Journal of Food and Nutrition Research
ISSN (Print): 2333-1119 ISSN (Online): 2333-1240 Website: Editor-in-chief: Prabhat Kumar Mandal
Open Access
Journal Browser
Journal of Food and Nutrition Research. 2020, 8(8), 399-409
DOI: 10.12691/jfnr-8-8-3
Open AccessArticle

Differential Effects of Agraz (Vaccinium meridionale Swartz) Consumption in Overweight and Obese Women with Metabolic Syndrome

Catalina Marín-Echeverri1, Manuela Piedrahita-Blandón1, Yeisson Galvis-Pérez1, Vitelbina Nuñez-Rangel1, Christopher N. Blesso2, María-Luz Fernández2 and Jacqueline Barona-Acevedo1,

1Research Group of Toxinology, Therapeutic and Food Alternatives; School of Microbiology; Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia

2Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA

Pub. Date: August 13, 2020

Cite this paper:
Catalina Marín-Echeverri, Manuela Piedrahita-Blandón, Yeisson Galvis-Pérez, Vitelbina Nuñez-Rangel, Christopher N. Blesso, María-Luz Fernández and Jacqueline Barona-Acevedo. Differential Effects of Agraz (Vaccinium meridionale Swartz) Consumption in Overweight and Obese Women with Metabolic Syndrome. Journal of Food and Nutrition Research. 2020; 8(8):399-409. doi: 10.12691/jfnr-8-8-3


Obesity implies higher cardiovascular risk (CVR) than overweight. Polyphenol-rich fruits have shown to ameliorate CVR factors (CVRF). It is not clear whether differential effects could be observed between obese and overweight people consuming these fruits. Objective: To evaluate the effects of agraz on CVRF in overweight and obese women with metabolic syndrome (MetS). Methods: Overweight (n=22) and obese (n=18) women (25-60 years) with MetS, were included in this crossover, double-blind and placebo-controlled study. They consumed agraz or placebo over 4-weeks separated by a 4-wk washout period. At the end of each period, the following parameters were measured: anthropometrics, blood pressure, serum lipid profile, glucose, insulin, adipokines, apolipoprotein (apo)-A1, high sensitivity C-reactive protein (hs-CRP), serum total antioxidant capacity (TAC), endogenous antioxidant enzymes and oxidative stress (OxS) markers. Results: Compared to placebo, agraz consumption significantly (p<0.05) reduced hs-CRP and urinary 8-hydroxy 2 deoxyguanosine (8-OHdG) levels in overweight and obese women, respectively. In both groups, changes in antioxidant markers were significant (p<0.05) and negatively correlated with changes in CVR factors and OxS markers, respectively. Positive correlations were observed with cardioprotective markers. Conclusions: Agraz consumption had differential effects in overweight and obese women, with better effects on inflammation and OxS markers, respectively. Further studies should consider these differential responses when analyzing the results of an intervention, and eventually adjust to get better outcomes.

Andean berry obesity oxidative stress total antioxidant capacity antioxidant enzymes inflammation cardiovascular risk factors

