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Dietary Supplementation with Polyphenol-Rich Chokeberry Juice Improves Skin Morphology in Cellulite

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Abstract The aim of our study was to investigate possible beneficial effects of organic chokeberry juice (OCJ) consumption in the treatment of cellulite. Twenty-nine women aged 25-48 with a cellulite grade 2 according to the Nurnberger-Muller scale were included. Anthropometric and biochemical parameters were measured. Skin structure was analyzed by ultrasonography. All subjects consumed 100 mL of OCJ per day, during 90 days. Measurements of investigated parameters were performed at 0, 45, and 90 days of the study. A marked reduction in the subcutaneous tissue thickness was observed in all subjects, with the average reduction of 1.9 mm. The length of subcutaneous tissue fascicles (ScTFL) was reduced in 97% (28 out of 29) of subjects, with the average value of 1.18 mm. After 45 days of chokeberry juice consumption, reduction of edema was observed in 55.2% of the subjects with edema at the baseline, while at the endpoint of the study, edemas were not observed in any of the subjects involved in the study. OCJ could have beneficial effects on the cellulite condition, including the length of ScTFL, subcutaneous tissue, and dermis thickness as well as on edema reduction.
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FULL COMMUNICATION
Dietary
AU1 cSupplementation with Polyphenol-Rich Chokeberry Juice
Improves Skin Morphology in Cellulite
Katarina
AU2 cS
ˇavikin,
1
Nemanja Menkovic
´,
2
Gordana Zdunic
´,
1
Dejan Pljevljakus
ˇic
´,
1
Slavica Spasic
´,
3
Nevena Kardum,
4
and Aleksandra Konic
´-Ristic
´
4
AU3 c
1
Institute for Medicinal Plants Research, Belgrade, Serbia.
2
Clinical Center of Serbia, Center for Radiology and Magnetic Resonance, Belgrade, Serbia.
3
Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
4
Department of Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.
ABSTRACT The aim of our study was to investigate possible beneficial effects of organic chokeberry juice (OCJ)
consumption in the treatment of cellulite. Twenty-nine women aged 25–48 with a cellulite grade 2 according to the
Nurnberger–Muller scale were included. Anthropometric and biochemical parameters were measured. Skin structure was
analyzed by ultrasonography. All subjects consumed 100 mL of OCJ per day, during 90 days. Measurements of investigated
parameters were performed at 0, 45, and 90 days of the study. A marked reduction in the subcutaneous tissue thickness was
observed in all subjects, with the average reduction of 1.9 mm. The length of subcutaneous tissue fascicles (ScTFL) was
reduced in 97% (28 out of 29) of subjects, with the average value of 1.18 mm. After 45 days of chokeberry juice consumption,
reduction of edema was observed in 55.2% of the subjects with edema at the baseline, while at the endpoint of the study,
edemas were not observed in any of the subjects involved in the study. OCJ could have beneficial effects on the cellulite
condition, including the length of ScTFL, subcutaneous tissue, and dermis thickness as well as on edema reduction.
KEY WORDS: anthropometric biochemistry cellulite chokeberry fascicles subcutaneous tissue
INTRODUCTION
Cellulite is a condition that occurs in over 85% of
women and has also been diagnosed in men.
1
Although
it is not recognized as a medical disorder, it is of special
importance in esthetic medicine.
2,3
Cellulite is characterized
by an irregular, dimpled appearance of the skin, mainly found
on the thighs, buttocks, and abdomen.
4
Multifactorial etiology
is assumed, including structural, genetic, and endocrine ab-
normalities. It was shown that weakened connective tissues,
enlarged fat cells, and diminished microcirculation, play key
roles in the pathophysiology of cellulite.
2,5–7
Cellulite progression or reduction is evaluated using dif-
ferent techniques, including imprecise palpation and de-
scribing using various scales,
8
as well as instrumental methods
such as termography,
9
macrophotography,
10
magnetic reso-
nance, computed tomography, and ultrasonography.
11–15
A variety of topical preparations, massage-based thera-
pies, and surgical techniques, as well as herbal preparations
for oral applications, functional foods, or changes in dietary
habits have been used to improve cellulite conditions.
2,3,17,18
There is increasing demand for functional foods and in this
category, functional beverages are the fastest growing seg-
ment.
19
A lot of them are made from berries, among them
chokeberry products are very frequent.
Chokeberry (Aronia melanocarpa) is a rich source of
proanthocyanidins, anthocyanins, flavonols, and phenolic
acids and due to this diverse chemical profile it possesses
numerous beneficial effects in humans and animals.
20–22
It is
shown that chokeberry is among the plant species with the
highest antioxidant activity.
20,23
A large number of inter-
vention studies demonstrated the beneficial effects of
chokeberry ingredients on various risk factors for cardio-
vascular diseases, the levels of total cholesterol, LDL, ox-
LDL, triglycerides, glucose, HbA1c and systolic and diastolic
blood pressure, body mass index, improving vasodilatation
dependent on endothelial function as well as vasoactive and
vasoprotective properties.
