Nutrition 33 (2017) 225233

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Nutrition
journal homepage: www.nutritionjrnl.com

Applied nutritional investigation

Natural antioxidant ice cream acutely reduces oxidative stress

and improves vascular function and physical performance in
healthy individuals
Valerio Sanguigni M.D. a, *, Melania Manco M.D. b, Roberto Sorge Ph.D. a,
Lucio Gnessi M.D. c, Davide Francomano M.D. c
a
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
b  Children Hospital, Rome, Italy
Research Unit for Multi-Factorial Diseases, Obesity and Diabetes, Scientic Directorate, Bambino Gesu
c
Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome,
Rome, Italy

a r t i c l e i n f o a b s t r a c t

Article history: Objective: The formation of reactive oxygen species (ROS) contributes to the pathogenesis and
Received 11 April 2016 progression of several diseases. Polyphenols have been shown to be benecial against ROS. The aim
Accepted 9 July 2016 of this study was to evaluate the effects of a natural antioxidant ice cream on oxidative stress,
vascular function, and physical performance.
Keywords: Methods: In this controlled, single-blind, crossover study, 14 healthy individuals were randomized
Oxygen free radicals
to consume 100 g of either antioxidant ice cream containing dark cocoa powder and hazelnut and
Endothelial function
green tea extracts or milk chocolate ice cream (control ice cream). Participants were studied at
Nitric oxide
Double product baseline and 2 h after ingesting ice cream. Serum polyphenols, antioxidant status (ferric-reducing
Ageing ability of plasma [FRAP]), nitric oxide (NOx) bioavailability, markers of oxidative stress (determi-
Cardiovascular prevention nation of reactive oxygen metabolites [d-ROMs] and hydrogen peroxide [H2O2]), endothelium
function (ow-mediated dilation [FMD] and reactive hyperemia index [RHI]), and exercise toler-
ance (stress test) were assessed, and the double product was measured.
Results: Serum polyphenols (P < 0.001), NOx (P < 0.001), FRAP (P < 0.005), FMD (P < 0.001), and
RHI (P < 0.05) increased signicantly, oxidative stress decreased (d-Roms, P < 0.001; H2O2,
P < 0.001), and the double product (P < 0.001) was improved only after antioxidant ice cream
ingestion. No changes were found after control ice cream ingestion.
Conclusions: To our knowledge, this is the rst study to demonstrate that a natural ice cream rich in
polyphenols acutely improved vascular function and physical performance in healthy individuals
through a reduction in oxidative stress.
2016 Elsevier Inc. All rights reserved.

Introduction myocardial infarction, stroke, diabetes, and cancer) [1]. Most

Oxidative stress promotes aging and related chronic diseases.
A healthy diet, rich in fruits and vegetables, is protective against
oxidative stress, thus reducing the risk for several conditions (i.e.,
VS participated in the design of the study, performed experimental work, and
contributed to the manuscript preparation. MM contributed to the interpreta-
tion of data and the manuscript preparation. RS performed statistical analysis
and contributed to the manuscript preparation. LG contributed to the inter-
pretation of data and to the manuscript preparation. DF performed experimental
work and contributed to the manuscript preparation. The authors have no
conicts of interest to declare.
* Corresponding author. Tel.: 00 39 06 86211558; fax: 00 39 06 3701490.
E-mail address: sanguigni.valerio@gmail.com (V. Sanguigni).
scientic studies suggest that the cardiometabolic effects of a
healthy diet are due to the polyphenol content; these chemicals
have powerful antioxidant activities [2,3]. Two reviews showed
an inverse association between the dietary intake of polyphenols
and the risk for cardiovascular disease (CVD), with
65%
reduction in cardiovascular mortality in clinical trials [4,5].
Studies tested the effect of antioxidant foods rich in polyphenols,
such as cocoa, nuts, tea, and red wine, on the endothelial
response in terms of the capacity to acutely increase and main-
tain the endothelium-dependent vasodilation over time in
healthy individuals [613]. For cocoa consumption, these studies
mostly evaluated derivatives, such as chocolate [6]. Cocoa de-
rivatives contain a high amount of caffeine, theobromine, and

