Dietary Supplementation Improves Markers of Inflammation, Oxidative Stress, and Endothelial Function in a Healthy Adults
Main Article Content
Abstract
Objectives: This study is to investigate the effects of 3 functional food supplements on basic metabolic parameters on 61 healthy adult individuals. The 24-week study was completed with 43 men and 18 adult women. The average age of the participants was 30 ± 9 years.
Methods: In this study, anti-atherosclerotic liquid (AAL)-Morinda citrifolia (3 mL once per day orally) anti-inflammatory capsules (AIC)-Omega-3 (3 capsules once per day orally) extract with antioxidant liquid (AOL)- Blueberry and 21 different red purple fruit vegetables (30 mL once per day orally) have been used. We compared 24 weeks before and after.
Results: The study shows the longitudinal changes of selected parameters in the 61 healthy people that completed the study. Following anti-atherosclerotic liquid (AAL), anti-inflammatory capsules (AIC) and antioxidant liquid (AOL) therapies, asymmetric dimethylarginine (ADMA), malondialdehyde (MDA), pentraxin-3 (PTX3), homeostatic model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), systolic blood pressure (SBP), diastolic blood pressure (DBP), glycated hemoglobin (HbA1c), body mass index (BMI), fasting plasma glucose (FPG), total cholesterol, and low-density lipoprotein cholesterol (LDL) levels were significantly decreased, while flow-mediated dilation (FMD), glutathione peroxidase (GSH-Px), high-density lipoprotein cholesterol (HDL), 25-hydroxyvitamin D (25OHVD), and folic acid levels were significantly increased.
Conclusions: Our results indicated that selected functional food supplements showed strong beneficial effect on selected metabolic parameters.
Keywords:
Morinda citrifolia, omega-3, blueberries, inflammation, oxidative stress, healthy people
Article Details
How to Cite
YILMAZ, Mahmut Ilker et al.
Dietary Supplementation Improves Markers of Inflammation, Oxidative Stress, and Endothelial Function in a Healthy Adults.
Medical Research Archives, [S.l.], v. 13, n. 8, aug. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6826>. Date accessed: 06 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i8.6826.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Yilmaz MI, Romano M, Basarali MK, et al. The Effect of Corrected Inflammation, Oxidative Stress and Endothelial Dysfunction on Fmd Levels in Patients with Selected Chronic Diseases: A Quasi-Experimental Study. Sci Rep. Jun 2 2020;10(1): 9018. doi:10.1038/s41598-020-65528-6
2. Godo S, Shimokawa H. Endothelial Functions. Arterioscler Thromb Vasc Biol. Sep 2017;37(9):e10 8-e114. doi:10.1161/atvbaha.117.309813
3. Senoner T, Dichtl W. Oxidative Stress in Cardiovascular Diseases: Still a Therapeutic Target? Nutrients. Sep 4 2019;11(9)doi:10.3390/nu11092090
4. Felgus-Lavefve L, Howard L, Adams SH, Baum JI. The Effects of Blueberry Phytochemicals on Cell Models of Inflammation and Oxidative Stress. Adv Nutr. Aug 1 2022;13(4):1279-1309. doi:10.1093/ advances/nmab137
5. Yilmaz M, Ozturk M, Demir Z, et al. A Different Approach to Malnutrition-Related Appetite and Weight Loss in Cancer Patients: Is Saturation Enough at The Cell Level? Medical Research Archives. 04/01 2025;13doi:10.18103/mra.v13i3.6419
6. Arulselvan P, Fard MT, Tan WS, et al. Role of Antioxidants and Natural Products in Inflammation. Oxid Med Cell Longev. 2016;2016:5276130. doi:10.1155/2016/5276130
7. Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction: testing and clinical relevance. Circulation. Mar 13 2007;115(10):1285-95. doi:10.1161/circulationaha.106.652859
8. Romano M, Garcia-Bournissen F, Piskin D, et al. Anti-Inflammatory, Antioxidant, and Anti-Atherosclerotic Effects of Natural Supplements on Patients with FMF-Related AA Amyloidosis: A Non-Randomized 24-Week Open-Label Interventional Study. Life (Basel). Jun 15 2022;12(6)doi:10.3390/ life12060896
9. Chaudron Z, Nicolas-Francès V, Pichereaux C, et al. Nitric oxide production and protein S-nitrosation in algae. Plant Sci. Jun 2025;355: 112472. doi:10.1016/j.plantsci.2025.112472
10. Lin YL, Chang YY, Yang DJ, Tzang BS, Chen YC. Beneficial effects of noni (Morinda citrifolia L.) juice on livers of high-fat dietary hamsters. Food Chem. Sep 1 2013;140(1-2):31-8. doi:10.1016/j.foo dchem.2013.02.035
11. West BJ, Deng S, Isami F, Uwaya A, Jensen CJ. The Potential Health Benefits of Noni Juice: A Review of Human Intervention Studies. Foods. Apr 11 2018;7(4)doi:10.3390/foods7040058
12. Sies H. Oxidative stress: a concept in redox biology and medicine. Redox Biol. 2015;4:180-3. doi:10.1016/j.redox.2015.01.002
13. Shahidi F, Ambigaipalan P. Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits. Annu Rev Food Sci Technol. Mar 25 2018; 9:345-381. doi:10.1146/annurev-food-111317-095850
14. Ishihara T, Yoshida M, Arita M. Omega-3 fatty acid-derived mediators that control inflammation and tissue homeostasis. Int Immunol. Aug 23 2019;31(9):559-567. doi:10.1093/intimm/dxz001
15. 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. Jun 1972;18(6):499-502.
