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Fruit and Vegetable Consumption and Its Relation to Markers of Inflammation and Oxidative Stress in Adolescents
Open accessAbstract
Background Fruits and vegetables, foods rich in flavonoids and antioxidants, have been associated with lower risk of stroke, coronary heart disease, and markers of inflammation and oxidative stress in adults. Markers of inflammation and oxidative stress are predictors of coronary heart disease risk; however, it is unknown whether these markers are related to dietary flavonoid and antioxidant intake in youth.Objective To determine whether greater intakes of fruit and vegetables, antioxidants, folate, and total flavonoids were inversely associated with markers of inflammation and oxidative stress in 285 adolescent boys and girls aged 13 to 17 years.Design In this cross-sectional study conducted between February 1996 and January 2000, diet was assessed by a 127-item food frequency questionnaire. Height and weight measurements were obtained and a fasting blood sample drawn. Spearman partial correlation analyses evaluated the relation of intakes of fruit and vegetables, antioxidants, folate, and flavonoids with markers of inflammation (C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and 15-keto-dihydro-PGF(2alpha) metabolite and oxidative stress (urinary 8-iso prostaglandin F(2alpha), an F(2)-isoprostane), adjusting for age, sex, race, Tanner stage, energy intake, and body mass index.Results Urinary F(2)-isoprostane was inversely correlated with intakes of total fruit and vegetables, vitamin C, beta carotene, and flavonoids. Serum C-reactive protein was significantly inversely associated with intakes of fruit (r=-0.19; P=0.004), vitamin C (r=-0.13, P=0.03), and folate (r=-0.18; P=0.004). Serum interleukin-6 was inversely associated with intakes of legumes, vegetables, beta carotene, and vitamin C. Serum tumor necrosis factor-alpha was inversely associated with beta carotene (r=-0.14, P=0.02) and luteolin (r=-0.15, P=0.02).Conclusion Study results show that the beneficial effects of fruit and vegetable intake on markers of inflammation and oxidative stress are already present by early adolescence and provide support for the Dietary Guidelines for Americans "to consume five or more servings per day" of fruits and vegetables to promote beneficial cardiovascular health.
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“Consumption of fruits and vegetables has been correlated with decreased risks of cardiovascular disease (CVD).”
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“This makes them disfavored regarding contemporary and future health, as it is shown that reduced intake of fruit and vegetables is of significance for cardiovascular health (Holt et al., 2009) and developing obesity (Roseman, Yeung, & Nickelsen, 2007); that physical activity is positively correlated with adolescent ps…”
BackgroundShin, S. H., Song, J.-L., Park, M.-G., Park, M., Hwang, S., & Park, K.-Y. (2015) · Nutrition Research and Practice · doi:10.4162/nrp.2015.9.6.619 · Cited by 10
“High intake of whole grains, vegetables, and fruits, which contain high levels of antioxidants, dietary fiber, and functional phytochemicals, might have a chemopreventive effect on colorectal diseases [34-37].”
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Sánchez, S. S., Quevedo, R. G., Fernandes, T. M., & da Fonseca, G. W. P. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1618360 · Cited by 12
“…appear to promote a chronic pro-in fl ammatory state (97), whilst diets with a higher content of whole, natural foods may reduce low-grade in fl ammation in obesity, placing particular emphasis on omega-3 polyunsaturated fatty acids, vitamins from vegetables and fruits (98), and dietary fi ber (99).”
Flor‐Alemany, M., Acosta‐Manzano, P., Migueles, J. H., Baena‐García, L., Aranda, P., & Aparicio, V. A. (2022) · Maternal and Child Nutrition · doi:10.1111/mcn.13454 · Cited by 11
“Moreover, it was proven that green vegetables and fruits rich in folate, flavonoids, and antioxidants can significantly reduce the concentrations of inflammatory serum markers, such as TNF‐α (Holt et al., 2009).”
BackgroundInfluentialCrimarco, A. E., Turner‐McGrievy, G. M., Wirth, M. D., Shivappa, N., Dunn, C. G., Vyas, S., Mandes, T., Hurley, T. G., West, D. S., & Hébert, J. R. (2018) · Nutrition and Health · doi:10.1177/0260106018800645 · Cited by 9
Moradi, S., Moloudi, J., Moradinazar, M., Sarokhani, D., Nachvak, S. M., & Samadi, M. (2020) · Preventive Nutrition and Food Science · doi:10.3746/pnf.2020.25.4.325 · Cited by 9
“, vegetables, fruits, plants proteins, and polyunsaturated-to-saturated fat ratio) have protective roles against AD (Devore et al., 2009; Holt et al., 2009; Farooqui, 2012; Berti et al., 2015; Calil et al., 2018).”