http://dx.doi.org/10.1016/j.nut.2016.07.008
0899-9007/ 2016 Elsevier Inc. All rights reserved.
226 V. Sanguigni et al. / Nutrition 33 (2017) 225233
fats. Caffeine and theobromine can induce arrhythmias and even
stimulate the central nervous system, causing restlessness and
agitation [14]. When cocoa consumption becomes habitual,
these effects cannot be tolerated and are potentially harmful in
people suffering from heart disease or hypertension [15].
Consequently, habitual consumption of only cocoa as an anti-
oxidant cannot be recommended. Furthermore, cocoa de-
rivatives contain a considerable amount of fat (55% of the total)
as butter [16]. Therefore, consumption of cocoa derivatives may
be harmful in overweight and obese individuals [17]. A mixture
of cocoa and other natural foods rich in polyphenols can, how-
ever, be more efcient as an antioxidant than cocoa alone while
also reducing its side effects.
Moderate physical exercise is considered an essential
component of a healthy lifestyle. Nevertheless, exercise, partic-
ularly exhaustive exercise, causes the organism to adapt to
different stresses. Thus, exercise induces acute oxidative stress,
inammation, and muscle damage [18]. Data from the literature
do not clearly show whether a diet can prevent or reduce
oxidative stress and mitigate the muscle damage induced by
physical exercise [19,20].
The aim of this controlled, single-blind, crossover study was
to evaluate the acute effect of on oxidative stress, endothelial
function and physical performance by ingesting 100 g natural ice
cream that is rich in polyphenols rather than a control ice cream.
Methods
We estimated serum markers of oxidative stress (determination of reactive
oxygen metabolites [d-ROMs] and hydrogen peroxide [H2O2]), serum antioxidant
status (ferric-reducing ability of plasma [FRAP]), nitric oxide (NO) bioavailability
(NOx), endothelium ow-mediated vasodilation (FMD), variation in reactive
hyperemia index (RHI by Endopat 2000), and exercise tolerance as measured by
the peak double product (heart rate  systolic blood pressure, after cyclo-
ergometer stress test).
Fig. 1. Study design.
Fourteen healthy, nonsmoking, volunteers (7 men and 7 women) aged be-
tween 20 and 40 y were enrolled. The study was randomized and placebo
controlled. After enrollment, 3 d before beginning the study, all participants
performed an exercise stress test. They were then randomly allocated to a
treatment sequence with 100 g of either natural antioxidant ice cream or milk
chocolate ice cream (control ice cream) in a crossover single-blind design. There
was a 1-wk washout between the two phases of the study (Fig. 1).
Markers of oxidative stress (d-ROMs and H2O2), serum antioxidant status
(FRAP), NO bioavailability (NOx), the endothelium ow-mediated vasodilation
(FMD) and the RHI (EndoPat 2000) were evaluated at the fasting condition at
baseline (time 0) and 2 h after the ingestion of the antioxidant or control ice
creams. The exercise stress test was performed before randomization and 2 h
after each ice cream meal test. In both experiments, the ice cream was consumed
within 10 min. We chose the single 2-h time point because the maximum ab-
sorption peak of the polyphenols is generally between 90 and 150 min, as shown
by previous studies [7,21,22]. The schedule of the procedure is showed in
Figure 2.
Each participant had been asked to abstain from any type of medication,
dietary supplement, or intensive physical activity and to avoid the consumption
of polyphenol-rich foods, such as cocoa-containing products, red wine, and tea,
during the previous 2 wk.
All participants gave written informed consent, the study was approved by
the Medical Ethics Committee of La Sapienza University of Rome (Ref: 3727, Prot:
2325/15) and registered on ClinicalTrials.gov Identier: NCT02685163.
Ice cream composition
The natural antioxidant ice cream was based on a mixture of dark cocoa
powder with hazelnut and green tea extracts (manufactured by handmade
procedure) that had a high content of polyphenols and low fat (Table 1). The
control ice cream consisted of 100 g of unsweetened milk chocolate ice cream.
The organoleptic characteristics make the appearance and taste of this mixture
similar to the antioxidant mixture just described.
The amount of polyphenols was measured using a modied Folin-Ciocalteu
colorimetric method, with results expressed as mg/gallic acid equivalent per liter.
Serum total polyphenol content
The total polyphenol content in serum was determined by a modied
FolinCiocalteu colorimetric method. Briey, 0.1 mL of FolinCiocalteu reagent
was added to 0.02 mL of serum. After 5 min at room temperature, 0.05 mL of
 V. Sanguigni et al. / Nutrition 33 (2017) 225233 227

Fig. 2. Schedule of procedure for each participant. d-ROM, determination of reactive oxygen metabolite; FMD, ow-mediated vasodilation; FRAP, ferric-reducing antioxidant
power; H2O2, hydrogen peroxide; NO, nitric oxide; NOx, mono-nitrogen oxides; RHI, reactive hyperemia index.

