***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of our study was to evaluate the effect of a st and ardized formulation of a polyphenolic extract of grapes ( Leucoselect-Phytosome [ LP ] ) on low-density lipoprotein ( LDL ) susceptibility to oxidation in a group of heavy smokers . A r and omized , double-blind , crossover study was undertaken in 24 healthy male heavy smokers , aged > or = 50 years . Enrolled subjects were given 2 capsules twice daily for 4 weeks ( phase 1 ) . Each capsule contained 75 mg of a grape procyanidin extracts and soy-phosphatidlcholine or placebo consisiting of 75 mg lactose and soy-phosphatidlcholine . A wash out period of 3 weeks was then followed by 4 weeks of the opposite treatment ( phase 2 ) . Blood sample s were taken at baseline and at the end of each phase and assayed for plasma lipids and LDL susceptibility to oxidation . Compliance was good , and no adverse effects were recorded . Subjects did not show significant modification of total cholesterol ( TC ) , triglycerides ( TG ) , high-density lipoprotein-cholesterol ( HDL-C ) and LDL-C during LP treatment . Among oxidative indices , thiobarbituric acid reactive substances ( TBARS ) concentration was significantly reduced in subjects taking LP ( -14.7 % + /- 21.1 % v + 5.0 % + /- 18.1 % , P < .01 ) , and the lag phase prolonged ( + 15.4 % + /- 24.4 % v -0.1 % + /- 16.0 % , P < .05 ) compared with placebo and basal values . The antioxidant potential of grape seed extract polyphenols may prove effective in a model of oxidative stress ( smoking ) ; however more investigational data are needed before use in wider clinical setting Background Raisins are a significant source of dietary fiber and polyphenols , which may reduce cardiovascular disease ( CVD ) risk by affecting lipoprotein metabolism and inflammation . Walking represents a low intensity exercise intervention that may also reduce CVD risk . The purpose of this study was to determine the effects of consuming raisins , increasing steps walked , or a combination of these interventions on blood pressure , plasma lipids , glucose , insulin and inflammatory cytokines . Results Thirty-four men and postmenopausal women were matched for weight and gender and r and omly assigned to consume 1 cup raisins/d ( RAISIN ) , increase the amount of steps walked/d ( WALK ) or a combination of both interventions ( RAISINS + WALK ) . The subjects completed a 2 wk run-in period , followed by a 6 wk intervention . Systolic blood pressure was reduced for all subjects ( P = 0.008 ) . Plasma total cholesterol was decreased by 9.4 % for all subjects ( P < 0.005 ) , which was explained by a 13.7 % reduction in plasma LDL cholesterol ( LDL-C ) ( P < 0.001 ) . Plasma triglycerides ( TG ) concentrations were decreased by 19.5 % for WALK ( P < 0.05 for group effect ) . Plasma TNF-α was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN ( P < 0.025 for time and group × time effect ) . All subjects had a reduction in plasma sICAM-1 ( P < 0.01 ) . Conclusion This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk BACKGROUND Patients treated with hemodialysis frequently experience cardiovascular complications attributed , among other causes , to dyslipidemia , increased oxidative stress , and inflammation . OBJECTIVE The aim of the study was to study the effects of dietary supplementation with concentrated red grape juice ( RGJ ) , a source of polyphenols , on lipoprotein profile , antioxidant capacity , LDL oxidation , and inflammatory biomarkers . DESIGN Twenty-six patients receiving hemodialysis and 15 healthy subjects were instructed to drink 100 mL RGJ/d for 14 d. Blood was drawn at baseline , twice during RGJ supplementation , and twice during the 6-mo follow-up period . As a control , 12 other r and omly recruited hemodialysis patients not receiving RGJ  were studied . Lipids , apolipoproteins , oxidized LDL , and antioxidant vitamins were measured in plasma . The bioavailability of RGJ polyphenols was assessed in healthy subjects . RESULTS The maximum plasma concentration of quercetin was achieved 3 h after RGJ ingestion , which indicates that supplement-derived polyphenols are rapidly absorbed . In both healthy subjects and hemodialysis patients , RGJ consumption increased the antioxidant capacity of plasma without affecting concentrations of uric acid or ascorbic acid ; reduced the concentration of oxidized LDL ; and increased the concentration of cholesterol-st and ardized alpha-tocopherol .  