Understanding complex effects on clinical outcomes and biomarker activities of food supplementation in heavy smokers: an approach using bayesian networks

BACKGROUND: Antioxidant administration can significantly alleviate smoking-mediated oxidative stress. In our previous research, using a concentrated mixed juice powder led to significant reduction in oxidative status markers and improved lung function among smokers. OBJECTIVE: To compare the effectiveness of different antioxidant formulations of the retail product Juice Plus+ ® on oxidative status and lung function in healthy smokers via a a Bayesian Network (BN) analysis. METHODS: At baseline and after 3 months’ supplementation, pulmonary function, cardiovascular risk factors, and oxidative status were assessed in 101 smokers, randomized into three groups: placebo (P), fruit/vegetable (FV), and fruit/vegetable/berry (FVB) group. BN analysis was performed via Monte Carlo simulations. Statistical significance was assigned as p <  0.05. RESULTS: No significant interaction was observed in P (network score –101.4, p = ns), whereas overall fit significantly improved in both FV (network score –185.7, p = 0.01) and FVB (–293.7, p = 0.003). Moreover, P group’s respiratory parameters appeared unrelated to the biochemical structure, whereas those of the FV and, to a greater extent, FVB groups were definitely related to it CONCLUSIONS: BN analysis demonstrated that the FV and FVB formulations contain nutraceutical compounds capable of synergistically acting and improving antioxidant modulation and respiratory function in smoking subjects