20 g/L sodium carbonate was added, and the reaction mixture was incubated
at 37 C for 20 min. The absorbance at 765 nm was measured using an Asys
UVM 340 microplate reader (Biochrom, Holliston, MA, USA) and compared
with a gallic acid calibration curve (1001000 mg/L). Results were expressed
as mg/L gallic acid equivalent (GAE). All experiments were performed in
triplicate.
Measurement of hydroperoxides with the plasma d-ROMs
test
The d-ROMs measurement is a photometric test for the
measurement of plasma hydroperoxides (ROOH), which repre-
sent the main oxidized molecules of the organism and thus are
an efcient indirect marker of oxidative stress. The test is based
on the Fenton reaction and the formation of oxygen radicals
(RLO) during lipid peroxidation; the RLO quantity is directly
proportional to the amount of peroxide in plasma. The analytical
imprecision of this method is between 2.25 and 4.5%. The results
are expressed in units of Carratelli (UC; 1 AU 0.08 mg/
100 mL H2O2).
Serum H2O2 concentration
A colorimetric assay kit (Tema Ricerca, Italy) was used to
determine the H2O2 concentration in 100 mL of serum. The intra-
228 V. Sanguigni et al. / Nutrition 33 (2017) 225233

Table 1 Table 2
Mean contents composition Baseline characteristics of participants
Contents Antioxidant ice cream Control ice cream Male/Female 7/7
Mild solids, % 42 39.13 Age (y) 38  3
Fats 9% 8.54% Total cholesterol (mg/dL) 177.14  22
HDL (mg/dL) 51.64  9
 Saturated: 1.35%  Saturated: 6.02% Triglycerides (mg/dL) 90.07  13
Glycemia (mg/dL) 75.57  10
 Monounsaturated: 6.14%  Monounsaturated: 2.24% BUN (mg/dL) 18.2  3

 Polyunsaturated: 1.52%  Polyunsaturated: 0.28% BUN, blood urea nitrogen; HDL, high-density lipoprotein

Carbohydrates 22.73% 24.30%

 Monosaccharides: 43.39%  Monosaccharides: 39.02%
 Disaccharides: 56.61%  Disaccharides: 60.98%
Proteins 4.24% 3.97%
assay and interassay coefcients of variation were 2.1% and 3.7%,
respectively. The results are expressed in m/M.
Analysis of the of NO levels
The NO concentration in the serum was determined by
measuring the metabolic end products (i.e., nitrite and nitrate
[NOx]) (Tema Ricerca). The intra- and interassay coefcients of
variation were 2.9% and 1.7%, respectively. Data are expressed in
micro/M.
Estimation of FRAP
The plasma FRAP was determined on the basis of the ability of
plasma to reduce ferric-tripyridyltriazine to its ferrous colored
form using a FRAP colorimetric detection kit (Arbor Assays, Ann
Arbor, MI, USA). The values are expressed in mmol Fe2/L; the
intra-assay and interassay coefcients of variation were 2.6% and
3.4%, respectively.
Endothelium FMD
The FMD test was performed by ultrasound evaluation of the
brachial artery, which was studied 3 to 7 inches above the
antecubital crease. To create a stimulus to the ow in the brachial
artery, a pressure cuff was placed on the forearm; the cuff was
inated to at least 50 mm Hg above the systolic pressure to
occlude the inow artery for 5 min. All measurements were
conducted to assess the vasodilation in late diastole. FMD was
expressed in terms of the variation in the post-stimulus diam-
eter, which was evaluated as a percentage of the basal diameter.
Arterial tonometry (EndoPat)
Endothelial function was noninvasively assessed according to
the principle of peripheral arterial tonometry (PAT) using an
EndoPAT 2000 device (Itamar Medical Inc., Caesarea, Israel). A
PAT probe was placed on the index nger of each hand for
continuous recording of the PAT signal. After 10 min of stabili-
zation of the blood ow, right brachial artery occlusion was ob-
tained by inating a previously placed pressure cuff on the
proximal forearm to supra-systolic pressures (60 mm Hg above
systolic blood pressure) for 5 min. Occlusion of pulsatile arterial
ow was conrmed by the reduction in the PAT tracing to zero.
After 5 min, the cuff was rapidly deated while the PAT tracing
post-ischemic phase to assess the hyperemic response. The
values of vasodilation digitalis are expressed by test/baseline (T/
B), which incorporates the RHI, an index of endothelial function;
RHI is the ratio of the post-occlusion signal to the pre-occlusion
signal in an occluded arm, with the signals normalized to a
control arm and further adjusted for the basal vascular tone. The
average amplitude of the PAT signal during the post-occlusion
period (test signal, T) relative to the baseline (B) signal before
occlusion (T/B ratio) was manually obtained; the time intervals
were the same as those used for the RHI calculation, but they
were not indexed to the contralateral arm.
Evaluation of physical performance using a test ergometer (stress
test)
The assessment of the individual response to physical exer-
cise was performed in each participant at baseline using an ex-
ercise stress test on a cycle ergometer with a scalar prole and
increasing loads of 25 watts/2 min. During the test, the electro-
cardiogram, heart rate, and blood pressure were monitored. The
test was stopped at muscular exhaustion. At this time point, the
maximum load reached in watts and the double product peak
effort (maximum load pressure  maximum heart rate) were
recorded. The second exercise test (during the second phase of
the study) was performed so that the individual would reach the
same load (watts) as the baseline load.
Statistical analysis
The primary endpoint of the study was the FMD change after
the ingestion of the antioxidant ice cream. Data from a pilot
study were used to calculate the sample size. For a 40% increase
from the baseline FMD after intake of the antioxidant ice cream
(FMD baseline 2.6  1.3 versus 3.7  1.3), 14 participants were
needed to provide a power of 92% with a 0.05.
The variables were tested for a normal distribution using
histograms and/or the KolmogorovSmirnov test. Normally
distributed variables were expressed as the mean and SD;
otherwise, variables were expressed as the median and range
(min/max). The frequency indexes of the total sample or any
subgroup were described as percentage rates. All comparisons of
proportions were performed using a c2 test or for cases with
fewer than ve occurrences, with Fishers exact test. Between-
Table 3
Total polyphenol content in the ice cream
Compounds Antioxidant ice Control ice P value
cream cream
Total polyphenols (mg/L GAE) 1817 96 <0.001
Epicatechin (mg/mL) 9.1 0.06 <0.001
Catechin (mg/mL) 10.5 0.03 <0.001

