Cardiovascular benefits of lycopene: fantasy or reality?

Epidemiological evidence indicates that high consumption of tomatoes and tomato-based products reduces the risk of chronic diseases such as CVD and cancer. Such potential benefits are often ascribed to high concentrations of lycopene present in tomato products. Mainly from the results of in vitro studies, potential biological mechanisms by which carotenoids could protect against heart disease and cancer have been suggested. These include cholesterol reduction, inhibition of oxidation processes, modulation of inflammatory markers, enhanced intercellular communication, inhibition of tumourigenesis and induction of apoptosis, metabolism to retinoids and antiangiogenic effects. However, with regard to CVD, results from intervention studies gave mixed results. Over fifty human intervention trials with lycopene supplements or tomato-based products have been conducted to date, the majority being underpowered. Many showed some beneficial effects but mostly on non-established cardiovascular risk markers such as lipid peroxidation, DNA oxidative damage, platelet activation and inflammatory markers. Only a few studies showed improvement in lipid profiles, C reactive protein and blood pressure. However, recent findings indicate that lycopene could exert cardiovascular protection by lowering HDL-associated inflammation, as well as by modulating HDL functionality towards an antiatherogenic phenotype. Furthermore, in vitro studies indicate that lycopene could modulate T lymphocyte activity, which would also inhibit atherogenic processes and confer cardiovascular protection. These findings also suggest that HDL functionality deserves further consideration as a potential early marker for CVD risk, modifiable by dietary factors such as lycopene.

Creating smoke-free homes for children.

This article describes a tool that was designed to help nurses deliver health education on the subject of passive smoking. The tool is based on a Scottish study, which encouraged mothers to identify their own strategies for reducing smoking in the home in order to protect their children from being exposed to second-hand smoke. It is designed to give nurses and other health professionals who work with families and children the knowledge, skills and confidence they need to raise the issue of second-hand smoke with parents and help them to find their own solutions to reducing smoking in the home. This article also takes into consideration the implications for nursing practice that relate to raising the issue of exposing children to second-hand smoke with parents and carers.

REFRESH--reducing families' exposure to secondhand smoke in the home: a feasibility study.

OBJECTIVE: To study a novel intervention (REFRESH) aimed at reducing children's exposure to secondhand smoke (SHS) in their homes. DESIGN: A randomised feasibility study. SETTING: Aberdeen City and Aberdeenshire. PARTICIPANTS: A total of 59 smoking mothers with at least one child younger than 6 years. Participation took place between July 2010 and March 2011. INTERVENTION: Four home visits over a 1-month period, which involved two 24-h measurements of home air quality (PM2.5) and a motivational interview to encourage changes to smoking behaviour within the home in order to reduce child SHS exposure. The enhanced group received their air quality data as part of their motivational interview at visit 2; the control group received that information at visit 4. MAIN OUTCOME MEASURES: The main outcome measures were comparisons of the data from visits 2 and 4 on the 24-h average concentration of PM2.5, the peak concentration of PM2.5, the percentage of time when household PM2.5 concentrations exceeded a health-based threshold of 35 µg/m(3) and child's salivary cotinine (in nanograms per millilitre). The views of the mothers from the enhanced group about their understanding of the intervention and the measures used were also analysed to assess the acceptability and utility of the intervention. RESULTS: Of the recruited 54 participants, 48 completed the study: 27 from the control group and 21 from the enhanced group. Both groups experienced reductions in PM2.5 concentrations. When testing paired samples for the enhanced group, there was a significant difference (p<0.05) between visit 2 and visit 4 values for maximum PM2.5 (p=0.006) and for percentage of time over 35 µg/m(3) (p=0.017), with average PM2.5 approaching significance (p=0.056). There was no significant difference for salivary cotinine. The qualitative findings showed that mothers were able to understand the data they were shown and were shocked by the values measured in their homes despite being aware of the effects of SHS exposure. They appreciated the intervention taking place in their homes as it allowed them to have personalised data. Many mothers described how they had changed their smoking behaviours in their home and in particular were motivated to protect their own children as a result of the knowledge they had gained. CONCLUSIONS: Providing mothers who smoke with personalised results about the indoor air quality of their homes along with a motivational interview is feasible and has an effect on improving household air quality. Participants found the intervention understandable and acceptable. Taken overall, the results suggest that a future large-scale trial using measurements of indoor air quality as part of a complex intervention to reduce children's SHS exposure should be explored.

