The suggested health effects (e.g., disease prevention) of dietary bioactive compounds such as resveratrol are challenging to prove in comparison to man-made drugs developed for therapeutic purposes. Dietary bioactive compounds have multiple cellular targets and therefore have a variety of biological effects. Extrapolating the biological effects of dietary compounds from in vitro and in vivo animal experiments to humans may lead to over- or under-estimation of the effect and role of these compounds. The present paper will discuss a few of these challenges and suggest directions for future research. Questions we address include: (1) Is the combinatorial effect of resveratrol and other compounds real? (2) What are the real and relevant doses of resveratrol after administration? and (3) Is it possible to estimate the preventive effect of resveratrol by clinical trials using standard experimental designs? The examples concerning resveratrol taken from the scientific literature are mainly from 2010 and later. The challenges pointed out in this review are similar to most naturally occurring bioactive compounds.

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Resveratrol (Resv), a natural polyphenol, is suggested to have various health benefits including improved insulin sensitivity. Resv activates Sirtuin (Sirt1) in several species and tissues. Sirt1 is a protein deacetylase with an important role in ageing, metabolism and β-cell function. In insulinoma β-cells (INS-1E), Resv is previously shown to improve glucose-stimulated insulin secretion in a Sirt1-dependent mechanism and to protect against β-cell dedifferentiation in non-human primates, while inducing hypertrophy in myoblasts. Mammalian (mechanistic) Target of Rapamycin (mTOR), is a key regulator of cellular metabolism and regulates the cell size, β-cell survival and proliferation. In order to understand the interaction of Sirt1 and mTOR cascade activity with Resv-induced changes in the INS-1E cell line, we generated stable Sirt1-down-regulated INS-1E cells, and analysed Sirt1-dependent effects of Resv with respect to mTOR cascade activity. Sirt1-knockdown (KD) had a significant increase in cell size compared to negative-control (NEG CTR) cells. Resveratrol treatment increased cell size in both cell types in a dose-dependent manner at 24 h (Resv conc: 15-60 μM), and decreased the cell number (Resv conc: 30-60 μM). Cell area was increased in NEG CTR cells (Resv conc: 60 μM) at 24 h and KD cells at 48 h (Resv conc: 15-60 μM). Rapamycin, a specific mTOR inhibitor, counteracted the Resv-induced cell enlargement (both cell diameter and area). Furthermore, Sirt1-downregulation by itself did not affect the mTOR cascade activities as measured by Western blotting for total and phosphorylated Akt and mTOR. Rapamycin decreased the mTORC1 activity, while increasing the pAkt levels. Resveratrol did not interfere with the mTOR activity or with Sirt1 expression. Altogether, this work indicates that Sirt1 is a negative regulator of cell size. Moreover, the effect of Resv on cell size increase is mTOR-cascade dependent.