was recorded for the subsequent 10 min during the GAE, gallic acid equivalent
 V. Sanguigni et al. / Nutrition 33 (2017) 225233 229

Fig. 3. (A) Total polyphenols; (B) hydroperoxides with plasma d-ROMs test; (C) H2O2; and (D) plasma ferric-reducing antioxidant power (FRAP) before and 2 h after intake of
antioxidant ice cream or control ice cream. d-ROM, determination of reactive oxygen metabolite; GAE, gallic acid equivalent; U-CARR, units of Carratelli. Data are expressed as
mean and condence interval 95%. Analysis of variance for repeated measures. *P < 0.001. yP < 0.05.

treatment data were compared using a one-way analysis of
variance (ANOVA) or two-way ANOVA for repeated measures, as
appropriate. Correlations were evaluated using the R of Pearsons
test.
The statistical analysis was performed using the statistical
software SPSS version 15 (Statistical Package for the Social Sci-
ences Windows, Chicago, IL, USA). For the risk level, a precise a
value of 5% was chosen, and a value of P < 0.05 was considered
statistically signicant.
Results
All 14 volunteers completed the study. The clinical charac-
teristics of the study population are reported in (Table 2). The
total and single polyphenol contents were signicantly higher
(P < 0.001) in the antioxidant ice cream than in the control ice
cream (Table 3).
Two h after the ingestion of the antioxidant ice cream, the
serum level of polyphenols (Fig. 3A) increased signicantly
(P < 0.001); the oxidative stress decreased, as indicated by the
average d-ROMs and H2O2 values (Fig. 3B, C; P < 0.001 for both);
and the antioxidant capacity measured by FRAP (Fig. 2D,
P < 0.005) and the NO bioavailability both improved signicantly
(Fig. 4A; P < 0.001). There was also a signicant improvement in
the endothelium-mediated artery dilation measured by FMD and
Endopat 2000 (Fig. 3B, C; P < 0.001 and P < 0.05, respectively).
The exercise test performed after the intake of antioxidant ice
cream showed a signicant improvement in the physical per-
formance compared with that for the control ice cream; the
change was indicated by the reduction in the double product at
the peak effort (Fig. 4D; P < 0.001).
230 V. Sanguigni et al. / Nutrition 33 (2017) 225233

Fig. 4. (A) Serum NOx; (B) Endothelium FMD; (C) Endopath (T/B); and (D) DP before and 2 h after intake of antioxidant ice cream or control ice cream. Data are expressed as
mean and 95% CI. DP, double product; FMD, ow-mediated vasodilation; NOx, mono-nitrogen oxides; T/B, test/baseline. Analysis of variance for repeated measures.
*
P < 0.001. yP < 0.05.