22,24–26
In addition, it was shown
that anthocyanins play a role in the redistribution of micro-
vascular blood
27
and together with other phenolics have
beneficial effects on small blood vessel permeability.
28
Ac-
cording to our knowledge, there is no information in the lit-
erature about the effects of chokeberry juice on the condition
of skin and subcutaneous tissue region affected by cellulite.
Taking into account all these facts, the aim of this study
was to investigate the possible beneficial effects of organic
chokeberry juice (OCJ) consumption in the treatment of
cellulite in a female subject with cellulite type 2 according
Manuscript received 12 April 2013. Revision accepted 6 November 2013.
Address correspondence to: Dejan Pljevljakus
ˇic
´
AU4 c, Institute for Medicinal Plants Research,
Tadeus
ˇa Kos
ˇc
´us
ˇka 1, Belgrade 11000, Serbia, E-mail: dpljevljakusic@mocbilja.rs
JOURNAL OF MEDICINAL FOOD
J Med Food 00 (0) 2013, 1–6
#Mary Ann Liebert, Inc., and Korean Society of Food Science and Nutrition
DOI: 10.1089/jmf.2013.0102
JMF-2013-0102-ver9-Savikin_1P
Type: research-article
1
JMF-2013-0102-ver9-Savikin_1P.3d 12/14/13 9:34am Page 1
to the Nurnberger–Muller scale. Different parameters were
monitored, including body mass index, percent of fat, the
abdominal, thigh, knee, and hip circumference, blood tests,
and also ultrasound examinations of the skin.
MATERIALS AND METHODS
Organic chokeberry juice
OCJ (A. melanocarpa) used in this study was imported and
donated from Conimex Trade d.o.o. (Belgrade, Serbia).
Producer of OCJ is Tlocznia Rembowscy (Popowko, Poland).
Total phenolics
The total concentration of phenols was estimated by the
Folin–Ciocalteu method with slight modifications.
29
Two
hundred microliters of properly diluted OCJ was added to
1 mL of 1:10 diluted Folin–Ciocalteu reagent. After 4 min,
800 lL of sodium carbonate (75 g/L) was added. After 2h of
incubation at room temperature, the absorbance at 765 nm
was measured. Gallic acid (0–100 mg/L) was used for cal-
ibration of a standard curve. The results were expressed as
milligrams of gallic acid equivalents per 100 g of juice (mg
GAE/100 g FW). Triplicate measurements were taken and
mean values were calculated.
Total anthocyanins
The total anthocyanin content was investigated according
to the procedure described in European Pharmacopoeia
6.0,
30
with slight modifications. A 50-fold dilution of OCJ in
a 0.1% v/v solution of hydrochloric acid in methanol was
prepared. The absorbance of the solution was measured at
528 nm, using a 0.1% v/v solution of hydrochloric acid in
methanol as the compensation liquid.
The percentage content of anthocyanins, expressed as
cyanidin-3-glucoside chloride, was calculated from the ex-
pression: A·5000/718 ·m(A=absorbance at 528 nm;
718 =specific absorbance of cyanidin-3-glucoside chloride at
528 nm; m=mass of the substance to be examined in grams).
1,1-Diphenyl-2-picrylhydrazyl radical scavenging activity
The free radical scavenging activity of OCJ on the stable
1,1-diphenyl-2-picrylhydrazyl (DPPH) radical was carried out
according to the procedure described previously,
31
with slight
modifications. The antiradical capacity of OCJ was evaluated
using a dilution series, to obtain a large spectrum of sample
concentrations. The samples (100 lL) were mixed with
1400 lLof80lM methanolic solution of DPPH. Absorbance
at 517 nm was measured after 20 min. The percentage of in-
hibition was calculated using the following equation:
Inhibition ¼[(A0Ai)=A0]·100;
where A
0
is absorbance of the control and A
i
is absorbance of
the samples. IC
50
values were estimated using a nonlinear
regression algorithm. All test analyses were run in triplicate.
Trolox was used as a positive control.
Subjects
Twenty-nine women aged 25–48 (mean age 34.9) par-
ticipated in the study. Cellulite grade 2 (orange peel ap-
pearance spontaneously visible and disappearing in layered
position), according to the Nurnberger–Muller scale,
32
was
the main inclusion criterion together with a regular monthly
menstrual cycle. Exclusion criteria included age under 18
and over 50 years; body mass index over 30; significant
changes in dietary habits, life style, or exercise program in
the past 12 months; cardiovascular diseases; pregnancy or
lactation; history of malignancy; any type of cellulite
treatment applied within 12 months before the study; sys-
temic lymphedema; menopause and premenopause.