16. 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. Jul 1985; 28(7):412-9. doi:10.1007/bf00280883
17. Chen BM, Xia LW, Zhao RQ. Determination of N(G),N(G)-dimethylarginine in human plasma by high-performance liquid chromatography. J Chromatogr B Biomed Sci Appl. May 9 1997;692 (2):467-71. doi:10.1016/s0378-4347(96)00531-2
18. Yilmaz MI, Stenvinkel P, Sonmez A, et al. Vascular health, systemic inflammation and progressive reduction in kidney function; clinical determinants and impact on cardiovascular outcomes. Nephrol Dial Transplant. Nov 2011;26 (11):3537-43. doi:10.1093/ndt/gfr081
19. Aydin A, Orhan H, Sayal A, Ozata M, Sahin G, Işimer A. Oxidative stress and nitric oxide related parameters in type II diabetes mellitus: effects of glycemic control. Clin Biochem. Feb 2001;34(1):65-70. doi:10.1016/s0009-9120(00)00199-5
20. Jain SK. Hyperglycemia can cause membrane lipid peroxidation and osmotic fragility in human red blood cells. J Biol Chem. Dec 15 1989;264 (35):21340-5.
21. Sun Y, Sun M, Liu B, et al. Inverse Association Between Serum Vitamin B12 Concentration and Obesity Among Adults in the United States. Front Endocrinol (Lausanne). 2019;10:414. doi:10.3389/ fendo.2019.00414
22. Yilmaz MI, Sonmez A, Saglam M, et al. FGF-23 and vascular dysfunction in patients with stage 3 and 4 chronic kidney disease. Kidney Int. Oct 2010;78(7):679-85. doi:10.1038/ki.2010.194
23. Kanbay M, Yilmaz MI, Apetrii M, et al. Relationship between Serum Magnesium Levels and Cardiovascular Events in Chronic Kidney Disease Patients. American Journal of Nephrology. 2012;36(3):228-237. doi:10.1159/000341868
24. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet. Nov 7 1992;340(8828):1111-5. doi:10.1016 /0140-6736(92)93147-f
25. Yilmaz MI, Carrero JJ, Martín-Ventura JL, et al. Combined therapy with renin-angiotensin system and calcium channel blockers in type 2 diabetic hypertensive patients with proteinuria: effects on soluble TWEAK, PTX3, and flow-mediated dilation. Clin J Am Soc Nephrol. Jul 2010;5(7):1174-81. doi:10.2215/cjn.01110210
26. Böger RH. Asymmetric dimethylarginine (ADMA) and cardiovascular disease: insights from prospective clinical trials. Vasc Med. Jul 2005;10 Suppl 1:S19-25. doi:10.1177/1358836x0501000104
27. Lundberg JO, Gladwin MT, Ahluwalia A, et al. Nitrate and nitrite in biology, nutrition and therapeutics. Nat Chem Biol. Dec 2009;5(12):865-9. doi:10.1038/nchembio.260
28. Yilmazer N, Coskun C, Gurel-Gurevin E, Yaylim I, Eraltan EH, Ikitimur-Armutak EI. Antioxidant and Anti-inflammatory Activities of a Commercial Noni Juice revealed by Carrageenan-induced Paw Edema. Pol J Vet Sci. Sep 1 2016;19(3):589-595. doi:10.1515/pjvs-2016-0074
29. Woolf EK, Terwoord JD, Litwin NS, et al. Daily blueberry consumption for 12 weeks improves endothelial function in postmenopausal women with above-normal blood pressure through reductions in oxidative stress: a randomized controlled trial. 10.1039/D3FO00157A. Food & Function. 2023;14 (6):2621-2641. doi:10.1039/D3FO00157A
