGoogle ScholarPubMed
Spencer, JP, Chowrimootoo, G, Choudhury, R, Debnam, ES, Srai, SK & Rice-Evans, C (1999) The small intestine can both absorb and glucuronidate luminal flavonoids. FEBS Letters 458, 224230.CrossRefGoogle ScholarPubMed
Strassburg, CP, Nguyen, N, Manns, MP & Tukey, RH (1998) Polymorphic expression of the UDP-glucuronosyltransferase UGT1A gene locus in human gastric epithelium. Molecular Pharmacology 54, 647654.Google ScholarPubMed
Talavéra, S, Felgines, C, Texier, O, Besson, C, Lamaison, J & Rémésy, C (2003) Anthocyanins are efficiently absorbed from the stomach in anesthetized rats. Journal of Nutrition 133, 41784182.CrossRefGoogle ScholarPubMed
Trevithick, JR & Mitton, KP (1999) Antioxidants and diseases of the eye. In Antioxidant Status, Diet, Nutrition, and Health, pp. 545566 [Papas, AM, editor]. Boca Raton, FL: CRC Press.Google Scholar
Tsuda, T, Horio, F & Osawa, T (1999) Absorption and metabolism of cyanidin 3-O-beta-D-glucoside in rats. FEBS Letters 449, 179182.CrossRefGoogle ScholarPubMed
Ueno, I, Nakano, N & Hirono, I (1983) Metabolic fate of quercetin in the ACI rat. Japanese Journal of Experimental Medicine 53, 4150.Google ScholarPubMed
Walgren, RA, Karnaky, KJ Jr, Lindenmayer, GE, Walle, T (2000) Efflux of dietary flavonoid quercetin 4'-beta-glucoside across human intestinal Caco-2 cell monolayers by apical multidrug resistance-associated protein-2. Journal of Pharmacology and Experimental Therapeutics 294, 830836.Google ScholarPubMed
Walle, T (2004) Absorption and metabolism of flavonoids. Free Radical Biology and Medicine 36, 829837.CrossRefGoogle ScholarPubMed
Walle, T, Otake, Y, Walle, UK & Wilson, FA (2000) Quercetin glucosides are completely hydrolyzed in ileostomy patients before absorption. Journal of Nutrition 30, 26582661.CrossRefGoogle Scholar
Walle, T, Walle, UK & Halushka, PV (2001) Carbon dioxide is the major metabolite of quercetin in humans. Journal of Nutrition 131, 26482652.CrossRefGoogle ScholarPubMed
Williamson, G, Day, AJ, Plumb, GW & Couteau, D (2000) Human metabolic pathways of dietary flavonoids and cinnamates. Biochemical Society Transaction 28, 1622.CrossRefGoogle ScholarPubMed
Williamson, G & Manach, C (2005) Bioavailability and bioefficacy of polyphenols in humans. II. Review of 93 intervention studies. American Journal of Clinical Nutrition 81, S243–S255.CrossRefGoogle ScholarPubMed
Wolffram, S, Weber, T, Grenacher, B & Scharrer, EA. (1995) Na(+)-dependent mechanism is involved in mucosal uptake of cinnamic acid across the jejunal brush border in rats. Journal of Nutrition 125, 13001308.Google ScholarPubMed
Wu, X, Cao, G & Prior, RL (2002) Absorption and metabolism of anthocyanins in elderly women after consumption of elderberry or blueberry. Journal of Nutrition 132, 18651871.Google ScholarPubMed