Next Article in Journal
Characterization of ACE and ACE2 Expression within Different Organs of the NOD Mouse
Next Article in Special Issue
Combined Effects of Curcumin and Lycopene or Bixin in Yoghurt on Inhibition of LDL Oxidation and Increases in HDL and Paraoxonase Levels in Streptozotocin-Diabetic Rats
Previous Article in Journal
Structural Characterization of Core Region in Erwinia amylovora Lipopolysaccharide
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Review

Effects and Mechanisms of Fruit and Vegetable Juices on Cardiovascular Diseases

1
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
2
School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
3
South China Sea Bioresource Exploitation and Utilization Collaborative Innovation Center, Sun Yat-sen University, Guangzhou 510006, China
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2017, 18(3), 555; https://doi.org/10.3390/ijms18030555
Submission received: 20 January 2017 / Revised: 23 February 2017 / Accepted: 28 February 2017 / Published: 4 March 2017
(This article belongs to the Special Issue Correlation between Nutrition, Oxidative Stress and Disease)

Abstract

:
Many studies have indicated that consumption of vegetables and fruits are positively related to lower incidence of several chronic noncommunicable diseases. Although composition of fruit and vegetable juices is different from that of the edible portion of fruits and vegetables, they contain polyphenols and vitamins from fruits and vegetables. Drinking vegetable and fruit juices is very popular in many countries, and also an efficient way to improve consumption of fruits and vegetables. The studies showed that fruit and vegetable juices affect cardiovascular risk factors, such as lowering blood pressure and improving blood lipid profiles. The main mechanisms of action included antioxidant effects, improvement of the aspects of the cardiovascular system, inhibition of platelet aggregation, anti-inflammatory effects, and prevention of hyperhomocysteinemia. Drinking juices might be a potential way to improve cardiovascular health, especially mixtures of juices because they contain a variety of polyphenols, vitamins, and minerals from different fruits and vegetables. This review summarizes recent studies on the effects of fruit and vegetable juices on indicators of cardiovascular disease, and special attention is paid to the mechanisms of action.

Graphical Abstract

1. Introduction

Many studies have shown that some natural products possess high antioxidant activities, such as vegetables, fruits, cereals, mushrooms, microalgae, wild flowers, and medicinal plants [1,2,3,4,5,6,7,8,9,10,11], which could be employed to prevent or treat several chronic noncommunicable diseases caused by oxidative stress [12,13,14,15,16]. Epidemiological studies also revealed that consuming fruits and vegetables were negatively associated with chronic noncommunicable diseases. The nutritionists have recommended that the public should eat more vegetables and fruits. Drinking juice is an effective method to promote consumption of fruit and vegetables, and is very popular in many countries [17,18,19,20]. A large amount of evidence shows that juice is a part of balanced diet offering profound risk reduction of many diseases, such as cancers, neurodegenerative diseases, and cardiovascular diseases [18,21,22].
Cardiovascular disease includes disorders of the blood vessels and heart, such as hypertension, cerebrovascular disease, peripheral artery disease, coronary heart disease, rheumatic heart disease, heart failure, and congenital heart disease. Cardiovascular disease is one of the major causes of chronic noncommunicable deaths, usually associated with metabolic disorders, including obesity and diabetes. Hypertension and high cholesterol are two risk factors for sudden stroke or heart attack, and abnormal blood lipids are also significant risk factors for cardiovascular diseases. A healthy heart and circulation system could benefit from a balanced diet with adequate fruits and vegetables. Epidemiological evidence supports a significantly positive correlation between eating fruits and vegetables and cardiovascular health [23,24,25,26]. Several studies reported healthy dietary patterns containing adequate fruits and vegetables show good results with respect to blood pressure control [27,28,29], and some studies found that there was a positive association between consuming fruits and vegetables and blood lipids control [30,31,32,33,34]. In addition, the relationship between obesity and cardiovascular diseases should be taken into account because sugar-sweetened juices might contribute to obesity [35,36,37,38,39,40].
Although composition of fruit and vegetable juices is different from that of the edible portion of fruits and vegetables, they contain polyphenols, vitamins, and minerals from fruits and vegetables. In fact, the consumption of vegetable juice was confirmed to help reach the daily dietary vegetable intake recommendations consistent with the 2005 Dietary Guidelines and the Dietary Approaches to Stop Hypertension (DASH) diet [34], and drinking fruit juice was also an effective way of supplementing fruits. In this review, Web of Science, MEDLINE, PubMed, and EMBASE databases were searched with the keywords “juice” and “fruit or vegetable” for relevant papers published in English in peer-reviewed journals. This paper summarizes current knowledge and recent studies on the effects of fruit and vegetable juices on the cardiovascular system. Special attention is paid to the effects on blood pressure and lipids, and the mechanisms of action have been discussed.

2. Juices and Blood Pressure

Intake of raw fruits and vegetables has been associated with low incidence of hypertension [41,42,43]. Several epidemiological studies paid attention to the effect of consumption of juices on blood pressure (Table 1).
Several studies revealed the relationship between consumption of fruit juice and blood pressure. For example, juice of sweetie fruit (a hybrid between grapefruit and pummelo) possessed an anti-hypertensive effect. Diastolic blood pressure (DBP) was reduced more by the high-flavonoid sweetie juice than by the low-flavonoid sweetie juice (p = 0.04). The flavonoids naringin and naritutin in sweetie juice might be the active ingredients contributing to the anti-hypertensive effect [44]. Moreover, a study was conducted to determine the effects of fresh juice of pomegranate (Punica granatum L.) on blood pressure. Consuming pomegranate juice consumption induced significant reductions in DBP (p = 0.038) and systolic blood pressure (SBP) (p = 0.002) [45]. Particularly, a meta-analysis focusing on the effect of fruit juice on blood pressure and cholesterol in humans was reported. DBP was reduced via fruit juice consumption by 2.07 mmHg, but SBP was not significantly affected [46].
Several studies have indicated that consumption of vegetable juice may reduce blood pressure. High nitrate content in certain vegetables might be a source of cardiovascular protective nitric oxide. A dietary nitrate load (500 mL of beetroot juice) could reduce blood pressure (Δmax −10.4/8 mmHg) approximately 3 h after ingestion, which was reciprocally associated with the nitrite concentration in plasma [47]. Two other studies focusing on the ingestion of nitrate-rich beetroot showed dose-dependently blood pressure lowering effects [48,49]. Another study confirmed that SBP was lowered significantly after drinking beetroot juice [50]. In addition to beetroot juice, rich in nitrate, other vegetable juices have also drawn wide attention. For instance, in a study, hypertensive subjects showed a remarkable decrease in blood pressure after the 12-week consumption of vegetable juice [34]. Furthermore, a pilot study was conducted to discover whether blood pressure was influenced by drinking fresh carrot juice, and results showed that SBP decreased (p = 0.06), but not DBP [51].
SBP and DBP were decreased significantly in prehypertensive and hypertensive subjects after consumption of the juice powder, consisting primarily of fruits and vegetables. This study supported the notion that the mixture of fruit and vegetable juices led to a decrease in blood pressure [52].
The anti-hypertensive effect of the juices may be related to bioactive components, such as polyphenols, vitamins, minerals, and nitrate (Table 1). It is thought that polyphenols are the main components in fruit juice to cause a decrease in blood pressure, while nitrate and minerals play an important role in the anti-hypertensive effect of vegetable juice.

3. Juices and Blood Lipids

Many studies have paid attention to the effects of fruit and vegetable juices on blood lipids (Table 2). For example, the relationship between orange juice consumption and cardiovascular disease was investigated. The results showed that total cholesterol (TC), apo B, low-density lipoprotein–cholesterol (LDL-C), and low-density lipoprotein / high-density lipoprotein (LDL/HDL) ratio were all significantly lowered by consuming orange juice, while the serum levels of homocysteine, high-density lipoprotein-cholesterol (HDL-C) and apo A-1 were not affected [64]. In another study, the effects of an acai berry-based juice blend on lipid profile were studied in a pilot study. Serum lipid profile (triglycerides, cholesterol, and its fractions) was substantially improved after the intervention. The improving blood lipids effects of the juice blend were mainly in relation to the high content of total polyphenol [65]. Additionally, the effects of cloudy apple juice with vitamin C on serum cholesterol were investigated. Total cholesterol showed a trend to decrease in the vitamin C-rich apple juice intervention period [66]. In another study, the effects of consuming cranberry juice cocktail on cardiometabolic outcomes were examined. The results showed levels of cholesterol tended to be lowered by a cranberry juice cocktail [67]. In addition, ingestion of lycopene-rich tomato decreased cholesterol. A study showed that serum levels of cholesterol were markedly reduced, while serum levels of adiponectin and triglyceride were increased by the intervention [68].
In the study of Houston et al. [52], HDL-C (p = 0.025) and apo A (p = 0.004) were remarkably decreased after two-year consumption of encapsulated juice powder containing the extract of different fruits and vegetables. In another study, the effects of a juice mixture of komatsuna and fresh fruit on serum cholesterol were investigated, and the results showed that serum TC and LDL-C were significantly reduced [69]. In addition, the effects of the fiber in fruits and vegetables in the diet were determined by Kelsay et al. [70]. When consuming the low fiber diet, the DBP of half of the men was 80 mmHg or more, and their DBP was significantly lower when consuming a high fiber diet. It was speculated that the DBP was probably affected by the fiber in the diet, so clear juices were less healthy than the whole fruits and vegetables.
However, there are a number of studies showing that consumption of juice does not decrease blood pressure or improve the blood lipid profiles. Several studies were conducted to assess the effects of clear apple juice, cloudy apple juices, squeezed orange juice, and grapefruit juice on blood pressure in healthy adults or adults with hypercholesterolemia and hypertriglyceridemia. No effect of any of these interventions was found on SBP or DBP [53,54,55]. In addition, two studies assessing the effects of vegetable juice showed that either beetroot juice or low sodium vegetable juice could not decrease blood pressure in individuals with type 2 diabetes or in people with metabolic syndrome [60,63]. Similarly, clear juice increased LDL-C without affecting HDL-C, and lipid panels were not affected after ingestion of orange juice or pomegranate juice [45,54,55]. In addition, according to a meta-analysis, consuming fruit juice showed no significant effects on TC, HDL-C, and LDL-C in adults [46]. Furthermore, the plasma cholesterol, triglycerides, apo A, apo B, LDL, and HDL were not affected by drinking fresh carrot juice [51].

4. Mechanisms of Action of Juice on Cardiovascular Diseases

The main mechanisms of action of juices on cardiovascular diseases included antioxidant effects, improvement of the aspects of cardiovascular system, inhibition of platelet aggregation, anti-inflammatory effects, and prevention of hyperhomocysteinemia.

4.1. Antioxidant Effects

Hypercholesterolemia is related to increased lipid peroxidation. Pomegranate juice drew wide attention because of the effects on lipid peroxidation. According to Betanzos-Cabrera et al. [73], LDL was protected by pomegranate polyphenols against cell-mediated oxidation. The oxidatively-modified LDL was reduced by pomegranate polyphenols, for the interaction of macrophages with LDL inhibited its oxidation by scavenging reactive oxygen species and reactive nitrogen species. In another study, serum paraoxonase activity was increased by pomegranate polyphenols, which led to the hydrolysis of lipid peroxides in oxidized lipoproteins and in atherosclerotic lesions. It was demonstrated that pomegranate polyphenols had antioxidant and anti-atherogenic effects both in vitro and in vivo in humans, and in atherosclerotic apo E deficient mice [60]. LDL oxidation was prevented by esterase paraoxonase1 (PON1) in animals. Cardiovascular disease was related to decreased levels of PON1. The effect of pomegranate juice on PON1 gene expression was investigated on streptozotocin-induced diabetic mice fed with a high-fat diet. Supplements with pomegranate juice significantly induced PON1 gene expression and activity in mice. In addition, blood glucose was dramatically reduced by the pomegranate juice, but not triacylglycerols and cholesterol levels [74]. Additionally, in the study of Potter et al. [51], the plasma total antioxidant capacity was significantly increased (p < 0.05) and the plasma malondialdehyde production was decreased (p < 0.05) after consuming 16 fl oz of fresh carrot juice daily for three months. Furthermore, in the study of Foroudi et al. [54], consuming orange juice markedly upregulated the total plasma antioxidant capacity, and remarkably reduced lipid peroxidation. In another study [75], after taking in an antioxidant-rich juice daily, plasma lipid oxidation (malondialdehyde concentration) was significantly decreased (−29%), while plasma antioxidant capacity was markedly increased (+115%) after the intervention. In another study, a commercial juice powder containing mangifera was investigated. The concentrations of ascorbic acid and plasma β-carotene were significantly increased after consuming the juice powder. Plasma total antioxidant status was also upregulated [76]. The antioxidant effect of green juice (orange, apple, lettuce, cabbage, and cucumber) was compared with orange juice in the study of Oliveira et al. [77]. The results showed that both green juice and orange juice exerted antioxidant effects, and green juice reduced weight gain, lipoperoxidation, and catalase activity. In another study, a juice made from dried apples and mandarin juice was investigated in obese children, and the antioxidant capacity of plasma showed a remarkable increase after the intake of the food, and DNA oxidative damage was reduced [78]. In the study of Huebbe et al. [79], inducible NO synthase was significantly inhibited by blackcurrant treatment in cultured macrophages and, compared with untreated controls, levels of iNOS protein were reduced while levels of heme oxygenase 1 were increased. In human subjects, blackcurrant significantly elevated both plasma ascorbic acid and radical-scavenging capacity. According to Miglio et al. [80], concomitant ingestion of antioxidant-rich fruit juice could prevent the increase in levels of uric acid and thiols induced by high-fat meals. In addition, the antioxidant defense mechanism against CCl4-induced reproductive toxicity could be augmented by pomegranate juice [81]. In addition, in an animal study [82], the hamsters received an atherogenic diet with either juice or tea daily. Aortic lipid deposition was inhibited after 12-week berry juices and teas, and reduced activity of hepatic antioxidant enzymes was triggered. It was suggested that the development of early atherosclerosis could be prevented by moderate consumption of berry juices. The composition and concentration of polyphenols in the juices were different, indicating that a diversity of polyphenols could induce anti-atherosclerotic effects.
However, some juices did not have antioxidant effects. Onion was rich in flavonoids, which were potential antioxidants. The effect of decocted onion juice (about 300 g onion) on mild hypercholesterolemic subjects was investigated. Twenty-seven subjects were recruited and the study lasted for 10 weeks. No significant differences were found in plasma total antioxidant capacity, antioxidant vitamins, LDL oxidation, or erythrocyte antioxidant enzyme activity [83]. In another study [53], the antioxidant effect of grapefruit was investigated, but results showed that oxidative stress was not affected after consumption of grapefruit juice.

4.2. Improving Aspects of the Cardiovascular System

Vascular health was affected by phenolic compounds of fruits and vegetables, and the cardiovascular protection of polyphenols was confirmed [16]. Endothelium-dependent vasodilatation played a key role in blood pressure. Poudyal et al. [84] compared the ability of purple carrot juice and β-carotene to reverse the structural and functional changes in the rat model of the metabolic syndrome. Endothelial dysfunction was observed in the rats. Both β-carotene and purple carrot juice were able to attenuate or reverse the endothelial dysfunction. It indicated that anthocyanins, as well as β-carotene, were related to improving the endothelial function. In addition, an animal study was developed to determine whether the blood pressure and vascular function of spontaneously hypertensive rats were affected by Finnish berry juices, including juices of lingonberry (Vaccinium vitis-idaea), cranberry (Vaccinium oxycoccos), and blackcurrant (Ribes nigrum) after the eight-week treatment. The results turned out that the impaired endothelium-dependent relaxation was observed in the cranberry, blackcurrant, and control groups, while it was normalized in the lingonberry group. All three kinds of fruit were rich in polyphenols. It could be concluded that endothelium-dependent vasodilatation of spontaneously hypertensive rats could be improved by long-term lingonberry juice treatment [85]. In another study, cranberry juice, which was rich in polyphenols, was investigated and no significant change caused by cranberry juice on peripheral endothelial function was found during the study [86]. Moreover, in the study of Asgary et al. [45], the effects of consuming juice of pomegranate on endothelial function were discussed. Serum levels of vascular endothelial adhesion molecule 1 (VCAM-1) were markedly down-regulated by pomegranate juice while those of E-selection were up-regulated. Additionally, in the study of Habauzit et al. [53], the effects of consuming grapefruit flavanone on vascular function were investigated. Central aortic stiffness was statistically significantly lowered after consumption of grapefruit juice. However, endothelial function in micro- and macrocirculation were not affected by the intervention. It could be concluded that grapefruit juice consumption was beneficial for arterial stiffness in middle-aged, healthy, postmenopausal women, which was related to flavanones presented in grapefruit. In the study of Auger et al. [87], the results indicated that very few commercial fruit juices could induce potent endothelium-dependent relaxations. The total polyphenol contents of active fruit juices and the less active juices were almost the same, so this effect did not contribute to their total polyphenol content, but to their specific polyphenol composition. In the study of Buscemi et al. [88], the effect of red orange juice consumption on endothelial function was investigated in subjects with higher cardiovascular risk. As a result, endothelial function was significantly improved. Additionally, the oriental plum (Prunus mume) fruit juice concentrate could improve human blood fluidity. Angiotensin II (AngII) stimulated the growth of vascular smooth muscle cells (VSMCs), through transactivating epidermal growth factor (EGF) receptor, which involved producing reactive oxygen species. Furthermore, the oriental plum fruit juice concentrate could inhibit AngII-induced EGF receptor transactivation. H2O2-induced EGF receptor transactivation was also inhibited. Thus, the oriental plum fruit juice concentrate remarkably inhibited AngII-induced extracellular signal-regulated kinase (ERK) activation. The oriental plum fruit juice concentrate inhibited AngII stimulated leucine uptake in VSMCs significantly. It was suggested that the oriental plum fruit juice concentrate could exert a significant cardiovascular protective effect [89]. Moreover, endothelial function and arterial tree vascular elastic properties could be improved by consuming Concord grape juice [90].
According to some studies [47,48,49,51,52], certain vegetables (such as beetroot) improved vascular protective NO endogenously, which could be elevated by ingestion of dietary nitrate by oral bacteria in the entero-salivary circulation. Consumption of beetroot juice containing nitrate might downregulate blood pressure, thus decreasing the risk of cardiovascular events. Blood pressure was lowered when consuming beetroot juice as part of a normal diet or supplement in most studies. Endothelial dysfunction was prevented by dietary nitrate. In addition, the underlying mechanism of Aronia melanocarpa (chokeberry) juice was determined. A. melanocarpa juice stimulated the endothelial formation of NO in coronary arteries; involving the phosphorylation of eNOS via activating the Src/PI3-kinase/Akt pathway [47,48,49,51,52].
The effects of blackcurrant juice on vascular function were investigated, and the flow-mediated dilatation increased significantly in the high blackcurrant juice drink group. Plasma vitamin C concentration was upregulated remarkably both in the low and high blackcurrant juice drink groups. In addition, the changes in plasma vitamin C and flow-mediated dilatation were correlative, remarkably. It could be concluded that vascular health was improved by consumption of blackcurrant juice resulting from elevating plasma vitamin C concentration [91]. Furthermore, results from the study of Noratto et al. [92] showed that plasma levels of MCP-1 and mRNA, as well as protein levels of VCAM-1, were lowered in the peach and plum groups. In another study, the effect of citrus fruits juice on vascular remodeling was assessed in a mouse model. Neointima formation was dramatically attenuated by 40% citrus unshiu juice, 10% citrus iyo juice, and 40% citrus iyo juice, but not 10% citrus unshiu juice. Vascular remodeling was attenuated partly through reducing oxidative stress [93]. In addition, in the study of Poudyal et al. [84], purple carrot juice was able to attenuate or reverse all of these changes. Carotenoid concentration was low in purple carrot juice, so anthocyanins might be the main contributor of antioxidant and anti-inflammatory properties to improve cardiovascular function. In the study of Ramli et al. [94], it was demonstrated that consuming red pitaya juice could reduce diastolic stiffness of the heart in rats. Aditionally, blood pressure downregulation effect of Carica papaya fruit juice was examined in male albino Wistar rats [95]. A significant depression of arterial blood pressure (MAP) was produced by juice and hydrallazine, and juice produced more depression of MAP than hydrallazine in the hypertensive rats. In vitro studies were conducted to explore the mechanism. Isolated rabbit arteries were used, and the results indicated that the juice produced relaxation of vascular muscle tone. It was concluded that C. papaya fruit juice could contain antihypertensive agents which exhibited mainly α-adrenoceptor activity.

4.3. Inhibitory Effect on Platelet Aggregation

Platelets were involved in atherosclerotic disease development and it was important to reduce platelet activity in the patients. Flavonoids could reduce platelet aggregation and lower the incidence of cardiovascular disease. Red wine and grapes were confirmed to be rich in polyphenolic compounds, including flavonoids. Citrus fruits contained different types of polyphenolics. In a randomized cross-over trial [96], the results turned out that the whole blood platelet aggregation responded to 1 mg/L of collagen was reduced by purple grape juice by 77% (from 17.9 ± 2.3 to 4.0 ± 6.8 ohms, p = 0.0002), but not affected by orange juice or grapefruit juice. The total polyphenolic concentration of purple grape juice was approximately two more times than that of the citrus juices. The flavonoids in grape juice reduced the risk of myocardial infarction and coronary thrombosis because of the platelet inhibitory effects. Another study [47] focused on the effects of beetroot juice consumption on platelet aggregation. The results showed that platelet aggregation was inhibited by the intervention. Additionally, in the study of Mattiello et al. [97], the antiplatelet effect of pomegranate (Punica granatum) juice was investigated. All of the platelet responses were reduced by pomegranate juices in study in vitro. The effective components were primarily hydrolyzed tannins, including ellagitannins. It could be concluded that cardiovascular health benefits of pomegranate were related to platelet inhibitory function of polyphenols.
The effect of consuming red or blond orange juice on whole blood procoagulant activity was investigated on healthy subjects. The red orange juice was rich in anthocyanins while the blond was not. The results showed that both intake of the two types of orange juice caused a prolongation of unstimulated and stimulated whole-blood clotting times, without any difference. It was suggested that procoagulant activity was decreased by orange juice, independent of its anthocyanin content [98].

4.4. Anti-Inflammation

Persistent inflammation was related to most chronic diseases including cardiovascular diseases [99]. Some diets reduced inflammation which was related to almost all phases of atherosclerosis, thus, they might reduce cardiovascular disease risk. The anti-inflammatory effects of some juices were confirmed in cardiovascular system. In the study of Li et al. [68], the effect of tomato juice rich in lycopene on monocyte chemoattractant protein-1 (MCP-1) was studied and the result showed that MCP-1 was markedly reduced after consumption of tomato juice containing lycopene. In addition, in the study of Noratto et al. [92], effects of plum and peach juice on obesity-induced inflammation related to cardiac dysfunction and heart failure were studied, and the results showed that protein levels of the active p-Iκ-Bα and p-NF-κBp65 subunits in heart tissue were lowered. In the plum juice group, mRNA levels of Iκ-Bα and TNF-α were significantly decreased. In the peach juice group, mRNA levels of TNF-α were lowered. In the study of Duffey and Sutherland [67], C-reactive protein was tested in cranberry juice cocktail consumers who consumed cranberry juice cocktail for two nonconsecutive 24-h dietary recalls. The results showed that C-reactive protein levels of adult cranberry juice cocktail consumers were significantly lowered. In the study of Codoner-Franch et al. [78], a novel food product containing mandarin juice was proved to reduce inflammatory markers of the subjects, such as tumor necrosis factor-α (TNF-α), high-sensitive C-reactive protein, and interleukins 1α and 6. In the study of Buscemi et al. [88], the effect of consuming red orange juice on inflammation markers in subjects with high cardiovascular risk was investigated. The results showed that high-sensitivity C-reactive protein, TNF-α, and IL-6 were remarkably downregulated.
However, some juices were not anti-inflammatory. In a placebo-controlled randomized study, orange juice or beverage alone did not lead to any remarkable effects on circulating cytokine levels or PAI-1 activity. However, IL-lβ and serum IL-6 levels were reduced significantly by sterol-fortified orange juice (p < 0.05) compared with baseline. No evidence has shown that orange juice alone could lower inflammatory biomarkers [100]. Additionally, in the study of Habauzit et al. [53], grapefruit juice was investigated. The result showed that biomarkers of inflammation were not affected by flavanones (naringenin glycosides) in grapefruit juice. Furthermore, in the study of Simao et al. [101], subjects with the metabolic syndrome consumed reduced-energy cranberry juice containing folic acid, after which the folic acid and adiponectin were increased (p = 0.010, p = 0.033, respectively), but the homocysteine was significantly decreased (p < 0.001). In another study, lipopolysaccharide-induced inflammation was significantly inhibited by blackcurrant treatment in cultured macrophages. Blackcurrant meal consumption did not remarkably change the production of TNF-α or IL-1β in the human subjects [79].

4.5. Preventing Hyperhomocysteinemia

Homocysteine drew attention in several studies. The effect of supplementation with fruit and vegetable juices on folate status, plasma homocysteine levels was determined in smokers, hypertensive patients, men with mild hypercholesterolemia, or patients with the metabolic syndrome. The results indicated that serum folate was increased and correlated with a decrease in plasma homocysteine [64,83,101,102,103,104].

4.6. Contributing to Body Weight Control

Some juices with low calorie content showed the potential prevent metabolic disorders, which is also beneficial for cardiovascular health. For example, mulberry (Morus australis Poir) and blueberry (Vaccinium ashei) juice was rich in anthocyanin, and it might reduce obesity. C57BL/6 mice were used to investigate the hypothesis. The results showed that body weight was reduced, serum cholesterol was down-regulated, and the resistance to insulin, lipid accumulation, and leptin secretin were inhibited in the high-fat diet mice [105]. In the study of Noratto et al. [92], results showed that taking in plum and peach juice could prevent metabolic disorders induced by obesity, and plum juice remarkably inhibited body weight gain. The content of polyphenols in plum was three times that of peach, which was related to the weight-reducing effect. In the study of Oliveira et al. [77], the mice taking in green juice as a supplement had remarkably less weight gain than the mice receiving water.

5. Possible Adverse Effects of Juices

It should be noted that the calorie content of juices might complicate the relationship between juice consumption and health. Some commercial fruit/vegetable juices contain too much sugar, which might increase the risk on weight gain/obesity and diabetes, and counteract the health benefits. According to the study of Morgan et al., drinking high-fructose corn syrup beverages could lead to childhood obesity, while limiting consumption of sweetened beverages may help decrease obesity in children [39]. In another study, consuming excess free fructose regularly was associated with arthritis in adults [106]. Additionally, consuming sugar-sweetened beverages regularly was associated with type 2 diabetes, and sweetened fruit juice was not a healthy alternative for preventing diabetes [40]. In addition, compared with solid foods, juices have a smaller satiating effect, so juice consumers might take in more energy. Regular excessive consumption of 100% fruit juice might contribute to weight gain/obesity because of the sugar naturally contained in fruits, so excessive consumption of juice is not recommended [107].

6. Conclusions

The effects of juices on cardiovascular diseases were widely studied. A large number of studies supported the view that consumption of juice could prevent the increase of blood pressure and improve lipids. Some juices, such as sweetie fruit juice, pomegranate juice, guava fruit juice, cherry juice, and beetroot juice could improve both SBP and DBP. On the other hand, juices like apple juice, berry juice, tomato juice could improve one’s lipid profile, such as lower serum LDL-C and total cholesterol, and increase adiponectin and triglyceride. The main underlying mechanisms of the cardiovascular protection included antioxidant effects, improvement of aspects of cardiovascular system, improvement of endothelial function, inhibition of platelet aggregation, anti-inflammation, and prevention of hyperhomocysteinemia. The effects of juices were related to components of the raw material, such as polyphenols and vitamins. The results suggested that some juices might be used as potential supplements for cardiovascular protection, especially mixture of juices containing a variety of fruits and vegetables with polyphenols, vitamins, and minerals. More epidemiological studies and further mechanism studies are still required to clarify the relationship between bioactive components, sugar and minerals in juices and cardiovascular health.

Acknowledgments

This work was supported by the National Natural Science Foundation of China (No. 81372976), Key Project of Guangdong Provincial Science and Technology Program (No. 2014B020205002), and the Hundred-Talents Scheme of Sun Yat-Sen University.

Author Contributions

Jie Zheng, Sha Li, and Hua-Bin Li conceived this paper; Jie Zheng, Yue Zhou, Pei Zhang, Tong Zhou, and Dong-Ping Xu wrote this paper; and Sha Li and Hua-Bin Li revised the paper.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Deng, G.F.; Lin, X.; Xu, X.R.; Gao, L.L.; Xie, J.F.; Li, H.B. Antioxidant capacities and total phenolic contents of 56 vegetables. J. Funct. Foods 2013, 5, 260–266. [Google Scholar] [CrossRef]
  2. Fu, L.; Xu, B.T.; Xu, X.R.; Gan, R.Y.; Zhang, Y.; Xia, E.Q.; Li, H.B. Antioxidant capacities and total phenolic contents of 62 fruits. Food Chem. 2011, 129, 345–350. [Google Scholar] [CrossRef]
  3. Deng, G.F.; Shen, C.; Xu, X.R.; Kuang, R.D.; Guo, Y.J.; Zeng, L.S.; Gao, L.L.; Lin, X.; Xie, J.F.; Xia, E.Q.; et al. Potential of fruit wastes as natural resources of bioactive compounds. Int. J. Mol. Sci. 2012, 13, 8308–8323. [Google Scholar] [CrossRef] [PubMed]
  4. Fu, L.; Xu, B.T.; Xu, X.R.; Qin, X.S.; Gan, R.Y.; Li, H.B. Antioxidant capacities and total phenolic contents of 56 wild fruits from South China. Molecules 2010, 15, 8602–8617. [Google Scholar] [CrossRef] [PubMed]
  5. Deng, G.F.; Xu, X.R.; Guo, Y.J.; Xia, E.Q.; Li, S.; Wu, S.; Chen, F.; Ling, W.H.; Li, H.B. Determination of antioxidant property and their lipophilic and hydrophilic phenolic contents in cereal grains. J. Funct. Foods 2012, 4, 906–914. [Google Scholar] [CrossRef]
  6. Li, H.B.; Cheng, K.W.; Wong, C.C.; Fan, K.W.; Chen, F.; Jiang, Y. Evaluation of antioxidant capacity and total phenolic content of different fractions of selected microalgae. Food Chem. 2007, 102, 771–776. [Google Scholar] [CrossRef]
  7. Guo, Y.J.; Deng, G.F.; Xu, X.R.; Wu, S.; Li, S.; Xia, E.Q.; Li, F.; Chen, F.; Ling, W.H.; Li, H.B. Antioxidant capacities, phenolic compounds and polysaccharide contents of 49 edible macro-fungi. Food Funct. 2012, 3, 1195–1205. [Google Scholar] [CrossRef] [PubMed]
  8. Li, A.N.; Li, S.; Li, H.B.; Xu, D.P.; Xu, X.R.; Chen, F. Total phenolic contents and antioxidant capacities of 51 edible and wild flowers. J. Funct. Foods 2014, 6, 319–330. [Google Scholar] [CrossRef]
  9. Li, S.; Li, S.K.; Gan, R.Y.; Song, F.L.; Kuang, L.; Li, H.B. Antioxidant capacities and total phenolic contents of infusions from 223 medicinal plants. Ind. Crops Prod. 2013, 51, 289–298. [Google Scholar] [CrossRef]
  10. Song, F.L.; Gan, R.Y.; Zhang, Y.; Xiao, Q.; Kuang, L.; Li, H.B. Total phenolic contents and antioxidant capacities of selected Chinese medicinal plants. Int. J. Mol. Sci. 2010, 11, 2362–2372. [Google Scholar] [CrossRef] [PubMed]
  11. Fu, L.; Xu, B.T.; Gan, R.Y.; Zhang, Y.; Xu, X.R.; Xia, E.Q.; Li, H.B. Total phenolic contents and antioxidant capacities of herbal and tea infusions. Int. J. Mol. Sci. 2011, 12, 2112–2124. [Google Scholar] [CrossRef] [PubMed]
  12. Zhou, Y.; Li, Y.; Zhou, T.; Zheng, J.; Li, S.; Li, H.B. Dietary natural products for prevention and treatment of liver cancer. Nutrients 2016, 8, 156. [Google Scholar] [CrossRef] [PubMed]
  13. Li, F.; Li, S.; Li, H.B.; Deng, G.F.; Ling, W.H.; Wu, S.; Xu, X.R.; Chen, F. Antiproliferative activity of peels, pulps and seeds of 61 fruits. J. Funct. Foods 2013, 5, 1298–1309. [Google Scholar] [CrossRef]
  14. Xia, E.Q.; Deng, G.F.; Guo, Y.J.; Li, H.B. Biological activities of polyphenols from grapes. Int. J. Mol. Sci. 2010, 11, 622–646. [Google Scholar] [CrossRef] [PubMed]
  15. Li, F.; Li, S.; Li, H.B.; Deng, G.F.; Ling, W.H.; Xu, X.R. Antiproliferative activities of tea and herbal infusions. Food Funct. 2013, 4, 530–538. [Google Scholar] [CrossRef] [PubMed]
  16. Li, A.N.; Li, S.; Zhang, Y.J.; Xu, X.R.; Chen, Y.M.; Li, H.B. Resources and biological activities of natural polyphenols. Nutrients 2014, 6, 6020–6047. [Google Scholar] [CrossRef] [PubMed]
  17. Drossard, C.; Frohling, B.; Bolzenius, K.; Dietrich, H.; Kunz, C.; Kersting, M. Liking of anthocyanin-rich juices by children and adolescents. Appetite 2012, 58, 623–628. [Google Scholar] [CrossRef] [PubMed]
  18. Bhardwaj, R.L.; Nandal, U.; Pal, A.; Jain, S. Bioactive compounds and medicinal properties of fruit juices. Fruits 2014, 69, 391–412. [Google Scholar] [CrossRef]
  19. Singh, G.M.; Micha, R.; Khatibzadeh, S.; Shi, P.L.; Lim, S.; Andrews, K.G.; Engell, R.E.; Ezzati, M.; Mozaffarian, D. Global, regional, and national consumption of sugar-sweetened beverages, fruit juices, and milk: A systematic assessment of beverage intake in 187 countries. PLoS ONE 2015, 10, e0124845. [Google Scholar] [CrossRef] [PubMed]
  20. Starek, M.; Guja, A.; Dabrowska, M.; Krzek, J. Assay of β-carotene in dietary supplements and fruit juices by TLC-densitometry. Food Anal. Methods 2015, 8, 1347–1355. [Google Scholar] [CrossRef]
  21. Peluso, I.; Villano, D.V.; Roberts, S.A.; Cesqui, E.; Raguzzini, A.; Borges, G.; Crozier, A.; Catasta, G.; Toti, E.; Serafini, M. Consumption of mixed fruit-juice drink and vitamin C reduces postprandial stress induced by a high fat meal in healthy overweight subjects. Curr. Pharm. Des. 2014, 20, 1020–1024. [Google Scholar] [CrossRef] [PubMed]
  22. Rodriguez-Roque, M.J.; Rojas-Grau, M.A.; Elez-Martinez, P.; Martin-Belloso, O. In vitro bioaccessibility of health-related compounds as affected by the formulation of fruit juice- and milk-based beverages. Food Res. Int. 2014, 62, 771–778. [Google Scholar] [CrossRef]
  23. Eriksen, A.; Tillin, T.; O’Connor, L.; Brage, S.; Hughes, A.; Mayet, J.; McKeigue, P.; Whincup, P.; Chaturvedi, N.; Forouhi, N.G. The impact of health behaviours on incident cardiovascular disease in europeans and south asians−A prospective analysis in the UK SABRE study. PLoS ONE 2015, 10, e0117364. [Google Scholar] [CrossRef] [PubMed]
  24. Okuda, N.; Miura, K.; Okayama, A.; Okamura, T.; Abbott, R.D.; Nishi, N.; Fujiyoshi, A.; Kita, Y.; Nakamura, Y.; Miyagawa, N.; et al. Fruit and vegetable intake and mortality from cardiovascular disease in Japan: A 24-year follow-up of the NIPPON DATA80 study. Eur. J. Clin. Nutr. 2015, 69, 482–488. [Google Scholar] [CrossRef] [PubMed]
  25. Sikand, G.; Kris-Etherton, P.; Boulos, N.M. Impact of functional foods on prevention of cardiovascular disease and diabetes. Curr. Cardiol. Rep. 2015, 17, 39. [Google Scholar] [CrossRef] [PubMed]
  26. Trude, A.; Kharmats, A.; Jock, B.; Liu, D.; Lee, K.; Martins, P.A.; Pardilla, M.; Swartz, J.; Gittelsohn, J. Patterns of food consumption are associated with obesity, self-reported diabetes and cardiovascular disease in five american indian communities. Ecol. Food Nutr. 2015, 54, 437–454. [Google Scholar] [CrossRef] [PubMed]
  27. Appel, L.J.; Moore, T.J.; Obarzanek, E.; Vollmer, W.M.; Svetkey, L.P.; Sacks, F.M.; Bray, G.A.; Vogt, T.M.; Cutler, J.A.; Windhauser, M.M.; et al. A clinical trial of the effects of dietary patterns on blood pressure. N. Engl. J. Med. 1997, 336, 1117–1124. [Google Scholar] [CrossRef] [PubMed]
  28. Kris-Etherton, P.; Eckel, R.H.; Howard, B.V.; St Jeor, S.; Bazzarre, T.L. Lyon diet heart study—Benefits of a mediterranean-style, national cholesterol education program/American heart association step I dietary pattern on cardiovascular disease. Circulation 2001, 103, 1823–1825. [Google Scholar] [CrossRef] [PubMed]
  29. Chaturvedi, S. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC 7): Is it really practical? Natl. Med. J. India 2004, 17, 227. [Google Scholar] [PubMed]
  30. Hallikainen, M.A.; Uusitupa, M.I. Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects. Am. J. Clin. Nutr. 1999, 69, 403–410. [Google Scholar] [PubMed]
  31. Hallikainen, M.A.; Sarkkinen, E.S.; Uusitupa, M.I. Effects of low-fat stanol ester enriched margarines on concentrations of serum carotenoids in subjects with elevated serum cholesterol concentrations. Eur. J. Clin. Nutr. 1999, 53, 966–969. [Google Scholar] [CrossRef] [PubMed]
  32. Deurenberg-Yap, M.; Li, T.; Tan, W.L.; van Staveren, W.A.; Chew, S.K.; Deurenberg, P. Can dietary factors explain differences in serum cholesterol profiles among different ethnic groups (Chinese, Malays and Indians) in Singapore? Asia Pac. J. Clin. Nutr. 2001, 10, 39–45. [Google Scholar] [CrossRef] [PubMed]
  33. Qin, Y.; Xia, M.; Ma, J.; Hao, Y.T.; Liu, J.; Mou, H.; Cao, L.; Ling, W.H. Anthocyanin supplementation improves serum LDL- and HDL-cholesterol concentrations associated with the inhibition of cholesteryl ester transfer protein in dyslipidemic subjects. Am. J. Clin. Nutr. 2009, 90, 485–492. [Google Scholar] [CrossRef] [PubMed]
  34. Shenoy, S.F.; Kazaks, A.G.; Holt, R.R.; Chen, H.J.; Winters, B.L.; Khoo, C.S.; Poston, W.; Haddock, C.K.; Reeves, R.S.; Foreyt, J.P.; et al. The use of a commercial vegetable juice as a practical means to increase vegetable intake: A randomized controlled trial. Nutr. J. 2010, 9, 38. [Google Scholar] [CrossRef] [PubMed]
  35. Zheng, R.Z.; Zhou, D.; Zhu, Y.M. The long-term prognosis of cardiovascular disease and all-cause mortality for metabolically healthy obesity: A systematic review and meta-analysis. J. Epidemiol. Community Health 2016, 70, 1024–1031. [Google Scholar] [CrossRef] [PubMed]
  36. Fan, H.M.; Li, X.L.; Zheng, L.; Chen, X.L.; Lan, Q.; Wu, H.; Ding, X.G.; Qian, D.G.; Shen, Y.X.; Yu, Z.R.; et al. Abdominal obesity is strongly associated with cardiovascular disease and its risk factors in elderly and very elderly community-dwelling Chinese. Sci. Rep. 2016, 6, 21521. [Google Scholar] [CrossRef] [PubMed]
  37. Zeng, Q.; Dong, S.Y.; Wang, M.L.; Li, J.M.; Ren, C.L.; Gao, C.Q. Obesity and novel cardiovascular markers in a population without diabetes and cardiovascular disease in China. Prev. Med. 2016, 91, 62–69. [Google Scholar] [CrossRef] [PubMed]
  38. Fuster, J.J.; Ouchi, N.; Gokce, N.; Walsh, K. Obesity-induced changes in adipose tissue microenvironment and their impact on cardiovascular disease. Circ. Res. 2016, 118, 1786–1807. [Google Scholar] [CrossRef] [PubMed]
  39. Morgan, R.E. Does consumption of high-fructose corn syrup beverages cause obesity in children? Pediatr. Obes. 2013, 8, 249–254. [Google Scholar] [CrossRef] [PubMed]
  40. Imamura, F.; O’Connor, L.; Ye, Z.; Mursu, J.; Hayashino, Y.; Bhupathiraju, S.N.; Forouhi, N.G. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: Systematic review, meta-analysis, and estimation of population attributable fraction. Br. J. Sports Med. 2016, 50, 484–496. [Google Scholar] [CrossRef] [PubMed]
  41. Heazlewood, V.; Kotseva, K.; Turner, E.L.; Wood, D. Blood pressure control in patients with coronary heart disease is facilitated by fruit and vegetable intake. Eur. Heart J. 2011, 321, 108. [Google Scholar]
  42. Du, H.; Li, L.; Bennett, D.; Guo, Y.; Bian, Z.; Chen, J.; Key, T.; Collins, R.; Peto, R.; Chen, Z. Fresh fruit consumption, blood pressure and cardiovascular disease risk: A prospective cohort study of 0.5 million adults in the China kadoorie biobank. Eur. Heart J. 2014, 351, 725. [Google Scholar]
  43. Pienovi, L.; Lara, M.; Bustos, P.; Amigo, H. Fruit and vegetable intake, and blood pressure: A population research. Arch. Latinoam. Nutr. 2015, 65, 21–26. [Google Scholar] [PubMed]
  44. Reshef, N.; Hayari, Y.; Goren, C.; Boaz, M.; Madar, Z.; Knobler, H. Antihypertensive effect of sweetie fruit in patients with stage I hypertension. Am. J. Hypertens. 2005, 18, 1360–1363. [Google Scholar] [CrossRef] [PubMed]
  45. Asgary, S.; Sahebkar, A.; Afshani, M.R.; Keshvari, M.; Haghjooyjavanmard, S.; Rafieian-Kopaei, M. Clinical evaluation of blood pressure lowering, endothelial function improving, hypolipidemic and anti-Inflammatory effects of pomegranate juice in hypertensive subjects. Phytother. Res. 2014, 28, 193–199. [Google Scholar] [CrossRef] [PubMed]
  46. Liu, K.; Xing, A.H.; Chen, K.; Wang, B.; Zhou, R.; Chen, S.H.; Xu, H.X.; Mi, M.T. Effect of fruit juice on cholesterol and blood pressure in adults: A meta-analysis of 19 randomized controlled trials. PLoS ONE 2013, 8, e61420. [Google Scholar] [CrossRef] [PubMed]
  47. Webb, A.J.; Patel, N.; Loukogeorgakis, S.; Okorie, M.; Aboud, Z.; Misra, S.; Rashid, R.; Miall, P.; Deanfield, J.; Benjamin, N.; et al. Acute blood pressure lowering, vasoprotective, and antiplatelet properties of dietary nitrate via bioconversion to nitrite. Hypertension 2008, 51, 784–790. [Google Scholar] [CrossRef] [PubMed]
  48. Kapil, V.; Milsom, A.B.; Okorie, M.; Maleki-Toyserkani, S.; Akram, F.; Rehman, F.; Arghandawi, S.; Pearl, V.; Benjamin, N.; Loukogeorgakis, S.; et al. Inorganic nitrate supplementation lowers blood pressure in humans role for nitrite-derived NO. Hypertension 2010, 56, 274–281. [Google Scholar] [CrossRef] [PubMed]
  49. Hobbs, D.A.; Kaffa, N.; George, T.W.; Methven, L.; Lovegrove, J.A. Blood pressure-lowering effects of beetroot juice and novel beetroot-enriched bread products in normotensive male subjects. Br. J. Nutr. 2012, 108, 2066–2074. [Google Scholar] [CrossRef] [PubMed]
  50. Coles, L.T.; Clifton, P.M. Effect of beetroot juice on lowering blood pressure in free-living, disease-free adults: A randomized, placebo-controlled trial. Nutr. J. 2012, 11, 106. [Google Scholar] [CrossRef] [PubMed]
  51. Potter, A.S.; Foroudi, S.; Stamatikos, A.; Patil, B.S.; Deyhim, F. Drinking carrot juice increases total antioxidant status and decreases lipid peroxidation in adults. Nutr. J. 2011, 10, 96. [Google Scholar] [CrossRef] [PubMed]
  52. Houston, M.C.; Cooil, B.; Olafsson, B.J.; Raggi, P. Juice powder concentrate and systemic blood pressure, progression of coronary artery calcium and antioxidant status in hypertensive subjects: A pilot study. Evid. Based Complement. Altern. 2007, 4, 455–462. [Google Scholar] [CrossRef] [PubMed]
  53. Habauzit, V.; Verny, M.A.; Milenkovic, D.; Barber-Chamoux, N.; Mazur, A.; Dubray, C.; Morand, C. Flavanones protect from arterial stiffness in postmenopausal women consuming grapefruit juice for 6 mo: A randomized, controlled, crossover trial. Am. J. Clin. Nutr. 2015, 102, 66–74. [Google Scholar] [CrossRef] [PubMed]
  54. Foroudi, S.; Potter, A.S.; Stamatikos, A.; Patil, B.S.; Deyhim, F. Drinking orange juice increases total antioxidant status and decreases lipid peroxidation in adults. J. Med. Food 2014, 17, 612–617. [Google Scholar] [CrossRef] [PubMed]
  55. Ravn-Haren, G.; Dragsted, L.O.; Buch-Andersen, T.; Jensen, E.N.; Jensen, R.I.; Nemeth-Balogh, M.; Paulovicsova, B.; Bergstrom, A.; Wilcks, A.; Licht, T.R.; et al. Intake of whole apples or clear apple juice has contrasting effects on plasma lipids in healthy volunteers. Eur. J. Nutr. 2013, 52, 1875–1889. [Google Scholar] [CrossRef] [PubMed]
  56. Thaptimthong, T.; Kasemsuk, T.; Sibmooh, N.; Unchern, S. Platelet inhibitory effects of juices from Pachyrhizus erosus L. root and Psidium guajava L. fruit: A randomized controlled trial in healthy volunteers. BMC Complement. Altern. Med. 2016, 16, 269. [Google Scholar] [CrossRef] [PubMed]
  57. Kent, K.; Charlton, K.E.; Jenner, A.; Roodenrys, S. Acute reduction in blood pressure following consumption of anthocyanin-rich cherry juice may be dose-interval dependant: A pilot cross-over study. Int. J. Food Sci. Nutr. 2016, 67, 47–52. [Google Scholar] [CrossRef] [PubMed]
  58. Tjelle, T.E.; Holtung, L.; Bohn, S.K.; Aaby, K.; Thoresen, M.; Wiik, S.A.; Paur, I.; Karlsen, A.S.; Retterstol, K.; Iversen, P.O.; et al. Polyphenol-rich juices reduce blood pressure measures in a randomised controlled trial in high normal and hypertensive volunteers. Br. J. Nutr. 2015, 114, 1054–1063. [Google Scholar] [CrossRef] [PubMed]
  59. Cho, M.R.; Han, J.H.; Lee, H.J.; Park, Y.K.; Kang, M.H. Purple grape juice supplementation in smokers and antioxidant status according to different types of GST polymorphisms. J. Clin. Biochem. Nutr. 2015, 56, 49–56. [Google Scholar] [CrossRef] [PubMed]
  60. Gilchrist, M.; Winyard, P.G.; Aizawa, K.; Anning, C.; Shore, A.; Benjamin, N. Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes. Free Radic. Biol. Med. 2013, 60, 89–97. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  61. Asgary, S.; Afshani, M.R.; Sahebkar, A.; Keshvari, M.; Taheri, M.; Jahanian, E.; Rafieian-Kopaei, M.; Malekian, F.; Sarrafzadegan, N. Improvement of hypertension, endothelial function and systemic inflammation following short-term supplementation with red beet (Beta vulgaris L.) juice: A randomized crossover pilot study. J. Hum. Hypertens. 2016, 30, 627–632. [Google Scholar] [CrossRef] [PubMed]
  62. Bondonno, C.P.; Liu, A.H.; Croft, K.D.; Ward, N.C.; Shinde, S.; Moodley, Y.; Lundberg, J.O.; Puddey, I.B.; Woodman, R.J.; Hodgson, J.M. Absence of an effect of high nitrate intake from beetroot juice on blood pressure in treated hypertensive individuals: A randomized controlled trial. Am. J. Clin. Nutr. 2015, 102, 368–375. [Google Scholar] [CrossRef] [PubMed]
  63. Shenoy, S.F.; Poston, W.; Reeves, R.S.; Kazaks, A.G.; Holt, R.R.; Keen, C.L.; Chen, H.J.; Haddock, C.K.; Winters, B.L.; Khoo, C.; et al. Weight loss in individuals with metabolic syndrome given DASH diet counseling when provided a low sodium vegetable juice: A randomized controlled trial. Nutr. J. 2010, 9, 8. [Google Scholar] [CrossRef] [PubMed]
  64. Aptekmann, N.P.; Cesar, T.B. Long-term orange juice consumption is associated with low LDL-cholesterol and apolipoprotein B in normal and moderately hypercholesterolemic subjects. Lipids Health Dis. 2013, 12, 119. [Google Scholar] [CrossRef] [PubMed]
  65. Sadowska-Krepa, E.; Klapcinska, B.; Podgorski, T.; Szade, B.; Tyl, K.; Hadzik, A. Effects of supplementation with acai (Euterpe oleracea Mart.) berry-based juice blend on the blood antioxidant defence capacity and lipid profile in junior hurdlers. A pilot study. Biol. Sport 2015, 32, 161–168. [Google Scholar] [CrossRef] [PubMed]
  66. Soriano-Maldonado, A.; Hidalgo, M.; Arteaga, P.; de Pascual-Teresa, S.; Nova, E. Effects of regular consumption of vitamin C-rich or polyphenol-rich apple juice on cardiometabolic markers in healthy adults: A randomized crossover trial. Eur. J. Nutr. 2014, 53, 1645–1657. [Google Scholar] [CrossRef] [PubMed]
  67. Duffey, K.J.; Sutherland, L.A. Adult consumers of cranberry juice cocktail have lower C-reactive protein levels compared with nonconsumers. Nutr. Res. 2015, 35, 118–126. [Google Scholar] [CrossRef] [PubMed]
  68. Li, Y.F.; Chang, Y.Y.; Huang, H.C.; Wu, Y.C.; Yang, M.D.; Chao, P.M. Tomato juice supplementation in young women reduces inflammatory adipokine levels independently of body fat reduction. Nutrition 2015, 31, 691–696. [Google Scholar] [CrossRef] [PubMed]
  69. Aiso, I.; Inoue, H.; Seiyama, Y.; Kuwano, T. Compared with the intake of commercial vegetable juice, the intake of fresh fruit and komatsuna (Brassica rapa L. Var. Perviridis) juice mixture reduces serum cholesterol in middle-aged men: A randomized controlled pilot study. Lipids Health Dis. 2014, 13, 102. [Google Scholar] [CrossRef] [PubMed]
  70. Kelsay, J.L.; Behall, K.M.; Prather, E.S. Effect of fiber from fruits and vegetables on metabolic responses of human subjects I. Bowel transit time, number of defecations, fecal weight, urinary excretions of energy and nitrogen and apparent digestibilities of energy, nitrogen, and fat. Am. J. Clin. Nutr. 1978, 31, 1149–1153. [Google Scholar] [PubMed]
  71. Nowak, D.; Grabczewska, Z.; Goslinski, M.; Obonska, K.; Dabrowska, A.; Kubica, J. Effect of chokeberry juice consumption on antioxidant capacity, lipids profile and endothelial function in healthy people: A pilot study. Czech J. Food Sci. 2016, 34, 39–46. [Google Scholar] [CrossRef]
  72. Salazar-Lugo, R.; Barahona, A.; Ortiz, K.; Chavez, C.; Freire, P.; Mendez, J.; Bermeo, B.; Santamaria, M.; Salas, H.; Oleas, M. Effect of consumption of tree tomato juice (Cyphomandra betacea) on lipid profile and glucose concentrations in adults with hyperlipidemia, Ecuador. Arch. Latinoam. Nutr. 2016, 66, 121–128. [Google Scholar]
  73. Aviram, M.; Dornfield, L.; Kaplan, M.; Coleman, R.; Gaitini, D.; Nitecki, S.; Hofman, A.; Rosenblat, M.; Volkova, N.; Presser, D.; et al. Pomegranate juice flavonoids inhibit low-density lipoprotein oxidation and cardiovascular diseases: Studies in atherosclerotic mice and in humans. Drug Exp. Clin. Res. 2002, 28, 49–62. [Google Scholar]
  74. Betanzos-Cabrera, G.; Guerrero-Solano, J.A.; Martinez-Perez, M.M.; Calderon-Ramos, Z.G.; Belefant-Miller, H.; Cancino-Diaz, J.C. Pomegranate juice increases levels of paraoxonasel (PON1) expression and enzymatic activity in streptozotocin-induced diabetic mice fed with a high-fat diet. Food Res. Int. 2011, 44, 1381–1385. [Google Scholar] [CrossRef]
  75. Diaz-Rubio, M.E.; Perez-Jimenez, J.; Martinez-Bartolome, M.A.; Alvarez, I.; Saura-Calixto, F. Regular consumption of an antioxidant-rich juice improves oxidative status and causes metabolome changes in healthy adults. Plant Food. Hum. Nutr. 2015, 70, 9–14. [Google Scholar] [CrossRef] [PubMed]
  76. Ibrahim, M.; Ismail, A.; Al-Sheraji, S.H.; Azlan, A.; Hamid, A.A. Effects of Mangifera pajang Kostermans juice on plasma antioxidant status and liver and kidney function in normocholesterolemic subjects. J. Funct. Foods 2013, 5, 1900–1908. [Google Scholar] [CrossRef]
  77. Oliveira, P.S.; Saccon, T.D.; da Silva, T.M.; Costa, M.Z.; Dutra, F.; de Vasconcelos, A.; Lencina, C.L.; Stefanello, F.M.; Barschak, A.G. Green juice as a protector against reactive species in rats. Nutr. Hosp. 2013, 28, 1407–1412. [Google Scholar] [PubMed]
  78. Codoner-Franch, P.; Betoret, E.; Betoret, N.; Lopez-Jaen, A.B.; Valls-Belles, V.; Fito, P. Dried apples enriched with mandarin juice by vacuum impregnation improve antioxidant capacity and decrease inflammation in obese children. Nutr. Hosp. 2013, 28, 1177–1183. [Google Scholar] [PubMed]
  79. Huebbe, P.; Giller, K.; de Pascual-Teresa, S.; Arkenau, A.; Adolphi, B.; Portius, S.; Arkenau, C.N.; Rimbach, G. Effects of blackcurrant-based juice on atherosclerosis-related biomarkers in cultured macrophages and in human subjects after consumption of a high-energy meal. Br. J. Nutr. 2012, 108, 234–244. [Google Scholar] [CrossRef] [PubMed]
  80. Miglio, C.; Peluso, I.; Raguzzini, A.; Villano, D.V.; Cesqui, E.; Catasta, G.; Toti, E.; Serafini, M. Fruit juice drinks prevent endogenous antioxidant response to high-fat meal ingestion. Br. J. Nutr. 2014, 111, 294–300. [Google Scholar] [PubMed]
  81. Al-Olayan, E.M.; El-Khadragy, M.F.; Metwally, D.M.; Moneim, A. Protective effects of pomegranate (Punica granatum) juice on testes against carbon tetrachloride intoxication in rats. BMC Complement. Altern. Med. 2014, 14, 164. [Google Scholar] [CrossRef] [PubMed]
  82. Rouanet, J.M.; Decorde, K.; del Rio, D.; Auger, C.; Borges, G.; Cristol, J.P.; Lean, M.; Crozier, A. Berry juices, teas, antioxidants and the prevention of atherosclerosis in hamsters. Food Chem. 2010, 118, 266–271. [Google Scholar] [CrossRef]
  83. Jeon, G.I.; Shin, M.J.; Lee, K.H.; Park, E. Effect of onion juice supplementation on antioxidant status in participants with mild hypercholesterolemia. Food Sci. Biotechnol. 2013, 22S, 227–231. [Google Scholar] [CrossRef]
  84. Poudyal, H.; Panchal, S.; Brown, L. Comparison of purple carrot juice and beta-carotene in a high-carbohydrate, high-fat diet-fed rat model of the metabolic syndrome. Br. J. Nutr. 2010, 104, 1322–1332. [Google Scholar] [CrossRef] [PubMed]
  85. Kivimaki, A.S.; Ehlers, P.I.; Turpeinen, A.M.; Vapaatalo, H.; Korpela, R. Lingonberry juice improves endothelium-dependent vasodilatation of mesenteric arteries in spontaneously hypertensive rats in a long-term intervention. J. Funct. Foods 2011, 3, 267–274. [Google Scholar] [CrossRef]
  86. Flammer, A.J.; Martin, E.A.; Gossl, M.; Widmer, R.J.; Lennon, R.J.; Sexton, J.A.; Loeffler, D.; Khosla, S.; Lerman, L.O.; Lerman, A. Polyphenol-rich cranberry juice has a neutral effect on endothelial function but decreases the fraction of osteocalcin-expressing endothelial progenitor cells. Eur. J. Nutr. 2013, 52, 289–296. [Google Scholar] [CrossRef] [PubMed]
  87. Auger, C.; Pollet, B.; Arnold, C.; Marx, C.; Schini-Kerth, V.B. Great heterogeneity of commercial fruit juices to induce endothelium-dependent relaxations in isolated porcine coronary arteries: Role of the phenolic content and composition. J. Med. Food 2015, 18, 128–136. [Google Scholar] [CrossRef] [PubMed]
  88. Buscemi, S.; Rosafio, G.; Arcoleo, G.; Mattina, A.; Canino, B.; Montana, M.; Verga, S.; Rini, G. Effects of red orange juice intake on endothelial function and inflammatory markers in adult subjects with increased cardiovascular risk. Am. J. Clin. Nutr. 2012, 95, 1089–1095. [Google Scholar] [CrossRef] [PubMed]
  89. Utsunomiya, H.; Takekoshi, S.; Gato, N.; Utatsu, H.; Motley, E.D.; Eguchi, K.; Fitzgerald, T.G.; Mifune, M.; Frank, G.D.; Eguchi, S. Fruit-juice concentrate of Asian plum inhibits growth signals of vascular smooth muscle cells induced by angiotensin II. Life Sci. 2002, 72, 659–667. [Google Scholar] [CrossRef]
  90. Siasos, G.; Tousoulis, D.; Kokkou, E.; Oikonomou, E.; Kollia, M.E.; Verveniotis, A.; Gouliopoulos, N.; Zisimos, K.; Plastiras, A.; Maniatis, K.; et al. Favorable effects of concord grape juice on endothelial function and arterial stiffness in healthy smokers. Am. J. Hypertens. 2014, 27, 38–45. [Google Scholar] [CrossRef] [PubMed]
  91. Khan, F.; Ray, S.; Craigie, A.M.; Kennedy, G.; Hill, A.; Barton, K.L.; Broughton, J.; Belch, J. Lowering of oxidative stress improves endothelial function in healthy subjects with habitually low intake of fruit and vegetables: A randomized controlled trial of antioxidant- and polyphenol-rich blackcurrant juice. Free Radic. Biol. Med. 2014, 72, 232–237. [Google Scholar] [CrossRef] [PubMed]
  92. Noratto, G.; Martino, H.; Simbo, S.; Byrne, D.; Mertens-Talcott, S.U. Consumption of polyphenol-rich peach and plum juice prevents risk factors for obesity-related metabolic disorders and cardiovascular disease in Zucker rats. J. Nutr. Biochem. 2015, 26, 633–641. [Google Scholar] [CrossRef] [PubMed]
  93. Ohnishi, A.; Asayama, R.; Mogi, M.; Nakaoka, H.; Kan-No, H.; Tsukuda, K.; Chisaka, T.; Wang, X.L.; Bai, H.Y.; Shan, B.S.; et al. Drinking citrus fruit juice inhibits vascular remodeling in cuff-induced vascular injury mouse model. PLoS ONE 2015, 10, e0117616. [Google Scholar] [CrossRef] [PubMed]
