[PHNUTR-L] Fruit and Vegetable Intakes, C-reactive Protein,
and the Metabolic Syndrome
fivestar at nutritionucanlivewith.com
Wed Mar 7 05:31:19 PST 2007
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Metabolic Syndrome, C-Reactive Protein, Fruit and Vegetables
Ahmad Esmaillzadeh, PhD
Department of Nutrition
School of Health
Isfahan University of Medical Sciences
Isfahan, PO Box 81745, Iran
+98 311 6688628 / +98 311 6682509 (FAX)
esmaillzadeh at hlth.mui.ac.ir
"Fruit and Vegetable Intakes, C-reactive Protein, and the Metabolic
Am J Clin Nut., 2006;84(6):1489-97. 44896 (2/2007)
Kirk Hamilton: Can you please share with us your educational
background and current position?
Ahmad Esmaillzadeh: I earned my BSc and MSc degrees in
Nutrition from the National Nutrition and Food Technology Research
Institute of Iran in 1998 and 2001, respectively, and I started my PhD
in 2001 in the above-mentioned institute. After five years of hard-work,
I completed my PhD in Nutrition in September, 2006. Before completing my
PhD, I spent a 6-month sabbatical at Harvard School of Public Health.
Now, I am an assistant professor of nutrition in the Department of
Nutrition, School of Health, Isfahan University of Medical Sciences,
KH: What got you interested in studying the role of fruit and
vegetable intake and metabolic syndrome and C-reactive protein?
AE: Prevalence of the metabolic syndrome among Iranian women is the
highest in the world. We think that dietary intakes of the Iranian
people are the major determinant of this high prevalence. So, we
wondered if low intakes of fruits and vegetables were associated with
this high prevalence.
KH: What hypothetically in fruit and vegetables might lower
C-reactive protein (CRP) concentrations? Might it be antioxidant
compounds or was it thought more that fruit and vegetable consumption
might reduce metabolic syndrome which might lower CRP levels?
AE: Actually, fruits and vegetables are rich sources of many beneficial
nutrients. We did not look at the responsible compounds in this paper,
however, previous studies have shown that both the fiber and vitamin C
content of fruits and vegetables might have a role in reducing CRP.
Fruits and vegetables have higher amounts of phytochemicals and fiber,
which might help reduce lipids and blood sugar. We showed in this
investigation that high consumption of fruits and vegetables is
associated with lower prevalence of metabolic syndrome. Part of this
could be mediated by the beneficial effects of fruits and vegetables on
CRP. In other words, consumption of fruits and vegetables can reduce CRP
levels, which in turn could reduce the risk of the metabolic syndrome.
KH: Were there any other markers of inflammation or biochemistry that
were assessed during this study that related to fruit and vegetable intake?
AE: This study was part of a cross-sectional study aimed at determining
the major dietary patterns among Iranian women and assessing the
relationship between these patterns and markers of systemic inflammation
and the metabolic syndrome. We measured more inflammatory markers (such
as serum amyloid A, IL-6, ICAM-1 and VCAM-1) in this study. Most of
these markers were inversely related to fruit and vegetable intake. Our
future papers, which are going to be published in AJCN and J Nutr, will
discuss the association of these inflammatory markers with dietary
patterns. Our healthy dietary pattern, which was rich in fruits and
vegetables, was inversely related to most of the above-mentioned
inflammatory markers and also with metabolic syndrome and insulin
KH: Can you tell us about your study and the basic results?
AE: As I mentioned above, our fruit paper was part of a major study. So
let me describe the basic results of the whole study. We found three
major dietary patterns among Iranian women; 1) healthy (rich in fruits
and vegetables); 2) western diet (rich in refined grains, sausages, …)
and 3) traditional Iranian dietary patterns: high in refined grains,
potato, whole-grains, tea, hydrogenated fats, legumes and casseroles.
The healthy dietary pattern was inversely associated with, and the
western dietary pattern was directly associated with the risk of insulin
resistance and the metabolic syndrome and most inflammatory markers.
KH: How significant a risk factor is CRP with regards to
cardiovascular disease (CVD)? Compared to cholesterol levels? Is there a
therapeutic goal (level) for TRP levels to reduce CVD risk?
AE: It seems that increasing serum levels of inflammatory markers like
CRP, can strongly predict the incidence of atherosclerosis.
Investigations from different regions of the world have shown that CRP
is a very powerful marker for predicting cardiovascular risk factors
such that one can use this marker for early detection of
atherosclerosis. High serum levels of CRP can result in high levels of
serum lipid profiles. It is recommended that serum CRP levels must be
below 3 mg/L to have a reduced risk of cardiovascular disease.
KH: What recommendations for fruit and vegetable intake can be made
with regards to reducing cardiovascular disease and metabolic syndrome risk?
AE: Eating at least five servings per day of fruits and vegetables is
recommended to reduce the risks for chronic diseases. Considering the
favorable association of fruit and vegetable consumption with the
metabolic syndrome and inflammatory markers we found in this study, it
seems that increased consumption of these products is likely to have
significant benefits in reducing the risk of metabolic disorders.
KH: Are there any specific fruit or vegetables that have a better
protective effect than others (i.e. pomegranate, blue berries,
cranberries, cherries, etc.)?
AE: Overall, consumption of fruits and vegetables is recommended for
reducing the risk of metabolic abnormalities; however, recommendation of
some fruits (fruits with high sugar level) for specific cases, like
diabetics, should be made cautiously. We showed in our previous
investigation that consumption of pomegranate juice among diabetics with
hyperlipidemia could help them control their lipid profiles.
KH: Is not pomegranate a traditional food in the Iranian diet? Can
you comment on what components of pomegranates make them such a
AE: Pomegranate is native to Iran, and pomegranate juice is a rich
source of flavonoids which are beneficial compounds that can affect
human health. The total polyphenol content of pomegranate juice varies
within the limit of 0.2–1.0%, depending on variety, and includes mainly
KH: Do you have any further comments you would like to make on this
AE: Our findings in this study support current dietary recommendations
to increase the intake of fruit and vegetable as a primary preventive
measure against cardiovascular disease.
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
"Ask the Parkinson Dietitian" http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
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