{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:48:34Z","timestamp":1765547314631,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Oxidative stress has emerged as a key contributor to numerous NCDs (non-communicable diseases), including cardiovascular diseases, cancer, and diabetes. This study aims to explore the potential of targeted interventions to mitigate oxidative stress as part of a primary prevention strategy. Methods: The study included 32 healthy participants (11 men, 21 women) aged 45\u201365 who completed both the initial and follow-up assessments of the Healthy Days Initiative, a community-based wellness program organized by the non-profit Associazione O.R.A. ETS. Through blood analysis, vital sign assessment, lifestyle questionnaires, and individualized recommendations, participants received guidance on improving their health and reducing disease risk. The initiative also offered the opportunity for participants to consume a flavonoid supplement containing quercitrin, rutin, and hesperidin, with the goal of reducing oxidative stress. Participants who opted for supplementation were instructed to take 1\u20132 tablets daily for two weeks. Data collected included demographic information, anthropometric measurements, vital signs, dietary and lifestyle habits, medical history, WHO-5 Well-Being Index scores, and blood parameters. Results: Significant reductions were observed in glucose levels (from 82 to 74.5 mg\/dL), reactive oxygen metabolites (d-ROMs) (from 394.5 to 365.5 U.CARR), and systolic blood pressure (from 133 to 122 mmHg) after the two-week flavonoid intervention. Most participants (26\/31) reported no side effects, and the majority (30\/31) expressed a willingness to continue using a product combination of quercitrin, rutin, and hesperidin or a similar product long-term. Conclusions: While limited in scope and duration, the PREVES-FLAVON study contributes valuable insights to the growing body of evidence suggesting that flavonoid supplementation may play a significant role in reducing risk factors associated with NCDs in primary prevention settings. By targeting novel risk factors such as oxidative stress, this intervention holds promise for mitigating the global burden of NCDs and promoting healthy aging.<\/jats:p>","DOI":"10.3390\/nu16193302","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T05:45:27Z","timestamp":1727675127000},"page":"3302","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Flavonoid Supplementation on Serum Oxidative Stress Levels Measured via D-ROMs Test in the General Population: The PREVES-FLAVON Retrospective Observational Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Giuseppe","family":"Di Lorenzo","sequence":"first","affiliation":[{"name":"Oncology Unit, \u201cAndrea Tortora\u201d Hospital, ASL Salerno, 84016 Pagani, Italy"},{"name":"Associazione O.R.A. ETS-Oncology Research Assistance, 84134 Salerno, Italy"},{"name":"UniCamillus\u2014Saint Camillus International University of Health Sciences, 00131 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Verde","sequence":"additional","affiliation":[{"name":"Oncology Unit, \u201cAndrea Tortora\u201d Hospital, ASL Salerno, 84016 Pagani, Italy"},{"name":"Associazione O.R.A. ETS-Oncology Research Assistance, 84134 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7410-8300","authenticated-orcid":false,"given":"Luca","family":"Scafuri","sequence":"additional","affiliation":[{"name":"Oncology Unit, \u201cAndrea Tortora\u201d Hospital, ASL Salerno, 84016 Pagani, Italy"},{"name":"Associazione O.R.A. ETS-Oncology Research Assistance, 84134 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferdinando","family":"Costabile","sequence":"additional","affiliation":[{"name":"Oncology Unit, \u201cAndrea Tortora\u201d Hospital, ASL Salerno, 84016 Pagani, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8750-4492","authenticated-orcid":false,"given":"Vincenza","family":"Caputo","sequence":"additional","affiliation":[{"name":"Oncology Unit, \u201cLuigi Curto\u201d Hospital, ASL Salerno, 84035 Polla, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Di Trolio","sequence":"additional","affiliation":[{"name":"Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione G. Pascale, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriana","family":"Strianese","sequence":"additional","affiliation":[{"name":"Oncology Unit, \u201cAndrea Tortora\u201d Hospital, ASL Salerno, 84016 Pagani, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vittorino","family":"Montanaro","sequence":"additional","affiliation":[{"name":"Urology Department, \u201cSan Leonardo\u201d Hospital\u2014ASL Napoli 3 Sud., Castellammare di Stabia, 80053 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4315-7660","authenticated-orcid":false,"given":"Felice","family":"Crocetto","sequence":"additional","affiliation":[{"name":"Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples \u201cFederico II\u201d, 80133 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3865-5988","authenticated-orcid":false,"given":"Francesco","family":"Del Giudice","sequence":"additional","affiliation":[{"name":"Department of Maternal Infant and Urologic Sciences, \u201cSapienza\u201d University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-0845","authenticated-orcid":false,"given":"Raffaele","family":"Baio","sequence":"additional","affiliation":[{"name":"Department of Urology, Umberto I, Nocera Inferiore, 84014 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Tufano","sequence":"additional","affiliation":[{"name":"Unit of Urology, Istituto Nazionale Tumori IRCCS Fondazione G. 