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This trial evaluated the potential impacts of saffron aqueous extract (SAE) and its main carotenoid on some of the atherosclerosis-related gene expression and serum levels of oxidized low-density cholesterol (ox-LDL) and Monocyte chemoattractant protein 1 (MCP-1) in patients with coronary artery disease (CAD). Participants of this randomized controlled trial included 84 CAD patients who categorized into three groups: Group 1 received crocin (30 mg/day), Group 2 SAE (30 mg/day), and Group 3 placebo for 8 weeks. Gene expression of Sirtuin 1 (SIRT1), 5'-adenosine monophosphate-activated protein kinase (AMPK), Lectin-like oxidized LDL receptor 1 (LOX1), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and MCP-1 in peripheral blood mononuclear cells assessed by real-time PCR. Furthermore, serum ox-LDL and MCP-1 levels measured at the beginning and end of the intervention. Compared with the placebo group, gene expression of SIRT1 and AMPK increased significantly in the crocin group (p = .001), and the expression of LOX1 and NF-κB decreased significantly (p = .016 and .004, respectively). Serum ox-LDL levels decreased significantly in the crocin group after the intervention (p = .002) while MCP-1 levels decreased both in crocin and SAE groups (p = .001). Crocin may have beneficial effects on CAD patients by increasing the gene expression of SIRT1 and AMPK and decreasing the expression of LOX1 and NF-κB.

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BACKGROUND AND PURPOSE: Molecular mechanisms of atherogenesis are considered to be emerging therapeutic targets for atherosclerosis prevention. Cell and animal studies have shown that crocetin can decelerate atherogenesis. However, the anti-atherogenic properties of crocetin in humans are still ambiguous. METHODS AND RESULTS: Fifty clinically diagnosed CAD patients were randomly divided into two parallel groups, crocetin and placebo, who received one capsule of crocetin (10 mg) and placebo per day, respectively, for two months. Serum circulating homocysteine (Hcy) [-1.09 (-1.64 to -0.54) µM, P = 0.001], heart-type fatty acid binding protein (h-FABP) [-2.07 (-2.72 to -1.43) ng mL-1, P = 0.001], intercellular adhesion molecule 1 [-14.92 (-21.92 to -7.92) ng mL-1, P = 0.001], vascular cell adhesion molecule 1 [-18.61 (-29.73 to -7.49) ng mL-1, P = 0.002], and monocyte chemoattractant protein 1 [-4.67 (-6.50 to -2.83) pg mL-1, P = 0.001] decreased significantly after the trial in the crocetin group, while high-density lipoprotein (HDL) significantly increased [+4.21 (0.68 to 7.73) mg mL-1, P = 0.021]. Also, systolic [-0.21 (-0.32 to -0.10) mmHg, P = 0.001] and diastolic [-0.20 (-0.34 to -0.07) mmHg, P = 0.004] blood pressures decreased significantly in the crocetin group. Nevertheless, clinically significant percentage changes were only observed in Hcy (-15.25 ± 3.15, µM), HDL (-10.70 ± 5.06, mg dL-1), and h-FABP (-21.10 ± 3.09, ng mL-1) in the crocetin group. Furthermore, the relative increase in the gene expressions of sirtuin1 and AMP-activated protein kinase and a decrease in the lectin-type oxidized LDL receptor 1 and nuclear factor-kappa B expression in isolated peripheral blood mononuclear cells in the crocetin group were significant at the end of the trial in comparison with the placebo. CONCLUSION: As the first human study, we showed the ability of crocetin to alter the expression of atherogenic genes and endothelial cell adhesion molecules in CAD patients. It appears that crocetin could be considered as a promising anti-atherogenic candidate for future studies.

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This study evaluated the potential impacts of supplementation with betalain-rich extracts of foods on some atherosclerotic risk factors in coronary artery disease patients. During an acute phase, 48 male patients received about 50 mg betalain/betacyanin, and their blood and urine samples were collected at 3, 8, and 24 hours after supplementations. Also, in a pilot randomized crossover trial, these participants were allocated to two-week interventions (a betacyanin-rich supplement of Opuntia stricta, a betalain-rich supplement of red beetroot and a placebo) with two-week washout periods. Then, their plasma samples were collected at the baseline after a two-week period. The concentrations of betanin in plasma and urine samples were determined using HPLC. Also, homocysteine and glucose levels, lipid profile, and blood pressure were analyzed. Additionally, quality of life and dietary intake were assessed. After these interventions, minimal amounts of betanin were found in plasma and about 0.13-0.93% in urine. Also, both supplements significantly decreased the concentration of homocysteine, glucose, total cholesterol, triglyceride, and LDL. Also, betalain-rich supplements lowered both systolic and diastolic blood pressures. Nevertheless, the clinically meaningful changes were only found in the case of Hcy, LDL, and non-HDL-c concentrations. It seems that food sources of betalains can be considered as functional foods because they improve the lipid profile and levels of homocysteine, glucose, blood pressure, and quality of life to some extent.

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Betalains are unique nitrogen-containing pigments found exclusively in families of the Caryophyllales order and some higher order fungi, where they replace anthocyanin pigments. Betalains, consisting of betacyanins and betaxanthins are generally used as color additives in food. This review discusses on the favorable effects of acute and chronic consumption of betalains, whose edible sources consist primarily of red beetroots (Beta vulgaris) and prickly pears (fruit of the Opuntia genus of cacti). Moreover, it encompasses in vivo and in vitro studies about the bioavailability and bioaccessibility of betanin and indicaxanthin. It seems that treatment with betalains and betalain-rich diets is not only nontoxic but could also prove to be a promising alternative to supplement therapies in oxidative stress-, inflammation-, and dyslipidemia-related diseases such as stenosis of the arteries, atherosclerosis, hypertension, and cancer, among others. Due to its toxicological safety, accessibility, low price, biodegradability, and potentially advantageous biological effects on health, the incorporation of betalains in food manufacturing and related industries could pave the way to overcome current concerns over the health risks of artificial colors. Nevertheless, further studies using pure betalains are required to gain a deeper understanding of their precise biological functions.

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Introduction: Central obesity is an independent risk factor for coronary artery disease (CAD). It can increase cardio-metabolic risks through hypertension, hyperlipidemia and insulin resistance. Saffron and its bioactive compounds (crocin and crocetin) can modify some of metabolic disorders through multiple mechanisms. The aim of this study was to assess the efficacy of saffron and crocin on lipid profile, appetite, dietary intakes, anthropometric indices and body composition in patients with CAD. Methods: This 8 weeks randomized, double-blind, and placebo-controlled trial was conducted on 84 patients with CAD between the ages of 40 and 65 years old. Participants were randomly divided into groups to receive a daily supplement of 30 mg saffron aqueous extract (SAE) or 30 mg crocin or placebo. Appetite, dietary intake, anthropometry, body composition, biochemical analysis were assessed before and after the study. Results: In SAE and crocin group, anthropometric and some body composition variables revealed a pattern of improvement after intervention. Decrease in body mass index (BMI), waist circumference and fat mass values in SAE group was significantly more than crocin group (P < 0.001). There was no significant difference at the end of study in lipid profile parameters. Both SAE and crocin yielded significant decrease in energy and dietary intake mean values (P < 0.001 and P = 0.046), while it remained unchanged in the placebo group, also the appetite decreased significantly in SAE and crocin group (P < 0.001 and P = 0.029, respectively). Conclusion: The results of present study regarding anti-obesity feature of SAE and crocin in patients with CAD was promising. However the SAE was better in appetite suppressing, dietary intake and central obesity reduction.