British Journal of Nutrition

Full Papers

Human and Clinical Nutrition

Supplementation with orange and blackcurrant juice, but not vitamin E, improves inflammatory markers in patients with peripheral arterial disease

Christine Dalgårda1 p1 c1, Flemming Nielsena2, Jason D. Morrowa3, Henrik Enghusen-Poulsena4, Torbjörn Jonunga5, Mogens Hørdera1 and Moniek P. M. de Maata6a7

a1 Research Unit of Biochemistry, Pharmacology and Genetics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

a2 Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark

a3 Department of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA

a4 Department of Clinical Pharmacology, Rigshospitalet, University Hospital Copenhagen, Denmark

a5 Department of Vascular Surgery, Ribe County Hospital, Esbjerg, Denmark

a6 Department of Thrombosis Research, University of Southern Denmark, Esbjerg, Denmark

a7 Department of Haematology, Erasmus MC, Rotterdam, The Netherlands


Inflammation and endothelial activation are associated with an increased risk of CVD and epidemiological evidence suggests an association between levels of markers of inflammation or endothelial activation and the intake of fruit. Also, vitamin E, a fat-soluble antioxidant, has anti-inflammatory properties. We performed a randomised 2 × 2 factorial, crossover trial to determine the effect of orange and blackcurrant juice (500 ml/d) and vitamin E (15 mg RRR-α-tocopherol/d) supplementation on markers of inflammation and endothelial activation in forty-eight patients with peripheral arterial disease. Patients were randomly allocated to two dietary supplements from the four possible combinations of juice and vitamin E: juice+vitamin E; juice+placebo; reference beverage (sugar drink)+vitamin E; and reference beverage+placebo. The supplementations were given for 28 d, separated by a 4-week wash-out period. Analysis of main effects showed that juice decreased C-reactive protein (CRP) by 11 % and fibrinogen by 3 % while the reference drink increased CRP by 13 % and fibrinogen by 2 % (P < 0·008 and P < 0·002, respectively). No significant differences were measured for IL-6 and the endothelial activation markers von Willebrand factor, tissue-plasminogen activator and plasmin activator inhibitor-1. Vitamin E supplementation had no significant effects on the various markers. We observed no significant interaction between juice and vitamin E. In this study, orange and blackcurrant juice reduced markers of inflammation, but not markers of endothelial activation, in patients with peripheral arterial disease, relative to sugar drinks.

(Received September 18 2007)

(Revised April 22 2008)

(Accepted April 24 2008)

(Online publication May 28 2008)


c1 Corresponding author: Dr Christine Dalgård, fax +45 6550 3682, email

p1  Present address: Institute of Public Health–Environmental Medicine, University of Southern Denmark, J.B. Winsløwvej 17/2, DK-5000 Odense C, Denmark.


Abbreviations: CRP, C-reactive protein; PAD, peripheral arterial disease