title: Health effects of mixed fruit and vegetable concentrates: a systematic review of the clinical interventions.
abstract: Diets rich in fruits and vegetables (FV) have been associated with a reduced risk of chronic disease, including cardiovascular disease. Unfortunately, public health campaigns to increase FV intake have had limited success. A number of mixed concentrated FV products have been studied, which may help certain individuals improve nutrient status. However, the possible health benefits of FV supplements have not been systematically reviewed. We, therefore, undertook a systematic search of MEDLINE and EMBASE to identify clinical interventions that examined the effect of commercially available concentrated mixed FV supplements on cardiovascular disease risk factors. Twenty-two reports, which used commercially available products, were identified. None of the studies reported any serious adverse effects. Overall, daily consumption of FV supplements significantly increased serum concentrations of the major antioxidant provitamins and vitamins found in plant foods (β-carotene, vitamins C and E) and folate. Functional changes, such as reduced serum homocysteine and markers of protein, lipid, and DNA oxidation, were also reported; in addition, the health advantages on markers of inflammation, immunity, and endothelial function are promising. Limitations of the available studies were related to the diversity of studies conducted with respect to design and study population and the variability in the measured outcomes and assays utilized. While mixed FV supplements may serve as an efficacious complement for individuals who have difficulty achieving their daily FV intake requirement, further research on additional retail preparations is warranted. Key teaching points: Mixed fruit and vegetable supplements produced from plant foods may serve as an efficacious complement to the habitual diet in individuals who have suboptimal intake or variety of nutrient-dense fruits and vegetables. Current research indicates that fruit and vegetable concentrates significantly increase serum levels of antioxidant provitamins and vitamins (β-carotene, vitamins C and E) and folate and reduce homocysteine and markers of oxidative stress. Mechanistic studies and larger, randomized, placebo-controlled double-blind trials in both healthy and high-risk populations are necessary to better understand the health effects of these supplements.
authors.affiliation: Department of Nutritional Sciences, University of Toronto, Ontario, Canada.
authors.forename: Amin
authors.initials: A
authors.lastname: Esfahani
authors.forename: Julia M W
authors.initials: JM
authors.lastname: Wong
authors.forename: Jennifer
authors.initials: J
authors.lastname: Truan
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Villa
authors.forename: Arash
authors.initials: A
authors.lastname: Mirrahimi
authors.forename: Korbua
authors.initials: K
authors.lastname: Srichaikul
authors.forename: Cyril W C
authors.initials: CW
authors.lastname: Kendall
mesh_terms: D000975:Antioxidants / Q000378:metabolism; D001205:Ascorbic Acid / Q000097:blood; D004032:Diet; D005247:Feeding Behavior; D005492:Folic Acid / Q000097:blood; D005638:Fruit; D006710:Homocysteine / Q000097:blood; D006801:Humans; D010084:Oxidation-Reduction; D018384:Oxidative Stress; D016032:Randomized Controlled Trials as Topic; D014675:Vegetables; D014810:Vitamin E / Q000097:blood; D014815:Vitamins / Q000097:blood; D019207:beta Carotene / Q000097:blood
chemical_list: D000975:Antioxidants; D014815:Vitamins; D019207:beta Carotene; D006710:Homocysteine; D014810:Vitamin E; D005492:Folic Acid; D001205:Ascorbic Acid