Protocol
The study protocol was approved by the Ethics Com-
mittee of Faculty of Pharmacy, University of Belgrade,
Serbia. The study was conducted in accordance with the
revised Declaration of Helsinki. All participants provided
written informed consent. The study was performed from
February till May 2012. Subjects were instructed to con-
sume 100 mL of OCJ per day, during 90 days, 30 min before
the main meal and to retain their regular diet, exercise
program, and life style. Analyzed parameters included pa-
rameters of epidermal, dermal, and subcutaneous structure
measured by ultrasound (subcutaneous tissue thickness
[ScTT], thickness of subcutaneous tissue and dermis,
thickness of dermis and epidermis [DET], the length of
subcutaneous tissue fascicles [ScTFL], the presence of
edemas within the dermis), biochemical parameters (total
cholesterol, triglycerides, HDL, LDL, glucose, urea, ALT,
AST, iron and hemoglobin levels, leukocytes and erythro-
cytes counts, sedimentation), and anthropometric parame-
ters (weight, body mass index, total body fat, arterial
pressure, abdominal, thigh, knee, and hip circumference).
Biochemical parameters were determined with a clinical
chemistry analyzer (Cobas e411; Roche Diagnostics, Basel,
Switzerland) and Roche Diagnostics kits according to the
manufacturer’s instructions, while full blood count was
performed using a hematology analyzer (Coulter Ac.T Diff;
Beckman Coulter, Miami, FL, USA).
Measurements of investigated parameters were per-
formed at three time points, at 0, 45, and 90 days of the study
for all parameters with the exception of biochemical pa-
rameters measured at the beginning and the end of the study.
The upper back and front part of the thigh were photo-
graphed at the beginning and the end of the study by a digital
camera (Nikon D90, Nikor lens 18–105 mm) at standardized
angles and positions.
At day 90, subjects were asked to fulfill a questionnaire on
self perception of the treatment effects.
High-frequency ultrasound measurements
The high-frequency ultrasound examinations were carried
out using SA 9900 Multi-beam 3D Ultrasound, system Kretz
5–12 MHz, and linear probe PB–99L5-12IR. The ultrasound
2S
ˇAVIKIN ET AL.
JMF-2013-0102-ver9-Savikin_1P.3d 12/14/13 9:34am Page 2
images obtained were saved on a personal computer, and
then analyzed using experimental software. The examina-
tions were performed on the posterior part of the thigh in
triplicate, always at the same location.
Statistical analysis
Data are presented as mean and standard deviations for
all 29 participants. All measurements were performed in
triplicate. The paired Student’s t-test and one-way ANOVA
for repeated measures (with Bonferroni adjustment for
multiple comparisons) were used to compare the data in two
or three time points, respectively, where P<.05 was con-
sidered statistically significant. SPSS program, version 19
(SPSS, Inc., Chicago, IL, USA) was used for the analysis.
RESULTS
Chemical characteristics and radical scavenging
activity of OCJ
Active ingredients were analyzed in our laboratories and
characteristics of OCJ were as follows: soluble solids
10.94% (Mettler Toledao HB43-S); pH 3.35 (pH meter
Testo 206); total phenolics 386 mg GAE/100 g of juice; total
anthocyanins 25 mg/100 g of juice. The radical scavenging
activity was investigated against synthetic DPPH radical
and the obtained IC
50
value for OCJ was 1.74 0.04 mg/mL.
Effects of chokeberry juice consumption on epidermis,
dermis, and subcutaneous tissue characteristics
The most significant changes that have been observed
during this study were recorded by ultrasonography. In this
study, statistically significant changes in all investigated
characteristics of epidermis, dermis, and subcutaneous tis-
sue, measured by ultrasound, were observed after the in-
tervention and compared with the baseline values (
T1 cTable 1).
ScTT and the thickness of dermal and subcutaneous tissue
(DScTT) were reduced in all subjects after 45 days of in-
tervention, with further reduction until the end of the study.
The average reductions of ScTT and DScTT at the end of the
study were 1.9 and 2.1 mm (9.5% and 9.6%), respectively,
compared with the baseline values. DET was reduced in
65% (19 out of 29) of subjects after 45 days of chokeberry
juice consumption and in 90% (26 out of 29) of subjects, at the
end of the study. An average reduction in DET for the whole
group was 0.3 mm (10.2%), compared with the baseline val-
ues. The growth of the ScTFL into the dermis is a typical
feature of cellulite
15,33
and in our study, the length of ScTFL
was reduced in 97% (28 out of 29) of subjects after 45 days of
the study, with further reduction at the end of the study ob-
served in the same percentage of subjects. An average value
of ScTFL reduction was observed at the end of the study.
Chokeberry juice consumption also showed positive ef-
fects on edema reduction as shown in bT2
Table 2. At the be-
ginning of the study, edema was observed in 60% (16 out of
29) of subjects. At the second time point (45 days after juice
consumption), reduction of edema severity was observed in
37% (6 out of 16) of subjects, and the absence of edema in
63% (10 out of 16) of subjects in whom edema was diag-
nosed at the beginning of the study. At the end of the study,
edema was not observed in any of the subjects included in
the study.
Digital photographs of the upper back and front part of the
thigh, taken at the beginning and at the end of the study,
were evaluated for visual changes by 10 independent eval-
uators. Five of them noticed an improvement in cellulite
appearance after the study was finished.
