## 4 The Evidence in Humans  
### Cardiovascular Risk  
Fruit juices have been investigated to control lipid profiles, antioxidants, and inflammatory status. In cigarette smokers, _Morinda citrifolia_ (noni) fruit juice has a significant antioxidant activity, improving serum lipid profiles, like cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), and homocysteine [138]. F105, a phytochemical formulation resulting from the combination of bergamot fruit extract (_Citrus bergamia_) with nine phytoextracts, acting synergistically as antioxidant and anti-inflammatory agents, has been revealed in vitro to have a marked antioxidant activity, and, in a clinical case report, a great ability to decrease lipid profiles [139]. In normal-weight and overweight volunteers, the intake of red-fleshed orange juice (red orange juice) [140] and polyphenol-rich chokeberry juice had similar effects, thanks to the antioxidant and reducing properties of citrus flavonoids, carotenoids, and lycopene, improving the risk factors for metabolic syndrome, including improvements in insulin resistance and blood pressure [141]. Also, the combined supplementation of grape pomace and omija fruit extracts [142], as well as _Sambucus ebulus_ fruit infusion [143], improved obesity-related dyslipidemia, inflammation, and serum oxidative stress, however, without evident effects on patient body weight. Both body weight and lipid profile were, instead, improved by green tea (_Camelia sinensis_) intake [144], which also had a positive effect on DNA repair via HO-1 expression, which is a cytoprotective enzyme against pro-oxidant changes [145]. Red grape seed extract, which contains antioxidant oligomeric proanthocyanidins, has been revealed to increase serum paraoxonase (PON) activity. Paraoxonase is an enzyme that protects against lipid oxidation in patients with mild to moderate hyperlipidemia [146] and in hemodialysis patients [147]. The red wine extract of onion, in particular, suppressed both the total cholesterol and LDL cholesterol levels, and also modulated inflammatory markers, such as factor VII [148]. A quercetin-rich onion skin extract was able to reduce day-time and night-time systolic blood pressure in overweight-to-obese patients with either pre-hypertension or stage I hypertension [149]. Red wine extract and red wine extract of onion did not produce significant changes in body weight or body mass index in hypercholesterolemia patients, however, they displayed remarkable antioxidant effects, delaying LDL oxidation [148]. Dietary wolfberry extract has reduced oxidative stress in overweight and hypercholesterolemia patients through decreasing erythrocyte SOD activity, increasing CAT activity, and controlling inflammatory mRNAs expression. Likewise, the percentage of DNA damage in lymphocytes was significantly lower after 8-week wolfberry extract intake [150]. The beneficial effects of Korean red ginseng on lymphocyte DNA damage, antioxidant enzyme activity, and LDL oxidation were demonstrated in healthy individuals, following a regulatory mechanism of plasma SOD, GSH, and CAT [151]. Indian kudzu (_Pueraria tuberosa_) has been shown to have a pronounced ability to decrease blood pressure, enhancing plasma fibrinolytic activity and serum total antioxidant status in patients with stage 1 hypertension [151]. Dietary supplementation with _Heracleum persicum_ fruit, which is a well-known spice with beneficial effect against oxidative stress, was associated with reduced MDA production, and increased GSH and total antioxidant capacity (TAC) in subjects undergoing coronary angiography [152]. Also, MDA levels, resulting from postprandial oxidative stress, decreased after the intake of an antioxidant-rich concentrate of berries, called BPC-350, as tested in healthy volunteers who at a turkey burger [153].