Observational evidence consistently shows that consumption of a diet rich in fruit and vegetables may offer protection against diseases such as cardiovascular disease and cancer. Assessment of dietary intake is complex and prone to many sources of error. More objective biomarkers of fruit and vegetable intake are therefore of interest. The aim of this review is to examine the usefulness of the main biomarkers of fruit and vegetable intake to act as objective indicators of compliance in dietary intervention studies. A comprehensive search of the literature was conducted using six databases. Suitable papers were selected and relevant data extracted. The papers were categorized into 3 sub-groups: whole diet interventions; mixed fruit and vegetable interventions; and studies involving individual varieties of fruits or vegetables. Ninety-six studies were included in the review. Overall, the most commonly measured, and most consistently responsive, biomarkers were the carotenoids and vitamin C. Based on the results of this systematic review, it remains prudent to measure a panel of biomarkers in fruit and vegetable intervention studies. The only possible exception to this is "fruit only" intervention studies where assessment of vitamin C alone may suffice.

Epidemiological evidence supports a positive relationship between fruit and vegetable (FV) intake, lung function and chronic obstructive pulmonary disease (COPD). Increasing FV intake may attenuate the oxidative stress and inflammation associated with COPD.An exploratory randomised controlled trial to examine the effect of increased consumption of FV on oxidative stress and inflammation in moderate-to-severe COPD was conducted. 81 symptomatically stable patients with a habitually low FV intake (two or fewer portions of FV per day) were randomised to the intervention group (five or more portions of FV per day) or the control group (two or fewer portions of FV per day). Each participant received self-selected weekly home deliveries of FV for 12 weeks.75 participants completed the intervention. There was a significant between-group change in self-reported FV intake and biomarkers of FV intake (zeaxanthin (p50.034) and b-cryptoxanthin (p50.015)), indicating good compliance; post-intervention intakes in intervention and control groups were 6.1 and 1.9 portions of FV per day, respectively. There were no significant changes in biomarkers of airway inflammation (interleukin-8 and myeloperoxidase) and systemic inflammation (C-reactive protein) or airway and systemic oxidative stress (8-isoprostane).This exploratory study demonstrated that patients with moderate-to-severe COPD were able to comply with an intervention to increase FV intake; however, this had no significant effect on airway or systemic oxidative stress and inflammation.

Background Epidemiologic evidence suggests that a diet rich in (poly)phenols has beneficial effects on many chronic diseases. Brown seaweed is a rich source of (poly)phenols. Objective The aim of this study was to investigate the bioavailability and effect of a brown seaweed (Ascophyllum nodosum) (poly)phenol extract on DNA damage, oxidative stress, and inflammation in vivo. Design A randomized, double-blind, placebo-controlled crossover trial was conducted in 80 participants aged 30–65 y with a body mass index (in kg/m2) ≥25. The participants consumed either a 400-mg capsule containing 100 mg seaweed (poly)phenol and 300 mg maltodextrin or a 400-mg maltodextrin placebo control capsule daily for an 8-wk period. Bioactivity was assessed with a panel of blood-based markers including lymphocyte DNA damage, plasma oxidant capacity, C-reactive protein (CRP), and inflammatory cytokines. To explore the bioavailability of seaweed phenolics, an untargeted metabolomics analysis of urine and plasma samples after seaweed consumption was determined by ultra-high-performance liquid chromatography–high-resolution mass spectrometry. Results Consumption of the seaweed (poly)phenols resulted in a modest decrease in DNA damage but only in a subset of the total population who were obese. There were no significant changes in CRP, antioxidant status, or inflammatory cytokines. We identified phlorotannin metabolites that are considered potential biomarkers of seaweed consumption including pyrogallol/phloroglucinol-sulfate, hydroxytrifurahol A-glucuronide, dioxinodehydroeckol-glucuronide, diphlorethol sulfates, C-O-C dimer of phloroglucinol sulfate, and C-O-C dimer of phloroglucinol. Conclusions To the best of our knowledge, this work represents the first comprehensive study investigating the bioactivity and bioavailability of seaweed (poly)phenolics in human participants. We identified several potential biomarkers of seaweed consumption. Intriguingly, the modest improvements in DNA damage were observed only in the obese subset of the total population. The subgroup analysis should be considered exploratory because it was not preplanned; therefore, it was not powered adequately. Elucidation of the biology underpinning this observation will require participant stratification according to weight in future studies. This trial was registered at clinicaltrials.gov as NCT02295878.