Biochemical and anthropometric measurements
Anthropometric and biochemical parameters of partici-
pants (29 women aged 25–48, with a height range from 156
to 181.5 cm and weight 49.3–93.8 kg) measured at the be-
ginning and the end of the study are shown in bT3
Table 3.
Although statistically significant difference of the results
obtained before and after the study was not shown for any of
analyzed parameters, beneficial changes were observed in
certain number of participants. Regarding anthropometric
parameters, at the end of the study, decrease in body weight
was observed in 16 of 29 women, reduction in body fat (%)
was noticed in the greatest number of subjects (n=20), re-
presenting 69% of the study group, with the maximum value
of 17%. Reduction in the abdominal circumference was
observed in 62% (18 out of 29) of subjects. Thigh circum-
ference reduction was not significant and was observed in
only 12 subjects, which was inconsistent to the results of
ultrasound measurements in the same region. Since only
healthy subjects were included in the study, most of them
were within the reference ranges for most of the biochemical
parameters before entering the study and at the final point of
control. Although not statistically significant for the whole
study population, changes in biochemical parameters after
the intervention were observed in more than 50% of the
Table 1. Characteristics of Epidermis, Dermis,
and Subcutaneous Tissue Measured by Ultrasound
Time
point
Dermis and
subcutaneous
tissue thickness
(mm)
Subcutaneous
tissue
thickness
(mm)
Dermis and
epidermis
thickness
(mm)
Length of
subcutaneous
fascicles
(mm)
Day 0 22.23 3.28
a
20.42 3.26
a
2.69 0.48
a
2.96 0.72
a
Day 45 21.10 3.23
b
19.44 3.07
b
2.52 0.51
ab
2.11 0.40
b
Day 90 20.09 3.33
c
18.52 3.24
c
2.38 0.39
b
1.61 0.35
c
Values are mean SD (n=29). All measurements were performed in
triplicate. Data were analyzed by one-way repeated measures ANOVA, with
Bonferroni confidence interval adjustment for multiple comparisons of main
effects, whereas means followed by different letters differ significantly P<.05.
Table 2. Effect of Intervention on Subcutaneous Edema
Day of the study Subjects with edema (n,%)
0 16/29 (55.2%)
45 6/29 (20.7%)
90 0
CHOKEBERRY JUICE IMPROVES SKIN MORPHOLOGY 3
JMF-2013-0102-ver9-Savikin_1P.3d 12/14/13 9:34am Page 3
subjects. In addition, investigated parameters, which are
indicators of liver and kidney function (urea, ALT, AST),
remained in reference values thus indicating safety of
chokeberry juice consumption.
Questionnaire analysis
Analysis of the answers from the questionnaire fulfilled
by all subjects at the end of the study showed that 41.4% of
subjects observed visual improvement in the condition of
cellulite, 48.3% did not observed any change, while 10.3%
of investigated subjects were ambivalent. The positive
overall effect of chokeberry juice consumption, which was
mainly referred on skin tightness, was reported by 69% of
subjects. Side effects, related to the gastrointestinal system
function (motility, constipation, diarrhea), were reported by
13.8% of subjects.
DISCUSSION
Considering that cellulite involves both the subcutaneous
tissue and the dermis, different methods for the analysis of
structure and characteristics of these tissues, including high-
frequency ultrasonography, are applied in both the diagnosis
and treatment of cellulite.
10,13,15
It was shown that some of
the key roles in pathophysiology of cellulite play enlarged
fat cells, weakened connective tissues, and diminished mi-
crocirculation.
6,7
It was shown that anthocyanins from bil-
berries could be effective in promoting and enhancing
arteriolar rhythmic diameter changes that play a role in the
redistribution of microvascular blood flow and interstitial
fluid formation,
27
while phenolics from bilberries, cranber-
ries, and grape seed extracts facilitate the repair of vessel
damage responsible for small blood vessel permeability.
28
Positive effects of polyphenols that reach OCJ consumma-
tion in the treatment of cellulite could be connected with
improvements in microcirculation as well as with protection
and restoration of endothelial cells and consequently their
function. It was shown previously that the flavonoid-rich
extract from chokeberry might preserve the function of the
endothelium and contributes to the prevention of athero-
sclerosis progression,
34
while the anthocyanin-rich choke-
berry extract inhibited the releasing of PGE2 in normal
human endothelial cells.
35
In addition, positive effects of
chokeberry on fat metabolism could contribute to beneficial
effects in cellulite conditions.
20,36
Ultrasonography was also used in the study of Mlosek et
al.
15
who investigated the effects of anticellulite cream
which, among other components, contained cranberry ex-
tracts rich in polyphenols. Although two different ap-
proaches to the treatment were applied, similar results were
obtained. They also noticed a decrease in all measured pa-
rameters, including thickness of subcutaneous tissue, length
of ScTFL, and the number of women with dermal edemas.
One of the mechanisms assumed was improvement in
microcirculation.
