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Lipids and cardiovascular/metabolic health

Anthocyanin supplementation at different doses improves cholesterol efflux capacity in subjects with dyslipidemia—a randomized controlled trial



Numerous clinical trials have confirmed that supplementation with purified anthocyanins has favorable effects on metabolic diseases, but the dose–response of dyslipidemia to anthocyanin supplementation remains unclear. This study aimed to investigate the effect of anthocyanin supplementation in different doses on lipid profile.


We randomly assigned 176 dyslipidemic subjects aged 35–70 to three purified anthocyanin groups (40 mg/day, n = 45; 80 mg/day, n = 42; 320 mg/day, n = 43) and a placebo group (n = 46). Anthropometric parameters, serum lipid profiles, and cholesterol efflux capacity (CEC) were measured at baseline, and at the end of 6 and 12 weeks.


After 12 weeks of supplementation, significant differences in CEC (P = 0.033), high-density lipoprotein cholesterol (HDL-C) (P = 0.043), and apolipoprotein A-I (ApoA-I) (P = 0.022) were observed between four groups. Compared with placebo, 320 mg/day anthocyanin significantly increased CEC (35.8%, 95% CI: 11.5–60.2%; P = 0.004), HDL-C (0.07 mmol/L, 95% CI: 0.01–0.14; P = 0.003), and ApoA-I (0.07 g/L, 95% CI: 0.01–0.12; P = 0.008). Linear trend analysis showed that anthocyanin supplementation has a strong dose–response relationship with CEC (P = 0.002), HDL-C (P = 0.038), and ApoA-I (P = 0.023). Moreover, the enhancement of CEC showed positive correlations with the increase in HDL-C (r = 0.215, P < 0.01) and APOA-I (r = 0.327, P < 0.01).


Anthocyanin supplementation at 0–320 mg/day for 12 weeks enhances CEC in a dose–response manner in dyslipidemic subjects. Anthocyanin supplementation doses of 80–320 mg/day can improve serum HDL-C levels and HDL-induced CEC.

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Fig. 1: The participant flowchart of the study.
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The authors are grateful to all the volunteers for their participation.


This work was supported by the National Natural Science Foundation of China (grant numbers 81730090 and 81973022) and the Guangzhou Science, Technology, and Innovation Commission (grant number 201804020045).

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ZX, JX, and WL developed the overall research plan and had study oversight; YY and WL provided the research guidance; ZX, HZ, JP, QL, and XW participated in collecting the data and the biological samples; ZX, HX, XS, and HZ performed the measurements of CEC and analyzed the data; ZX, JX, and WL wrote the paper and had the primary responsibility for the final content. All authors read and approved the final paper.

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Correspondence to Yan Yang or Wenhua Ling.

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Xu, Z., Xie, J., Zhang, H. et al. Anthocyanin supplementation at different doses improves cholesterol efflux capacity in subjects with dyslipidemia—a randomized controlled trial. Eur J Clin Nutr 75, 345–354 (2021).

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