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. Essential nutrients for a healthy diet

2. Protection against cardiovascular disease
3. No association with gain of weight or obesity
4. Decrease of insulin resistance
5. Improvement of antioxidant capacity
6. Decrease of inflammation markers
7. 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
ONeil et al Nutr Res 2011, Nutr J 2012
 Nutritional contribuition
100
% RDA - 2000 kcal diet

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 & Naringin
15.6 mg/240mL 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 (1866 y)

26 women (1865 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 Normolipidemic Hypercholesterolemic

Orange juice 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 Normolipidemic Hypercholesterolemic

Orange juice 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

Total fat (g/d) 95 32 99 28 90 38 91 27

Vitamin C (mg/d) 138 115 227 121* 174 120 273 158*

Folate (g/d) 393 138 500 148* 423 146 538 166*

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 (mol/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)

14
 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-, IL-6, C-Reactive Protein (CRP)

Free Fat Acids

Oxidative Stress & Adipokines
Atherosclerosis
Pro-thrombotic
Pro-inflammatory
Diabetes
(Grundy et al, 2005)
16
 Insulin resistance

Biochemical and Normal Weight Overweight/Obese

Clinical Charac.
N = 37 N = 28
Orange Juice (750mL/d) 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 Normal weight Overweight

Clinical Charact. N = 17 N = 17
Orange Juice (750mL/d) 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 Normal weight

Patients N = 46

Orange Juice (500mL/d) 1o day 60o day

TBARS % 5.7 2.1 2.9 1.9**

Antioxidant Capacity % 12.1 10.7 19.7 8.5*

C reactive protein, mg/mL 4.6 2.1 0.9 1.4**

Preliminary data, Cesar et al

 Inflammation in patients
with C hepatitis treated with OJ
Liver Enzymes Normal High Level
Level
Orange Juice 1o day 60o day 1o day 60o day
Alanine Transaminase 11 45 > 46
(U/L) 27 12 26 13 82 31 67 22*
Aspartate Transaminase 11 39 > 40
(U/L) 31 7 32 8 81 12 66 12*
-Glutamyl Transpeptidase 7 58 > 58
(U/L) 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 76g Folate

8oz processed OJ: 86mg Vit C and 46g 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 Insulin
Leptin Adiponectin
 140 Glucose (BMI < 25kg/m2) 140 Glucose (BMI 25kg/m2)
130 Test 130 Test
Fresh OJ Fresh OJ
120 120
Past OJ Past OJ
110 110

mg/dL
mg/dL

100 100

90 90

80 80

70 70
0 50 100 150 200 250 300 0 50 100 150 200 250 300
min min

Normal Weight Obese

140 Insulin (BMI < 25kg/m2) 140 Insulin (BMI 25kg/m2)
Test
Test
120 120 Fresh OJ
Fresh OJ
100 100 Past OJ
Past OJ
mol/L

mol/L
80 80

60 60

40 40

20 20

0 0
0 50 100 150 200 250 300 0 50 100 150 200 250 300
min min
 Normal weight Obese
35000 A
A A
a a,b
30000
b
25000

20000
Glucose
15000 (AUC after 300 min)
10000

5000

0
Test Fresh OJ Past OJ Test Fresh OJ Past OJ

Normal weight Obese

40000
B
35000 B
Insulin 30000
B
25000
(AUC after 300 min) 20000
a
15000
b b
10000

5000

0
Test Fresh OJ Past OJ Test Fresh OJ Past OJ
Biochemical markers and appetite after
acute intake of OJ
Appetite

Leptin
Energy appetite stimulators
satiety
Expenditure
appetite inhibitors
in the hypothalamic ARC and
postsynaptic sites

Adiponectin
Insulin-sensitizing property
Inverse association with IR
Leptin
CNTF and Diabetes (obesity)
(cytokine)

Adipocytes
 25000
A

20000
Normal weight Obese

15000 A
Leptin
ng/mL

A
10000
b
(AUC after 300 min)
a a,b
5000

0
Test Fresh OJ Past OJ Test Fresh OJ Past OJ
Normal Obese

4000 Normal weight Obese

A
A A
3000
B
Adiponectin B B
ng/mL

2000

(AUC after 300 min)

1000

0
Test Fresh OJ Past OJ Test Fresh OJ Past OJ
Normal Obese
 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!