Atherosclerosis is one of the principle pathologies of cardiovascular disease with blood cholesterol a significant risk factor. The World Health Organization estimates that approximately 2.5 million deaths occur annually because of the risk from elevated cholesterol, with 39% of adults worldwide at future risk. Atherosclerosis emerges from the combination of many dynamical factors, including haemodynamics, endothelial damage, innate immunity and sterol biochemistry. Despite its significance to public health, the dynamics that drive atherosclerosis remain poorly understood. As a disease that depends on multiple factors operating on different length scales, the natural framework to apply to atherosclerosis is mathematical and computational modelling. A computational model provides an integrated description of the disease and serves as an in silico experimental system from which we can learn about the disease and develop therapeutic hypotheses. Although the work completed in this area to date has been limited, there are clear signs that interest is growing and that a nascent field is establishing itself. This article discusses the current state of modelling in this area, bringing together many recent results for the first time. We review the work that has been done, discuss its scope and highlight the gaps in our understanding that could yield future opportunities.

BackgroundOwing to hospitalization, reduced functional capacity and consequently, less sunlight exposure, suboptimal vitamin D status (25-hydroxyvitamin D [25(OH)D]⩽50 nmol/L) is prevalent among COPD patients.ObjectiveThis study aimed to investigate seasonal changes in vitamin D status and any associated changes in fat-free mass (FFM), muscle strength and quality of life (QoL) in COPD patients.Patients and methodsCOPD patients living in Northern Ireland (n=51) completed study visits at the end of winter (March/April) and at the end of summer (September/October), corresponding to the nadir and peak of vitamin D status, respectively. At both time points, serum concentration of 25(OH)D was quantified by liquid chromatography-tandem mass spectrometry, FFM (kg) was measured using bioelectrical impedance and muscle strength (kg) was measured using handgrip dynamometry. QoL was assessed using the validated St George’s Respiratory Questionnaire.ResultsMean±SD 25(OH)D concentration was significantly higher at the end of summer compared to the end of winter (52.5±30.5 nmol/L vs 33.7±28.4 nmol/L, P<0.001); and house- bound patients had significantly lower 25(OH)D concentration compared to nonhousebound patients at the end of summer (42.9±4.2 vs 57.2±9.9 nmol/L; P⩽0.001). Muscle strength (at both time points) and QoL (end of summer only) were positively predicted by 25(OH)D concentration, independent of age, sex and smoking status.ConclusionThis study highlights the need for health policies to include a recommendation for year-round vitamin D supplementation in housebound COPD patients, and wintertime supplementation in nonhousebound patients, to maintain optimal 25(OH)D concentrations to protect musculoskeletal health. Furthermore, an optimal vitamin D status may have potential benefits for QoL in these patients.

Vitamin D is well known for its role in bone health and calcium homeostasis. However, emerging evidence suggests that vitamin D may also have an influence on other health issues such as type 2 diabetes, cardiovascular disease, cancer, autoimmune diseases and respiratory function (1,2) . Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation and is associated with an abnormal inflammatory response (3) . It has been hypothesised that vitamin D deficiency may enhance chronic airway and systemic inflammation and increase the risk of infectious exacerbations (1) in COPD. Vitamin D status in this population is, therefore, of interest. The aim of the present study was to examine the prevalence of sub-optimal vitamin D status in a sample of patients with moderate to severe COPD and to compare the vitamin D status of a sub-sample of this patient group with healthy age-, sex-, and season-matched controls.The serum 25-hydroxyvitamin D (25-OHD) levels of 81 Northern Irish patients with moderate to severe COPD (classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines (3) ) were measured using Ultra Performance Liquid Chromatography followed by tandem mass spectrometry (UPLC/MS/MS). Twenty-two COPD patients were matched for age-, sex-, and season of blood sample collection with healthy participants recruited from Northern Ireland at the same time as the COPD cohort.The mean vitamin D status for male and female COPD patients was 35.3 (SD 23.3) nmol/l and 38.5 (SD 49.6) nmol/l, respectively (P = 0.701; Independent samples t-test). There was no significant difference in mean vitamin D status between those with moderate (32.3 (SD 20.2) nmol/l) compared to severe COPD (39.8 (SD 44.8) nmol/l) (P = 0.372; Independent samples t-test). Season of blood sample collection had no significant effect on vitamin D status in this group of COPD patients (P = 0.116; analysis of variance). Overall, almost half of the COPD patients (45.7 %) were vitamin D deficient ( < 25 nmol/l), with 79 % showing biochemical evidence of sub-optimal vitamin D status ( < 50 nmol/l). Only 10 % of this sample had adequate vitamin D concentrations ( > 75 nmol/l). The vitamin D status of patients with moderate to severe COPD (n = 22) was significantly lower compared with healthy age-, sex-, and season-matched controls (n = 22) (36.7 (SD 36.8) nmol/l versus 52.5 (SD 23.2) nmol/l, respectively; P = 0.003; Independent samples t-test).Suboptimal vitamin D status was prevalent in this sample of patients with moderate to severe COPD. Furthermore, patients with moderate to severe COPD had significantly lower vitamin D concentrations compared to healthy age-, sex-, and season-matched controls. The potential role of vitamin D supplementation in the prevention or management of COPD is worthy of further investigation.

