Abstract
Objective
The present research aimed to investigate the anti-inflammatory potential of dietary anthocyanin (ACN) in type 2 diabetic (T2D), T2D-at-risk and healthy individuals. Furthermore, dietary inflammatory index (DII) was used to study the association of diet with biomarkers of inflammation.
Research methods
An open-label clinical trial was conducted at Griffith University investigating the efficacy of 320 mg ACN supplementation per day over the course of 4 weeks. Diabetes-associated inflammatory biomarkers and relevant biochemical and physical parameters were tested pre-and post-intervention, and participants’ dietary inflammatory potential was estimated.
Results
A significant reduction in the pro-inflammatory biomarkers’ interleukin-6, interleukin-18, and tumour necrosis factor-α was observed in the T2D group. In addition, some, but not all, biochemical parameters including fasting blood glucose, low-density lipoprotein cholesterol and uric acid were significantly improved in T2D-at-risk group. Moreover, a significant difference was detected between the DII scores of the healthy and T2D groups. DII score for the T2D group was consistent with an anti-inflammatory diet.
Conclusion
Anti-inflammatory potential of dietary ACN in T2D participants was evidenced in the present study. Although, anti-inflammatory dietary patterns of T2D participants may have accelerated the anti-inflammatory effect of the ACN capsules supplemented in this trial.
Similar content being viewed by others
References
Hameed I, et al. Type 2 diabetes mellitus: from a metabolic disorder to an inflammatory condition. World J Diabetes. 2015;6(4):598.
Robertson RP, et al. β-cell glucose toxicity, lipotoxicity, and chronic oxidative stress in type 2 diabetes. Diabetes. 2004;53(suppl 1):S119–24.
Hotamisligil GS, Erbay E. Nutrient sensing and inflammation in metabolic diseases. Nat Rev Immunol. 2008;8(12):923–34.
Ferrante A. Obesity-induced inflammation: a metabolic dialogue in the language of inflammation. J Intern Med. 2007;262(4):408–14.
Ferrero-Miliani L, et al. Chronic inflammation: importance of NOD2 and NALP3 in interleukin-1beta generation. Clin Exp Immunol. 2007;147(2):227–35.
Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annu Rev Immunol. 2011;29:415–45.
Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 2011;11(2):98–107.
Ashcroft FM, Rorsman P. Diabetes mellitus and the β cell: the last ten years. Cell. 2012;148(6):1160–71.
Shi Y, Hu FB. The global implications of diabetes and cancer. Lancet (London, England). 2014;383(9933):1947.
World Health Organization, Global report on diabetes. 2016.
Burch E, et al. Dietary intake by food group of individuals with type 2 diabetes mellitus: A systematic review. Diabetes Res Clin Pract. 2018;137:160–72.
Donath MY, et al. Islet inflammation impairs the pancreatic β-cell in type 2 diabetes. Physiology. 2009;24(6):325–31.
Maki KC. Dietary factors in the prevention of diabetes mellitus and coronary artery disease associated with the metabolic syndrome. Am J Cardiol. 2004;93(11):12–7.
Fujioka K, et al. The effects of grapefruit on weight and insulin resistance: relationship to the metabolic syndrome. J Med Food. 2006;9(1):49–54.
Middleton E Jr, Kandaswami C, Theoharides TC. The effects of plant flavonoids on mammalian cells: implications for inflammation, heart disease, and cancer. Pharmacol Rev. 2000;52(4):673–751.
Anhê FF, et al. Polyphenols and type 2 diabetes: A prospective review. PharmaNutrition. 2013;1(4):105–14.
Jayaprakasam B, et al. Insulin secretion by bioactive anthocyanins and anthocyanidins present in fruits. J Agricul Food Chem. 2005;53(1):28–31.
Wedick NM, et al. Dietary flavonoid intakes and risk of type 2 diabetes in US men and women. Am J Clin Nutr. 2012;95(4):925–33.
Dohadwala MM, et al. Effects of cranberry juice consumption on vascular function in patients with coronary artery disease. Am J Clin Nutr. 2011;93(5):934–40.
Stull AJ, et al. Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and women. J Nutr. 2010;140(10):1764–8.
Dunstan DW, et al. The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes Obesity and Lifestyle Study. Diabetes Care. 2002;25(5):829–34.
Grundy SM. Pre-diabetes, metabolic syndrome, and cardiovascular risk. J Am Coll Cardiol. 2012;59(7):635–43.
Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35(2):121.
Qin Y, et al. 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(3):485–92.
Karlsen A, et al. Anthocyanins inhibit nuclear factor-κ B activation in monocytes and reduce plasma concentrations of pro-inflammatory mediators in healthy adults. J Nutr. 2007;137(8):1951–4.