Recent investigations on gene expression levels provided
more insight in the pathophysiology of cellulite, and pos-
tulated new targets in the prevention and therapy of this
cosmetic problem. Emanuele et al.
37,38
showed that adipo-
nectin mRNA expression in the subcutaneous adipose tissue
of the gluteal region was significantly lower in areas with
cellulite compared with areas with normal skin and subcu-
taneous tissue architecture, without any change in plasma
Table 3. Anthropometric and Biochemical Characteristics
of Subjects (n=29) Before and After the Study
Before After P
BMI (%) 22.9 4.0 22.9 4.1 NS
Fat (%) 30.0 6.5 29.6 6.9 NS
Abdominal circumference (cm) 75.1 10.4 74.0 9.8 NS
Hip circumference (cm) 100.7 7.6 101.3 7.9 NS
Thigh circumference (cm) 58.5 4.8 58.6 4.9 NS
Knee circumference (cm) 42.1 4.7 42.1 4.2 NS
Glucose (mM) 4.5 0.4 4.4 0.5 NS
Triglycerides (mM) 0.9 0.4 0.8 0.4 NS
Total cholesterol (mM) 5.1 1.2 5.0 1.0 NS
HDL cholesterol (mM) 1.5 0.3 1.5 0.3 NS
LDL cholesterol (mM) 3.2 1.1 3.1 0.9 NS
Urea (mM) 3.9 0.8 4.1 1.2 NS
ALT (U/L) 17.8 9.4 17.0 8.0 NS
AST (U/L) 19.9 4.4 19.2 5.5 NS
Values are mean standard deviation (n=29). Data were analyzed by a
paired Student’s t-test.
NS, statistically not significant if P.05.
FIG. 1. Ultrasound images at the beginning (A)
and end (B) of the study, indicating the reduction
in the length fascicle. bAU7
4S
ˇAVIKIN ET AL.
JMF-2013-0102-ver9-Savikin_1P.3d 12/14/13 9:34am Page 4
adiponectin levels.
37
Based on the gene expression analysis,
they also highlighted the independent role of angiotenzin-
converting enzyme and hypoxia-inducible factor 1A in
predisposing to cellulite.
38
At the same time, anthocyanins
have shown a beneficial influence on gene expression of
several adipocytokines, including adiponectine
39,40
in ani-
mal in vivo models. The inhibitory potential of anthocyanins
and their metabolites on ACE activity in vitro was also re-
ported.
41
These findings could hypothetically explain the
observed beneficial effects of anthocyanin-rich chokeberry
juice on morphological features of cellulite, measured by
ultrasound.
On the other side, low sensitivity and reproducibility of
circumference measurements could contribute to the obtained
inconsistency, postulating the advantage of the direct analysis
of skin and subcutaneous tissues thus indicating that cellulite
disturbed architecture of these tissues could be the optimal
target rather than fat tissue alone. Sasaki et al.
18
investigated
the effectiveness of anticellulite gel combined with LED light
and although they noticed positive changes using ultrasound
imaging, significant changes in body weight, BMI, body fat
indices, and thigh circumferences were not observed.
Results obtained in this study showed marked potential of
anthocyanin-rich chokeberry juice to improve the mor-
phology of skin and subcutaneous tissue in the regions af-
fected by cellulite under in vivo conditions. These findings
add new evidence in the dossier of beneficial effects of
anthocyanins and postulate a new research strategy for both
prevention and treatment of cellulite.
ACKNOWLEDGMENTS
The authors acknowledge their gratitude to the Ministry
of Education and Science of Serbia for financial support,
project number 46013. We heartily thank the Conimex
Trade d.o.o., Belgrade, Serbia.
AUTHOR DISCLOSURE STATEMENT
The authors disclose any commercial associations that
might create a conflict of interest in connection with sub-
mitted manuscripts.
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AUTHOR QUERY FOR JMF-2013-0102-VER9-SAVIKIN_1P
AU1: Please note that gene symbols in any article should be formatted as per the gene nomenclature. Thus, please make sure
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AU3: Please confirm the authors’ affiliations.
AU4: Please mention the degrees of the corresponding author.
AU5: Please cite Ref. 16 in the text.
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AU7: Please cite Figure 1 in the text.
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... Black rice is well known for its high content of phenolic compounds, such as flavonoids, that are reported to have beneficial impacts on human health for their role as natural antioxidants [17][18][19][20], together with recognized effects on several diseases [21][22][23][24][25]. Anthocyanins are a flavonoid sub-class commonly known, among others, for their potential antidiabetic effect [26][27][28]. It is also well known that these compounds are effective on venous microcirculation and lymph drainage, and they can reduce capillary permeability and fragility, while also showing antiedemigenic properties [29][30][31]. Recent investigation efforts have focused on the novel health benefits of anthocyanins. ...