30. Visioli F, Lastra CADL, Andres-Lacueva C, et al. Polyphenols and Human Health: A Prospectus. Critical Reviews in Food Science and Nutrition. 2011/07/01 2011;51(6):524-546. doi:10.1080/1040 8391003698677
31. Manach C, Scalbert A, Morand C, Rémésy C, Jiménez L. Polyphenols: food sources and bioavailability. The American Journal of Clinical Nutrition. 2004/05/01/ 2004;79(5):727-747. doi:https://doi.org/10.1093/ajcn/79.5.727
32. Del Bo C, Martini D, Porrini M, Klimis-Zacas D, Riso P. Berries and oxidative stress markers: an overview of human intervention studies. Food Funct. Sep 2015;6(9):2890-917. doi:10.1039/c5fo00657k
33. Najjar RS, Mu S, Feresin RG. Blueberry Polyphenols Increase Nitric Oxide and Attenuate Angiotensin II-Induced Oxidative Stress and Inflammatory Signaling in Human Aortic Endothelial Cells. Antioxidants (Basel). Mar 232022;11(4)doi:10.3390/antiox11040616
34. Yamagata K. Prevention of Endothelial Dysfunction and Cardiovascular Disease by n-3 Fatty Acids-Inhibiting Action on Oxidative Stress and Inflammation. Curr Pharm Des. 2020;26(30):36 52-3666. doi:10.2174/1381612826666200403121952
35. Calder PC. Omega-3 fatty acids and inflammatory processes. Nutrients. Mar 2010;2(3):355-374. doi: 10.3390/nu2030355
36. Serhan CN. Pro-resolving lipid mediators are leads for resolution physiology. Nature. Jun 5 2014;510(7503):92-101. doi:10.1038/nature13479
37. Ambati RR, Phang SM, Ravi S, Aswathanarayana RG. Astaxanthin: sources, extraction, stability, biological activities and its commercial applications--a review. Mar Drugs. Jan 7 2014;12(1):128-52. doi:10.3390/md12010128
38. Aggarwal BB, Sundaram C, Prasad S, Kannappan R. Tocotrienols, the vitamin E of the 21st century: its potential against cancer and other chronic diseases. Biochem Pharmacol. Dec 1 2010; 80(11):1613-31. doi:10.1016/j.bcp.2010.07.043
39. Ibrahim Mohialdeen Gubari M. Effect of omega-3 fatty acid supplementation on markers of inflammation and endothelial function in patients with chronic heart disease: A systematic review and meta-analysis. Cell Mol Biol (Noisy-le-grand). Jun 5 2024;70(6):171-177. doi:10.14715/cmb/2024.70.6.26
40. Basu A, Rhone M, Lyons TJ. Berries: emerging impact on cardiovascular health. Nutr Rev. Mar 20 10;68(3):168-77. doi:10.1111/j.1753-4887.2010.00273.x
41. Visioli F, Davalos A. Polyphenols and cardiovascular disease: a critical summary of the evidence. Mini Rev Med Chem. Dec 2011;11(14): 1186-90. doi:10.2174/13895575111091186
42. Petersen KF, Shulman GI. Etiology of insulin resistance. Am J Med. May 2006;119(5 Suppl 1):S1 0-6. doi:10.1016/j.amjmed.2006.01.009
2. Godo S, Shimokawa H. Endothelial Functions. Arterioscler Thromb Vasc Biol. Sep 2017;37(9):e10 8-e114. doi:10.1161/atvbaha.117.309813
3. Senoner T, Dichtl W. Oxidative Stress in Cardiovascular Diseases: Still a Therapeutic Target? Nutrients. Sep 4 2019;11(9)doi:10.3390/nu11092090
4. Felgus-Lavefve L, Howard L, Adams SH, Baum JI. The Effects of Blueberry Phytochemicals on Cell Models of Inflammation and Oxidative Stress. Adv Nutr. Aug 1 2022;13(4):1279-1309. doi:10.1093/ advances/nmab137
