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Foods, Plant Bioactives and Nutraceuticals for Reducing Cardiometabolic Disease Risk

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (25 April 2024) | Viewed by 26596

Special Issue Editors


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Guest Editor
Atherosclerosis and Metabolic Disease Study Center, University of Bologna, 40138 Bologna, Italy
Interests: hypercholesterolemia; lipoproteins; hypertension; cardiovascular risk factors; nutraceuticals
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Atherosclerosis and Metabolic Disease Study Center, University of Bologna, 40138 Bologna, Italy
Interests: cholesterol; hypertension; uric acid; cardiovascular risk factors; cardiovascular prevention
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular diseases (CVDs) are major causes of mortality and disability in Western countries. Prevention is known to be the cornerstone of lessening the incidence of CVDs and reducing the economic burden on both the citizen and the healthcare system. "Interventional medicine" places lifestyle modification as the first therapeutic step, including a healthy diet and physical activity. Secondly, a large body of research has individuated a number of food and plant bioactives which are potentially efficacious in preventing and reducing some highly prevalent CV risk factors, such as hypercholesterolemia, hypertension, vascular inflammation and vascular compliance. Some lipid- and blood-pressure-lowering bioactives have been studied for their impact on human vascular health, particularly as regards endothelial function and arterial stiffness. Several nutraceuticals showed additive or synergistic properties in combination, sometimes (but not always) allowing a reduction of the administered dose of extracts and determining a “multi-factorial” final effect on many cardiovascular risk factors.

In this Special Issue, we invite researchers to contribute original research and review articles focusing on available evidence regarding the effects of food, plant bioactives and nutraceuticals on lipid profile, blood pressure, inflammatory and endothelial markers, and vascular compliance.

Dr. Federica Fogacci
Prof. Dr. Claudio Borghi
Dr. Arrigo Cicero
Guest Editors

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Keywords

  • plant bioactives
  • nutraceuticals
  • lipids
  • blood pressure
  • inflammation
  • metabolic syndrome
  • endothelium
  • arterial stiffness

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Published Papers (9 papers)

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Editorial

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3 pages, 183 KiB  
Editorial
Functional Foods and Nutraceuticals to Reduce the Risk of Cardiometabolic Disease: Where We Are, and Where We Are Going
by Federica Fogacci, Claudio Borghi and Arrigo Francesco Giuseppe Cicero
Nutrients 2024, 16(18), 3152; https://doi.org/10.3390/nu16183152 - 18 Sep 2024
Viewed by 1104
Abstract
Atherosclerotic cardiovascular diseases (ASCVDs) remain leading causes of mortality and disability in Western countries [...] Full article

