Christine Sardo, MPH, RD PhD

Christine Sardo, MPH, RD PhD

Biography

Christine’s research has focused on the effects of fruit phenolics, physical activity, and inflammation on colorectal neoplasia. Related to this research, she has also studied the post-prandial effects of black raspberries on post-prandial inflammation in older overweight and obese men.Christine is a Teaching Assistant at the University of Arizona Mel and Enid Zuckerman College of Public Health and a Clinical Nutritionist at Canyon Ranch Health Resort and Spa in Tucson, Arizona.

Prior to her current positions, Christine was the Partnerships and Policies Director at Canyon Ranch Institute, in addition to holding positions as the program manager for Canyon Ranch Institute’s partnerships with the Lance Armstrong Foundation and the Cleveland Clinic. Canyon Ranch Institute is a 501(c)3 non-profit organization. Canyon Ranch Institute (CRI) catalyzes the possibility of optimal health for all people by translating the best practices of Canyon Ranch and CRI’s partners to help educate, inspire, and empower every person to prevent disease and choose a life of wellness.

Prior to joining Canyon Ranch Institute in February 2009, Christine managed the Cancer Chemoprevention Clinical Trials with black raspberries at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio. She has also served as a research and planning analyst for the Leo Burnett Company in Chicago and a senior pharmaceutical representative for SmithKline Beecham and Janssen Pharmaceutica (Johnson & Johnson) in Columbus, Ohio. Christine has also worked as a research assistant at the National Institutes of Health – National Heart, Lung and Blood Institute, in the laboratory of Dr. Theodor Kolobow, investigating novel lung ventilation devices.

Collaborating with the public and her professional colleagues, Christine has developed educational seminars, articles, videos, and cooking demonstrations to improve health literacy about how we can all achieve optimal wellness. Christine also served as the nutrition and cancer prevention and survivorship expert for LIVESTRONG.com and writes a bimonthly article on cancer prevention and survivorship for The Wellness Community in Columbus, Ohio.

In addition, Christine has taught cancer prevention and survivorship seminars and led educational sessions in the United States and internationally. Among those numerous presentations, Christine is particularly pleased to have had the opportunity to present at The Ohio State University Lance Armstrong Center of Excellence; Dr. Andrew Weil’s Nutrition and Health: State of the Science and Clinical Applications conference; Canyon Ranch; the American Dietetic Association’s National Conference; and Peking University Health Sciences Center in Beijing, China.

Christine has authored and co-authored several nutrition and chemoprevention articles for the public and for peer-reviewed publications, including the Journal of Clinical Pharmacology, Seminars in Cancer Biology, Nutrition and Cancer, and Cancer Epidemiology Biomarkers and Prevention. She was also a contributor to the National Call to Action (NCTA) on Cancer Prevention and Survivorship.

Christine earned a bachelor’s of science degree in pre-medicine and nutrition from The Ohio State University, and a master’s in public health degree from the University of Minnesota. She completed a National Institutes of Health Fellowship in Patient-Based Clinical Research and is a registered dietitian. She is also a board member of The Wellness Community, an active member of the American Dietetic Association, and past-president of the Columbus Dietetic Association.

Abstract

The Role Of Black Raspberries and Fruit Phenolics on Inflammation Andcolorectal Neoplasia

STUDY 1: Pharmacodynamics of polyphenols: a clinical trial investigating the inflammomodulatory effects of freeze-dried black raspberries fed to older overweight or obese males in the postprandial state

STUDY 2: The biologic effects of fruit phenolics on adenoma recurrence: a pooled analysis of two large phase III, double-blind, placebo controlled clinical trials

BACKGROUND
Risk of colorectal cancer is significantly increased in obese individuals [1, 2] and overweight and obesity have been associated with increased risk for adenoma occurrence[3-5]. In addition, obesity leads to substantial metabolic dysregulation creating a physiologic environment characterized by chronic activation of inflammatory mediators[6] including pro-inflammatory cytokines such as interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α)[7]. Importantly, this dysregulation is exacerbated by the post-prandial state[8], suggesting that diet may have an important impact on colorectal neoplasia. One specific group of dietary components of interest is fruit polyphenols. Few epidemiological studies have specifically determined the role of fruit polyphenols (bioflavonoids, phenolic acids) on colorectal adenoma recurrence[9] although dietary-based fruit phenolic compounds have demonstrated effectiveness in numerous chemoprevention studies of colorectal and esophageal cancer[10], possibly due to their role in attenuating inflammatory pathways[11]. Polyphenols are found at high concentrations in berries, as are carotenoids (B-carotene, zeaxanthin, lutein) and phytosterols (B-sitosterol, campesterol)[11]. A subclass of very active polyphenols, called anthocyanins, are responsible for the pigmentation seen in many dark purple and red-colored fruits and vegetables such as black raspberries, red cabbage, red and black grapes, and watermelon[12 13]. With several potential mechanisms of action for black raspberries now established[11], two studies were conducted. The first study objective was to continue experimental research the effect of powdered black raspberries (BRB) on post-prandial measures of inflammation in overweight and obese male adults. The objective of the second study was to further elucidate the role of plant-based foodstuffs on the recurrence of colorectal adenomas. The possibility of effect modification by body size will be investigated, since several studies have indicated a significant direct association between body size and elevated risk of colorectal adenomas; specifically in men compared to women[14].

The relationship between recurrence of colorectal adenomas and fruit phenolics, obesity, and inflammation were investigated by: (i) a pooled analysis of data from the Wheat Bran Fiber study (WBF)[15] and Ursodeoxycholic Acid Trial (UDCA)[16] and, (ii) a post-prandial pilot study to investigate the effects of black raspberries on the modulation of inflammatory markers in obese and overweight men. An understanding of the interactions between these various parameters will help guide us toward the goal of colorectal cancer prevention in the general population or in high-risk subpopulations.

Study 1:
Pharmacodynamics of polyphenols: a clinical trial investigating the
inflammomodulatory effects of freeze-dried black raspberries fed to older overweight or obese males in the postprandial state

Background:
Excess adiposity and the postprandial state are associated with inflammation.
Polyphenols may attenuate this response.

Objective:
To determine whether polyphenol-rich black raspberries (BRBs) modulate postprandial inflammation in ten overweight and obese males.

Design:
Subjects consumed 45 g/day of BRBs x 4 days, followed by a high-fat-high-calorie (HFHC) breakfast plus BRBs on Day 6 or consumed the HFHC breakfast on Day 6 without prior consumption of BRBs, then crossed over to the other treatment after a two-day washout. Blood samples were obtained before and 1, 2, 4, 8, and 12 hours after the HFHC meal. The primary study outcomes were changes in areas under the curves (AUC) of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α). The secondary outcome was tolerability of BRBs.

Results:
The mean AUC of serum IL-6 was significantly lower (p=0.03) with BRBs (34.3±7.6 pg/mL; mean±SD), compared to HFHC meal alone (42.4±17.9 pg/mL). No statistically significant differences were observed in the mean AUC of serum TNF-α or CRP.

Conclusions:
Polyphenol exposure via BRBs significantly decreased postprandial IL-6 in older overweight and obese men. Additional studies should be undertaken to evaluate the anti-inflammatory effects of BRBs.

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