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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 March 2015) | Viewed by 169691

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Prof. Dr. Ronald P. Mensink

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Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Interests: lipids; bioactive nutrients; cardiometabolic health; metabolic syndrome; dietary intervention studies
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Alison M. Coates

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Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia
Interests: meal timing; eating patterns; circadian rhythm; shift work; cardiovascular risk factors
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

The incidence of diet-related diseases, such as cardiovascular diseases (CVD), is still increasing. CVD is often linked to metabolic syndrome, which refers to a cluster of metabolic disturbances related to an abnormal lipid and carbohydrate metabolism, obesity and a pro-inflammatory state of the body. Many of the earlier human dietary studies have focused on the effects of macronutrients on single CVD risk markers. These studies have provided valuable information and have contributed to current dietary guidelines. In recent years, however, there has been increasing interest in the effects of a wide variety of bioactive ingredients on established and emerging CVD risk markers. Although a strict definition of bioactive ingredients does not exist, the compounds can be considered as foods substances that positively influence functional, physiological or cellular activities.

The focus of this Supplement is on how bioactive ingredients—or specific foods or dietary patterns—may affect CVD risk in humans, and the underlying mechanisms to explain these effects. Increasing our knowledge in this area will be helpful for the development of evidence-based nutrition guidelines for the prevention and management of CVD.

Prof. Dr. Ronald P. Mensink
Dr. Alison M. Coates
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

nutrition
bioactive ingredients
dietary patterns
human studies
metabolism
metabolic syndrome
cardiovascular risk

Published Papers (12 papers)

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Research

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943 KiB

Open AccessArticle

Red Blood Cell Docosapentaenoic Acid (DPA n-3) is Inversely Associated with Triglycerides and C-reactive Protein (CRP) in Healthy Adults and Dose-Dependently Increases Following n-3 Fatty Acid Supplementation

by Ann C. Skulas-Ray, Michael R. Flock, Chesney K. Richter, William S. Harris, Sheila G. West and Penny M. Kris-Etherton

Nutrients 2015, 7(8), 6390-6404; https://doi.org/10.3390/nu7085291 - 04 Aug 2015

Cited by 35 | Viewed by 7716

Abstract

The role of the long-chain omega-3 (n-3) fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in lipid metabolism and inflammation has been extensively studied; however, little is known about the relationship between docosapentaenoic acid (DPA, 22:5 n-3) and inflammation and triglycerides (TG). We evaluated whether n-3 DPA content of red blood cells (RBC) was associated with markers of inflammation (interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and C-reactive protein (CRP) and fasting TG prior to n-3 supplementation in two studies (Study 1: n = 115, aged 20–44 years, body mass index (BMI) 20–30 kg/m², TG = 34–176 mg/dL; Study 2: n = 28, aged 22–65 years, BMI 24–37 kg/m², TG = 141–339 mg/dL). We also characterized the dose-response effects of n-3 fatty acid supplementation on RBC n-3 DPA after five months of supplementation with fish oil (Study 1: 0, 300, 600, 900, and 1800 mg/day EPA + DHA) and eight weeks of prescription n-3 ethyl esters (Study 2: 0, 850, and 3400 mg/day EPA + DHA). In Study 1, RBC n-3 DPA was inversely correlated with CRP (R² = 36%, p < 0.001) and with fasting TG (r = −0.30, p = 0.001). The latter finding was replicated in Study 2 (r = −0.33, p = 0.04). In both studies, n-3 supplementation significantly increased RBC n-3 DPA dose-dependently. Relative increases were greater for Study 1, with increases of 29%–61% vs. 14%–26% for Study 2. The associations between RBC n-3 DPA, CRP, and fasting TG may have important implications for the prevention of atherosclerosis and chronic inflammatory diseases and warrant further study. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessArticle

Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the PREDIMED Study

by Ana Garcia-Arellano, Raul Ramallal, Miguel Ruiz-Canela, Jordi Salas-Salvadó, Dolores Corella, Nitin Shivappa, Helmut Schröder, James R. Hébert, Emilio Ros, Enrique Gómez-Garcia, Ramon Estruch, José Lapetra, Fernando Arós, Miquel Fiol, Lluis Serra-Majem, Xavier Pintó, Nancy Babio, José I. González, Montse Fitó, J. Alfredo Martínez, Miguel A. Martínez-González and The PREDIMED Investigators Show full author list Hide full author list

