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Nutrition and the endothelium

Abstract

Growing evidence suggests that dietary factors play an important role in modulating endothelial function. Epidemiologic and clinical studies have related intake of α-linolenic acid and long-chain n-3 fatty acids to lower plasma concentrations of inflammatory cytokines and endothelial adhesion molecules, both of which are considered markers of endothelial dysfunction. In contrast, trans fatty acid intake and a higher dietary glycemic load have been associated with increased plasma concentrations of these biomarkers. Recently, several epidemiologic and intervention studies have examined the relationship between overall dietary patterns and endothelial dysfunction. In general, a "prudent diet," characterized by higher intake of fruits, vegetables, legumes, fish, poultry, and whole grains, is associated with a beneficial effect on the endothelium. Conversely, a "Western diet," characterized by higher intake of red and processed meats, sweets, desserts, French fries, and refined grains, is associated with an impairment of the endothelial function. These findings provide additional biological mechanisms through which dietary factors influence the risk of cardiovascular diseases.

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References and Recommended Reading

  1. Ross R: Atherosclerosis-an inflammatory disease. N Engl J Med 1999, 340:115–126.

    PubMed  Article  CAS  Google Scholar 

  2. