Written by Joyce Smith, BS. AMD, a novel neutraceutical product formulated with Annurca apple polyphenolic extracts, significantly decreased the solubility and absorption of cholesterol in the intestine.
Annurca polyphenol extract (APE) has been shown in vitro studies to increase high density lipoprotein (HDL-C) and decrease low density lipoprotein (LDL-C) 1,2. A recent in vivo study demonstrated APE’s ability to increase HDL-C and decrease LDL-C in mild hypercholesterolemic participants; 3 however, the molecular mechanisms involved have not yet been clarified.
A new study 4 suggests that an Annurca apple extract microencapsulated in maltodextrins (AMD) provided by MB-Med Company (Turin, Italy), may also be an effective cholesterol-reducing agent. The study included an in vitro segment that explored the molecular action between Annurca polyphenols and bile acids. Using a model that mimicked the duodenal environment, researchers demonstrated that AMD had the highest effect on cholesterol solubility compared to extracts from annurca, golden delicious and pink lady apples, In fact, AMD was able to decrease the solubility of cholesterol aggregates by 85.7% compared to annurca, golden delicious and pink lady apples whose extracts decreased cholesterol solubility by 58%, ≈ 43%, ≈18% respectively (P<0.001). These results prompted researchers to use an extract from the Annurca apple for the following in vivo study.
This study was a randomized, double blind, single center, placebo-controlled, crossover study that explored the potential effect of AMD on fecal cholesterol excretion in 50 subjects, ages 18-33 years (30 men, 20 women). The cross-over design had two 7-day wash-out periods and two 7-day intervention periods. During the intervention periods, each group received twice-daily a 35-day supplementation with 185 mg of cholesterol (derived from hard boiled eggs) and either 500 mg of AMD or malt dextran (placebo). Food diaries, fasting blood lipids on days 8, 18, 28, and 35 and fecal samples on the final three days were analyzed. The measurements of variations of total cholesterol (TC) in the fecal samples were the primary endpoints while key secondary outcomes (collected during clinic visits) were measurements of plasma TC, (HDL-C), (LDL-C), glucose, triglycerides, blood pressure and heart rate, and evaluation of body mass index.
Fecal cholesterol excretion was significantly increased (≈35%) in the AMD intervention periods compared to the placebo intervention periods (P<0.01). Only the concentration of plasma triglycerides differed significantly from the initial baseline values within the same treatment group (P<0.01). Plasma total cholesterol concentration differed significantly between the placebo and AMD groups (P < 0.05). However, researchers found no other differences between initial and final values in both placebo and AMD groups.
Limitations of the study included the short study duration, the absence of a diverse ethnic group, and the absence of a restricted age group of recruited participants. However, the results may provide a practical, valuable and innovative alternative solution to cholesterol management and cardiovascular support.
Source: Tenore, Gian Carlo, Alfonso Carotenuto, Domenico Caruso, Giuseppe Buonomo, Maria D’Avino, Diego Brancaccio, Roberto Ciampaglia, Maria Maisto, Connie Schisano, and Ettore Novellino. “A nutraceutical formulation based on Annurca apple polyphenolic extract is effective on intestinal cholesterol absorption: A randomised, placebo-controlled, crossover study.” PharmaNutrition 6, no. 3 (2018): 85-94.
© 2018 Elsevier B.V. All rights reserved.
Posted February 25, 2019.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
- Tenore GC, Campiglia P, Stiuso P, Ritieni A, Novellino E. Nutraceutical potential of polyphenolic fractions from Annurca apple (M. pumila Miller cv Annurca). Food chemistry. 2013;140(4):614-622.
- Tenore GC, Calabrese G, Stiuso P, Ritieni A, Giannetti D, Novellino E. Effects of Annurca apple polyphenols on lipid metabolism in HepG2 cell lines: A source of nutraceuticals potentially indicated for the metabolic syndrome. Food research international. 2014;63:252-257.
- Tenore GC, Caruso D, Buonomo G, et al. A healthy balance of plasma cholesterol by a novel Annurca apple-based nutraceutical formulation: Results of a randomized trial. Journal of medicinal food. 2017;20(3):288-300.
- Tenore GC, Carotenuto A, Caruso D, et al. A nutraceutical formulation based on Annurca apple polyphenolic extract is effective on intestinal cholesterol absorption: A randomised, placebo-controlled, crossover study. PharmaNutrition. 2018;6(3):85-94.