BackgroundInfluentialLam, R., Kwon, S., Riggs, J., Sunseri, M. W., Crowley, G., Schwartz, T. M., Zeig‐Owens, R., Colbeth, H., Halpren, A., Liu, M., et al. (2021) · Respiratory Research · doi:10.1186/s12931-020-01596-6 · Cited by 11
Can dietary intake protect against low-grade inflammation in children and adolescents?
Bujtor, M. (2021) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2021.100369 · Cited by 10
“…et al., 2014) and six observational (Arouca et al., 2018; Gonz alez-Gil et al., 2016; Qureshi et al., 2009; Han et al., 2015; Cabral et al., 2018; Hur and Reicks, 2012) studies, five of which were previously discussed (Arouca et al., 2018; Gonz alez-Gil et al., 2016; Qureshi et al., 2009; Han et…”
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“In the above-mentioned study, based on DII, they have assessed the contributions of dietary exposures on the inflammatory status and consequently the development of IR [33].”
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Carotenoid Supplements and Consumption
Linnewiel‐Hermoni, K., Paran, E., & Wolak, T. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-801816-3.00034-0 · Cited by 9
Chiappara, G., Vincenzo, S. D., Cascio, C., & Pace, E. (2024) · Carcinogenesis · doi:10.1093/carcin/bgae049 · Cited by 8
“Adequate fruit and vegetable consumption is associated with lower markers of oxidative stress and inflammation, and higher levels of anti-oxidant markers [83].”
Initial Evaluation of a Student-Run Fruit and Vegetable Business in Urban High Schools
Sikic, N. I., Erbstein, N., Welch, K., Grundberg, E., & Miller, E. P. (2012) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2012.0166 · Cited by 9
Lara-Guzmán, O. J., Rivera, D. A., Corrales-Agudelo, V., Salazar-Jaramillo, L., Gil‐Izquierdo, Á., Medina, S., Oger, C., Durand, T., Galano, J., Escobar, J. S., et al. (2022) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2022.07.023 · Cited by 9
“An inverse association between urinary F 2 -IsoPs and intakes of total fruit, vegetables, vitamin C, and β -carotene in adolescents aged 13 – 17 has been reported [94].”
Increased whole grain, fruits and vegetable intake reduced oxidative stress in high school students
Kim, S. H., Cho, S. W., Hwang, S. S., Ahn, M., Lee, D., Kang, S. W., & Park, Y. K. (2012) · Journal of Nutrition and Health · doi:10.4163/kjn.2012.45.5.452 · Cited by 8
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“correlated with intakes of total fruits and vegetables, vitamin C, β-carotene and flavonoids((47)).”
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Role of Nutrition and Diet during COVID-19 pandemic: A narrative review
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“EPA and DHA help to suppress pro‐inflammatory prostaglandin production as well.[82] • Carbohydrates: Highly processed carbohydrates or carbohydrates with a high glycaemic index (GI) are not good for health as they generate free radicals.”
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“Journal of Young Pharmacists, 6(1), 42-45.”
The Effect of Acai (Euterpe spp.) Fruit Pulp on Brain Health and Performance
Schauss, A. G. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-411462-3.00019-9 · Cited by 8
Dietary behaviors in newly diagnosed youth with inflammatory bowel disease
Hagin, S., Lobato, D. J., Sands, B. E., Korzenik, J. R., Merrick, M., Shah, S. A., Bancroft, B., Bright, R., Law, M. M., Moniz, H., et al. (2016) · Children s Health Care · doi:10.1080/02739615.2016.1227935 · Cited by 8
“Previous research in non-IBD populations has demonstrated the positive impact of dietary behaviors on inflammation (Holt et al., 2009; Qureshi, Singer, & Moore, 2009).”
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Mahmoodi, M., Shateri, Z., Nouri, M., Vali, M., Nasimi, N., Sohrabi, Z., Dabbaghmanesh, M. H., & Makhtoomi, M. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04790-z · Cited by 7
“The beneficial effects of fruits in reducing oxidative stress have been demonstrated in previous studies [47].”
ResultFadhul, T., Park, S., Ali, H., Alsiraj, Y., Wali, J. A., Simpson, S. J., & Softic, S. (2024) · Nutrients · doi:10.3390/nu17010124 · Cited by 7
“…together with fiber, vitamins, and antioxidants, which could lead to potential benefits by encouraging a feeling of fullness [15,16], slowing down its absorption to enhance protective intestinal fructose metabolism [17–19], and neutralizing its metabolic sequela by scavenging oxidative stress [20].”