  94. Ramli, N.S.; Brown, L.; Ismail, P.; Rahmat, A. Effects of red pitaya juice supplementation on cardiovascular and hepatic changes in high-carbohydrate, high-fat diet-induced metabolic syndrome rats. BMC Complement. Altern. Med. 2014, 14, 189. [Google Scholar] [CrossRef] [PubMed]
  95. Eno, A.E.; Owo, O.I.; Itam, E.H.; Konya, R.S. Blood pressure depression by the fruit juice of Carica papaya L. in renal and DOCA-induced hypertension in the rat. Phytother. Res. 2000, 14, 235–239. [Google Scholar] [CrossRef]
  96. Keevil, J.G.; Osman, H.E.; Reed, J.D.; Folts, J.D. Grape juice, but not orange juice or grapefruit juice, inhibits human platelet aggregation. J. Nutr. 2000, 130, 53–56. [Google Scholar] [PubMed]
  97. Mattiello, T.; Trifiro, E.; Jotti, G.S.; Pulcinelli, F.M. Effects of pomegranate juice and extract polyphenols on platelet function. J. Med. Food 2009, 12, 334–339. [Google Scholar] [CrossRef] [PubMed]
  98. Napoleone, E.; Cutrone, A.; Zurlo, F.; di Castelnuovo, A.; D’Imperio, M.; Giordano, L.; de Curtis, A.; Iacoviello, L.; Rotilio, D.; Cerletti, C.; et al. Both red and blond orange juice intake decreases the procoagulant activity of whole blood in healthy volunteers. Thromb. Res. 2013, 132, 288–292. [Google Scholar] [CrossRef] [PubMed]
  99. Cancalon, P.F.; King, D. Health benefits of polyphenol-rich orange and grapefruit juices. XII Int. Citrus Congr. Int. Soc. Citric. 2015, 1065, 727–734. [Google Scholar]
  100. Devaraj, S.; Jialal, I.; Rockwood, J.; Zak, D. Effect of orange juice and beverage with phytosterols on cytokines and PAI-1 activity. Clin. Nutr. 2011, 30, 668–671. [Google Scholar] [CrossRef] [PubMed]
  101. Simao, T.; Lozovoy, M.; Simao, A.; Oliveira, S.R.; Venturini, D.; Morimoto, H.K.; Miglioranza, L.; Dichi, I. Reduced-energy cranberry juice increases folic acid and adiponectin and reduces homocysteine and oxidative stress in patients with the metabolic syndrome. Br. J. Nutr. 2013, 110, 1885–1894. [Google Scholar] [CrossRef] [PubMed]
  102. Bamonti, F.; Novembrino, C.; Ippolito, S.; Soresi, E.; Ciani, A.; Lonati, S.; Scurati-Manzoni, E.; Cighetti, G. Increased free malondialdehyde concentrations in smokers normalise with a mixed fruit and vegetable juice concentrate: A pilot study. Clin. Chem. Lab. Med. 2006, 44, 391–395. [Google Scholar] [CrossRef] [PubMed]
  103. Bamonti, F.; Pellegatta, M.; Novembrino, C.; Vigna, L.; de Giuseppe, R.; de Liso, F.; Gregori, D.; della Noce, C.; Patrini, L.; Schiraldi, G.; et al. An encapsulated juice powder concentrate improves markers of pulmonary function and cardiovascular risk factors in heavy smokers. J. Am. Coll. Nutr. 2013, 32, 18–25. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  104. Kawashima, A.; Madarame, T.; Koike, H.; Komatsu, Y.; Wise, J.A. Four week supplementation with mixed fruit and vegetable juice concentrates increased protective serum antioxidants and folate and decreased plasma homocysteine in Japanese subjects. Asia Pac. J. Clin. Nutr. 2007, 16, 411–421. [Google Scholar] [PubMed]
  105. Wu, T.; Tang, Q.; Gao, Z.C.; Yu, Z.P.; Song, H.Z.; Zheng, X.D.; Chen, W. Blueberry and mulberry juice prevent obesity development in C57BL/6 mice. PLoS ONE 2013, 8, e77585. [Google Scholar] [CrossRef] [PubMed]
  106. DeChristopher, L.R.; Uribarri, J.; Tucker, K.L. Intake of high-fructose corn syrup sweetened soft drinks, fruit drinks and apple juice is associated with prevalent arthritis in US adults, aged 20–30 years. Nutr. Diabetes 2016, 6, e199. [Google Scholar] [CrossRef] [PubMed]
  107. Shefferly, A.; Scharf, R.J.; DeBoer, M.D. Longitudinal evaluation of 100% fruit juice consumption on BMI status in 2–5-year-old children. Pediatr. Obes. 2016, 11, 221–227. [Google Scholar] [CrossRef] [PubMed]
Table 1. Effects of juices on blood pressure.
Table 1. Effects of juices on blood pressure.
Juices Effective ComponentsSubjectsStudy TypesResultsReference
Fruit juices
Sweetie fruit juiceNaringinStage I hypertensionCross-overDecrease in systolic blood pressure (SBP) dose-dependent decrease in diastolic blood pressure (DBP)[44]
Pomegranate juiceEllagitannins and anthocyaninsHypertensiveRandomized controlledDecrease in SBP and DBP[45]
Grapefruit juiceFlavanonesHealthy postmenopausal womenRandomized, controlled, crossoverNo effect[53]
Orange juice-Persons with hypercholesterolemia and hypertriglyceridemiaRandomized controlledNo effect[54]
Clear and cloudy apple juicesPolyphenolsHealthy personsRandomized crossoverNo effect[55]
Guava fruit juice-Healthy volunteersRandomized, controlledDecrease in SBP and DBP[56]
Cherry juiceAnthocyaninHealthy volunteersCrossoverDecrease in SBP and DBP[57]
Polyphenol-rich juices 1PolyphenolsHealthy individualsRandomized, controlledDecrease in SBP and DBP[58]
Purple grape juiceAnthocyaninSmokersPilotDecrease in DBP[59]
Vegetable juices
Commercial vegetable juice 2Minerals and vitaminsHealthy personsRandomized, controlled, parallel-armDecrease in BP[34]
Beetroot juiceNitrateHealthy personsRandomized crossover, Randomized, controlledDecrease in BP[47,48,49,50]
Persons with type 2 diabetesRandomized, crossoverNo effect[60]
Hypertensive subjectsRandomized, crossoverDecrease in BP[61]
Hypertensive individualsRandomized controlledNo effects[62]
Carrot juiceFiber, potassium, nitrates, and vitamin CPersons with elevated Plasma cholesterol and Triglyceride levelsPilotDecrease in SBP[51]
Commercial vegetable juice 2Vitamin C and potassiumPersons with metabolic syndromeRandomized, controlled, parallel-armNo effects[63]
Yam bean root juicenitrateHealthy volunteersRandomized, controlledDecrease in DBP[56]
Mixture juice
Fruit and vegetable powder juice 3-Healthy personsPilotDecrease in SBP and DBP[52]
1 Juice based on cherries, chokeberries, red grapes, bilberries, and blackcurrant; 2 Commercial vegetable juice (V8®; Campbell Soup Company, Camden, NJ, USA) that provided Vitamin A, Vitamin C, calcium and iron; 3 Encapsulated juice powder containing acerola cherry, apple, beet, tomato, etc.
Table 2. Effects of juices on blood lipids.
Table 2. Effects of juices on blood lipids.
Juices Effective ComponentsSubjectsStudy TypesResultsReference
Fruit juices
Pomegranate juiceEllagitannins and anthocyaninsHypertensiveRandomized controlledNo effect[45]
Orange juiceVitamin C, folate, and potassiumPersons with hypercholesterolemia and hypertriglyceridemiaRandomized controlledNo effect[54]
Persons with normal and moderately high cholesterol blood levelsCross-sectionalTC, LDL-C, apo B and LDL/HDL ratio were all significantly lowered 1[64]
Apple juicePolyphenolsHealthy personsRandomized crossoverLower serum LDL-C for cloudy juice, no effect for clear juice[55]
Vitamin CHealthy personsRandomized crossoverDecreased trend in total cholesterol[66]
Acai berry juicePolyphenolsJunior hurdlersPilotImprovement in lipid profile[65]
Cranberry juicePolyphenolsHealthy personsCross-sectional, associationA tendency of lower levels of cholesterol[67]
Chokeberry juice-Healthy volunteersPilotNo significant effect[71]
Vegetable juices
Carrot juiceCarotenoid, anthocyaninHealthy personsPilotNo effect[51]
Tomato juiceLycopene, mineralsHealthy personsRandomized controlledDecrease in serum cholestol, increase in adiponectin and triglyceride[68]
Tree tomato juice-Persons with hypercholesterolemiaRandomized, controlledDecrease in TC and LDL-C[72]
Mixture juices
Mixture of vegetables and fruits juice 2Minerals, vitamins, and polyphenolsPrehypertensive and hypertensivePilotDecrease in HDL-C and apo A[52]
Fruit and komatsuna juice 3Minerals, vitamins. and polyphenolsHealthy personsRandomized controlledDecrease in TC and LDL-C[69]
1 TC, total cholesterol; LDL-C, low-density lipoprotein–cholesterol; LDL/HDL ratio, low-density lipoprotein/high-density lipoprotein ratio; 2 It an encapsulated juice powder containing acerola cherry, apple, beet, tomato, etc.; 3 The fruit includes banana and apple.

Share and Cite

MDPI and ACS Style

Zheng, J.; Zhou, Y.; Li, S.; Zhang, P.; Zhou, T.; Xu, D.-P.; Li, H.-B. Effects and Mechanisms of Fruit and Vegetable Juices on Cardiovascular Diseases. Int. J. Mol. Sci. 2017, 18, 555. https://doi.org/10.3390/ijms18030555

AMA Style

Zheng J, Zhou Y, Li S, Zhang P, Zhou T, Xu D-P, Li H-B. Effects and Mechanisms of Fruit and Vegetable Juices on Cardiovascular Diseases. International Journal of Molecular Sciences. 2017; 18(3):555. https://doi.org/10.3390/ijms18030555

Chicago/Turabian Style

Zheng, Jie, Yue Zhou, Sha Li, Pei Zhang, Tong Zhou, Dong-Ping Xu, and Hua-Bin Li. 2017. "Effects and Mechanisms of Fruit and Vegetable Juices on Cardiovascular Diseases" International Journal of Molecular Sciences 18, no. 3: 555. https://doi.org/10.3390/ijms18030555

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop