Nutraceuticals for Cardiometabolic Diseases: Prophylactic and Therapeutic Research

The global prevalence of cardiometabolic diseases has risen over the last two decades [1,2,3], resulting in significant mortality, healthcare challenges, and economic burdens [4]. Cardiometabolic diseases are the leading cause of death globally, accounting for 18 million deaths in 2019 [5]. Cardiometabolic diseases encompass metabolic conditions such as obesity and type II diabetes mellitus, as well as cardiovascular conditions, including hypertension, heart failure, and ischemic heart disease. Indeed, obesity is now recognized as a major cause of cardiometabolic disease associated with body mass index (BMI) [6,7].

However, significant progress has been made in both the prophylaxis and treatment of these conditions. Notably, novel cardiovascular drugs targeting inflammation have been developed [8]. Additionally, GLP-1 inhibitors have emerged as a promising therapy, addressing obesity while providing additional cardiovascular benefits [9] and reducing risk for other diseases [10]. Despite these advancements, cardiometabolic diseases remain a predominant global health concern. The complexity of cardiometabolic diseases necessitates a multifactorial approach to their prevention and management.

While genetics undoubtedly play a role in cardiometabolic disease risk, lifestyle factors are also a major contributor to their onset and development. In particular, diet and physical activity play a significant role in preventing cardiometabolic disease [11,12]. In alignment with the growing consumer and cultural awareness of “wellness” products, many individuals have turned to dietary supplements and nutraceuticals to maintain health and prevent illness [13].

This Special Issue titled “Nutraceuticals for cardiometabolic diseases: prophylactic and therapeutic research” invited research focused on nutraceuticals, supplements, and bioactive ingredients for the prevention and treatment of cardiometabolic diseases. A total of five articles were published on various nutraceuticals with potential efficacy against cardiometabolic disease.

Reactive oxygen species have been linked to cardiovascular pathologies, and the search for antioxidant therapeutics is ongoing. Oliveira et al. [contribution 1] conducted a study to compare the antioxidant potential and cardiovascular benefits of a restricted sample of ten fruits and ten vegetables commonly consumed in Portugal. They reported that fruits and vegetables are natural sources of compounds for the development of nutraceuticals, including vitamins, minerals, phytochemicals and dietary fibers, which may be beneficial for cardiovascular health. To compare the antioxidant potential and cardiovascular benefits found in the 10 fruits and 10 vegetables, the authors established seven criteria, including the antioxidant capacity measured by FRAP, and the presence of n-3 polyunsaturated fatty acids (PUFA), saturated fat, cholesterol, trans fats, fiber, and sodium in the foods. They reported that lemons, grapes, and melon had the highest potential cardiovascular benefits, and tomato and onion had the highest potential among the vegetables. While this approach simplifies complex nutritional data and may appear reductionist, it provides a practical framework for consumer education.

Angelopoulos et al. [contribution 2] took a different approach for cardiometabolic health by investigating the efficacy and safety of a multicomponent nutraceutical targeting the lipid profile of mild-to-moderate hypercholesterolemic (140–180 mg/dL LDL) male (n = 4) and female (n = 33) patients. The nutraceutical containing monacolin K, coenzyme Q10, grape seed, and olive leaf extracts was taken once daily for 8 weeks. Notably, these components have been shown to have lipid-lowering effects [14,15,16]. The lipid profile after treatment was compared to baseline levels. Overall, the authors reported statistically significant reductions in total cholesterol (TC), LDL, and triglycerides (TG), with no effect on HDL. While this proof-of-concept study appears promising, larger controlled studies are required to determine the true lipid modulating potential of the nutraceutical. The authors have started this process and conducted a promising randomized controlled trial [17].

As shown by Velissaridou et al. [contribution 3], functional foods hold great potential for promoting and maintaining cardiovascular health. They reviewed the literature surrounding functional foods and the mechanisms by which some products may raise HDL levels and HDL functionality. Indeed, antioxidant, anti-inflammatory, and antiplatelet effects are posited as potential mechanisms by which functional foods may improve HDL function. Foods, including phenol-rich fruit, legumes, fish, extra virgin olive oil, fungi, alcohol, cocoa, coffee, tea, and more, are discussed.

Casanova et al. [contribution 4] reviewed parsley (Petroselinum crispum), which is commonly used as an aromatic herb or garnish in cooking, as a potential source of cardioprotective substances. Their review reported various compounds in parsley, including flavone apigenin and related glycosides such as apiin and malonylapiin. Extracts from the leaves, seeds, and aerial parts of the plant have been shown to reduce platelet activation in vitro and to positively affect hypertension and lipid profiles in vivo. Ergo, the review discusses the potential applications of parsley and its derivatives in functional foods and nutraceuticals.

Lastly, Valado et al. [contribution 5] reviewed the bioactivity of carrageenans in metabolic syndrome and cardiovascular diseases, with a particular focus on lipid profile markers, including LDL, TC, HDL, and TGs. Carrageenans are phycocolloids made of long-chain polysaccharides found in red macroalgae in both marine and freshwater habitats. These aquatic photosynthetic organisms are rich in polysaccharides and other bioactive substances, including polyphenols associated with health benefits [18]. Valado et al. determined from the literature that carrageenans may positively affect blood lipids and potentially adiposity and body weight associated with metabolic syndrome. However, as the authors highlight, there does appear to be a dearth of research in the field. Consequently, further research is required to further characterize the cardiometabolic potential of developing carrageenan as a nutraceutical.

Overall, this Special Issue highlights some of the cutting-edge research in the field of cardiometabolic nutraceuticals. Further investment and support for this field is required to discover, develop, and characterize the cardiometabolic nutraceuticals of the future. Additionally, studying these nutraceuticals must occur alongside standard-of-care treatments for cardiometabolic diseases to ensure both safety and efficacy.