Nutrients 2015, 7(6), 4124-4138; https://doi.org/10.3390/nu7064124 - 29 May 2015

Cited by 177 | Viewed by 16216

Abstract

Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases. The Dietary Inflammatory Index (DII) was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern. We prospectively examined the association between the DII and the incidence of cardiovascular disease (CVD: myocardial infarction, stroke or cardiovascular death) in the PREDIMED (Prevención con Dieta Mediterránea) study including 7216 high-risk participants. The DII was computed based on a validated 137-item food frequency questionnaire. Multivariate-adjusted hazard ratios (HR) and 95% confidence intervals of CVD risk were computed across quartiles of the DII where the lowest (most anti-inflammatory) quartile is the referent. Risk increased across the quartiles (i.e., with increasing inflammatory potential): HR_quartile2= 1.42 (95%CI = 0.97–2.09); HR_quartile3= 1.85 (1.27–2.71); and HR_quartile4= 1.73 (1.15–2.60). When fit as continuous the multiple-adjusted hazard ratio for each additional standard deviation of the DII was 1.22 (1.06–1.40). Our results provide direct prospective evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessArticle

An Organic Khorasan Wheat-Based Replacement Diet Improves Risk Profile of Patients with Acute Coronary Syndrome: A Randomized Crossover Trial

by Anne Whittaker, Francesco Sofi, Maria Luisa Eliana Luisi, Elena Rafanelli, Claudia Fiorillo, Matteo Becatti, Rosanna Abbate, Alessandro Casini, Gian Franco Gensini and Stefano Benedettelli

Nutrients 2015, 7(5), 3401-3415; https://doi.org/10.3390/nu7053401 - 11 May 2015

Cited by 35 | Viewed by 13091

Abstract

Khorasan wheat is an ancient grain with previously reported health benefits in clinically healthy subjects. The aim of this study was to examine whether a replacement diet, thereby substituting all other cereal grains, with products made with organic khorasan wheat could provide additive protective effects in reducing lipid, oxidative and inflammatory risk factors, in patients with Acute Coronary Syndromes (ACS) in comparison to a similar replacement diet using products made from organic modern wheat. A randomized double-blinded crossover trial with two intervention phases was conducted on 22 ACS patients (9 F; 13 M). The patients were assigned to consume products (bread, pasta, biscuits and crackers) made either from organic semi-whole khorasan wheat or organic semi-whole control wheat for eight weeks in a random order. On average, patients ingested 62.0 g dry weight (DW) day⁻¹ khorasan or control semolina; and 140.5 g DW day⁻¹ khorasan or control flour, respectively. An eight-week washout period was implemented between the respective interventions. Blood analyses were performed both at the beginning and end of each intervention phase; thereby permitting a comparison of both the khorasan and control intervention phases, respectively, on circulatory risk factors for the same patient. Consumption of products made with khorasan wheat resulted in a significant amelioration in total cholesterol (−6.8%), low-density lipoprotein cholesterol (LDL-C) (−8.1%) glucose (−8%) and insulin (−24.6%) from baseline levels, independently of age, sex, traditional risk factors, medication and diet quality. Moreover, there was a significant reduction in reactive oxygen species (ROS), lipoperoxidation of circulating monocytes and lymphocytes, as well as in the levels of Tumor Necrosis Factor-alpha. No significant differences from baseline in the same patients were observed after the conventional control wheat intervention phase. The present results suggest that a replacement diet with cereal products made from organic khorasan wheat provides additional protection in patients with ACS. Circulating cardiovascular risk factors, including lipid parameters, and markers of both oxidative stress and inflammatory status, were reduced, irrespective of the number and combination of medicinal therapies with proven efficacy in secondary prevention. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessArticle

Consumption of a Polyphenol-Rich Grape-Wine Extract Lowers Ambulatory Blood Pressure in Mildly Hypertensive Subjects

by Richard Draijer, Young De Graaf, Marieke Slettenaar, Eric De Groot and Chris I. Wright