Research

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18 pages, 4415 KiB  
Article
Ancestry Specific Polygenic Risk Score, Dietary Patterns, Physical Activity, and Cardiovascular Disease
by Dale S. Hardy, Jane T. Garvin and Tesfaye B. Mersha
Nutrients 2024, 16(4), 567; https://doi.org/10.3390/nu16040567 - 19 Feb 2024
Viewed by 2071
Abstract
It is unknown whether the impact of high diet quality and physical activity depends on the level of polygenic risk score (PRS) in different ancestries. Our cross-sectional study utilized de-identified data from 1987–2010 for self-reported European Americans (n = 6575) and African [...] Read more.
It is unknown whether the impact of high diet quality and physical activity depends on the level of polygenic risk score (PRS) in different ancestries. Our cross-sectional study utilized de-identified data from 1987–2010 for self-reported European Americans (n = 6575) and African Americans (n = 1606). The high-risk PRS increased ASCVD risk by 59% (Risk Ratio (RR) = 1.59; 95% Confidence Interval:1.16–2.17) in the highest tertile for African Americans and by 15% (RR = 1.15; 1.13–1.30) and 18% (RR = 1.18; 1.04–1.35) in the second and highest tertiles compared to the lowest tertile in European Americans. Within the highest PRS tertiles, high physical activity-diet combinations (Dietary Approaches to Stop High Blood Pressure (DASH), Mediterranean, or Southern) reduced ASCVD risks by 9% (RR = 0.91; 0.85–0.96) to 15% (RR = 0.85; 0.80–0.90) in European Americans; and by 13% (RR = 0.87; 0.78–0.97) and 18% (RR = 0.82; 0.72–0.95) for DASH and Mediterranean diets, respectively, in African Americans. Top molecular pathways included fructose metabolism and catabolism linked to obesity, insulin resistance, and type 2 diabetes. Additional molecular pathways for African Americans were Vitamin D linked to depression and aging acceleration and death signaling associated with cancer. Effects of high diet quality and high physical activity can counterbalance the influences of genetically high-risk PRSs on ASCVD risk, especially in African Americans. Full article
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13 pages, 1317 KiB  
Article
The Impact of an 8-Week Supplementation with Fermented and Non-Fermented Aronia Berry Pulp on Cardiovascular Risk Factors in Individuals with Type 2 Diabetes
by Christine B. Christiansen, Per B. Jeppesen, Kjeld Hermansen and Søren Gregersen
Nutrients 2023, 15(24), 5094; https://doi.org/10.3390/nu15245094 - 13 Dec 2023
Cited by 1 | Viewed by 1912
Abstract
Aronia berries contain antioxidants that may be health-promoting, e.g., demonstrated positive effects on hypertension and dyslipidaemia. There is a close link between cardiovascular diseases and hypertension and dyslipidaemia, and cardiovascular events are the leading cause of death among subjects with type 2 diabetes [...] Read more.
Aronia berries contain antioxidants that may be health-promoting, e.g., demonstrated positive effects on hypertension and dyslipidaemia. There is a close link between cardiovascular diseases and hypertension and dyslipidaemia, and cardiovascular events are the leading cause of death among subjects with type 2 diabetes (T2D). Thus, we investigated the effect of an 8-week supplementation with fermented aronia extract (FAE), non-fermented aronia extract (AE), and placebo on cardiovascular risk factors. Snack bars were produced containing 34 g (37%) aronia extract, or 17 g (21%) wheat bran for placebo, as well as raisins and coconut oil. The study was randomized and blinded with a triple-crossover design. We examined the effects of aronia extracts on blood pressure, adiponectin, and high-sensitive C-reactive protein, and found no effects. After supplementation with placebo, there were significantly higher blood concentrations of total cholesterol, LDL-cholesterol, and HDL-cholesterol, with the placebo group showing significantly higher increases in total cholesterol and LDL-cholesterol than the AE group. Furthermore, we observed an increase in HDL-cholesterol in the FAE group and an increase in triglyceride in the AE group. Thus, we assume that the raisins may have increased the participants’ cholesterol levels, with both AE and FAE having the potential to prevent this increase. Full article
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9 pages, 280 KiB  
Communication
