Skip to main content
    • Aa
    • Aa

Fruit polyphenols and CVD risk: a review of human intervention studies

  • Mary F.-F. Chong (a1), Rory Macdonald (a1) and Julie A. Lovegrove (a1)

Epidemiological evidence suggests that polyphenols may, in part, explain the cardioprotective properties of fruits. This review aims to summarise the evidence for the effects of fruit polyphenols on four risk factors of CVD: platelet function, blood pressure, vascular function and blood lipids. This review includes human dietary intervention studies investigating fruits and their polyphenols. There was some evidence to suggest that fruits containing relatively high concentrations of flavonols, anthocyanins and procyanindins, such as pomegranate, purple grapes and berries, were effective at reducing CVD risk factors, particularly with respect to anti-hypertensive effects, inhibition of platelet aggregation and increasing endothelial-dependent vasodilation than other fruits investigated. Flavanone-rich fruits, such as oranges and grapefruits, were reported to have hypocholesterolaemic effects, with little impact on other risk factors being examined. However, the evidence was limited, inconsistent and often inconclusive. This is in part due to the heterogeneity in the design of studies, the lack of controls, the relatively short intervention periods and low power in several studies. Details of the polyphenol content of the fruits investigated were also omitted in some studies, negating comparison of data. It is recommended that large, well-powered, long-term human dietary intervention studies investigating a wider range of fruits are required to confirm these observations. Investigations into the potential synergistic effects of polyphenols on a combination of CVD risk markers, dose–response relationships and standardisation in methodology would facilitate the comparison of studies and also provide valuable information on the types of fruits which could confer protection against CVD.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Fruit polyphenols and CVD risk: a review of human intervention studies
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Fruit polyphenols and CVD risk: a review of human intervention studies
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Fruit polyphenols and CVD risk: a review of human intervention studies
      Available formats
Corresponding author
*Corresponding author: Professor J. A. Lovegrove, fax +44 0118 931 0080, email
Hide All
3 L Dauchet , P Amouyel & J Dallongeville (2009) Fruits, vegetables and coronary heart disease. Nat Rev Cardiol 6, 599608.

6 MG Hertog , EJ Feskens , PC Hollman , (1993) Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet 342, 10071011.

9 D Grassi , G Desideri , G Croce , (2009) Flavonoids, vascular function and cardiovascular protection. Curr Pharm Des 15, 10721084.

11 AJ Lusis (2000) Atherosclerosis. Nature 407, 233241.

17 M Aviram (2007) Hyperlipidaemia and cardiovascular disease. Curr Opin Lipidol 18, 473475.

18 S Yusuf , S Hawken , S Ounpuu , (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet 364, 937952.

20 JP Halcox , AE Donald , E Ellins , (2009) Endothelial function predicts progression of carotid intima–media thickness. Circulation 119, 10051012.

24 WR Leifert & MY Abeywardena (2008) Cardioprotective actions of grape polyphenols. Nutr Res 28, 729737.

25 JE Freedman , C Parker 3rd, L Li , (2001) Select flavonoids and whole juice from purple grapes inhibit platelet function and enhance nitric oxide release. Circulation 103, 27922798.

28 JA Polagruto , HB Gross , F Kamangar , (2007) Platelet reactivity in male smokers following the acute consumption of a flavanol-rich grapeseed extract. J Med Food 10, 725730.

30 C Eccleston , Y Baoru , R Tahvonen , (2002) Effects of an antioxidant-rich juice (sea buckthorn) on risk factors for coronary heart disease in humans. J Nutr Biochem 13, 346354.

33 AR Rechner & C Kroner (2005) Anthocyanins and colonic metabolites of dietary polyphenols inhibit platelet function. Thromb Res 116, 327334.

36 CR Pace-Asciak , O Rounova , SE Hahn , (1996) Wines and grape juices as modulators of platelet aggregation in healthy subjects. Clin Chim Acta 246, 163182.

37 R Freese , O Vaarala , AM Turpeinen , (2004) No difference in platelet activation or inflammation markers after diets rich or poor in vegetables, berries and apple in healthy subjects. Eur J Nutr 43, 175182.

41 J Moline , IF Bukharovich , MS Wolff , (2000) Dietary flavonoids and hypertension: is there a link? Med Hypotheses 55, 306309.

45 T Wilson , AP Singh , N Vorsa , (2008) Human glycemic response and phenolic content of unsweetened cranberry juice. J Med Food 11, 4654.

46 H Borochov-Neori , S Judeinstein , A Greenberg , (2008) Phenolic antioxidants and antiatherogenic effects of Marula (Sclerocarrya birrea Subsp. caffra) fruit juice in healthy humans. J Agric Food Chem 56, 98849891.

51 JH Stein , JG Keevil , DA Wiebe , (1999) Purple grape juice improves endothelial function and reduces the susceptibility of LDL cholesterol to oxidation in patients with coronary artery disease. Circulation 100, 10501055.

52 MH Davidson , KC Maki , MR Dicklin , (2009) Effects of consumption of pomegranate juice on carotid intima–media thickness in men and women at moderate risk for coronary heart disease. Am J Cardiol 104, 936942.

53 M Aviram , M Rosenblat , D Gaitini , (2004) Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima–media thickness, blood pressure and LDL oxidation. Clin Nutr 23, 423433.

54 EJ Chou , JG Keevil , S Aeschlimann , (2001) Effect of ingestion of purple grape juice on endothelial function in patients with coronary heart disease. Am J Cardiol 88, 553555.

55 PM Clifton (2004) Effect of grape seed extract and quercetin on cardiovascular and endothelial parameters in high-risk subjects. J Biomed Biotechnol 2004, 272278.

57 J Yamakoshi , S Kataoka , T Koga , (1999) Proanthocyanidin-rich extract from grape seeds attenuates the development of aortic atherosclerosis in cholesterol-fed rabbits. Atherosclerosis 142, 139149.

58 JC Stoclet , T Chataigneau , M Ndiaye , (2004) Vascular protection by dietary polyphenols. Eur J Pharmacol 500, 299313.

59 I Serraino , L Dugo , P Dugo , (2003) Protective effects of cyanidin-3-O-glucoside from blackberry extract against peroxynitrite-induced endothelial dysfunction and vascular failure. Life Sci 73, 10971114.

62 AA Franke , RV Cooney , SM Henning , (2005) Bioavailability and antioxidant effects of orange juice components in humans. J Agric Food Chem 53, 51705178.

66 M Aviram & L Dornfeld (2001) Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis 158, 195198.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary Materials

Chong supplementary material
Chong supplementary material

 Word (31 KB)
31 KB


Full text views

Total number of HTML views: 52
Total number of PDF views: 546 *
Loading metrics...

Abstract views

Total abstract views: 614 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 17th October 2017. This data will be updated every 24 hours.