The total serum polyphenol level was positively correlated
with the NOx levels (Fig. 5A; r 0.724; P < 0.001) and the FMD
(Fig. 5B, r 0.697; P < 0.001). By contrast, the total serum
polyphenol level was negatively correlated with the DP (Fig. 5C;
r 0.559; P < 0.001).
Discussion
To our knowledge, this is the rst study to demonstrate the
acute antioxidant effects of a mixture of cocoa, hazelnuts, and
green teaditems with high polyphenol contentsdthat has been
incorporated into ice cream. After the ingestion of the antioxi-
dant ice cream, there was a signicant reduction in the levels of
circulating markers of oxidative stress (serum hydroperoxides
and H2O2) and an increased bioavailability of NO. The antioxidant
status, as measured by the FRAP, improved signicantly. The
reduction in the oxidative stress and the enhanced availability of
NO led to the signicant improvement in vascular function
(increased FMD and T/B) and allowed the better physical per-
formance of the healthy individuals.
Many diseases, particularly those associated with aging (e.g.,
such as atherosclerosis, CVD, cancer, and chronic disease), are
closely related to oxidative stress status due to the high pro-
duction of ROS [2325]. A diet rich in polyphenols, which are
ultimately obtained from plants, seems to signicantly decrease
the risk and has been associated with lower risk for developing
degenerative disease [26]. Recent studies reported a strong as-
sociation between polyphenol intake and a 46% reduction in risk
for CVD when comparing the highest (1235 mg/d) versus the
lowest (483 mg/d) quintile of intake [27]. Most of the studies
were performed with the use of a single food, which could
explain the variability of the data obtained. The Phenol-Explorer
 V. Sanguigni et al. / Nutrition 33 (2017) 225233
Fig. 5. Correlations (A) between serum NOx and total polyphenols, (B) between FMD and
total polyphenols and (C) between DP and total polyphenols. DP, double product; FMD,
ow-mediated vasodilation; GAE, gallic acid equivalent; NOx, mono-nitrogen oxides.
231
database provides composition data for 502 polyphenols in 452
foods, and provides calculations of the amount of polyphenols
contained in a food serving [28]. The top richest dietary sources
for total polyphenols include dark cocoa powder, hazelnut, and
green tea, which are indeed the main ingredients of our anti-
oxidant ice cream.
Scientic evidence supports a cause and effect relationship
between the consumption of cocoa and the maintenance of
normal endothelium-dependent vasodilation [7,8,29]. A possible
mechanism explaining the effects of cocoa on the vasculature is
the antioxidative effect of the avonols contained in cocoa; these
avonols can reduce the production of oxygen-free radicals and
therefore improve nitric oxide bioavailability and endothelial
nitric oxide synthase activation [3032].
Increased nut consumption has been associated with a
reduced risk for major chronic diseases. In two large, indepen-
dent cohorts of 76 464 women (Nurses Health Study) and 42 498
men (the Health Professionals Follow-up Study), the frequency of
nut consumption was inversely associated with total and cause-
specic mortality [33]. A recent systematic review and
meta-analysis of epidemiologic studies, with a total of 354 933
participants, 44 636 cumulative incident deaths, and 3 746 534
cumulative person-years [34], showed that nut consumption is
associated with lower risk of all-cause, CVD, and cancer deaths.
These effects are likely due to the signicant improvement in
FMD found in some investigations [9,10].
A recent meta-analysis of prospective observational studies
that investigated the association between tea consumption and
major cardiovascular outcomes or total mortality reported data
on 856 206 individuals. The analysis showed that an increase in
tea consumption by three cups per day was associated with a
reduced risk for coronary artery disease, cardiac death, stroke,
cerebral infarction, and intracerebral hemorrhage, as well as total
mortality [35]. The benecial effects also are related to the direct
effects of tea on endothelium-dependent vasodilation [11,12].
No previous study, to our knowledge, has investigated the
combined effect of a natural antioxidant mixture.
There are several good reasons to incorporate these natural
compounds in an ice cream and expect that the combination
would work more efciently as an antioxidant than a single
compound. First, the combination of different compounds can
improve the antioxidant response relative to that for a single
ingredient with a nonlinear potentiating effect. The exclusive
and habitual consumption of certain foods can often cause side
effects (such as the arrhythmias and restlessness with dark
chocolate) or become boring and repetitive. Indeed, as often
happens in nature, the sum of the parts can be more effective in
