Functional properties and health
benefits of orange juice
Thais Cesar, PhD
Pharmaceutical School,
Sao Paulo State University – UNESP
Araraquara SP, Brazil
Orange juice
Functional Properties:
1.
2.
3.
4.
5.
6.
7.
Essential nutrients for a healthy diet
Protection against cardiovascular disease
No association with gain of weight or obesity
Decrease of insulin resistance
Improvement of antioxidant capacity
Decrease of inflammation markers
Improves satiety
Orange juice
• Natural source of vitamins and minerals:
Vitamin C, Folic Acid, Potassium
• Easily incorporated into a healthy diet plan
100% fruit juices, as Orange Juice, are associated with a
lower BMI and a healthier diet in children and adults
O’Neil et al Nutr Res 2011, Nutr J 2012
% RDA - 2000 kcal diet
Nutritional contribuition
100
80
60
40
20
0
kcal
Carb
Ca
K
Vit C
Folate
6%
12%
18%
9.6%
100%
12.5%
8 oz of orange juice
USDA Nutrient Database (2005 e 2007) release 2.1b
4
Orange juice
• Citrus flavonoids
Hesperidin
&
15.6 mg/240mL
Naringin
1.9 mg/240mL
• Cholesterol-lowering potential in animal
and human
(Kurowska et al, 2000; Roza et al, 2007)
Orange juice and
Coronary Heart Disease
• Naringenin and Hesperitin in vivo
1)  activity ACAT1, ACAT2, MTP
2)  lipoproteins assembly (VLDL)
3)  LDL receptor ( Plasma Clearance of LDL)
 total Cholesterol and LDL-C
(Roza 2007, Wilcox 2001; Borradaile 2002; Aptekman and Cesar, 2010)
6
Orange juice and
Coronary Heart Disease
• Clinical study
• Orange Juice:  transfer of Cholesterol to HDL in
normolipidemic and hypercholesterolemic individuals
(Cesar et al, Nut Res 2010, 30: 689)
7
Long-term orange juice consumption is associated
with low LDL-cholesterol and apolipoprotein B in
normal and moderately hypercholesterolemic subjects
Hypothesis:
OJ consumption (≥ 12 months) is associate
with low risk factors for CVD in subjects with normal
and moderately high cholesterol blood levels.
Aptekmann and Cesar;
Lipids in Health and Disease 2013, 12:119
http://www.lipidworld.com/content/12/1/119
Long-term orange juice consumption is associated
with low LDL-cholesterol and apolipoprotein B …
Subjects:
• employees OJ factory with free daily access to OJ
• 103 men (18–66 y)
• 26 women (18–65 y)
OJ Consumption:
• 41% = 2 cups (480 mL) OJ/d
• 59% = non-consumers
Long-term orange juice consumption is associated
with low LDL-cholesterol and apolipoprotein B …
Anthropometric
Orange juice
Normolipidemic
Hypercholesterolemic
Non-consum. Consumers
Non-consum. Consumers
Weight (kg)
75.9  11.4
70.8 10.0
78.5 13.8
83.0  10.5
BMI ( kg/m2)
25.1  3.63
23.8 2.89
26.6  2.8
27.0  3.4
Body fat (%)
27.8  5.03
25.1  7.52
28.0  5.7
27.0  4.1
Waist circ.(cm)
90.4 9.96
87.5  9.33
96.3  8.2
97.5  9.3
No differences between OJ consumers and non-consumers
Long-term orange juice consumption is associated
with low LDL-cholesterol and apolipoprotein B …
Dietary
Orange juice
Normolipidemic
Hypercholesterolemic
Non-consum. Consumers Non-consum. Consumers
Energy (MJ/d)
11.5  5.04
11.6  2.51
12.0  2.88
11.8  2.0
Carbohydrate (g/d)
327  111
346  113
382  123
367  72
95  32
99  28
90  38
91  27
Vitamin C (mg/d)
138  115
227  121*
174  120
273  158*
Folate (µg/d)
393  138
500  148*
423  146
538  166*
Total fat (g/d)
Increase of Vitamin C (+60%) and Folate (+27%) in OJ consumers
Long-term orange juice consumption is associated