Fruit and vegetable (FV) intake is associated with reduced risk of a number of non-communicable diseases. Research tends to focus on antioxidants, flavonoids and polyphenols contained in FV as the main beneficial components to health; however, increasing FV may also alter overall diet profile. Extra FV may be substituted for foods thought to be less healthy, therefore altering the overall macronutrient and/or micronutrient content in the diet. This analysis merged dietary data from four intervention studies in participants with varying health conditions and examined the effect of increased FV consumption on diet profile. Dietary intake was assessed by either diet diaries or diet histories used in four FV randomised intervention studies. All food and drink intake recorded was analysed using WISP version 3.0, and FV portions were manually counted using household measures. Regression analysis revealed significant increases in intakes of energy (172 kJ (+41 kcal)), carbohydrate (+3·9 g/4184 kJ (1000 kcal)), total sugars (+6·0 g/4184 kJ (1000 kcal)) and fibre (+0·8 g/4184 kJ (1000 kcal)) and significant decreases in intakes of total fat (-1·4 g/4184 kJ (1000 kcal)), SFA (-0·6 g/4184 kJ (1000 kcal)), MUFA (-0·6 g/4184 kJ (1000 kcal)), PUFA (-0·1 g/4184 kJ (1000 kcal)) and starch (-2·1 g/4184 kJ (1000 kcal)) per one portion increase in FV. Significant percentage increases were also observed in vitamin C (+24 %) and -carotene (+20 %) intake, per one portion increase in FV. In conclusion, pooled analysis of four FV intervention studies, that used similar approaches to achieving dietary change, in participants with varying health conditions, demonstrated an increase in energy, total carbohydrate, sugars and fibre intake, and a decrease in fat intake alongside an expected increase in micronutrient intake.

Cardiovascular disease (CVD) is currently the leading cause of death worldwide (1) . Epidemiological evidence has shown a positive effect of polyphenol intake on CVD risk (2) . Seaweed is a rich source of polyphenolic compounds, which can comprise 5 to 15% of the dried weight (3) . Some studies suggest that the potential antioxidant and anti-inflammatory benefits of seaweed-derived polyphenols may yield highly bioactive components with commercial potential for food and pharma applications (4) . The aim of this randomised, double-blind, placebo controlled, crossover design study was to investigate the biological activity of a food grade seaweed polyphenol extract (CEVA, France) in terms of reducing oxidative damage to DNA, modulation of inflammatory responses and reduction on chronic, low level inflammation in vivo.Volunteers were randomised to receive either a capsule containing 100 mg seaweed extract or a matched placebo daily for an 8 week period, with an 8 week washout period between each treatment. Fasting blood and urine samples were taken from each volunteer at 4 time-points during the study, at baseline and completion of the 2 treatment phases.80 apparently healthy volunteers (42·7 (SD 7·1) years, BMI 30·2(SD 3·9) kg/m 2 ) were recruited onto the study for 24 weeks; n = 78 completed both treatment periods. Blood and urine samples were analysed for an array of outcome measures including DNA damage to lymphocytes (Comet assay), intracellular cytokine activity (flow cytometer) (in preparation), C-reactive protein (CRP), triglycerides and isoprostane levels.There were no significant changes in either the placebo or seaweed treatment group for any of the parameters measured. However, there was a 31% decrease in CRP, although this did not reach statistical significance. The inflammatory markers are yet to be analysed but may provide additional information on the anti-inflammatory potential of a range of novel seaweed extracts that could be further exploited.