Kelley DS, et al. Consumption of Bing sweet cherries lowers circulating concentrations of inflammation markers in healthy men and women. J Nutr. 2006;136(4):981–6.
Cavicchia PP, et al. A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. J Nutr. 2009;139(12):2365–72.
Shivappa N, et al. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014;17(8):1689–96.
World Health Organisation. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva. 2008;8–11:2011.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499–502.
Dacie JV, Lewis SM, Practical haematology. 2002.
de Onis M, Habicht J-P. Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. Am J Clin Nutr. 1996;64(4):650–8.
Whelton PK, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;2017:24430.
Bastard JP, et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. 2006;17(1):4–12.
Wu T, et al. Blackberry and Blueberry Anthocyanin Supplementation Counteract High-Fat-Diet-Induced Obesity by Alleviating Oxidative Stress and Inflammation and Accelerating Energy Expenditure. Oxid Med Cell Longev. 2018;2018:4051232.
Tsalamandris S, et al. The role of inflammation in diabetes: current concepts and future perspectives. Eur Cardiol Rev. 2019;14(1):50.
Zhu Y, et al. Anti-inflammatory effect of purified dietary anthocyanin in adults with hypercholesterolemia: a randomized controlled trial. Nutr Metabol Cardiovascular Dis. 2013;23(9):843–9.
Chen L, et al. Protective effects of raspberry on the oxidative damage in HepG2 cells through Keap1/Nrf2-dependent signaling pathway. Food Chem Toxicol. 2019;133:110781.
Shivappa N, et al. Associations between dietary inflammatory index and inflammatory markers in the Asklepios Study. Br J Nutr. 2015;113(4):665–71.
King DE, Egan BM, Geesey ME. Relation of dietary fat and fiber to elevation of C-reactive protein. Am J Cardiol. 2003;92(11):1335–9.
Estruch R, et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 2006;145(1):1–11.
Papamichou D, Panagiotakos D, Itsiopoulos C. Dietary patterns and management of type 2 diabetes: A systematic review of randomised clinical trials. Nutr Metabol Cardiovascular Dis. 2019;29(6):531–43.
Kitabchi AE, et al. Effects of high-protein versus high-carbohydrate diets on markers of β-cell function, oxidative stress, lipid peroxidation, proinflammatory cytokines, and adipokines in obese, premenopausal women without diabetes: a randomized controlled trial. Diabetes Care. 2013;36(7):1919–25.
Ferrucci L, et al. Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrinol Metabol . 2006;91(2):439–46.
Wannamethee SG, et al. Associations of vitamin C status, fruit and vegetable intakes, and markers of inflammation and hemostasis. Am J Clin Nutr. 2006;83(3):567–74.
Bertran N, et al. Diet and lifestyle are associated with serum C-reactive protein concentrations in a population-based study. J Labor Clin Med. 2005;145(1):41–6.
Erlinger TP, et al. Relationship between systemic markers of inflammation and serum β-carotene levels. Arch Intern Med. 2001;161(15):1903–8.
King DE, et al. Dietary magnesium and C-reactive protein levels. J Am Coll Nutr. 2005;24(3):166–71.
Ma Y, et al. Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr. 2006;83(4):760–6.
Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2006;29(1):S43.
Hashem Dabaghian F, et al. Effects of Rosa canina Lfruit on glycemia and lipid profile in type 2 diabetic patients: A randomized, double-blind, placebo-controlled clinical trial. J Med Plants. 2015;14(55):95–104.
Li D, et al. Purified anthocyanin supplementation reduces dyslipidemia, enhances antioxidant capacity, and prevents insulin resistance in diabetic patients. J Nutr. 2015;145(4):742–8.
American Diabetes. A Peripheral arterial disease in people with diabetes. Diabetes Care, 2003; 26(12)
Dehghan A, et al. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care. 2008;31(2):361–2.
Jacob RA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr. 2003;133(6):1826–9.
Zhu JX, et al. Effects of Biota orientalis extract and its flavonoid constituents, quercetin and rutin on serum uric acid levels in oxonate-induced mice and xanthine dehydrogenase and xanthine oxidase activities in mouse liver. J Ethnopharmacol. 2004;93(1):133–40.
Acknowledgements
This study was financially supported by Griffith University, School of Medical Science. The authors would like to gratefully acknowledge the cooperation of the trial participants and the assistance of Dr. Anahita Aboonabi (School of Medical Science, Griffith University) with biochemistry assay.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None of the authors have any conflicts of interest.
Additional information
Responsible Editor: John Di Battista.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Nikbakht, E., Singh, I., Vider, J. et al. Potential of anthocyanin as an anti-inflammatory agent: a human clinical trial on type 2 diabetic, diabetic at-risk and healthy adults. Inflamm. Res. 70, 275–284 (2021). https://doi.org/10.1007/s00011-021-01438-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00011-021-01438-1