title: Feasibility and preliminary efficacy of the effects of flavanoid-rich purple grape juice on the vascular health of childhood cancer survivors: a randomized, controlled crossover trial.
abstract: BACKGROUND
  Childhood cancer survivors have an increased risk of developing cardiovascular disease following treatment, yet few interventions have been evaluated to reduce this risk. Purple grape juice (pGJ), a rich source of flavonoids with antioxidant properties, has been shown in adults to reduce oxidative stress and improve endothelial function. We examined the effects of supplementing meals with pGJ on microvascular endothelial function and markers of oxidative stress and inflammation in 24 cancer survivors (ages 10-21 years).
  
  
  METHODS
  In a randomized controlled crossover trial consisting of two, 4 week intervention periods, each preceded by a 4 week washout period, subjects received in random order 6 ounces twice daily of pGJ and clear apple juice (cAJ; similar in calories but lower in flavonoids). Measurements were obtained before and after each supplementation period; change was evaluated using mixed effects ANOVA.
  
  
  RESULTS
  pGJ did not improve endothelial function, measured using digital reactive hyperemia, compared with cAJ (mean change: pGJ 0.06, cAJ 0.22; difference of mean change [95% CI]: -0.16 [-0.42 - 0.11], P = 0.25). No significant changes in plasma concentrations of oxidized-LDL, myeloperoxidase, or high sensitivity C-reactive protein were observed.
  
  
  CONCLUSIONS
  After 4 weeks of daily consumption of flavonoid-rich pGJ, no measurable change in vascular function was observed in these childhood cancer survivors.
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Cindy K
authors.initials: CK
authors.lastname: Blair
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kelly
authors.forename: Julia
authors.initials: J
authors.lastname: Steinberger
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Eberly
authors.forename: Char
authors.initials: C
authors.lastname: Napurski
authors.forename: Kim
authors.initials: K
authors.lastname: Robien
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Neglia
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mulrooney
authors.forename: Julie A
authors.initials: JA
authors.lastname: Ross
mesh_terms: D000293:Adolescent; D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D001628:Beverages; D015415:Biomarkers / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D005419:Flavonoids / Q000494:pharmacology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D011379:Prognosis; D015996:Survival Rate; D017741:Survivors; D027843:Vitis / Q000737:chemistry*; D055815:Young Adult
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D005419:Flavonoids
keywords: cardiovascular disease; childhood cancer survivors; endothelial function; grape juice; intervention