Prototype Star Fruit-Honey Product and Effectiveness on Antixidants, Inflammation and Walking Distance in Participants with Stable Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Background: Star fruit (Averrhoa carambola L.) is a seasonal fruit, which has proven antioxidant and inflammation activities in vitro. However, sweet-type is more available than sour-type. Therefore, developing a new product from sweet-type star fruit, and evaluating its effectiveness on antioxidants and inflammation have been very challenging. Objectives: The aims were to develop a prototype product from sweet-type star fruit and evaluate its effectiveness with or without walking exercise on participants with stable chronic obstructive pulmonary disease (COPD). Methods: The prototype product of sweet-type star fruit was prepared industrially by mixing with honey before nutrients such as L-ascorbic acid (Vit C) and total phenolic compound, and contaminants like chemicals, microbials and oxalic acid were evaluated. Effectiveness of this product on antioxidents, inflammation and physical function was evaluated in participants with stable COPD with and without walking exercise, and compared to walking exercise and control participants. Two spoons of the product (20 g) in sterile warm water (150 mL) were guided and consumed twice daily for 4 weeks, whereas the walking exercise was prescribed with moderate intensity at home for 30 min 3 days per week. Plasma Vit C, total antioxidant capacity (TAC), malondialdehyde (MDA), tumor necrotic factoralpha (TNF-∝) and 6-minutes walking distance (6MWD) were evaluated before and after the 4-week study period. Results: The prototype product composed of star fruit juice with honey (1:1, v:v). Main nutrients were composed of ash (0.4 g), carbohydrate (74.59 g), lipid (2.88 g), protein (0.57 g) and 326.56 kcal of total energy, whereas Vit C and total phenolic compound were equivalent to 0.25 ± 0.11 mg and 144.89 ± 2.51 µg gallic acid equivalent in a 100 gram of product. The results of chemicals and microbials showed safety under food conditions. The results of study compared the ages of stable COPD participants between those of the controls (n=10, 69.20±1.40 years), and those with star fruit juice and honey supplement (n=20, 71.25 ± 6.01 years), walking exercise (n=15, 60.60±3.38 years), and supplement with walking exercise (n=15, 64.40±1.63 years) and no statistical difference was shown in any parameters in the control group. Whereas, the plasma Vit C and TAC levels increased, and MDA and TNF-∝ levels reduced significantly, in the supplement consumption group, which was in contrast to the Vit C, MDA and TNF-∝ levels in the walking exercise group. However, the TAC level increased significantly when the walking exercise was completed. When the prototype product was applied to the walking exercise, the levels of Vit C and TAC increased, and MDA and TNF-∝ levels reduced significantly. Whereas, the supplement levels increased significantly in all of the groups, especially in the 6MWD. Conclusion: This study proposed that sweet-type star fruit can be prepared industrially by mixing with honey, and be developed as a new commercial product with antioxidant and inflammation activities for p...

Comparative active compounds and antioxidant activity between the sweet- and sour-type star fruit (Averrhoa carambola L.) In Vitro

“…39 Thus, the results in this study showed the pro-oxidation activity of SF sour-type and antioxidant activity of sweet-type in in vitro models. Thus, the results in this study supported previous studies in which participants who had chronic obstructive pulmonary disease (COPD) 10 stabilized with antioxidant activity in sweet-type SF. However, the benefits of sour-type SF must be considered and need to be studied further.…”

“…This study was an updated and a confirmed work of SF distributed in Thailand, 9,10 and it also supports a previous study on elderly people. 8,20 The results in this study represented active compounds such as phenolics and Vit C is the same as in the previous evidence from the data.…”

“…9 In addition, it could improve total antioxidant capacity (TAC) and ascorbic acid (Vit C), and reduced lipid peroxide, as well as TNF-α in the plasma of people suffering from chronic obstructive pulmonary disease (COPD), after taking one-month of a prototype supplement containing sweet-type star fruit and honey. 10 Thus, both types of SF showed antioxidant compounds and effectiveness in people.…”

Supplementation of Sweet-type Star Fruit Product Controls the Oxidative Stress Status and Enhances the Walking Capacity from Home-Walking Exercise Among Dwelling Elderly in Chiang Mai Province

“…Contamination from yeast, fungi [36], microbial pathogens, especially coliforms, Escherichia coli, yeast, fungi, Salmonela sp, Clostridium perfringens, Staphylocossus aureus and Bacillus cereus, placed under a compendium of methods for food analysis [37], was approved with a food serial number of 50-1-02237-2-0122. Moreove, possible toxicity from oxalic acid content in the SF product in this study, which may affect neurotoxic or neuphrotoxic conditions [38] was rechecked as in the previous study [29]. Previous evidence reported that a minimal dose of 4-5 grams of oxalate caused death in adults [39].…”

“…Updated evidence on sweet-type SF extract showed activities on radical scavenging as well as suppressed in ammation through inhibiting TNF-∝ in vitro [26]. Thus, the new product of sweet-type SF was very challenging at the industrial level as in previous study [29]. The SF product was prepared similarly under the guideline of the Department of Public Health, Thailand, before being approved for the study of people with COPD in that study and in a community of elderly people in this study.…”