Study of Chokeberry to Reduce Cardiovascular Disease Risk in Former Smokers

More than 31% of Connecticut adults are former smokers, which may contribute to the high CVD
risk in this state. Atherosclerosis, a hallmark of CVD, is a progressive life-long process.
Chronic cigarette smoking increases atherosclerosis and CVD risk. While smoking cessation
may lower CVD risk, former smokers still are at high CVD risk. The mechanisms by which
smoking accelerates atherosclerosis formation are not fully understood. This knowledge gap
prevents development of informed interventions to reduce CVD risk in former smokers.

Previous work suggests smoking increases oxidative stress and leads to elevated CVD risk.
Former smokers also have decreased antioxidants and markers of vascular function in the
circulation, suggesting that despite cessation, smoking has a lingering adverse effect on
CVD protective mechanisms. Chokeberry (Aronia melanocarpa) is a native Connecticut plant
rich in polyphenol antioxidants and is a promising intervention for reducing CVD risk in
former smokers. Chokeberries have diverse polyphenols such as anthocyanins,
proanthocyanidins, resveratrol, quercetin, and chlorogenic acid. Chokeberry consumption
improves dyslipidemia, inhibits inflammation, and reduces oxidative stress in humans and
animals, all of which could contribute to the prevention of CVD in former smokers.
Therefore, our central hypothesis is that dietary chokeberry polyphenols reduce CVD risk in
former smokers by improving lipid profiles and inhibiting inflammation and oxidative stress.
Our long-term goal is to define the mechanisms by which polyphenol antioxidants mitigate CVD
risk. The overall goal of this project is to conduct a randomized placebo-controlled
clinical trial to evaluate the cardio-protective effects of dietary chokeberry polyphenols
in former smokers.

Our objectives are to determine 1) the effect of chokeberry polyphenols on plasma
cholesterol and triglyceride levels and on gene expression involved in cholesterol
metabolism; 2) the extent to which chokeberry improves antioxidant and vascular function in
former smokers; and 3) the association of bioavailability of chokeberry polyphenols to
changes in biomarkers of CVD risk.

Successful completion of this work will result in improved understanding of the role of
dietary berry polyphenols to regulate lipid metabolism, inflammation and oxidative stress.
Thus, this study will be an important step to developing dietary recommendations for
individuals predisposed to CVD risk, particularly former smokers.

Inclusion Criteria:

- Former smoker (previously smoked ≥3 cigarettes/day for at least 1 year, cessation for
at least 6 months

- Healthy male or female between 18-65 y

- Serum clinical ranges no more than mildly elevated (serum cholesterol <240 mg/dL) and
serum triglyceride (<150 mg/dL)

- Resting blood pressure <140/90 mm Hg

- Stable body weight (±5 lb) for last 2 months

- BMI ranges within normal and overweight (18.5-39 kg/m2)

- Willing to maintain normal exercise level (<7 h/wk)

- Willing to avoid exercise 24 h prior to blood sampling

- Willing to ingest a dietary chokeberry supplement or placebo (500 mg/d) daily for 12
wks.

Exclusion Criteria:

- Previous diagnoses of CVD, diabetes, or arthritis (except for osteo-arthritis)

- Currently being treated for cancer (i.e., chemotherapy, radiation therapy)

- Women with prescribed estrogen replacement therapy

- Practicing slimming diet

- Practicing vegetarian diet

- Currently taking vitamin or mineral supplements or plant pills

- Alcohol consumption exceeding the definition of moderate drinking (2 drinks/day or a
total of 12/week for men or 1 drink/day or a total of 7/week for women)