CVD is the leading cause of morbidity and mortality in developed countries, and chronic inflammation plays a major role in its development. As CVD risk and inflammation increases with age, older people now account for the majority of CVD morbidity worldwide⁽ Reference Man and Jugdutt ^{1 )}. Conversely, increased fruit and vegetable (F&V) intake has been suggested to correlate with reduced CVD risk⁽ Reference He, Nowson and MacGregor ^{2 )}, although direct trial evidence of their ability to influence markers of inflammation is lacking.

To assess if increased F&V intake reduces serum amyloid-A (SAA), in serum and HDL_2&3 and if this latter enhances the antiatherogenic properties of HDL_2&3.

Subjects aged between 65 to 85 years were randomised to 2 or 5 portions of F&Vs per day, for 16-weeks (n=38 per group). HDL_2&3 were isolated by rapid ultracentrifugation. Serum-hsCRP was measured by an immuoturbimetric assay, serum-IL-6, e-selectin, SAA and HDL_2&3-SAA were measured by ELISA procedures, and HDL_2&3-CETP activity was measured by a fluorometric assay.

These results demonstrated that hsCRP, IL-6 and e-selectin were unchanged following either the 2 or 5 portion interventions. However, following the 5-portion intervention, SAA significantly decreased in serum at weeks 12 and 16, in HDL₂ at weeks 6, 12 and 16 and in HDL₃ at weeks 12 and 16 (table 1), which was accompanied by a decrease in the activity of CETP in HDL₂ at weeks 6, 12 and 16 (p=0.03, 0.02 and 0.001, respectively). Additionally, in the between group analyses (2 vs. 5 portions), SAA decreased in serum at week 12, in HDL₂ at weeks 6 and 16 and in HDL₃ at weeks 12 and 16 (table 1). Additionally, CETP activity decreased in HDL₂ at week 16 (p=0.03).

Table 1. SAA changes and statistical differences following F&V intervention Results were logarithmically transformed and are summarised as mean geometric change from baseline (IQ range). P1 pre vs. post 5-portion intervention: P2 between group statistics (2 vs. 5 portion change)

These results have identified: i) SAA responds to increased F&V intake, where other markers of inflammation/endothelial activation were unresponsive. ii) Increased F&V intake lowered systemic and HDL-associated inflammation, and this latter influenced the antiatherogenic properties of HDL_2&3. Overall, these results provide tangible evidence of the effectiveness of increasing F&V intake on inflammation and possible CVD risk in an older population.