Benefits of Fiber-Enriched Foods on Satiety and Parameters of Human Well-Being in Adults with and without Cardiometabolic Risk
by Janine Ehret, Beate Brandl, Karsten Schweikert, Rachel Rennekamp, Nanette Ströbele-Benschop, Thomas Skurk and Hans Hauner
Nutrients 2023, 15(18), 3871; https://doi.org/10.3390/nu15183871 - 6 Sep 2023
Cited by 2 | Viewed by 2129
Abstract
Consumption of fiber-rich foods is linked to beneficial effects on chronic diseases and gut health, while implications towards improving satiety and parameters of well-being remain unclear. A randomized placebo-controlled intervention study was conducted to compare the effects of fiber-enriched foods to their non-enriched [...] Read more.
Consumption of fiber-rich foods is linked to beneficial effects on chronic diseases and gut health, while implications towards improving satiety and parameters of well-being remain unclear. A randomized placebo-controlled intervention study was conducted to compare the effects of fiber-enriched foods to their non-enriched counterparts in adults over a 12-week period on selected clinical parameters—satiety, quality of life, body sensation, and life satisfaction—subjective health status, and importance of diet for well-being. Quality of life (QOL) differed significantly between intervention and control groups at baseline, throughout, and at the end of the study. No effects on satiety, satisfaction with life, or the importance of diet for well-being could be shown between groups. With higher fiber intake, body sensation ratings increased. A higher BMI was significantly associated with lower-body sensation, subjective health status and quality of life. Fiber-enriched foods do not seem to affect feeling of satiety or parameters of well-being. Larger samples and additional methods are necessary to fully explore the effect of increased fiber intake on patient-related outcomes in more detail. Full article
22 pages, 3838 KiB  
Article
Circulating Human Metabolites Resulting from TOTUM-070 Absorption (a Plant-Based, Polyphenol-Rich Ingredient) Improve Lipid Metabolism in Human Hepatocytes: Lessons from an Original Ex Vivo Clinical Trial
by Fabien Wauquier, Line Boutin-Wittrant, Stéphanie Krisa, Josep Valls, Cedric Langhi, Yolanda F. Otero, Pascal Sirvent, Sébastien Peltier, Maxime Bargetto, Murielle Cazaubiel, Véronique Sapone, Annie Bouchard-Mercier, Véronique Roux, Nicolas Macian, Gisèle Pickering and Yohann Wittrant
Nutrients 2023, 15(8), 1903; https://doi.org/10.3390/nu15081903 - 14 Apr 2023
Cited by 2 | Viewed by 2333
Abstract
TOTUM-070 is a patented polyphenol-rich blend of five different plant extracts showing separately a latent effect on lipid metabolism and potential synergistic properties. In this study, we investigated the health benefit of such a formula. Using a preclinical model of high fat diet, [...] Read more.
TOTUM-070 is a patented polyphenol-rich blend of five different plant extracts showing separately a latent effect on lipid metabolism and potential synergistic properties. In this study, we investigated the health benefit of such a formula. Using a preclinical model of high fat diet, TOTUM-070 (3 g/kg of body weight) limited the HFD-induced hyperlipemia with a reduction in triglyceride (−32% after 6 weeks; −20.3% after 12 weeks) and non-HDL cholesterol levels (−21% after 6 weeks; −38.4% after 12 weeks). To further investigate such a benefit and its underlying mechanisms in humans, we designed an ex vivo clinical approach to collect the circulating bioactives resulting from TOTUM-070 ingestion and to determine their biological activities on human hepatocytes. Human serum was obtained from healthy subjects before and after intake of TOTUM-070 (4995 mg). The presence of circulating metabolites was assessed by UPLC-MS/MS. Serum containing metabolites was further incubated with hepatocytes cultured in a lipotoxic environment (palmitate, 250 µM). RNA sequencing analyses show that lipid metabolism was one of the most impacted processes. Using histologic, proteomic, and enzymatic assays, the effects of human TOTUM-070 bioactives on hepatocyte metabolism were characterized by (1) the inhibition of lipid storage, including both (2) triglycerides (−41%, p < 0.001) and (3) cholesterol (−50%, p < 0.001) intracellular content, (4) a reduced de novo cholesterol synthesis (HMG-CoA reductase activity −44%, p < 0.001), and (5) a lowered fatty acid synthase protein level (p < 0.001). Altogether, these data support the beneficial impact of TOTUM-070 on lipid metabolism and provide new biochemical insights in human mechanisms occurring in liver cells. Full article