RGJ supplementation also caused a significant decrease in LDL-cholesterol and apolipoprotein B-100 concentrations , while increasing the concentrations of HDL cholesterol and apolipoprotein A-I. In a further study in hemodialysis patients , RGJ supplementation for 3 wk significantly reduced plasma monocyte chemoattractant protein 1 , an inflammatory biomarker associated with cardiovascular disease risk . CONCLUSION Dietary supplementation with concentrated RGJ improves the lipoprotein profile , reduces plasma concentrations of inflammatory biomarkers and oxidized LDL , and may favor a reduction in cardiovascular disease risk To evaluate the effects of grape polyphenols on plasma lipids , inflammatory cytokines , and oxidative stress , 24 pre- and 20 postmenopausal women were r and omly assigned to consume 36 g of a lyophilized grape powder ( LGP ) or a placebo for 4 wk . The LGP consisted of 92 % carbohydrate and was rich in flavans , anthocyanins , quercetin , myricetin , kaempferol , and resveratrol . After a 3-wk washout period , subjects were assigned to the alternate treatment for an additional 4 wk . The placebo consisted of an equal ratio of fructose and dextrose and was similar in appearance and energy content ( 554 kJ ) to LGP . Plasma triglyceride concentrations were reduced by 15 and 6 % in pre- and postmenopausal women , respectively ( P < 0.01 ) after LGP supplementation . In addition , plasma LDL cholesterol and apolipoproteins B and E were lower due to LGP treatment ( P < 0.05 ) . Further , cholesterol ester transfer protein activity was decreased by approximately 15 % with intake of LGP ( P < 0.05 ) . In contrast to these beneficial effects on plasma lipids , LDL oxidation was not modified by LGP treatment . However , whole-body oxidative stress as measured by urinary F(2)-isoprostanes was significantly reduced after LGP supplementation . LGP also decreased the levels of plasma tumor necrosis factor-alpha , which plays a major role in the inflammation process . Through alterations in lipoprotein metabolism , oxidative stress , and inflammatory markers , LGP intake beneficially affected key risk factors for coronary heart disease in both pre- and postmenopausal women BACKGROUND Atherosclerotic cardiovascular disease is the most common cause of death among hemodialysis patients ; it has been attributed to increased oxidative stress , dyslipidemia , malnutrition , and chronic inflammation . Activation of neutrophils is a well-recognized feature in dialysis patients , and superoxide-anion production by neutrophil NADPH oxidase may contribute significantly to oxidative stress . OBJECTIVE The aim of the study was to compare the effects of dietary supplementation with concentrated red grape juice ( RGJ ) , a source of polyphenols , and vitamin E on neutrophil NADPH oxidase activity and other cardiovascular risk factors in hemodialysis patients . DESIGN Thirty-two patients undergoing hemodialysis were recruited and r and omly assigned to groups to receive dietary supplementation with RGJ , vitamin E , or both or a control condition without supplementation or placebo . Blood was obtained at baseline and on days 7 and 14 of treatment . RESULTS RGJ consumption but not vitamin E consumption reduced plasma concentrations of total cholesterol and apolipoprotein B and increased those of HDL cholesterol . Both RGJ and vitamin E reduced plasma concentrations of oxidized LDL and ex vivo neutrophil NADPH oxidase activity . These effects were intensified when the supplements were used in combination ; in that case , reductions in the inflammatory biomarkers intercellular adhesion molecule 1 and monocyte chemoattractant protein 1 also were observed . CONCLUSIONS Regular ingestion of concentrated RGJ by hemodialysis patients reduces neutrophil NADPH-oxidase activity and plasma concentrations of oxidized LDL and inflammatory