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Impact of the quantity and flavonoid content of fruits and vegetables on markers of intake in adults with an increased risk of cardiovascular disease : the FLAVURS trial . PURPOSE Limited robust randomised controlled trials investigating fruit and vegetable ( F & V ) intake in people at risk of cardiovascular disease ( CVD ) exist . We aimed to design and validate a dietary strategy of increasing flavonoid-rich versus flavonoid-poor F & V consumption on nutrient biomarker profile . METHODS A parallel , randomised , controlled , dose-response dietary intervention study . Participants with a CVD relative risk of 1.5 assessed by risk scores were randomly assigned to one of the 3 groups : habitual ( control , CT ) , high-flavonoid ( HF ) or low-flavonoid ( LF ) diets . While the CT group ( n = 57 ) consumed their habitual diet throughout , the HF ( n = 58 ) and LF ( n = 59 ) groups sequentially increased their daily F & V intake by an additional 2 , 4 and 6 portions for 6-week periods during the 18-week study . RESULTS Compliance to target numbers and types of F & V was broadly met and verified by dietary records , and plasma and urinary biomarkers . Mean ( ± SEM ) number of F & V portions/day consumed by the HF and LF groups at baseline ( 3.8 ± 0.3 and 3.4 ± 0.3 ) , 6 weeks ( 6.3 ± 0.4 and 5.8 ± 0.3 ) , 12 weeks ( 7.0 ± 0.3 and 6.8 ± 0.3 ) and 18 weeks ( 7.6 ± 0.4 and 8.1 ± 0.4 ) , respectively , was similar at baseline yet higher than the CT group ( 3.9 ± 0.3 , 4.3 ± 0.3 , 4.6 ± 0.4 , 4.5 ± 0.3 ) ( P = 0.015 ) . There was a dose-dependent increase in dietary and urinary flavonoids in the HF group , with no change in other groups ( P = 0.0001 ) . Significantly higher dietary intakes of folate ( P = 0.035 ) , non-starch polysaccharides ( P = 0.001 ) , vitamin C ( P = 0.0001 ) and carotenoids ( P = 0.0001 ) were observed in both intervention groups compared with CT , which were broadly supported by nutrient biomarker analysis . CONCLUSIONS The success of improving nutrient profile by active encouragement of F & V intake in an intervention study implies the need for a more hands-on public health approach .
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Intervention_Pharmacological
fruits and vegetables
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Intervention_Pharmacological
fruit and vegetable ( F & V ) intake
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Intervention_Pharmacological
dietary strategy of increasing flavonoid-rich versus flavonoid-poor F & V consumption
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Intervention_Control
habitual ( control , CT )
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Intervention_Physical
high-flavonoid ( HF )
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Intervention_Physical
low-flavonoid ( LF ) diets
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Outcome_Physical
quantity and flavonoid content
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Outcome_Mental
fruit and vegetable ( F & V ) intake
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Outcome_Mental
F & V consumption
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Outcome_Physical
plasma and urinary biomarkers
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Participant_Age
adults
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Participant_Condition
with an increased risk of cardiovascular disease
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Participant_Condition
people at risk of cardiovascular disease ( CVD )
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Participant_Condition
Participants with a CVD relative risk of 1.5 assessed by risk scores