CVD is the leading cause of morbidity and mortality in developed countries, and chronic inflammation plays a major role in its development. As CVD risk and inflammation increases with age, older people now account for the majority of CVD morbidity worldwide( Reference Man and Jugdutt 1 ). Conversely, increased fruit and vegetable (F&V) intake has been suggested to correlate with reduced CVD risk( Reference He, Nowson and MacGregor 2 ), although direct trial evidence of their ability to influence markers of inflammation is lacking.
To assess if increased F&V intake reduces serum amyloid-A (SAA), in serum and HDL2&3 and if this latter enhances the antiatherogenic properties of HDL2&3.
Subjects aged between 65 to 85 years were randomised to 2 or 5 portions of F&Vs per day, for 16-weeks (n=38 per group). HDL2&3 were isolated by rapid ultracentrifugation. Serum-hsCRP was measured by an immuoturbimetric assay, serum-IL-6, e-selectin, SAA and HDL2&3-SAA were measured by ELISA procedures, and HDL2&3-CETP activity was measured by a fluorometric assay.
These results demonstrated that hsCRP, IL-6 and e-selectin were unchanged following either the 2 or 5 portion interventions. However, following the 5-portion intervention, SAA significantly decreased in serum at weeks 12 and 16, in HDL2 at weeks 6, 12 and 16 and in HDL3 at weeks 12 and 16 (table 1), which was accompanied by a decrease in the activity of CETP in HDL2 at weeks 6, 12 and 16 (p=0.03, 0.02 and 0.001, respectively). Additionally, in the between group analyses (2 vs. 5 portions), SAA decreased in serum at week 12, in HDL2 at weeks 6 and 16 and in HDL3 at weeks 12 and 16 (table 1). Additionally, CETP activity decreased in HDL2 at week 16 (p=0.03).
Table 1. SAA changes and statistical differences following F&V intervention Results were logarithmically transformed and are summarised as mean geometric change from baseline (IQ range). P1 pre vs. post 5-portion intervention: P2 between group statistics (2 vs. 5 portion change)
These results have identified: i) SAA responds to increased F&V intake, where other markers of inflammation/endothelial activation were unresponsive. ii) Increased F&V intake lowered systemic and HDL-associated inflammation, and this latter influenced the antiatherogenic properties of HDL2&3. Overall, these results provide tangible evidence of the effectiveness of increasing F&V intake on inflammation and possible CVD risk in an older population.
This work was funded by the Food Standards Agency and the Department of Health, UK.