with low LDL-cholesterol and apolipoprotein B …
Biochemical
Normolipidemic
Hypercholesterolemic
Orange juice
Non-consumers Consumers
Non-consumers Consumers
Triglicerides (mmol/L)
1.15  0.37
1.11  0.55
1.86  0.63
2.16 1.12
Total Cholesterol (mmol/L)
5.08  0.70
4.54  0.78*
6.77  0.41
6.40 0.58*
HDL-C (mmol/L)
1.20  0.29
1.16  0.31
1.14  0.27
1.16  0.23
LDL-C (mmol/L)
3.35  0.61
2.74  0.80*
4.78  0.48
4.20  0.86*
Apo B (g/L)
0.90  0.19
0.79  0.21*
1.27  0.17
1.12  0.17*
Homocysteine (µmol/L)
9.95  2.81
9.17  2.31
11.1  2.53
10.0  2.31
-8% Cholesterol, -15% LDL-C , -14% LDL/HDL , -12% Apo B
in OJ consumers
Long-term orange juice consumption is associated
with low LDL-cholesterol and apolipoprotein B …
Conclusions
OJ consumption was not associated with:
• weight, BMI, waist or body fat
• blood serum Triglyceride or Homocysteine
But, OJ consumption was associated with reduction of:
• total cholesterol
• LDL-cholesterol
• LDL/HDL ratio
• apo B
Orange juice
High carbohydrate intake associated with
Insulin Resistance (sub-normal response of Insulin)
(NCEP Report, 2004; IDF 2005)
 Controversia:
Sugar OJ increases the Insulin Resistance?
• 1 cup (8 oz) = 22g sugar (sucrose : glucose : fructose/ 2:1:1)
 OJ flavonoids
• prevent oxidative and inflammatory stress,
• safe energy source
(Ghanim et al, 2007)
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Insulin resistance
• IR is commonly associated with obesity and large
waist circumference
 hyperlipidemia
• Development of IR: diabetes mellitus type 2
 hypertension
 cardiovascular disease
• Pre-condition to Metabolic Syndrome
Metabolic syndrome
Adipose Tissue:
 Release pro-inflammatory mediators:
PAI1, TNF-α, IL-6, C-Reactive Protein (CRP)
 Free Fat Acids
 Oxidative Stress & Adipokines
Atherosclerosis
Pro-thrombotic
Pro-inflammatory
(Grundy et al, 2005)
Diabetes
16
Insulin resistance
Biochemical and
Clinical Charac.
Orange Juice (750mL/d)
Normal Weight
Overweight/Obese
N = 37
N = 28
1o day
60o day
1o day
60o day
Glucose mg/dL
79  6.8
79  5.0
80  8.5
81  6.9
Insulin IU/mL
6.8  3.1 5.0  2.3* 8.5  4.3 6.9  3.4*
Insulin Resistance Index 1.3  0.6 1.0  0.5* 1.7  1.0 1.4  0.7*
HOMA index %
 26 %
 18%
Overall: IR  22 %
Preliminary data, Cesar et al
Oxidative Stress
Biochemical and
Clinical Charact.
Orange Juice (750mL/d)
Normal weight
Overweight
N = 17
N = 17
1o day
60o day
1o day
60o day
C-Reactive Protein, mg/dL
0.32  0.3 0.28  0.6*
0.38  0.5
0.27  0.5*
Antioxidant capacity %
10.6  3.9 27.9  7.5*
12.1  7.1
26.6  8.5*
Blood Pressure
Systolic, mmHg
119 ± 8
114 ± 11*
128 ± 10
123 ± 12
Diastolic, mmHg
75 ± 5
74 ± 9
83 ± 9
79 ± 7*
Preliminary data, Cesar et al
Oxidative Stress and Inflammation
in patients with C hepatitis
Chronic C Hepatitis
Patients
Orange Juice (500mL/d)
TBARS %
Antioxidant Capacity %
C reactive protein, mg/mL
Normal weight
N = 46
1o day
60o day
5.7 ± 2.1
2.9 ± 1.9**
12.1 ± 10.7 19.7 ± 8.5*
4.6 ± 2.1
0.9 ± 1.4**
Preliminary data, Cesar et al
Inflammation in patients
with C hepatitis treated with OJ
Liver Enzymes
Orange Juice
Alanine Transaminase
(U/L)
Aspartate Transaminase
(U/L)
-Glutamyl Transpeptidase
(U/L)
Normal
Level
1o day 60o day
11 – 45
27 ± 12 26 ± 13
11 – 39
31 ± 7
32 ± 8
7 – 58
High Level
1o day
60o day
> 46
82 ± 31
67 ± 22*
> 40
81 ± 12
66 ± 12*
> 58
35 ± 13 34 ± 16 182 ± 132 135 ± 87*
Fresh or Pasteurized OJ ?
