What nutrients can be used for enhancing cardiovascular health?
Dr. John Lewis Ph. D.
09 May 2017
Cardiovascular health is one of the most important issues to address as a global priority, as cardiovascular diseases (CVD) continue to be the number 1 killer of people.  Worldwide, an estimated 17.5 million people died from CVD in 2012 (82% occurred in low and middle income countries), representing 31% of all global deaths.  Approximately 7.4 million deaths were due to coronary heart disease and 6.7 million deaths were due to stroke.  By 2030, an estimated 25 million people will die from CVD, primarily due to heart disease and stroke, which will remain the single leading cause of death.  The most important behavioral risk factors of CVD are unhealthy diet, physical inactivity, tobacco use, and harmful use of alcohol.  These so-called behavioral risk factors are responsible for about 80% of coronary heart disease and cerebrovascular disease.

In this article, we will focus on nutritional factors that can reduce the risk of CVD and help to improve overall cardiovascular health.  Dietary behavior modification (improvement) has been shown to be effective for reducing the risk of CVD by among other things improving cholesterol and blood sugar control without side effects (unlike medications).  Additionally, dietary modification is important in its application for people who are interested in preventing CVD in the first place.  Most people with CVD are overweight or obese, especially in the center of the body, and dietary interventions have primarily focused on weight reduction.  In most instances, a 5-10% weight reduction is sufficient for significant clinical benefits, including improved insulin sensitivity.  However, even if a dietary intervention fails to improve insulin sensitivity, it may still be beneficial for other characteristics of cardiovascular health.  Therefore, modifying the diet of individuals with CVD should have specific criteria to impact the metabolic and cardiovascular abnormalities associated with CVD (e.g., atherosclerosis, high blood pressure, poor blood glucose control, and high total and LDL cholesterol and low HDL cholesterol).  This dietary approach should have at least the following basic properties:  (a) a focus on predominantly whole (unprocessed) plant-foods, (b) reduced saturated fat (<7% of total daily calories), (c) moderate amounts of monounsaturated fat with total fat intake not exceeding 38%, (d) high-fiber/low-glycemic index foods consumed without specific limitations, (e) low sodium content (<2,300 mg/day), and (f) limited alcohol intake (<1 drink/day for women and <2 drinks/day for men).

Additionally, several studies suggest that a Mediterranean-style diet, with high amounts of vegetables, fruit, and legumes and reductions in saturated fat, salt, and alcohol, might be effective in reducing the prevalence of the CVD.  The Dietary Approach to Stop Hypertension (DASH), which is a diet rich in fruits, vegetables, and low-fat dairy foods, reduces blood pressure and has beneficial effects on all forms of cholesterol.  In addition, the effect of certain foods on CVD has been extensively examined.  Whole grains, fruits, vegetables, and nuts have been linked to a lower prevalence of CVD, whereas dairy, processed red meats, fried foods, and sodas have been associated with a higher prevalence of CVD.  The effect of foods such as coffee is debatable, regarding whether it has a beneficial or detrimental effect on the risk of CVD.  Furthermore, in an attempt to examine the intake of commonly-eaten foods into a single treatment, a group of Canadian scientists originated the Dietary Portfolio Approach to Cholesterol Reduction (“Portfolio Diet”).  This dietary intervention contains four functional foods/food groups with cholesterol-lowering effects (soy, sterol-containing foods, soluble fiber, and almonds), and the diet also promotes a low intake of animal products.  This dietary intervention type has been shown to be effective in reducing LDL cholesterol in individuals with high cholesterol, so it thus has a beneficial effect for reducing the risk of CVD.  Although the Portfolio diet is still not yet very popular, compared to for example the Mediterranean diet, the composition of these particular foods has an impressive effect on cardiovascular health.

Two of the main components of this diet are phytosterols (stanols and sterols) and antioxidants (e.g., vitamins C and E), both components that have been classically shown to improve cardiovascular health.  Sterols and stanols are particularly noted for lowering LDL cholesterol in persons at increased risk for coronary heart disease.  Taking 2 g/day of plant sterols and stanols typically results in an 8-10% reduction in LDL cholesterol, as they cause the body to inhibit cholesterol absorption.  These compounds are also shown to be safe for children over 6 years of age and can be used to help people with familial high cholesterol.  Stanols and sterols also reduce oxidative stress and inflammation, two very important markers of CVD and other diseases.

As the cardiovascular system has long been shown to be susceptible to oxidative stress from free radical damage, acute ischemia-reperfusion injury, endothelial damage, and chronic oxidative damage secondary to lipid peroxidation, antioxidants and other key phytochemicals have also been shown to counteract the effects of free radicals and keep our heart and vascular components healthy.  The effects of antioxidants have been studied thoroughly in basic studies in tissues and animals and in clinical trials and population-based studies in humans and their benefits are essentially scientific consensus at this point.  Ascorbic acid containing vitamin C and the different forms of tocopherols that make up vitamin E have wide-ranging and powerful antioxidant effects.  These vitamins minimize the risk associated with free radical damage, which will ultimately reduce the detrimental effects of oxidative stress on the cardiovascular system.  Vitamin E is also particularly important to counteract oxidative stress due to its effect on LDL cholesterol to prevent atherosclerotic plaque.

In summary, you can read lots of advice in the mainstream media about how to maintain cardiovascular health or how to recover it if you have been stricken with CVD.  Lots of research has been conducted showing the benefits of particular diets and individual nutrients (e.g., phytosterols and antioxidants) that have broad and wide-ranging effects on cardiovascular health.  To date, these studies have been confirmed by many investigators from around the world in hundreds of thousands of people.  Thus, you can feel confident in knowing that if you purchase a product with these particular nutrients, then you will be giving yourself the best chance to stay “heart healthy” and free from CVD.  The combination of a proper plant-based diet supplemented with antioxidants and phytosterols may be useful in the prevention and promotion of optimum cardiovascular health.  Remember also to engage in daily exercise to help ensure that you keep a strong cardiovascular system throughout your life and keep from becoming another sad statistic.  Eat the right foods and do not fall victim to coronary heart disease or stroke!  If you have already been diagnosed with a cardiovascular problem, please remember to discuss any changes to your diet or supplement regimen with your physician.  Meanwhile, continue reading my articles to help you make the best decisions about your health!

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