biomarkers to a greater extent than does that of vitamin E. This effect of RGJ consumption may favor a reduction in cardiovascular risk Grape seed extract ( GSE ) has in vitro antioxidant activity but whether or not it works in vivo is not clear . In a fully r and omised , crossover trial with 4-week treatment periods on 36 men and women with above-average vascular risk , we aim ed to demonstrate that 2 g/day of GSE ( 1 g of polyphenols ) alone , or with 1 g/day of added quercetin in yoghurt , favourably alters vascular function , endothelial function , and degree of oxidative damage in comparison to a control yoghurt . GSE alone improved flow-mediated dilatation determined ultrasonically by an absolute 1.1 % compared with control . There was no effect of the combination of GSE with quercetin . No other blood or urine measure was altered . Thus sufficient polyphenols from GSE appear to be absorbed to influence endothelial nitric oxide production , and GSE has the potential to favourably influence vascular function OBJECTIVE The objective of the study was to evaluate the effects of a grape product rich in dietary fiber and natural antioxidants on cardiovascular disease risk factors . METHODS A r and omized , controlled parallel-group trial was carried out . Thirty-four non-smoking ( 21 normocholesterolemic and 13 hypercholesterolemic ) adults were supplemented for 16 wk with 7.5 g/d of grape antioxidant dietary fiber , a natural product containing 5.25 g of dietary fiber and 1400 mg of polyphenols .  Nine non-supplemented non-smokers were followed as a control group . Fasting blood sample s , blood pressure , and anthropometric readings were obtained at baseline and at week 16 . Subjects were allowed to consume their regular diet , which was monitored weekly . RESULTS Grape antioxidant dietary fiber ( 7.5 g/d ) reduced significantly ( P < 0.05 ) total cholesterol ( 9 % ) , low-density lipoprotein cholesterol ( 9 % ) , and systolic and diastolic blood pressures ( 6 % and 5 % respectively ) . Greater reductions in total cholesterol ( 14.2 % ) and low-density lipoprotein cholesterol ( 11.6 % , P < 0.05 ) were observed in hypercholesterolemic subjects . No changes were observed in the control group . There was a reduction of 2.5 points in the Framingham Global Risk Score in the supplemented group . A significant reduction in triacylglycerol concentration took place in the supplemented hypercholesterolemic subjects ( 18.6 % , P < 0.05 ) . CONCLUSION Grape antioxidant dietary fiber showed significant reducing effects in lipid profile and blood pressure . The effects appear to be higher than the ones caused by other dietary fibers , such as oat fiber or psyllium , probably due to the combined effect of dietary fiber and antioxidants The aim of this study was to evaluate the effects of Eminol ® , the polyphenol-rich grape extract supplement ( 700 mg ) , on cardiovascular risk and oxidant stress indicators in a sample of volunteers . A r and omized , double-blind , placebo-controlled clinical trial was performed over 56 days and included 60 volunteers . Thirty volunteers took 700 mg of the grape extract , Eminol ® ( E ) , and 30 took the placebo ( P ) . On comparison of the results , a decrease in total cholesterol ( E : 213.77 ± 4.1 mg/dl and P : 245.57 ± 4.1 mg/dl ; p = 0.01 ) and LDL cholesterol ( E : 142.17 ± 3.1 mg/dl and P : 165.13 ± 3.1 mg/dl ; p = 0.02 ) levels as well as an increase in antioxidant capacity ( E : 65.63 ± 5.8 μmol TE/mg and P : 57.80 ± 7.7 μmol TE/mg ; p <  
    Output:
    
Subgroup analyses indicated larger reduction was identified in the intake of low-dose of grape polyphenols ( < 733 mg/day , median level of the included studies ) or patients with metabolic syndrome .
Contrarily , diastolic blood pressure was not significantly decreased in the grape polyphenols group as compared to controls .
No significant heterogeneity or publication bias was detected in the meta- analysis of either systolic or diastolic blood pressure .
CONCLUSIONS Daily grape polyphenol intake can significantly reduce the systolic blood pressure in humans , although the reduction is modest when compared with anti-hypertensive medications .