Nutrients 2015, 7(5), 3138-3153; https://doi.org/10.3390/nu7053138 - 30 Apr 2015

Cited by 68 | Viewed by 10017

Abstract

Polyphenols in grape and wine have been suggested to contribute to the cardiovascular health benefits of the Mediterranean lifestyle. The reported effects of grape products on blood pressure (BP) remain, however, equivocal. In a double-blind placebo controlled crossover study, the effect of two grape extracts on BP and vascular function was assessed in 60 untreated, mildly hypertensive subjects after four weeks intervention. Both extracts (grape-red wine and grape alone) had high concentrations of anthocyanins and flavonols, but the grape alone was relatively poor in catechins and procyanidins. Parameters measured included ambulatory and office BP, flow-mediated vasodilation, arterial distensibility, platelet function and plasma lipoproteins. Results showed that 24-hour ambulatory systolic/diastolic BPs were significantly lower in the grape-wine extract intervention (135.9 ± 1.3/84.7 ± 0.8 mmHg; mean ± SEM) compared to placebo (138.9 ± 1.3/86.6 ± 1.2 mmHg), predominantly during daytime. Plasma concentrations of the vasoconstrictor endothelin-1 decreased by 10%, but other measures of vascular function were not affected. Grape juice extract alone had no effect on BP or any measures of vascular function. Polyphenol-rich food products, and may be specifically catechins and procyanidins, may thus help sustain a healthy BP and contribute to the healthy Mediterranean lifestyle. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessArticle

Effects of Supplementation with the Fat-Soluble Vitamins E and D on Fasting Flow-Mediated Vasodilation in Adults: A Meta-Analysis of Randomized Controlled Trials

by Peter J. Joris and Ronald P. Mensink

Nutrients 2015, 7(3), 1728-1743; https://doi.org/10.3390/nu7031728 - 10 Mar 2015

Cited by 23 | Viewed by 9476

Abstract

The effects of fat-soluble vitamin supplementation on cardiovascular disease (CVD) risk are not clear. Therefore, we performed a meta-analysis to quantify effects of fat-soluble vitamin supplements on fasting flow-mediated vasodilation (FMD) of the brachial artery, a validated marker to assess CVD risk. Randomized placebo-controlled trials (RCTs) were identified by a systematic search till July 2014. Seven RCTs studying the effects of vitamin E supplements (range: 300 to 1800 IU per day) and nine RCTs examining the effects of vitamin D supplements, that involved, respectively, 303 and 658 adults, were included. No studies with carotenoid or vitamin K supplements were found. Vitamin E supplementation increased FMD vs. control by 2.42% (95% CI: 0.46% to 4.37%; p = 0.015). No effects of vitamin D supplementation were found (0.15%; 95% CI: −0.21% to 0.51%; p = 0.41). These effects did not depend on subject characteristics, treatment characteristics or technical aspects of the FMD measurement. However, no dose-response relationship was evident for vitamin E, statistical significance depended on one study, while the levels of supplement were far above recommended intakes. The current meta-analysis, therefore, does not provide unambiguous evidence to support the use of fat-soluble vitamin supplements to improve fasting FMD in adults. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessArticle

Black Tea Lowers Blood Pressure and Wave Reflections in Fasted and Postprandial Conditions in Hypertensive Patients: A Randomised Study

by Davide Grassi, Richard Draijer, Giovambattista Desideri, Theo Mulder and Claudio Ferri

Nutrients 2015, 7(2), 1037-1051; https://doi.org/10.3390/nu7021037 - 04 Feb 2015

Cited by 48 | Viewed by 15237

Abstract

Hypertension and arterial stiffening are independent predictors of cardiovascular mortality. Flavonoids may exert some vascular protection. We investigated the effects of black tea on blood pressure (BP) and wave reflections before and after fat load in hypertensives. According to a randomized, double-blind, controlled, cross-over design, 19 patients were assigned to consume black tea (129 mg flavonoids) or placebo twice a day for eight days (13 day wash-out period). Digital volume pulse and BP were measured before and 1, 2, 3 and 4 h after tea consumption. Measurements were performed in a fasted state and after a fat load. Compared to placebo, reflection index and stiffness index decreased after tea consumption (p < 0.0001). Fat challenge increased wave reflection, which was counteracted by tea consumption (p < 0.0001). Black tea decreased systolic and diastolic BP (−3.2 mmHg, p < 0.005 and −2.6 mmHg, p < 0.0001; respectively) and prevented BP increase after a fat load (p < 0.0001). Black tea consumption lowers wave reflections and BP in the fasting state, and during the challenging haemodynamic conditions after a fat load in hypertensives. Considering lipemia-induced impairment of arterial function may occur frequently during the day, our findings suggest regular consumption of black tea may be relevant for cardiovascular protection. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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25-Hydroxyvitamin D and Its Relationship with Autonomic Dysfunction Using Time- and Frequency-Domain Parameters of Heart Rate Variability in Korean Populations: A Cross-Sectional Study