Khan, N., Monagas, M., Urpí-Sardà, M., Llorach, R., & Andrés‐Lacueva, C. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-397156-2.00256-8 · Cited by 7
Bangladeshi Student's Standpoint on Junk Food Consumption and Social Behaviour
Nipun, T. S., Debnath, D., Miah, M. S.-U. H., Kabir, A., & Hossain, M. K. (2017) · IOSR Journal of Pharmacy and Biological Sciences · doi:10.9790/3008-1201016875 · Cited by 7
“This is an important issue since the establishment of healthy eating patterns in childhood is linked to a reduction in chronic diseases, such as obesity, coronary heart disease, hypertension, type 2 diabetes, osteoporosis, and diet-related cancers later in life [32-37].”
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Are young adults following the Dietary Guidelines for Americans?
McDaniel, J. C., & Belury, M. A. (2012) · The Nurse Practitioner · doi:10.1097/01.npr.0000413484.90121.d8 · Cited by 7
“They are low in fat and sodium and contain signifi cant amounts of minerals, antioxidants, and other compounds linked to health.(27) Several epidemiologic investigations have reported a signifi cant inverse relationship between fruit and vegetable intake and hypertension, weight loss, and the risk of developing type 2…”
BackgroundKim, Y., Kwon, Y.-S., Park, Y. H., Choe, J., & Lee, J.-Y. (2015) · Nutrition Research and Practice · doi:10.4162/nrp.2015.9.4.411 · Cited by 7
“Among previous studies that have examined the importance of adequate intake of vegetables and fruits, a report from Europe demonstrated a close correlation between cancer prevention and vegetable or fruit intake as well as a negative correlation between sufficient vegetable and fruit intake, inflammatory index, and ox…”
BackgroundConsumo de frutas y verduras por escolares adolescentes de la ciudad de Chillán. Chile
Jacqueline Araneda, F., Marcia Ruiz, N., Vallejos, T., & Moresco, P. O. (2015) · Revista chilena de nutrición · doi:10.4067/s0717-75182015000300004 · Cited by 7
Burnett, B. P., & Levy, R. M. (2012) · Functional Foods in Health and Disease · doi:10.31989/ffhd.v2i11.74 · Cited by 7
“In humans, flavonoid intake has also been shown to be inversely related to CRP levels suggestive of systemic inflammation in males and females of all ages [36-39].”
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Psychoneurological Links Contributing to Body Mass Index and Eating Disorder Severity
Ortiz, G. G. R., Elizalde, B., Tapia, C. J. R., & Granero, R. (2025) · Nutrients · doi:10.3390/nu17020296 · Cited by 6
“Concretely, stress has been associated with an increased likelihood of being overweight/obese [40–42], arguing that exposure to life events may release appetite hormones that increase the desire for foods rich in fats and sugars [40] with weak efforts for healthy activity levels [43].”
Metadata
- Authors
- Holt, E. M., Steffen, L. M., Moran, A., Basu, S., Steinberger, J., Ross, J. A., Hong, C.-P., & Sinaiko, A. R.
- Affiliations
- University of Minnesota (US)
- Uppsala University (SE)
- Corresponding author
- Steffen, Lyn M.
- Venue
- Journal of the American Dietetic Association
- Publisher
- Elsevier BV
- Published
- 2009-03
- Volume
- 109
- Issue
- 3
- Pages
- 414-421
- ISSN
- 0002-8223 (ISSN-L)
- PMC
- PMC2676354
- OpenAlex
- W2051281636
- Cited by
- 496
- References
- 80
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 45 · 2023: 25 · 2022: 35 · 2021: 35 · 2020: 30 · 2019: 24 · 2018: 29 · 2017: 33 · 2016: 28 · 2015: 33 · 2014: 34 · 2013: 35 · 2012: 30
- FWCI
- 26.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Dietetic Association (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL052851, HL-52851)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
- Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
- Keywords
- fruit and vegetable intake, dietary flavonoids, antioxidants, folic acid, inflammatory markers, oxidative stress, C-reactive protein, interleukin-6, TNF-α, vitamin C, beta-carotene, adolescents, cardiovascular disease prevention, dietary guidelines, Fabaceae, luteolin, dietary habits, body mass index, sex differences
- MeSH terms
- Adolescent, Antioxidants, C-Reactive Protein, Cardiovascular Diseases, Cross-Sectional Studies, Diet, Diet Surveys, Female, Flavonoids, Folic Acid, Fruit, Humans, Inflammation, Male, Surveys and Questionnaires, Tumor Necrosis Factor-alpha, Vegetables, Dinoprost, Biomarkers, Interleukin-6, Body Mass Index, Oxidative Stress, Statistics, Nonparametric, F2-Isoprostanes
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