Which one is better?
OJ processing can influence the
concentration of citric bioactive
compounds and therefore may affect
their bioavailability in human body.
Fresh OJ is perceived as a superior
flavor beverage, but pasteurization
process is needed for the consumers
safety.
OJ commercially processing
• 8oz fresh OJ:
125mg Vit C and 76µg Folate
• 8oz processed OJ: 86mg Vit C and 46µg Folate
(Bai, et al, 2010)
• OJ bioactive compounds and flavonoids:
Can processing methods influence the satiety
(appetite) and energy intake?
Biochemical markers and
appetite after acute intake of OJ
• Effect of acute intake of fresh and pasteurized OJ on
markers of satiety in individuals with normal weight
and overweight.
• Test drink: sugars + H2O
Glucose
Leptin
Insulin
Adiponectin
140
Glucose (BMI < 25kg/m2)
140
Test
130
Fresh OJ
130
Test
120
Fresh OJ
Past OJ
110
mg/dL
mg/dL
120
Glucose (BMI  25kg/m2)
100
100
90
90
80
80
70
Past OJ
110
70
0
50
100
150
min
200
250
300
0
50
100
Normal Weight
200
250
Insulin (BMI  25kg/m2)
140
Test
Test
120
Fresh OJ
100
Past OJ
µmol/L
µmol/L
300
Obese
Insulin (BMI < 25kg/m2)
140
150
min
80
60
120
Fresh OJ
100
Past OJ
80
60
40
40
20
20
0
0
0
50
100
150
min
200
250
300
0
50
100
150
min
200
250
300
Normal weight
A
35000
30000
Obese
a
A
A
a,b
b
Glucose
25000
20000
(AUC after 300 min)
15000
10000
5000
0
Test
Fresh OJ
Past OJ
Test
Fresh OJ
Normal weight
40000
Insulin
35000
(AUC after 300 min)
25000
Past OJ
Obese
B
30000
20000
15000
B
B
a
b
10000
b
5000
0
Test
Fresh OJ Past OJ
Test
Fresh OJ Past OJ
Biochemical markers and appetite after
acute intake of OJ
Appetite
Leptin
Energy
Expenditure
•  appetite stimulators
 satiety
•  appetite inhibitors
• in the hypothalamic ARC and
postsynaptic sites
Adiponectin
Leptin
CNTF
(cytokine)
Adipocytes
• Insulin-sensitizing property
• Inverse association with IR
and Diabetes (obesity)
25000
A
Normal weight
20000
Obese
ng/mL
Leptin
A
15000
A
10000
(AUC after 300 min)
b
5000
a,b
a
0
Test
Fresh OJ
Past OJ
Test
Fresh OJ
Normal
Past OJ
Obese
4000
A
Normal weight
A
Obese
A
Adiponectin
(AUC after 300 min)
ng/mL
3000
B
B
B
Test
Fresh OJ
2000
1000
0
Test
Fresh OJ
Past OJ
Normal
Obese
Past OJ
Conclusions
Consumption of Orange Juice (long and short-term):
•
•
•
•
•
No effect on the Nutritional Status of regular consumers
Reduced markers related to insulin resistance and
cardiovascular disease
Increased the antioxidant capacity
Decrease inflammation markers in blood and liver
Improve the satiety
•
Is good for your health!