'I'm not doing this for me': mothers' accounts of creating smoke-free homes.

This article explores mothers' narratives of changing home smoking behaviours after participating in an intervention (Reducing Families' Exposure to Smoking in the Home [REFRESH]) aimed at reducing families' exposure to secondhand smoke (SHS) in homes in Scotland. An analysis of qualitative findings illuminates quantitative changes in levels of SHS exposure. Prospective quantitative and qualitative data were drawn from 21 smoking mothers with at least one child under 6 years. Quantitative change was measured by home air quality, i.e. fine particulate matter <2.5µg (PM(2.5)). These measurements guided the organization of mothers into categories of change (smoke-free home at baseline [SFB], smoke-free home at final, some change and no change [NC]). Qualitative data from 17 mothers with non-SFB were analysed thematically within and across these categories. Three comparative case studies illustrate the varying changes made, barriers to change and how mothers valued such changes. The outcomes varied post-intervention, with homes smoke-free, partially smoke-free or making NC. The changes in home smoking behaviour were incremental, yet beneficial to reducing SHS exposure, and related to the nature of the restrictions and personal circumstances in the home pre-intervention. Across all change categories, mothers valued the changes they had made and expressed an intention to increase the changes.

Lycopene inhibits lymphocyte proliferation through mechanisms dependent on early cell activation.

SCOPE: Epidemiological evidence suggests that lycopene is potentially cardio-protective. Recruitment and activation of T cells in the arterial wall is a critical process during atherogenesis, but the effects of lycopene on T-cell response remain to be elucidated. We aimed to determine whether lycopene could modulate T-cell function and activity. METHODS AND RESULTS: Peripheral blood mononuclear cells from 16 healthy adults were cultured in the presence of lycopene-enriched liposomes (0-2.9 µg lycopene/mL) with or without mitogens. Cell cycle as well as the expression of CD69 (marker of early cell activation), CD25 (IL-2 receptor), and CD11a (late activation marker) were measured in T cells, T-helper cells, and T-cytotoxic cells by flow cytometry. IL-2 secretion and cell proliferation were determined by ELISA and [³H]-thymidine incorporation, respectively. Lycopene significantly inhibited lymphocyte proliferation (up to 40%) in activated cells. Lycopene also significantly inhibited CD69 expression (by up to 12%) as well as IL-2 secretion (by up to 29%). However, CD25 and CD11a expression as well as the cell-cycle profile were unaffected by lycopene. CONCLUSION: Lycopene influences lymphocyte proliferation through its effects on processes involved in early cellular activation, providing one possible mechanism to explain the beneficial effects of tomato-rich diets against cardiovascular disease.

Factors influencing exposure to secondhand smoke in preschool children living with smoking mothers.

INTRODUCTION: The health effects on young children of exposure to secondhand smoke (SHS) are well described. Recent work suggests that over one quarter of school-aged children in Scotland are regularly exposed to SHS in the home. The study was designed to describe SHS exposure in preschool children whose mothers smoked and identify factors that influence exposure. METHODS: Smoking mothers with at least one child aged 1-5 years were recruited to the Reducing Families' Exposure to Secondhand Smoke in the Home study. Concentrations of airborne particulate matter less than 2.5 µm in size (PM(2.5)) in the home were measured together with child's salivary cotinine. Demographics including age, accommodation type, socioeconomic status, and number of cigarettes smoked at home were recorded. RESULTS: Data were collected from 54 homes. In 89% of the homes, concentrations of PM(2.5) exceeded health-based guidance values at some point of the day. Household PM(2.5) concentrations were highest during the evening hours of 6 p.m. to midnight. Younger children had higher salivary cotinine concentrations than older children, and the geometric mean of salivary cotinine was 2.36 ng/ml. Household smoking restrictions and maternal confidence in enforcing smoking restrictions in their own home were strongly associated with child's SHS exposure. CONCLUSIONS: Preschool children's exposure to SHS in homes where the mother smokes is considerable. Interventions and policy development to increase parental awareness of the health effects of SHS and provide parents with the confidence to implement smoke-free households are required to reduce the SHS exposure of preschool age children.