[PHNUTR-L] Fruit and Vegetable Intakes, C-reactive Protein, and the Metabolic Syndrome

[Kathrynne Holden]

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Metabolic Syndrome, C-Reactive Protein, Fruit and Vegetables
http://www.vitasearch.com/CP/experts/AEsmaillzadehAT01-18-07.htm

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 
Syndrome,"
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, 
Isfahan, Iran.

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 
resistance.



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 
beneficial food?

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 
anthocyanins.

KH:    Do you have any further comments you would like to make on this 
interesting subject?

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 >
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