... Briefly, 10 mg of the nutraceutical ingredient were dissolved in 10 mL of distilled water by sonication for 10 min. Then, 50,40,30, and 20 μL of the solution prepared were added to 2.0 mL of phosphate buffer solution (PBS 0.1 M pH 8.0), 150 μL of pancreatic lipase solution (3 mg/mL in distilled water), and 150 μL of substrate solution (4-nitrophenyl octanoate 0.075 M in DMSO). The samples were incubated at 37 °C and, after 30 min, the absorbance was measured at 412 nm. ...
... New therapeutic approaches involve the use of food supplements, such as polyphenol-rich juices, bromelain-based products, and botanical extracts [14,30,56]. Nevertheless, only the use of different combined natural ingredients can ensure simultaneous action on the different biochemical pathways responsible for cellulite-derived blemishes. ...
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... In two [108,109] of the three published studies, the tested formulation contained a plant complex based on Vitis vinifera, Ginkgo biloba, Centella asiatica, Mellilotus officinalis, Fucus vesiculosus, fish oil, and borage oil ( Table 6). Savikin et al. [110] evaluated the ability of organic chokeberry juice (OCJ) to treat cellulite. The proposed mechanism of all these plant extracts is an enhancement of cell metabolism by increasing collagen and elastin synthesis, the reduction of edema and intestinal inflammation, and the improvement of microcirculation. ...
... The proposed mechanism of all these plant extracts is an enhancement of cell metabolism by increasing collagen and elastin synthesis, the reduction of edema and intestinal inflammation, and the improvement of microcirculation. The plant extracts should further act as potent antioxidants that inhibit the oxidation of tissue molecules [108,110]. A total of 239 subjects received dietary supplements in two RCTs [108,109] and in one observational study [110]. ...
... The plant extracts should further act as potent antioxidants that inhibit the oxidation of tissue molecules [108,110]. A total of 239 subjects received dietary supplements in two RCTs [108,109] and in one observational study [110]. Distante et al. [108] found the active treatment to be superior to the control treatment and reported a significant reduction in weight and circumference. ...
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Cellulite is a multifactorial condition that is present in 80-90 % of post-pubertal women. Despite its high prevalence, it remains a major cosmetic concern for women. A wide range of products and treatments for cellulite reduction is available; however, no systematic review has been performed so far to evaluate the efficacy of the available treatment options for cellulite. The objective of this review is to provide a systematic evaluation of the scientific evidence of the efficacy of treatments for cellulite reduction. This systematic review followed the PRISMA guidelines for reporting systematic reviews and meta-analyses. Only original articles in English or German reporting data on the efficacy of cellulite treatments from in vivo human studies were considered. In total, 67 articles were analyzed for the following information: therapy, presence of a control group, randomization, blinding, sample size, description of statistical methods, results, and level of evidence. Most of the evaluated studies, including laser- and light-based modalities, radiofrequency, and others had important methodological flaws; some did not use cellulite severity as an endpoint or did not provide sufficient statistical analyses. Of the 67 studies analyzed in this review, only 19 were placebo-controlled studies with randomization. Some evidence for potential benefit was only seen for acoustic wave therapy (AWT) and the 1440 nm Nd:YAG minimally invasive laser. This article provides a systematic evaluation of the scientific evidence of the efficacy of treatment for cellulite reduction. No clear evidence of good efficacy could be identified in any of the evaluated cellulite treatments.
... It was found that berries of chokeberry (Aronia melanocarpa (Michx.) Elliott), have the highest antioxidant activity among the plant species (Kedzierska et al., 2009;Šavikin et al., 2014). The bioactive compounds found in the chokeberries strengthen blood vessel walls and improve their elasticity (Szajdek & Borowska, 2008). ...
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The researchers’ aims were to evaluate the effects of chokeberry juice in the treatment of burning mouth syndrome (BMS) and oral discomfort in menopausal women. The following validated scales and questionnaires were used before and after treatment: questionnaire used for selection of research participants with xerostomia, the xerostomia inventory, Visual Analogue Scale (VAS), localization of pain before and after treatment, short-form McGill pain questionnaire. There was statistically significant decrease in number of research participants who felt pain after therapeutic procedure (p < 0.05). Chokeberry juice, as additional therapy for BMS, reduced intensity of characteristic types of pain sensations and oral dryness feeling.
... The authors did not investigate polyphenolic composition of the juices, they only performed determinations using a Folin-Ciocalteu reagent. Therefore it is difficult to state which particular polyphenols were primarily responsible for such an effect [91]. ...
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Studies on the cosmetic applications of plant extracts are increasingly appearing in the scientific literature, which is due to the growing popularity of skincare products around the world. In the light of the observed changes, a return to natural treatment and skincare with cosmetics free of harmful substances or toxic preservatives is visible. Currently, tea extracts, due to their rich composition and various biological actions, play an important role among the dietary supplements and cosmetics. This review is intended to collect the reports on the properties of the tea plant, its extracts and preparations in cosmetology: for skin care products and for the treatment of selected dermatological diseases. Particular attention is paid to its antioxidant, anti-hyaluronidase, anti-inflammatory, slimming, hair-strengthening, photoprotective and sealing blood vessels properties.
