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 Health promotion by flavonoids, tocopherols, tocotrienols, and other phenols:  direct or indirect effects? Antioxidant or not?Halliwell B; Rafter J; Jenner AAm J Clin Nutr  2005[Jan]; 81 (1 Suppl): 268S-276SFoods and beverages rich in phenolic compounds, especially flavonoids, have often  been associated with decreased risk of developing several diseases. However, it  remains unclear whether this protective effect is attributable to the phenols or  to other agents in the diet. Alleged health-promoting effects of flavonoids are  usually attributed to their powerful antioxidant activities, but evidence for in  vivo antioxidant effects of flavonoids is confusing and equivocal. This may be  because maximal plasma concentrations, even after extensive flavonoid intake, may  be low (insufficient to exert significant systemic antioxidant effects) and  because flavonoid metabolites tend to have decreased antioxidant activity.  Reports of substantial increases in plasma total antioxidant activity after  flavonoid intake must be interpreted with caution; findings may be attributable  to changes in urate concentrations. However, phenols might exert direct effects  within the gastrointestinal tract, because of the high concentrations present.  These effects could include binding of prooxidant iron, scavenging of reactive  nitrogen, chlorine, and oxygen species, and perhaps inhibition of cyclooxygenases  and lipoxygenases. Our measurements of flavonoids and other phenols in human  fecal water are consistent with this concept. We argue that tocopherols and  tocotrienols may also exert direct beneficial effects in the gastrointestinal  tract and that their return to the gastrointestinal tract by the liver through  the bile may be physiologically advantageous.|*Antioxidants/metabolism/therapeutic use[MESH]|*Diet[MESH]|*Flavonoids/metabolism/therapeutic use[MESH]|*Phenols/metabolism/therapeutic use[MESH]|*Tocopherols/metabolism/therapeutic use[MESH]|*Tocotrienols/metabolism/therapeutic use[MESH]|Feces/chemistry[MESH]|Gastrointestinal Tract/*metabolism[MESH]|Health Promotion/*methods[MESH]|Humans[MESH]
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