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21 pages, 1516 KiB  
Article
Impact of Regular Intake of Microalgae on Nutrient Supply and Cardiovascular Risk Factors: Results from the NovAL Intervention Study
by Fabian Sandgruber, Anna-Lena Höger, Julia Kunze, Benjamin Schenz, Carola Griehl, Michael Kiehntopf, Kristin Kipp, Julia Kühn, Gabriele I. Stangl, Stefan Lorkowski and Christine Dawczynski
Nutrients 2023, 15(7), 1645; https://doi.org/10.3390/nu15071645 - 28 Mar 2023
Cited by 5 | Viewed by 2929
Abstract
A 14-day randomized controlled study with a parallel design was conducted with 80 healthy participants. Intervention groups I (IG1) and II (IG2) received a defined background diet and consumed a smoothie enriched with either 15 g of Chlorella dry weight (d.w.) or 15 [...] Read more.
A 14-day randomized controlled study with a parallel design was conducted with 80 healthy participants. Intervention groups I (IG1) and II (IG2) received a defined background diet and consumed a smoothie enriched with either 15 g of Chlorella dry weight (d.w.) or 15 g of Microchloropsis d.w. daily. Control group II (CG2) received a defined background diet without the smoothie. Control group I (CG1) received neither. Blood samples and 24-h urine were collected at the beginning and the end of the study. Serum concentrations of 25-hydroxyvitamin D3, vitamin D3, selenium, iron, ferritin, transferrin saturation, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL cholesterol and the LDL-cholesterol/HDL cholesterol ratio decreased in IG1 (p < 0.05), while 25-hydroxyvitamin D2 increased (p < 0.05). In IG2, vitamin D3, 25-hydroxyvitamins D2 and D3 decreased (p < 0.05), while concentrations of fatty acids C20:5n3 and C22:5n3 increased. Serum and urine uric acid increased in IG1 and IG2 (p < 0.05). Microchloropsis is a valuable source of n3 fatty acids, as is Chlorella of vitamin D2. Regular consumption of Chlorella may affect the iron and selenium status negatively but may impact blood lipids positively. An elevated uric acid concentration in blood and urine following the regular consumption of microalgae poses potential risks for human health. Full article
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11 pages, 281 KiB  
Article
Adherence to the Mediterranean Diet Association with Serum Levels of Nitric Oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal Angina Patients and Healthy Persons
by Mahsa Mohajeri and Arrigo F. G. Cicero
Nutrients 2023, 15(3), 738; https://doi.org/10.3390/nu15030738 - 1 Feb 2023
Cited by 5 | Viewed by 2357
Abstract
This study aimed to assess the association between adherence to the Mediterranean diet with serum Nitric oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal angina patients and healthy persons. This case-control study was conducted among 100 Prinzmetal angina patients and 100 healthy persons [...] Read more.
This study aimed to assess the association between adherence to the Mediterranean diet with serum Nitric oxide, Prostacyclin, and Thromboxane B2 among Prinzmetal angina patients and healthy persons. This case-control study was conducted among 100 Prinzmetal angina patients and 100 healthy persons referred to the Ardabil Imam Khomeini hospital between 2021 and 2022. Blood samples were obtained from all study participants for measurement of serum Nitric oxide, Prostacyclin, and Thromboxane B2. To calculate adherence to the Mediterranean diet, the ten-item screener was used. The serum Nitric oxide in patients who adhered more to the Mediterranean diet was higher than patients with less adherence (coeff. = 0.41 p = 0.04). The serum Prostacyclin level in patients with greater adherence to the Mediterranean diet was 0.34 units higher than patients with less adherence (coeff. = 0.34 p = 0.02). The level of serum Thromboxane B2 had a negative association with adherence to the Mediterranean diet (coeff. = −0.48 p = 0.04). The amount of consumption of olive oil, fruits, vegetables, and legumes in healthy people was more than Prinzmetal angina patients. In Prinzmetal angina patients, more adherence to the Mediterranean diet can decrease the serum Thromboxane B2 and increase the serum Nitric oxide and Prostacyclin. Full article