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Collaborators G 2015 O, Afshin A, Forouzanfar M, Reitsma M, Sur P, Estep K, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017; 377: 13-27.
[2]  Mongraw-Chaffin ML, Peters SAE, Huxley RR, Woodward M. The sex-specific association between BMI and coronary heart disease: a systematic review and meta-analysis of 95 cohorts with 1·2 million participants. Lancet Diabetes Endocrinol 2015; 3: 437-49.
[3]  Damiri B, Abualsoud MS, Samara AM, Salameh SK. Metabolic syndrome among overweight and obese adults in Palestinian refugee camps. Diabetol Metab Syndr 2018; 10: 34.
[4]  Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
[5]  WHO (World Health Organization). Global status report on noncommunicable diseases 2014 2014: 79-93. (accessed February 8, 2018).
[6]  Amirkhizi F, Siassi F, Djalali M, Shahraki SH. Impaired enzymatic antioxidant defense in erythrocytes of women with general and abdominal obesity. Obes Res Clin Pract 2014; 8: e26-34.
[7]  Morelli NR, Scavuzzi BM, Miglioranza LH da S, Lozovoy MAB, Simão ANC, Dichi I, et al. Metabolic syndrome components are associated with oxidative stress in overweight and obese patients. Arch Endocrinol Metab 2018; 62: 309-18.
[8]  Venojärvi M, Korkmaz A, Wasenius N, Manderoos S, Heinonen OJ, Lindholm H, et al. 12 Weeks’ aerobic and resistance training without dietary intervention did not influence oxidative stress but aerobic training decreased atherogenic index in middle-aged men with impaired glucose regulation. Food Chem Toxicol 2013; 61: 127-35.
[9]  Urakawa H, Katsuki A, Sumida Y, Gabazza EC, Murashima S, Morioka K, et al. Oxidative stress is associated with adiposity and insulin resistance in men. J Clin Endocrinol Metab 2003; 88: 4673-6.
[10]  Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004; 114: 1752-61.
[11]  Abu-Saleh N, Aviram M, Hayek T. Aqueous or lipid components of atherosclerotic lesion increase macrophage oxidation and lipid accumulation. Life Sci. 2016; 154: 1-14.
[12]  Basu A, Wilkinson M, Penugonda K, Simmons B, Betts NM, Lyons TJ. Freeze-dried strawberry powder improves lipid profile and lipid peroxidation in women with metabolic syndrome: baseline and post intervention effects. Nutr J 2009; 8: 43.
[13]  Basu A, Du M, Leyva MJ, Sanchez K, Betts NM, Wu M, et al. Blueberries decrease cardiovascular risk factors in obese men and women with metabolic syndrome. J Nutr 2010; 140: 1582-7.
[14]  Name T, Simão C, Alysson M, Lozovoy B, Name A, Oliveira SR, et al. 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: 1885-94.
[15]  Basu A, Betts NM, Ortiz J, Simmons B, Wu M, Lyons TJ. Low-energy cranberry juice decreases lipid oxidation and increases plasma antioxidant capacity in women with metabolic syndrome. Nutr Res 2011; 31: 190-6.
[16]  Broncel M, Kozirog M, Duchnowicz P, Koter-Michalak M, Sikora J, Chojnowska-Jezierska J. Aronia melanocarpa extract reduces blood pressure, serum endothelin, lipid, and oxidative stress marker levels in patients with metabolic syndrome. Med Sci Monit 2010; 16: CR28-34.
[17]  Chu S, Fu H, Yang J, Liu G, Dou P, Zhang L, et al. A randomized double-blind placebo-controlled study of Pu’er tea extract on the regulation of metabolic syndrome. Chin J Integr Med 2011; 17: 492-8.
[18]  Stull AJ, Cash KC, Johnson WD, Champagne CM, Cefalu WT. Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and women. J Nutr 2010; 140: 1764-8.
[19]  Suliburska J, Bogdanski P, Szulinska M, Stepien M, Pupek-Musialik D, Jablecka A. Effects of green tea supplementation on elements, total antioxidants, lipids, and glucose values in the serum of obese patients. Biol Trace Elem Res 2012; 149: 315-22.
[20]  Moazen S, Amani R, Homayouni Rad A, Shahbazian H, Ahmadi K, Taha Jalali M. Effects of freeze-dried strawberry supplementation on metabolic biomarkers of atherosclerosis in subjects with type 2 diabetes: a randomized double-blind controlled trial. Ann Nutr Metab 2013; 63: 256-64.
[21]  van der Made SM, Plat J, Mensink RP. Resveratrol does not influence metabolic risk markers related to cardiovascular health in overweight and slightly obese subjects: a randomized, placebo-controlled crossover trial. PLoS One 2015; 10: e0118393.
[22]  Murkovic M, Abuja PM, Bergmann AR, Zirngast A, Adam U, Winklhofer-Roob BM, et al. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr 2004; 58: 244-9.
[23]  Herranz-López M, Olivares-Vicente M, Boix-Castejón M, Caturla N, Roche E, Micol V. Differential effects of a combination of Hibiscus sabdariffa and Lippia citriodora polyphenols in overweight/obese subjects: A randomized controlled trial. Sci Rep 2019; 9: 2999.