5. Yilmaz M, Ozturk M, Demir Z, et al. A Different Approach to Malnutrition-Related Appetite and Weight Loss in Cancer Patients: Is Saturation Enough at The Cell Level? Medical Research Archives. 04/01 2025;13doi:10.18103/mra.v13i3.6419
6. Arulselvan P, Fard MT, Tan WS, et al. Role of Antioxidants and Natural Products in Inflammation. Oxid Med Cell Longev. 2016;2016:5276130. doi:10.1155/2016/5276130
7. Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction: testing and clinical relevance. Circulation. Mar 13 2007;115(10):1285-95. doi:10.1161/circulationaha.106.652859
8. Romano M, Garcia-Bournissen F, Piskin D, et al. Anti-Inflammatory, Antioxidant, and Anti-Atherosclerotic Effects of Natural Supplements on Patients with FMF-Related AA Amyloidosis: A Non-Randomized 24-Week Open-Label Interventional Study. Life (Basel). Jun 15 2022;12(6)doi:10.3390/ life12060896
9. Chaudron Z, Nicolas-Francès V, Pichereaux C, et al. Nitric oxide production and protein S-nitrosation in algae. Plant Sci. Jun 2025;355: 112472. doi:10.1016/j.plantsci.2025.112472
10. Lin YL, Chang YY, Yang DJ, Tzang BS, Chen YC. Beneficial effects of noni (Morinda citrifolia L.) juice on livers of high-fat dietary hamsters. Food Chem. Sep 1 2013;140(1-2):31-8. doi:10.1016/j.foo dchem.2013.02.035
11. West BJ, Deng S, Isami F, Uwaya A, Jensen CJ. The Potential Health Benefits of Noni Juice: A Review of Human Intervention Studies. Foods. Apr 11 2018;7(4)doi:10.3390/foods7040058
12. Sies H. Oxidative stress: a concept in redox biology and medicine. Redox Biol. 2015;4:180-3. doi:10.1016/j.redox.2015.01.002
13. Shahidi F, Ambigaipalan P. Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits. Annu Rev Food Sci Technol. Mar 25 2018; 9:345-381. doi:10.1146/annurev-food-111317-095850
14. Ishihara T, Yoshida M, Arita M. Omega-3 fatty acid-derived mediators that control inflammation and tissue homeostasis. Int Immunol. Aug 23 2019;31(9):559-567. doi:10.1093/intimm/dxz001
15. 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. Jun 1972;18(6):499-502.
16. 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. Jul 1985; 28(7):412-9. doi:10.1007/bf00280883
17. Chen BM, Xia LW, Zhao RQ. Determination of N(G),N(G)-dimethylarginine in human plasma by high-performance liquid chromatography. J Chromatogr B Biomed Sci Appl. May 9 1997;692 (2):467-71. doi:10.1016/s0378-4347(96)00531-2
18. Yilmaz MI, Stenvinkel P, Sonmez A, et al. Vascular health, systemic inflammation and progressive reduction in kidney function; clinical determinants and impact on cardiovascular outcomes. Nephrol Dial Transplant. Nov 2011;26 (11):3537-43. doi:10.1093/ndt/gfr081
19. Aydin A, Orhan H, Sayal A, Ozata M, Sahin G, Işimer A. Oxidative stress and nitric oxide related parameters in type II diabetes mellitus: effects of glycemic control. Clin Biochem. Feb 2001;34(1):65-70. doi:10.1016/s0009-9120(00)00199-5
20. Jain SK. Hyperglycemia can cause membrane lipid peroxidation and osmotic fragility in human red blood cells. J Biol Chem. Dec 15 1989;264 (35):21340-5.
21. Sun Y, Sun M, Liu B, et al. Inverse Association Between Serum Vitamin B12 Concentration and Obesity Among Adults in the United States. Front Endocrinol (Lausanne). 2019;10:414. doi:10.3389/ fendo.2019.00414
22. Yilmaz MI, Sonmez A, Saglam M, et al. FGF-23 and vascular dysfunction in patients with stage 3 and 4 chronic kidney disease. Kidney Int. Oct 2010;78(7):679-85. doi:10.1038/ki.2010.194
23. Kanbay M, Yilmaz MI, Apetrii M, et al. Relationship between Serum Magnesium Levels and Cardiovascular Events in Chronic Kidney Disease Patients. American Journal of Nephrology. 2012;36(3):228-237. doi:10.1159/000341868
24. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet. Nov 7 1992;340(8828):1111-5. doi:10.1016 /0140-6736(92)93147-f
25. Yilmaz MI, Carrero JJ, Martín-Ventura JL, et al. Combined therapy with renin-angiotensin system and calcium channel blockers in type 2 diabetic hypertensive patients with proteinuria: effects on soluble TWEAK, PTX3, and flow-mediated dilation. Clin J Am Soc Nephrol. Jul 2010;5(7):1174-81. doi:10.2215/cjn.01110210
26. Böger RH. Asymmetric dimethylarginine (ADMA) and cardiovascular disease: insights from prospective clinical trials. Vasc Med. Jul 2005;10 Suppl 1:S19-25. doi:10.1177/1358836x0501000104
27. Lundberg JO, Gladwin MT, Ahluwalia A, et al. Nitrate and nitrite in biology, nutrition and therapeutics. Nat Chem Biol. Dec 2009;5(12):865-9. doi:10.1038/nchembio.260
28. Yilmazer N, Coskun C, Gurel-Gurevin E, Yaylim I, Eraltan EH, Ikitimur-Armutak EI. Antioxidant and Anti-inflammatory Activities of a Commercial Noni Juice revealed by Carrageenan-induced Paw Edema. Pol J Vet Sci. Sep 1 2016;19(3):589-595. doi:10.1515/pjvs-2016-0074
29. Woolf EK, Terwoord JD, Litwin NS, et al. Daily blueberry consumption for 12 weeks improves endothelial function in postmenopausal women with above-normal blood pressure through reductions in oxidative stress: a randomized controlled trial. 10.1039/D3FO00157A. Food & Function. 2023;14 (6):2621-2641. doi:10.1039/D3FO00157A
30. Visioli F, Lastra CADL, Andres-Lacueva C, et al. Polyphenols and Human Health: A Prospectus. Critical Reviews in Food Science and Nutrition. 2011/07/01 2011;51(6):524-546. doi:10.1080/1040 8391003698677
31. Manach C, Scalbert A, Morand C, Rémésy C, Jiménez L. Polyphenols: food sources and bioavailability. The American Journal of Clinical Nutrition. 2004/05/01/ 2004;79(5):727-747. doi:https://doi.org/10.1093/ajcn/79.5.727
32. Del Bo C, Martini D, Porrini M, Klimis-Zacas D, Riso P. Berries and oxidative stress markers: an overview of human intervention studies. Food Funct. Sep 2015;6(9):2890-917. doi:10.1039/c5fo00657k
33. Najjar RS, Mu S, Feresin RG. Blueberry Polyphenols Increase Nitric Oxide and Attenuate Angiotensin II-Induced Oxidative Stress and Inflammatory Signaling in Human Aortic Endothelial Cells. Antioxidants (Basel). Mar 232022;11(4)doi:10.3390/antiox11040616
34. Yamagata K. Prevention of Endothelial Dysfunction and Cardiovascular Disease by n-3 Fatty Acids-Inhibiting Action on Oxidative Stress and Inflammation. Curr Pharm Des. 2020;26(30):36 52-3666. doi:10.2174/1381612826666200403121952
35. Calder PC. Omega-3 fatty acids and inflammatory processes. Nutrients. Mar 2010;2(3):355-374. doi: 10.3390/nu2030355
36. Serhan CN. Pro-resolving lipid mediators are leads for resolution physiology. Nature. Jun 5 2014;510(7503):92-101. doi:10.1038/nature13479
37. Ambati RR, Phang SM, Ravi S, Aswathanarayana RG. Astaxanthin: sources, extraction, stability, biological activities and its commercial applications--a review. Mar Drugs. Jan 7 2014;12(1):128-52. doi:10.3390/md12010128
38. Aggarwal BB, Sundaram C, Prasad S, Kannappan R. Tocotrienols, the vitamin E of the 21st century: its potential against cancer and other chronic diseases. Biochem Pharmacol. Dec 1 2010; 80(11):1613-31. doi:10.1016/j.bcp.2010.07.043
39. Ibrahim Mohialdeen Gubari M. Effect of omega-3 fatty acid supplementation on markers of inflammation and endothelial function in patients with chronic heart disease: A systematic review and meta-analysis. Cell Mol Biol (Noisy-le-grand). Jun 5 2024;70(6):171-177. doi:10.14715/cmb/2024.70.6.26
40. Basu A, Rhone M, Lyons TJ. Berries: emerging impact on cardiovascular health. Nutr Rev. Mar 20 10;68(3):168-77. doi:10.1111/j.1753-4887.2010.00273.x
41. Visioli F, Davalos A. Polyphenols and cardiovascular disease: a critical summary of the evidence. Mini Rev Med Chem. Dec 2011;11(14): 1186-90. doi:10.2174/13895575111091186
42. Petersen KF, Shulman GI. Etiology of insulin resistance. Am J Med. May 2006;119(5 Suppl 1):S1 0-6. doi:10.1016/j.amjmed.2006.01.009