Review

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28 pages, 866 KiB  
Review
Red Yeast Rice for the Improvement of Lipid Profiles in Mild-to-Moderate Hypercholesterolemia: A Narrative Review
by Arrigo F. G. Cicero, Federica Fogacci, Anca Pantea Stoian and Peter P. Toth
Nutrients 2023, 15(10), 2288; https://doi.org/10.3390/nu15102288 - 12 May 2023
Cited by 12 | Viewed by 5343
Abstract
Reducing low-density lipoprotein cholesterol (LDL-C) levels is a key target for lowering cardiovascular risk and preventing atherosclerotic cardiovascular disease (ASCVD). Red yeast rice (RYR) is a nutraceutical widely used as a lipid-lowering dietary supplement. The main cholesterol-lowering components of RYR are monacolins, particularly [...] Read more.
Reducing low-density lipoprotein cholesterol (LDL-C) levels is a key target for lowering cardiovascular risk and preventing atherosclerotic cardiovascular disease (ASCVD). Red yeast rice (RYR) is a nutraceutical widely used as a lipid-lowering dietary supplement. The main cholesterol-lowering components of RYR are monacolins, particularly monacolin K, which is structurally identical to lovastatin and targets the same key enzyme of cholesterol biosynthesis. RYR supplementation reduces LDL-C levels by approximately 15–34% versus placebo, with a similar effect to low-dose, first-generation statins in subjects with mild-to-moderate dyslipidemia. RYR has also demonstrated beneficial reductions of up to 45% versus placebo in the risk of ASCVD events in secondary prevention studies. RYR at a dose that provides about 3 mg/d of monacolin K is well tolerated, with an adverse event profile similar to that of low-dose statins. RYR is therefore a treatment option for lowering LDL-C levels and ASCVD risk for people with mild-to-moderate hypercholesterolemia who are ineligible for statin therapy, particularly those who are unable to implement lifestyle modifications, and also for people who are eligible for statin therapy but who are unwilling to take a pharmacologic therapy. Full article
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Other

22 pages, 1231 KiB  
Systematic Review
An Assessment of Mushroom Consumption on Cardiometabolic Disease Risk Factors and Morbidities in Humans: A Systematic Review
by Cassi N. Uffelman, Nok In Chan, Eric M. Davis, Yu Wang, Bethany S. McGowan and Wayne W. Campbell
Nutrients 2023, 15(5), 1079; https://doi.org/10.3390/nu15051079 - 21 Feb 2023
Cited by 13 | Viewed by 5278
Abstract
Mushrooms, unique edible fungi, contain several essential nutrients and bioactive compounds which may positively influence cardiometabolic health. Despite a long history of consumption, the health benefits of mushrooms are not well documented. We conducted a systematic review to assess the effects of and [...] Read more.
Mushrooms, unique edible fungi, contain several essential nutrients and bioactive compounds which may positively influence cardiometabolic health. Despite a long history of consumption, the health benefits of mushrooms are not well documented. We conducted a systematic review to assess the effects of and associations between mushroom consumption and cardiometabolic disease (CMD)-related risk factors and morbidities/mortality. We identified 22 articles (11 experimental and 11 observational) from five databases meeting our inclusion criteria. Limited evidence from experimental research suggests mushroom consumption improves serum/plasma triglycerides and hs-CRP, but not other lipids, lipoproteins, measures of glucose control (fasting glucose and HbA1c), or blood pressure. Limited evidence from observational research (seven of 11 articles with a posteriori assessments) suggests no association between mushroom consumption and fasting blood total or LDL cholesterol, glucose, or morbidity/mortality from cardiovascular disease, coronary heart disease, or type 2 diabetes mellitus. Other CMD health outcomes were deemed either inconsistent (blood pressure, HDL cholesterol, and triglycerides) or insufficient (HbA1c/hyperglycemia, hs-CRP, cerebrovascular disease, and stroke). The majority of the articles vetted were rated “poor” using the NHLBI study quality assessment tool due to study methodology and/or poor reporting issues. While new, high-quality experimental and observational research is warranted, limited experimental findings suggest greater mushroom consumption lowers blood triglycerides and hs-CRP, indices of cardiometabolic health. Full article
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