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Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"54","DOI":"10.15280\/jlm.2024.14.1.54","article-title":"Intervention for Primary Prevention of Non-Communicable Diseases","volume":"14","author":"Singh","year":"2024","journal-title":"J. Lifestyle Med."},{"key":"ref_5","first-page":"e596","article-title":"2019 ACC\/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"140","author":"Arnett","year":"2019","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2020). 3. Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes\u20142021. Diabetes Care, 44, S34\u2013S39.","DOI":"10.2337\/dc21-S003"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1016\/j.canep.2014.12.016","article-title":"European Code against Cancer 4th Edition: Diet and Cancer","volume":"39","author":"Norat","year":"2015","journal-title":"Cancer Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"30","DOI":"10.3322\/caac.20140","article-title":"American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention","volume":"62","author":"Kushi","year":"2012","journal-title":"CA Cancer J. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Crocetto, F., di Zazzo, E., Buonerba, C., Aveta, A., Pandolfo, S.D., Barone, B., Trama, F., Caputo, V.F., Scafuri, L., and Ferro, M. (2021). Kaempferol, Myricetin and Fisetin in Prostate and Bladder Cancer: A Systematic Review of the Literature. Nutrients, 13.","DOI":"10.3390\/nu13113750"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"FSO784","DOI":"10.2144\/fsoa-2022-0002","article-title":"Fisetin as an Adjuvant Treatment in Prostate Cancer Patients Receiving Androgen-Deprivation Therapy","volume":"8","author":"Lorenzo","year":"2022","journal-title":"Future Sci. OA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1093\/ajcn\/nqac055","article-title":"Effect of Cocoa Flavanol Supplementation for the Prevention of Cardiovascular Disease Events: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) Randomized Clinical Trial","volume":"115","author":"Sesso","year":"2022","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1017\/S1368980013003169","article-title":"Mediterranean Diet and Health Status: An Updated Meta-Analysis and a Proposal for a Literature-Based Adherence Score","volume":"17","author":"Sofi","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8416763","DOI":"10.1155\/2017\/8416763","article-title":"Oxidative Stress: Harms and Benefits for Human Health","volume":"2017","author":"Pizzino","year":"2017","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4103\/0973-7847.70902","article-title":"Free Radicals, Antioxidants and Functional Foods: Impact on Human Health","volume":"4","author":"Lobo","year":"2010","journal-title":"Pharmacogn. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1007\/s00204-023-03562-9","article-title":"Reactive Oxygen Species, Toxicity, Oxidative Stress, and Antioxidants: Chronic Diseases and Aging","volume":"97","author":"Jomova","year":"2023","journal-title":"Arch. Toxicol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sch\u00f6ttker, B., Brenner, H., Jansen, E.H., Gardiner, J., Peasey, A., Kub\u00ednov\u00e1, R., Paj\u0105k, A., Topor-Madry, R., Tamosiunas, A., and Saum, K.-U. (2015). Evidence for the Free Radical\/Oxidative Stress Theory of Ageing from the CHANCES Consortium: A Meta-Analysis of Individual Participant Data. BMC Med., 13.","DOI":"10.1186\/s12916-015-0537-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.2337\/dc19-0292","article-title":"Association of Serum Markers of Oxidative Stress with Incident Major Cardiovascular Events, Cancer Incidence, and All-Cause Mortality in Type 2 Diabetes Patients: Pooled Results from Two Cohort Studies","volume":"42","author":"Xuan","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/ijc.32073","article-title":"Pre-diagnostic Derivatives of Reactive Oxygen Metabolites and the Occurrence of Lung, Colorectal, Breast and Prostate Cancer: An Individual Participant Data Meta-analysis of Two Large Population-based Studies","volume":"145","author":"Wilsgaard","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Singh, D., Ham, D., Kim, S.-A., Kothari, D., Park, Y.J., Joung, H., and Lee, C.H. (2024). Urine Metabolomics Unravel the Effects of Short-Term Dietary Interventions on Oxidative Stress and Inflammation: A Randomized Controlled Crossover Trial. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-65742-6"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1177\/172460080502000304","article-title":"Plant-Based Diet, Serum Fatty Acid Profile, and Free Radicals in Postmenopausal Women: The Diet and Androgens (DIANA) Randomized Trial","volume":"20","author":"Colombo","year":"2005","journal-title":"Int. J. Biol. Markers"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Annunziata, G., Ciampaglia, R., Maisto, M., D\u2019Avino, M., Caruso, D., Tenore, G.C., and Novellino, E. (2021). Taurisolo\u00ae, a Grape Pomace Polyphenol Nutraceutical Reducing the Levels of Serum Biomarkers Associated with Atherosclerosis. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.697272"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Yao, J., Zhang, Y., Zhao, J., Wang, X.-Z., Lin, Y.-P., Sun, L., Lu, Q.-Y., and Fan, G.-J. (2022). Efficacy of Flavonoids-Containing Supplements on Insulin Resistance and Associated Metabolic Risk Factors in Overweight and Obese Subjects: A Systematic Review and Meta-Analysis of 25 Randomized Controlled Trials. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.917692"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Wang, Y., Tian, Z., Li, Z., and Kim, J.C. (2023). Effects of Flavonoid Supplementation on Athletic Performance in Healthy Adults: A Systematic Review and Meta-Analysis. Nutrients, 15.","DOI":"10.3390\/nu15214547"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"488","DOI":"10.3945\/an.115.010538","article-title":"Effect of Flavonoids on Upper Respiratory Tract Infections and Immune Function: A Systematic Review and Meta-Analysis","volume":"7","author":"Somerville","year":"2016","journal-title":"Adv. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s12970-019-0303-x","article-title":"Effects of Enzymatically Modified Isoquercitrin in Supplementary Protein Powder on Athlete Body Composition: A Randomized, Placebo-Controlled, Double-Blind Trial","volume":"16","author":"Omi","year":"2019","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3208","DOI":"10.1093\/jn\/131.12.3208","article-title":"Bioavailability and Antioxidant Activity of Some Food Supplements in Men and Women Using the D-Roms Test as a Marker of Oxidative Stress","volume":"131","author":"Cornelli","year":"2001","journal-title":"J. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4916","DOI":"10.1080\/10408398.2021.2009761","article-title":"Efficacy of Flavonoids on Biomarkers of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"63","author":"Liu","year":"2023","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Buonerba, C., De Placido, P., Bruzzese, D., Pagliuca, M., Ungaro, P., Bosso, D., Ribera, D., Iaccarino, S., Scafuri, L., and Liotti, A. (2018). Isoquercetin as an Adjunct Therapy in Patients with Kidney Cancer Receiving First-Line Sunitinib (QUASAR): Results of a Phase I Trial. Front. Pharmacol., 9.","DOI":"10.3389\/fphar.2018.00189"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e002713","DOI":"10.1161\/JAHA.115.002713","article-title":"Effects of Quercetin on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"5","author":"Serban","year":"2016","journal-title":"J. Am. Heart Assoc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5080","DOI":"10.1002\/ptr.7971","article-title":"The Effects of Quercetin Supplementation on Cardiometabolic Outcomes: An Umbrella Review of Meta-analyses of Randomized Controlled Trials","volume":"37","author":"Arabi","year":"2023","journal-title":"Phytother. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"FSO867","DOI":"10.2144\/fsoa-2023-0041","article-title":"Nature\u2019s hidden gem: quercitrin\u2019s promising role in preventing prostate and bladder cancer","volume":"9","author":"Mirto","year":"2023","journal-title":"Future Sci. OA"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Imperatrice, M., Cuijpers, I., Troost, F.J., and Sthijns, M.M.J.P.E. (2022). Hesperidin Functions as an Ergogenic Aid by Increasing Endothelial Function and Decreasing Exercise-Induced Oxidative Stress and Inflammation, Thereby Contributing to Improved Exercise Performance. Nutrients, 14.","DOI":"10.3390\/nu14142955"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"6241017","DOI":"10.1155\/2018\/6241017","article-title":"Rutin as a Potent Antioxidant: Implications for Neurodegenerative Disorders","volume":"2018","author":"Enogieru","year":"2018","journal-title":"Oxid. Med. Cell. Longev."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/19\/3302\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:06:25Z","timestamp":1760112385000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/19\/3302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,29]]},"references-count":33,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["nu16193302"],"URL":"https:\/\/doi.org\/10.3390\/nu16193302","relation":{},"ISSN":["2072-6643"],"issn-type":[{"type":"electronic","value":"2072-6643"}],"subject":[],"published":{"date-parts":[[2024,9,29]]}}}