[24]  Garzón GA, Narváez CE, Riedl KM, Schwartz SJ. Chemical composition, anthocyanins, non-anthocyanin phenolics and antioxidant activity of wild bilberry (Vaccinium meridionale Swartz) from Colombia. Food Chem 2010; 122: 980-6.
[25]  Torres D, Reyes-Deeck C, Gallego E, Gómez-García AC, Posada G, Maldonado-Celis ME. Impact of osmodehydrated Andean berry (Vaccinium meridionale Swartz) on overweight adults. Vitae 2018; 25: 141-7.
[26]  Quintero-Quiroz J, Galvis-Pérez Y, Galeano-Vásquez S, Marín-Echeverri C, Franco-Escobar C, Ciro-Gómez G, et al. Physico-chemical characterization and antioxidant capacity of the Colombian berry (Vaccinium meridionale Swartz) with a high-polyphenol content: potential effects in people with metabolic syndrome. Food Sci Technol 2019.
[27]  Espinosa-Moncada J, Marín-Echeverri C, Galvis-Pérez Y, Ciro-Gómez G, Aristizábal JC, Blesso CN, et al. Evaluation of Agraz Consumption on Adipocytokines, Inflammation, and Oxidative Stress Markers in Women with Metabolic Syndrome. Nutrients 2018; 10: 1639.
[28]  WHO (World Health Organization). Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1-253.
[29]  Álvarez Monsalve JM, González Zapata LI. Diseño de un cuestionario de frecuencia para evaluar ingesta alimentaria en la Universidad de Antioquia, Colombia. Nutr Hosp 2011; 26: 1333-44.
[30]  CDC. Anthropometry Procedures Manual. Centers for Disease Control and Prevention. 2017.
[31]  CDC. Health Tech/Blood Pressure Procedures Manual. Centers for Disease Control and Prevention. 2009.
[32]  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: 499-502.
[33]  Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-9.
[34]  Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 2000; 85: 2402-10.
[35]  Re R, Pellegrini N, Proteggente A, Pannala A, Yang M, Rice-Evans C. Antioxidant activity applying an improved ABTS radical cation decolorization assay. Free Radic Biol Med 1999; 26: 1231-7.
[36]  Benzie IFF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: the FRAP assay. Anal Biochem 1996; 239: 70-6.
[37]  Millar CL, Duclos Q, Garcia C, Norris GH, Lemos BS, DiMarco DM, et al. Effects of Freeze-Dried Grape Powder on High-Density Lipoprotein Function in Adults with Metabolic Syndrome: A Randomized Controlled Pilot Study. Metab Syndr Relat Disord 2018; 16: 464-9.
[38]  Marín-Echeverri C, Blesso CN, Fernández ML, Galvis-Pérez Y, Ciro-Gómez G, Núñez-Rangel V, et al. Effect of Agraz (Vaccinium meridionale Swartz) on High-Density Lipoprotein Function and Inflammation in Women with Metabolic Syndrome. Antioxidants (Basel, Switzerland) 2018; 7: E185.
[39]  Zhang R, Dong S-Y, Wang F, Ma C, Zhao X-L, Zeng Q, et al. Associations between Body Composition Indices and Metabolic Disorders in Chinese Adults: A Cross-Sectional Observational Study. Chin Med J (Engl) 2018; 131: 379-88.
[40]  Félix-Redondo FJ, Grau M, Baena-Díez JM, Dégano IR, León AC de, Guembe MJ, et al. Prevalence of obesity and associated cardiovascular risk: the DARIOS study. BMC Public Health 2013; 13: 542.
[41]  Huang H, Chen G, Liao D, Zhu Y, Xue X. Effects of Berries Consumption on Cardiovascular Risk Factors: A Meta-analysis with Trial Sequential Analysis of Randomized Controlled Trials. Sci Rep 2016; 6: 23625.
[42]  Lucey A, Heneghan C, Kiely ME. Guidance for the design and implementation of human dietary intervention studies for health claim submissions. Nutr Bull 2016; 41: 378-94.
[43]  Michael Gibson C, Korjian S, Tricoci P, Daaboul Y, Yee M, Jain P, et al. Safety and Tolerability of CSL112, a Reconstituted, Infusible, Plasma-Derived Apolipoprotein A-I, After Acute Myocardial Infarction: The AEGIS-I Trial (ApoA-I Event Reducing in Ischemic Syndromes I). Circulation 2016; 134: 1918-30.
[44]  Waksman R, Torguson R, Kent KM, Pichard AD, Suddath WO, Satler LF, et al. A first-in-man, randomized, placebo-controlled study to evaluate the safety and feasibility of autologous delipidated high-density lipoprotein plasma infusions in patients with acute coronary syndrome. J Am Coll Cardiol 2010; 55: 2727-35.
[45]  Khera A V., Cuchel M, de la Llera-Moya M, Rodrigues A, Burke MF, Jafri K, et al. Cholesterol Efflux Capacity, High-Density Lipoprotein Function, and Atherosclerosis. N Engl J Med 2011; 364: 127-35.
[46]  Yang L, Ling W, Yang Y, Chen Y, Tian Z, Du Z, et al. Role of Purified Anthocyanins in Improving Cardiometabolic Risk Factors in Chinese Men and Women with Prediabetes or Early Untreated Diabetes-A Randomized Controlled Trial. Nutrients 2017; 9: 1104.
