Effectiveness of Consumption of a Combination of Citrus Fruit Flavonoids and Olive Leaf Polyphenols to Reduce Oxidation of Low-Density Lipoprotein in Treatment-Naïve Cardiovascular Risk Subjects: A Randomized Double-Blind Controlled Study

Abstract: The aim of the study was to assess whether oral intake of a nutraceutical product (Cit-rolive™) could determine changes in low-density lipoprotein (LDL) oxidation and other param-eters of lipid metabolism and plasma atherogenic capacity. Citrolive™ is a commercial extract obtained from the combination of citrus fruit flavonoids and olive leaf extracts. Twenty-three un-treated subjects (69.6% males, 30.4% females, mean age 41.9 9.4 years) with cardiovascular risk factors and a total cholesterol level >200 mg/dL and LDL cholesterol (LDL-C) > 130 mg/dL par-ticipated in a 3-month randomized double-blind controlled study. Participants in the intervention group (71.4% males, 28.6% females, mean age 42.7 9.7 years) consumed Citrolive™ (500 mg, two capsules/day), and controls (66.7% males, 33.3% females, mean age 40.6 9.4 years) received a matched placebo. At 3 months, oxidized LDL (ox-LDL) decreased significantly in the interven-tion group from 93.8 19.1 U/L to 62.8 28.7 U/L (p < 0.05), whereas the control group increased from 98.2 23.5 U/L to 105.7 21.9 U/L (p = 0.1). Between-group differences were also significant (p < 0.05). Similar findings in the ox-LDL/LDL-C ratio were observed. Serum paraoxonase activity (PON1) increased significantly in the intervention group from 64.5 15.6 U/L to 78.7 28.8 U/L (p < 0.05) but remained unchanged in controls. Consumption of Citrolive™ for 3months in treatment-naïve subjects with moderate risk of atherosclerosis was associated with a reduction in oxidized LDL-C and LDL-oxidase/LDL-C ratio as compared to controls.