by Young Jin Tak, Jeong Gyu Lee, Yun Jin Kim, Sang Yeoup Lee and Byung Mann Cho

Nutrients 2014, 6(10), 4373-4388; https://doi.org/10.3390/nu6104373 - 16 Oct 2014

Cited by 14 | Viewed by 7647

Abstract

Previous studies have demonstrated that reduced heart rate variability (HRV) and hypovitaminosis D are associated with cardiovascular disease (CVD). However, few reports have investigated the effects of vitamin D on HRV. This cross-sectional study analyzed serum 25-hydroxyvitamin D (25(OH)D) and HRV indices using 5-min R-R interval recordings with an automatic three-channel electrocardiography in healthy subjects (103 males and 73 females). Standard deviation of N-N interval (SDNN), square root of mean squared differences of successive N-N intervals (RMSSD), total power (TP), very low frequency (VLF), low frequency (LF), and high frequency (HF) were reported. The mean age of subjects was 55.3 ± 11.3 years and the mean 25(OH)D level was 21.2 ± 9.9 ng/mL. In a multiple linear regression model, 25(OH)D was positively correlated with SDNN (β = 0.240, p < 0.002), and LF (β = 0.144, p = 0.044). Vitamin D deficiency (25(OH)D < 15 ng/mL) was associated with decreased SDNN (<30 m/s) (OR, 3.07; 95% confidence interval (CI), 1.32–7.14; p = 0.014) after adjusting for covariates. We found that lower 25(OH)D levels were associated with lower HRV, suggesting a possible explanation for the higher risk of CVD in populations with hypovitaminosis D. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Review

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183 KiB

Open AccessReview

Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence

by Taraka V. Gadiraju, Yash Patel, J. Michael Gaziano and Luc Djoussé

Nutrients 2015, 7(10), 8424-8430; https://doi.org/10.3390/nu7105404 - 06 Oct 2015

Cited by 126 | Viewed by 23660

Abstract

Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week). Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying), temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessReview

Dietary Patterns, Alcohol Consumption and Risk of Coronary Heart Disease in Adults: A Meta-Analysis

by Xiao-Yan Zhang, Long Shu, Cai-Juan Si, Xiao-Long Yu, Dan Liao, Wei Gao, Lun Zhang and Pei-Fen Zheng

Nutrients 2015, 7(8), 6582-6605; https://doi.org/10.3390/nu7085300 - 07 Aug 2015

Cited by 41 | Viewed by 8671

Abstract

Previous studies reported the potential associations between dietary patterns and the risk of coronary heart disease (CHD) in adulthood, however a consistent perspective has not been established to date. Herein, we carried out this meta-analysis to evaluate the associations between dietary patterns and the risk of CHD. MEDLINE and EBSCO were searched for relevant articles published up to April 2015. A total of 35 articles (reporting 37 original studies) met the inclusion criteria and were included in the present meta-analysis. The decreased risk of CHD was shown for the highest compared with the lowest categories of healthy/prudent dietary patterns (odds ratio (OR) = 0.67; 95% confidence interval (CI): 0.60, 0.75; p < 0.00001) and alcohol consumption (OR = 0.68; 95% CI: 0.59, 0.78; p < 0.00001). There was evidence of an increased risk of CHD in the highest compared with the lowest categories of the unhealthy/Western-type dietary patterns (OR = 1.45; 95% CI: 1.05, 2.01; p = 0.02). The results of this meta-analysis indicate that different dietary patterns may be associated with the risk of CHD. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessReview

Apples and Cardiovascular Health—Is the Gut Microbiota a Core Consideration?