[47]  Aasvee K, Rasmussen M, Kelly C, Kurvinen E, Giacchi MV, Ahluwalia N. Validity of self-reported height and weight for estimating prevalence of overweight among Estonian adolescents: the Health Behaviour in School-aged Children study. BMC Res Notes 2015; 8: 606.
[48]  Farrell N, Norris G, Lee SG, Chun OK, Blesso CN. Anthocyanin-rich black elderberry extract improves markers of HDL function and reduces aortic cholesterol in hyperlipidemic mice. Food Funct 2015; 6: 1278-87.
[49]  Castro AM, Macedo-de la Concha LE, Pantoja-Meléndez CA. Low-grade inflammation and its relation to obesity and chronic degenerative diseases. Rev Médica Del Hosp Gen México 2017; 80: 101-5.
[50]  Ridker PM, Buring JE, Cook NR, Rifai N. C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events. Circulation 2003; 107: 391-7.
[51]  Azizian M, Mahdipour E, Mirhafez SR, Shoeibi S, Nematy M, Esmaily H, et al. Cytokine profiles in overweight and obese subjects and normal weight individuals matched for age and gender. Ann Clin Biochem 2016; 53: 663-8.
[52]  Karlsen A, Paur I, Bøhn SK, Sakhi AK, Borge GI, Serafini M, et al. Bilberry juice modulates plasma concentration of NF-kappaB related inflammatory markers in subjects at increased risk of CVD. Eur J Nutr 2010; 49: 345-55.
[53]  Du C, Shi Y, Ren Y, Wu H, Yao F, Wei J, et al. Anthocyanins inhibit high-glucose-induced cholesterol accumulation and inflammation by activating LXRα pathway in HK-2 cells. Drug Des Devel Ther 2015; 9: 5099-113.
[54]  Gouédard C, Barouki R, Morel Y. Dietary polyphenols increase paraoxonase 1 gene expression by an aryl hydrocarbon receptor-dependent mechanism. Mol Cell Biol 2004; 24: 5209-22.
[55]  Bakhtiari A, Hajian-Tilaki K, Omidvar S, Nasiri Amiri F. Association of lipid peroxidation and antioxidant status with metabolic syndrome in Iranian healthy elderly women. Biomed Reports 2017; 7: 331-6.
[56]  Lee SG, Wang T, Vance TM, Hubert P, Kim D-O, Koo SI, et al. Validation of Analytical Methods for Plasma Total Antioxidant Capacity by Comparing with Urinary 8-Isoprostane Level. J Microbiol Biotechnol 2017; 27: 388-94.
[57]  Kontush A, de Faria EC, Chantepie S, Chapman MJ. A normotriglyceridemic, low HDL-cholesterol phenotype is characterised by elevated oxidative stress and HDL particles with attenuated antioxidative activity. Atherosclerosis 2005; 182: 277-85.
[58]  Thérond P, Bonnefont-Rousselot D, Laureaux C, Vasson M-P, Motta C, Legrand A, et al. Copper Oxidation of in Vitro Dioleolylphosphatidylcholine-Enriched High-Density Lipoproteins: Physicochemical Features and Cholesterol Effluxing Capacity. Arch Biochem Biophys 1999; 362: 139-47.
[59]  Zhu Y, Huang X, Zhang Y, Wang Y, Liu Y, Sun R, et al. Anthocyanin supplementation improves HDL-associated paraoxonase 1 activity and enhances cholesterol efflux capacity in subjects with hypercholesterolemia. J Clin Endocrinol Metab 2014; 99: 561-9.
[60]  Furler SM, Gan SK, Poynten AM, Chisholm DJ, Campbell L V., Kriketos AD. Relationship of Adiponectin with Insulin Sensitivity in Humans, Independent of Lipid Availability. Obesity 2006; 14: 228-34.
[61]  Kim JH, Baik HW, Yoon YS, Joung HJ, Park JS, Park SJ, et al. Measurement of antioxidant capacity using the biological antioxidant potential test and its role as a predictive marker of metabolic syndrome. Korean J Intern Med 2014; 29: 31-9.
[62]  Shen M, Li K, Jing H, Zheng L. In Vivo Therapeutic Effect of Vaccinium Meridionale Swartz in Ischemia-Reperfusion Induced Male Albino Rats. J Food Sci 2018; 83: 221-8.
[63]  Wu J, Li Q, Wang X, Yu S, Li L, Wu X, et al. Neuroprotection by curcumin in ischemic brain injury involves the Akt/Nrf2 pathway. PLoS One 2013; 8: e59843.
[64]  Iwakami S, Misu H, Takeda T, Sugimori M, Matsugo S, Kaneko S, et al. Concentration-dependent dual effects of hydrogen peroxide on insulin signal transduction in H4IIEC hepatocytes. PLoS One 2011; 6: e27401.
[65]  Di Minno A, Turnu L, Porro B, Squellerio I, Cavalca V, Tremoli E, et al. 8-Hydroxy-2-Deoxyguanosine Levels and Cardiovascular Disease: A Systematic Review and Meta-Analysis of the Literature. Antioxid Redox Signal 2016; 24: 548-55.
[66]  Alvarez-Suarez JM, Giampieri F, Tulipani S, Casoli T, Di Stefano G, González-Paramás AM, et al. One-month strawberry-rich anthocyanin supplementation ameliorates cardiovascular risk, oxidative stress markers and platelet activation in humans. J Nutr Biochem 2014; 25: 289-94.