Polyphenols increase circulating lipids but improve LDL particle quality and reduce LDL oxidation in postmenopausal women: metabotype- and age-dependent effects in a randomised, placebokontrollerad crossover trial.

I PolyPAUSE-studien fick 90 postmenopausala kvinnor med lätt förhöjt kolesterol en daglig polyfenolblandning under 8 veckor: ellagitanniner plus ellagsyra på 312 mg, resveratrol på 133 mg och isoflavoner på 166 mg. Därefter följde 4 veckors uppehåll och en 8 veckor lång placeboperiod. 78 kvinnor fullföljde. Lipidresultaten pekar åt två håll samtidigt. Total cholesterol rose 7%, LDL cholesterol rose 9.5%, and triglycerides rose 16% (all p < 0.001), and the increases were larger in older participants. At the same time oxidised LDL fell (p < 0.001) and three ratios covering LDL particle quality and oxidative burden improved (p < 0.001). ApoB reduction was borderline at p = 0.056. Bone markers and lipopolysaccharide-binding protein did not move. Gut microbiota metabotype mattered: equol producers saw a 65% drop in oxidised LDL, and the urolithin A plus equol plus lunularin-producer cluster saw 60%. The design cannot separate the three compounds. Any single-ingredient claim from this trial is unsupported.

Polyphenol supplementation increased Tchol, LDLc, and TGs age-dependently, yet improved LDL oxidative quality. The extent of oxLDL reduction depended on metabotypes, supporting precision health approaches to better characterise cardiometabolic responses to polyphenol intake in postmenopausal women.