Is a flavonoid-rich diet with steamer cooking safe during calcineurin inhibitors therapy?

Abstract

Summary What is known and objective Dietary therapy is recommended for decreasing the symptoms of the metabolic syndrome and the risk of type 2 diabetes and cardiovascular diseases in subjects on calcineurin inhibitors. However, food–drug interactions may occur particularly with patients on such immunosuppressive therapy. This article comments on the benefit/risk assessment of a flavonoid‐rich diet and steam‐cooking of such food during calcineurin inhibitors therapy. Comment Patients are commonly advised against consuming citrus fruits and juices, grape juice and green tea. High vegetable intake may however increase the risk of food–diet interactions by inhibiting drug metabolic enzymes and transporters. Vegetable glucosinolates are potential interactants and may lead to adverse effects of drugs with narrow therapeutic indices and in the presence of genetic polymorphism. Examples of food components with potential drug interactants include all members of the Brassicaceae family. What is new and conclusion The potential additive and synergistic effects of flavonoids with other molecules in interfering with drug bioavailability need to be taken into account. The risk is highest with drugs with a narrow therapeutic index and in subjects with genetic polymorphisms of proteins involved in the disposition of those drugs.

Bioactive Compounds in Brassicaceae Vegetables with a Role in the Prevention of Chronic Diseases

“…In the last few years, several studies, both in vitro and in vivo, have focused on the effects of Brassicaceae on chronic diseases and on the bioactive compounds of these plants that may be responsible for the observed effects [ 7 , 8 ] ( Figure 1 ). It has been discussed that the known healthy effects of Brassicaceae may be related to the presence of several bioactive compounds in the edible parts, such as ascorbic acid (AsA), phenolics, carotenoids, and glucosinolates, as summarized in Table 1 [ 9 , 10 ].…”

“…Adverse effects of compounds that are present in Brassicaceae towards metabolic syndromes are also possible. For example, the potential additive and synergistic effects of flavonoids from Brassicaceae with other molecules could interfere with the bioavailability of specific drugs with a narrow therapeutic index [ 9 ].…”

Sulforaphane Ameliorates the Severity of Psoriasis and SLE by Modulating Effector Cells and Reducing Oxidative Stress

“…Cruciferous vegetables have been considered sanatory, and can reduce the risk of chronic diseases (Raiola et al, 2017). The bioactive compounds that have been reported are ascorbic acid, phenolics, carotenoids, and glucosinolates (Peluso and Palmery, 2014). Sulforaphane, also known as isothiocyanate 1-isothiocyanato-(4R)-(methylsulfinyl) butane (Figure 1A), is a kind of isothiocyanate that is a hydrolysate of glucosinolates produced by the enzyme myrosinase in cruciferous vegetables (Raiola et al, 2017).…”

Dietary Antioxidants: Micronutrients and Antinutrients in Physiology and Pathology

“…[14]. Levels of flavanols comparable to those of formulated supplements can be reached with 180 g of apples or 8 g of dark chocolate, and a serving of 150-200 g of red fruits may yield amounts of flavanols and anthocyanins that are comparable to those of formulated supplements [15]. The EFSA Panel concluded that there is evidence from interventional clinical trials that the intake of doses equal to or above 800 mg epigallocatechin gallate (EGCG)/day taken as a food supplement has been shown to induce a statistically significant increase of serum transaminases in treated subjects compared to control [16].…”