Introduction
The prevalence of overweight and obesity continues to escalate globally, affecting both developed and developing countries. The Food and Drug Organization of the United Nations has identified these conditions as major contributors to mortality worldwide. approximately 3.4 million adults die annually from complications linked to excessive weight. Overweight and obesity are responsible for 44% of diabetes cases, 23% of ischemic heart disease incidents, and 7%–41% of specific cancer occurrences. These conditions are characterized by chronic inflammation due to increased body fat, leading to higher levels of inflammatory agents, systemic oxidative stress, and lowered antioxidant capacity. Furthermore, extracellular vesicles (EVs), diverse small particles produced by various cells, are being explored as potential indicators of cellular harm in cardiovascular diseases owing to their ability to carry molecules and facilitate complex cell-to-cell communication.
Tomatoes, which are essential to the Mediterranean diet, are rich in antioxidants, such as carotenoids, phenolic compounds, and vitamins. Both fresh and processed tomatoes offer bioactive properties that may counteract the chronic inflammation observed in overweight and obese individuals. Research, including a clinical trial with overweight and obese women, has shown that consuming tomato juice can reduce inflammation and oxidative stress, although its effects on antioxidant enzymes and total capacity vary. Animal studies have further supported the anti-inflammatory properties of tomatoes, particularly in obese subjects. However, the high consumption of tomato products or lycopene supplements has not significantly lowered the risk of cardiovascular disease in moderately overweight individuals. The effects on blood profiles in healthy and obese groups require further exploration. Tomatoes have also been linked to reduced platelet aggregation, although the effect of soffritto consumption on this aspect in overweight and obese populations remains unclear.
The health benefits of tomatoes are partly influenced by lycopene bioavailability, which is higher in processed forms, such as tomato paste. Cooking methods, especially those involving olive oil and onions, enhance the accessibility of bioactive compounds in tomatoes and protect them from oxidation. While the increase in bioactive compounds through sautéing has been recognized, its specific health implications for overweight and obese populations are not fully understood. To address this, we initiated a clinical study to examine the effects of daily soffritto consumption in overweight or obese individuals without other cardiovascular risk factors. This study will also monitor vascular endothelial function, weight fluctuations, lipoprotein profiles, and arterial stiffness to identify potential negative outcomes of regular soffritto intake.
Materials and Methods
Subjects
The study involved 40 healthy adult men and women, aged 27–60 years, who were non-smokers and either overweight or class 1 obese. They were selected through word of mouth and newspaper advertisements. Exclusion criteria included chronic illnesses such as cancer, diabetes, dyslipidemia, hypertension, and liver, heart, or kidney disease; excessive alcohol consumption; usage of certain medications; history of cardiovascular diseases or psychiatric disorders; participation in weight-loss programs; or intolerance to tomato-based products. All participants underwent a physical examination.
Ethics Statement
The participants provided informed consent and could withdraw at any time. This study was approved by the Human Ethical Review Committee of the Hospital Santa Creu I Sant Pau in Barcelona.
Soffritto Samples
Provided by PREPARADOS ALIMENTICIOS S.A., the soffritto consisted of tomatoes, onions, olive oil, sugar, and salt. It is rich in carotenoids and other bioactive compounds.
Study Design and Dietary Monitoring
This was a prospective, controlled, randomized, two-arm, longitudinal, crossover trial. It included two 6-week intervention periods separated by a 2-week washout phase. Participants either added 100 g of soffritto daily to their regular diet or were in the control group. They avoided using other tomato-based products during the study. Adherence was monitored using regular communication and diary cards. Blood samples were collected at various time points for the analysis.
Outcomes
The primary outcome was the effect of soffritto intake on vascular endothelial function and platelet activity. The secondary outcomes included measurements of blood pressure, lipid profile, hepatic and renal markers, and blood parameters.
Results
Study Completion and Adherence
The study involved 40 individuals, averaging 40.8 years in age, and all participants completed both phases of the study without adverse effects. The adherence to diet was > 97%.
Platelet Function
In the soffritto group, there was a trend towards decreased platelet aggregation, but most changes were not statistically significant. However, a significant reduction in collagen-induced platelet aggregation at 2 µM was observed in the soffritto group compared with in that the control group.
Endothelial Function
The baseline endothelial function was similar in both groups. No significant differences were observed in endothelial function parameters in either group.