... Chokeberry fruits and related products are believed to have health-promoting effects, including impact on cardiovascular system, gastrointestinal and urinary tract, improving memory and cognitive functions, and protection from bacteria and viruses (Chrubasik, Li, & Chrubasik, 2010). The recent study showed that chokeberry juice could be effective in treatment of cellulite, by acting on morphological properties of skin and possibly circulation (Savikin et al., 2014). ...
Chapter
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... 1 Recently, an oral supplementation with polyphenol-rich chokeberry juice taken over a period of 90 days improved cellulite with a marked reduction in the subcutaneous tissue thickness and edema. 22 Most therapeutic approaches focus on the induction of lipolysis. However, the efficacy of such cellulite treatments seems to be less than completely satisfying, as reported by Wanner and Avram. ...
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... 1 Recently, an oral supplementation with polyphenol-rich chokeberry juice taken over a period of 90 days improved cellulite with a marked reduction in the subcutaneous tissue thickness and edema. 22 Most therapeutic approaches focus on the induction of lipolysis. However, the efficacy of such cellulite treatments seems to be less than completely satisfying, as reported by Wanner and Avram. ...
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Aronia melanocarpa berries (chokeberries) constitute a very rich source of numerous substances exerting a beneficial impact on health, including mainly polyphenols (proanthocyanidins, anthocyanins, flavonoids, and phenolic acids), possessing antioxidative, anti-inflammatory, antiviral, anticancer, antiatherosclerotic, hypotensive, antiplatelet, and antidiabetic properties. Thus, the consumption of products made from chokeberries is of vital importance for health maintenance and protection. Nowadays, due to the growing prevalence of noncommunicable diseases and ubiquitous human exposure to numerous man-made and naturally occurring toxic substances, some of which are dangerous even at low amounts, it is very important to look for effective means of health protection. An important role in this regard may be played by A. melanocarpa berries; however, up to now the attention of scientists, nutritionists, and health practitioners has been focused mainly on the effectiveness of chokeberry products in the prevention and treatment of noncommunicable diseases, while only little attention has been paid to the possibility of their use to counteract the adverse health effects of exposure to xenobiotics. That is why in this review article the main interest has been focused on the possibility of using chokeberries in the protection against unfavorable health effects caused by the action of substances to which humans may be exposed environmentally and/or occupationally. The available experimental data indicate that not only the fruit but also the leaves of A. melanocarpa and their products may be effective means for prevention and treatment of the effects of toxic action of some xenobiotics in humans; however, further studies on this subject are necessary.
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An effective and long-term treatment of cellulite has not been well established. To our knowledge, no review has analyzed the whole range of treatments for this condition. We conducted a review of in vivo studies on humans adopting the key words "cellulite" and "treatment." The studies were included according to eligibility criteria. We performed an analysis to estimate the overall effect of cellulite treatments from clinical studies. Medline library was screened up to December 2014 to identify eligible studies. We included 73 original studies in the present review. All of them were clinical studies, in most of them, only women were recruited. Above the studies searched up, 66 tested the effectiveness of an exclusive treatment performed without the association to other procedures: 11 topical agents, 10 shock-wave therapy, 10 radio frequency, eight laser therapy, five oral therapy, four manual massage therapy, three carbon dioxide therapy, two compressive therapy, two infrared therapy, one dermabrasion, and 11 devices that use an association of multiple treatments. Seven papers tested a combination of two or more treatments. The mean difference of clinical morphologic features and ultrastructural changes between the treated group and the controlled showed significant heterogeneity between studies. It is still difficult to indicate an exclusive and effective single treatment for this condition. Our analysis purposed to obtain a complete overview of the available treatments in cellulite reduction. © 2015 Wiley Periodicals, Inc.
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Aronia melanocarpa fruit juice (AMFJ) is very rich in phenolic antioxidants, mainly flavonoids from the subclass anthocyanins. The aim of this study was to assess the influence of AMFJ on body and liver mass, plasma lipids and lipoprotein profiles, and the histopathology of liver and aorta in rats fed with cholesterol diets. AMFJ was applied orally for 30 days at doses of 5, 10 and 20 mL/kg. In rats fed the cholesterol-containing diets, AMFJ significantly hindered an increase in plasma lipids (total cholesterol, low-density lipoprotein cholesterol and triglycerides) because of cholesterol feeding. Body weight gains, liver weights, and liver and aorta histopathology were not influenced either by high-cholesterol diets or by AMFJ treatment. In conclusion, AMFJ showed lipid-lowering effects in rats with experimentally induced hyperlipidemia, and could be valuable in reducing lipidemia as a factor of cardiovascular risk. Hyperlipidemia characterized by an increase in low-density lipoprotein (LDL) cholesterol and a decrease in high-density lipoprotein cholesterol is one of the major risk factors for atherosclerosis and cardiovascular disease. Plant foods with high contents of phenolic phytochemicals are reported to be inversely correlated with plasma total cholesterol (TC) and LDL cholesterol. Aronia melanocarpa fruits are remarkably rich in phenolic substances. They are used for human consumption as juice, syrup, jam and wine. Our research demonstrated that A. melanocarpa fruit juice hindered the dietary-induced elevation of plasma TC, LDL cholesterol and triglycerides in rats. In view of the results from our experiment, we can suppose that the juice may be further tested for reducing hyperlipidemia in humans and possibly approved a valuable dietary supplement.