providing health benets than single compounds [36]. For these
reasons, we have developed an antioxidant mixture of natural
selected compounds at a predetermined dose; the mixture is
characterized by a high content of polyphenols (1817 mg/L GAE).
Second, a low temperature can make the antioxidant properties
of these polyphenols more stable over time and preserve them
from degradation. Polyphenols are easily oxidized, leading to the
formation of polymerized molecules with reduced antioxidant
capacities, such as phenolic compounds [26]. Indeed, phenolic
compounds are antioxidants, and they are subject to oxidation
during storage and processing [37]. The storage of food con-
taining polyphenols at room temperature results in the pro-
duction of phenols, and the optimal stability of polyphenols
during long-term storage seems to occur at low temperature
(4 C). In general, freezing causes minimal destruction of phenolic
compounds. The levels of total phenols in refrigerated products
have been shown to increase during the rst 3 d of storage. This
232 V. Sanguigni et al. / Nutrition 33 (2017) 225233
increase has been attributed to a probable increased activity of
enzymes involved in phenolic synthesis [38]. Third, the
bioavailability of polyphenols from natural sources is expected to
be larger than that from supplements [39]. Based on these ob-
servations, we incorporated a mixture of natural selected com-
pounds into an antioxidant ice cream to achieve a powerful
antioxidant effect, which would be durable and stable over time.
Because of its high amount of polyphenols, the antioxidant ice
cream might act directly via a reduction in oxidative stress and
thus an enhancement in NO generation that is responsible for
endothelium-mediated artery dilation; this effect is explained by
the signicant positive correlation between the levels of poly-
phenols and NOx and between the level of polyphenols and FMD.
The evidence from the literature consistently demonstrates
that during strenuous exercise, ROS generation increases to a
level that overwhelms tissue antioxidant defense systems,
resulting in oxidative stress [40]. The magnitude of the stress
depends on the ability of the tissues to detoxify ROS [41].
Antioxidant supplements generally do not improve physical
performance. Data from the literature suggest that the intake of
polyphenol-rich beverages and food can provide protection
against oxidative stress and even exercise-induced muscle
damage due to their potent antioxidant properties, but no study
has evaluated the effect, if any, on exercise performance [20,42].
Physical exercise is associated with a 10- to 20-fold increase in
whole body oxygen uptake. The oxygen ux in the active pe-
ripheral skeletal muscle bers increases by as much as 100- to
200-fold during exercise. Endothelium-mediated artery dilation
can result in a signicant increase in blood ow [40].
Our data show an improvement in physical performance after
the intake of the antioxidant ice cream; this benet is indicated
by the reduction in the double product to the same load,
measured in watts, that was reached in the baseline condition.
This change is likely due to the important increase in
endothelium-mediated artery dilation, which is probably
dependent on the augmented levels of polyphenols in blood, as
corroborated by the signicant inverse correlation by the double
product levels and the polyphenol content.
Because the present study aimed to evaluate the acute effects
of polyphenols contained in an antioxidant ice cream, we did not
examine the possible subacute effects (46 h) of saturated and
simple carbohydrates on oxidative stress activity. Therefore,
further studies are needed to evaluate the chronic effects of
natural antioxidant ice cream.
Conclusions
The present study suggests that the ingestion of an antioxi-
dant ice cream consisting of a mixture of selected foods with
high polyphenol contents strongly improves the vascular func-
tion and physical performance, probably through an oxidative
stress-mediated mechanism.
The ice cream is potentially effective in counteracting oxida-
tive stress in healthy individuals, athletes, elderly, and even in
patients suffering from many chronic and degenerative diseases
because of the powerful antioxidant effects and the durability
and stability over time. The palatability and the low fat, caffeine,
and theobromine contents also make this ice cream suitable for
daily consumption, particularly in individuals who have a low
polyphenol intake due to poor consumption of fruit and
vegetables.
Further studies are necessary to verify whether habitual
consumption could be a valid natural therapeutic approach for
the prevention of cardiovascular, metabolic, aging, and chronic
degenerative diseases.
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