Anthropometric and Biochemical Variables
Baseline characteristics, including BMI, weight, waist circumference, and blood pressure, were similar in both groups. Hemodynamic parameters were also similar after treatment, with a significant decrease in diastolic pressure in the control group. The kidney and liver function markers remained normal and unaltered.
Lipid Profile
Both the groups had similar baseline lipid profiles. Six weeks of soffritto intake did not significantly change lipid levels (TC, TAG, HDL, and LDL) in either group. No significant changes were observed in the LDL/HDL ratio.
Blood Parameters
At baseline, both groups had similar levels of hemoglobin, red and white blood cells, platelets, and other blood parameters. After six weeks, no significant differences were observed in these parameters between the groups.
Discussion
The impact of tomatoes and their products, such as purée and sauces, on cardiovascular disease (CVD) risk has been extensively studied. However, the effects of soffritto, a Mediterranean cooking method rich in carotenoids and polyphenols, on overweight and obese individuals are not well understood. This controlled, randomized, two-arm longitudinal crossover trial aimed to investigate the impact of daily soffritto consumption on platelet activity in overweight or obese class 1 individuals without other CVD risk factors. We also evaluated potential adverse effects on vascular endothelial function, body weight, lipoprotein profile, and arterial stiffness.
The primary focus of this study was platelet activity, which is known to be influenced by various intracellular signaling pathways triggered by soluble agonists, such as ADP, collagen, and arachidonic acid. The findings indicated a trend towards reduction in ADP and collagen-induced platelet aggregation in the soffritto group, with a significant decrease observed in ADP-induced aggregation at 20 µM. These results suggest the potential of soffritto to differentially affect the signaling pathways involved in platelet activation, particularly those involving collagen and ADP. However, the lack of a significant effect on arachidonic acid-induced aggregation indicated that the impact of soffritto might not involve the COX-1 and thromboxane pathways. More research is needed to understand the exact mechanisms by which soffritto modulates platelet response.
Previous studies have demonstrated beneficial effects of tomato-based products on CVD and platelet aggregation. For instance, consumption of tomato supplements has been shown to significantly reduce platelet aggregation in healthy humans. These effects are attributed to bioactive compounds in tomatoes, such as lycopene, flavonoids, phenolic acids, and vitamin E, which have demonstrated antiplatelet activity in various studies. The findings of this study align with this evidence, suggesting that soffritto may contribute to primary CVD prevention by reducing platelet activation regardless of factors such as sex, age, or BMI.
The authors also explored the effect of soffritto on endothelial function, which is an important marker of vascular health. Although previous studies have reported mixed results regarding the effects of tomato products on endothelial function, they did not observe any significant negative influence of soffritto on endothelial function. This is significant because endothelial dysfunction is a precursor to atherosclerosis. It is worth noting that different forms of tomato products or individual comorbidities might affect the bioavailability of bioactive compounds, thereby influencing their effectiveness.
In terms of anthropometric and biochemical variables, this study found that soffritto intake did not significantly affect these factors in overweight or obese individuals. This is consistent with other studies in which tomato product consumption did not affect these variables in healthy populations. Interestingly, although an increase in TAG was noted in the soffritto group, it was not significant and could be related to the composition of the soffritto.
Regarding the serum lipid profile, this study aligns with previous research showing that tomato products and lycopene supplementation do not significantly alter lipid levels in various populations. This further supports the conclusion that soffritto intake does not negatively affect the serum lipid profiles in overweight or obese individuals.
Finally, the study found no significant changes in blood parameters, such as hemoglobin, red and white blood cells, and platelets, after soffritto consumption. This is in line with previous studies in which tomato juice intake did not induce changes in these parameters.
Although this study provides valuable insights, it has some limitations, including a relatively small sample size. Further research with a larger and more diverse population is necessary to validate these findings. Additionally, the inclusion of participants with a higher BMI or existing CVD risk factors could potentially reveal more pronounced effects of soffritto intake.
Read all at: López-Yerena, A.; Padro, T.; de Santisteban Villaplana, V.; Muñoz-García, N.; Pérez, A.; Vilahur, G.; Badimon, L. Vascular and Platelet Effects of Tomato Soffritto Intake in Overweight and Obese Subjects. Nutrients 2023, 15, 5084. https://doi.org/10.3390/nu15245084