by Athanasios Koutsos, Kieran M. Tuohy and Julie A. Lovegrove

Nutrients 2015, 7(6), 3959-3998; https://doi.org/10.3390/nu7063959 - 26 May 2015

Cited by 117 | Viewed by 31198

Abstract

There is now considerable scientific evidence that a diet rich in fruits and vegetables can improve human health and protect against chronic diseases. However, it is not clear whether different fruits and vegetables have distinct beneficial effects. Apples are among the most frequently consumed fruits and a rich source of polyphenols and fiber. A major proportion of the bioactive components in apples, including the high molecular weight polyphenols, escape absorption in the upper gastrointestinal tract and reach the large intestine relatively intact. There, they can be converted by the colonic microbiota to bioavailable and biologically active compounds with systemic effects, in addition to modulating microbial composition. Epidemiological studies have identified associations between frequent apple consumption and reduced risk of chronic diseases such as cardiovascular disease. Human and animal intervention studies demonstrate beneficial effects on lipid metabolism, vascular function and inflammation but only a few studies have attempted to link these mechanistically with the gut microbiota. This review will focus on the reciprocal interaction between apple components and the gut microbiota, the potential link to cardiovascular health and the possible mechanisms of action. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessReview

Casein-Derived Lactotripeptides Reduce Systolic and Diastolic Blood Pressure in a Meta-Analysis of Randomised Clinical Trials

by Ágnes A. Fekete, D. Ian Givens and Julie A. Lovegrove

Nutrients 2015, 7(1), 659-681; https://doi.org/10.3390/nu7010659 - 20 Jan 2015

Cited by 106 | Viewed by 10427

Abstract

There is an urgent need to treat individuals with high blood pressure (BP) with effective dietary strategies. Previous studies suggest a small, but significant decrease in BP after lactotripeptides (LTP) ingestion, although the data are inconsistent. The study aim was to perform a comprehensive meta-analysis of data from all relevant randomised controlled trials (RCT). Medline, Cochrane library, EMBASE and Web of Science were searched until May 2014. Eligibility criteria were RCT that examined the effects of LTP on BP in adults, with systolic BP (SBP) and diastolic BP (DBP) as outcome measures. Thirty RCT met the inclusion criteria, which resulted in 33 sets of data. The pooled treatment effect for SBP was −2.95 mmHg (95% CI: −4.17, −1.73; p < 0.001), and for DBP was −1.51 mmHg (95% CI: −2.21, −0.80; p < 0.001). Sub-group analyses revealed that reduction of BP in Japanese studies was significantly greater, compared with European studies (p = 0.002 for SBP and p < 0.001 for DBP). The 24-h ambulatory BP (AMBP) response to LTP supplementation was statistically non-significant (p = 0.101 for SBP and p = 0.166 for DBP). Both publication bias and “small-study effect” were identified, which shifted the treatment effect towards less significant SBP and non-significant DBP reduction after LTP consumption. LTP may be effective in BP reduction, especially in Japanese individuals; however sub-group, meta-regression analyses and statistically significant publication biases suggest inconsistencies. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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Open AccessReview

Mediterranean Diet and Cardiodiabesity: A Review

by Elena García-Fernández, Laura Rico-Cabanas, Nanna Rosgaard, Ramón Estruch and Anna Bach-Faig

Nutrients 2014, 6(9), 3474-3500; https://doi.org/10.3390/nu6093474 - 04 Sep 2014

Cited by 103 | Viewed by 15175

Abstract

Cardiodiabesity has been used to define and describe the well-known relationship between type 2 Diabetes Mellitus (T2DM), obesity, the metabolic syndrome (MetS) and cardiovascular disease (CVD). The objective of this study was to perform a scientific literature review with a systematic search to examine all the cardiovascular risk factors combined and their relationship with adherence to the Mediterranean Diet (MedDiet) pattern as primary prevention against cardiodiabesity in a holistic approach. Research was conducted using the PubMed database including clinical trials, cross-sectional and prospective cohort studies. Thirty-seven studies were reviewed: fourteen related to obesity, ten to CVD, nine to MetS, and four to T2DM. Indeed 33 provided strong evidence on the association between adherence to a MedDiet and a reduced incidence of collective cardiodiabesity risk in epidemiological studies. This scientific evidence makes the MedDiet pattern very useful for preventive strategies directed at the general population and also highlights the need to consider all these diet-related risk factors and health outcomes together in daily primary care. Full article

(This article belongs to the Special Issue Nutrition and CVD)

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