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Full-text available
The purpose of the present study was to evaluate small and high molecular phenolics (tannins) and antioxidant activity of Aronia melanocarpa berries, juice and pomace in order to find new potential sources of natural antioxidants. The fruits of Aronia melanocarpa Elliot were collected in the middle of October at a plantation near Wroclaw, Poland. The pomace has a much higher content of phenolics in comparision to juice and fruits. Results showed that polymeric proanthocyanins, predominantly of (−)epicatechin, are the major class of polyphenolic compounds in chokeberry, represent 66% of fruits polyphenols. The average concentration ranged from 1578.79mg/100g of DW for chokeberry juice up to 8191.58mg/100g in pomace. The concentration of phenolic acids (chlorogenic and neochlorogenic acids) in juice was higher than in pomace. Anthocyanins in Aronia melanocarpa are second phenolic compound group and represent about 25% of total polyphenols, mixture of four different cyanidin glycosides: 3-galactoside, 3-glucoside, 3-arabinoside and 3-xyloside. The higher antioxidant activity expressed as TEAC was measured in pomace >fruit >juice.
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Epidemiological studies have indicated a positive association between the intake of foods rich in anthocyanins and the protection against cardiovascular diseases. Some authors have shown that anthocyanins are degraded by the gut microflora giving rise to the formation of other breakdown metabolites, which could also contribute to anthocyanin health effects. The objective of this study was to evaluate the effects of anthocyanins and their breakdown metabolites, protocatechuic, syringic, gallic, and vanillic acids, on different parameters involved in atherosclerosis, including inflammation, cell adhesion, chemotaxis, endothelial function, estrogenic/anti-estrogenic activity, and angiotensin-converting enzyme (ACE) inhibitory activity. From the assayed metabolites, only protocatechuic acid exhibited a slight inhibitory effect on NO production and TNF-α secretion in LPS-INF-γ-induced macrophages. Gallic acid caused a decrease in the secretion of MCP-1, ICAM-1, and VCAM-1 in endothelial cells. All anthocyanins showed an ACE-inhibitory activity. Delphinidin-3-glucoside, pelargonidin-3-glucoside, and gallic acid showed affinity for ERβ and pelargonidin and peonidin-3-glucosides for ERα. The current data suggest that anthocyanins and their breakdown metabolites may partly provide a protective effect against atherosclerosis that is multi-causal and involves different biochemical pathways. However, the concentrations of anthocyanins and their metabolites, as used in the present cell culture and in vitro assays mediating anti-inflammatory, anti-adhesive, anti-estrogenic, and angiotensin-converting enzyme inhibitory activities, were often manifold higher than those physiologically achievable.
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Cellulite is a multifactorial condition that is present in 80% to 90% of postpubertal women and is one of the most intolerable esthetic imperfections. There are several theories on the pathophysiology of cellulite, and a number of different therapeutic regimens have been developed, from topical treatments to mechanical or energy-based devices. In this brief review, we summarize the scientific landscape to determine the clinical evidence with regard to the safety and efficacy of cellulite treatment options. Clinical protocols and the author’s experience using a combination of internal and external procedures are also discussed. Studies using laser and light modalities along with radiofrequency have shown improvements in cellulite and a good safety profile, but acoustic wave therapy, subcision, and the 1440-nm Nd:YAG minimally invasive laser have demonstrated the most beneficial results in cellulite reduction. Although there is paucity of scientific evidence for treatments that improve cellulite, future emerging options and their combination may pave the way to eradicate this primarily cosmetic esthetic concern. Keywords: Cellulite, pathophysiology, adipocytes, radiofrequency, lasers
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The antioxidant potentials of a total ethanolic extract of Hypericum perforatum (TE) and fractions were evaluated and correlated with their phenolic contents. The extracts were fully characterised by HPLC–DAD–MS–MS. Kaempferol 3-rutinoside and rutin-acetyl were identified for the first time in TE extracts. The free radical-scavenging properties of TE (EC50=21 μg dwb/ml) and fractions were studied using DPPH. Fractions containing flavonoids and/or caffeoylquinic acids were found to be the main contributors to the free radical-scavenging activity of the TE. Lipid peroxidation, induced with ascorbate/Fe2+, was significantly reduced in the presence of the TE (EC50=26 μg dwb/ml) and fractions containing flavonoids and/or caffeoylquinic acids. The fraction containing flavonoid aglycones was found to be responsible for a major part of the TE protection against lipid peroxidation. Hypericins and hyperforins made no significant contributions to the antioxidant properties of TE. Human consumption of H. perforatum extract or fractions could be beneficial.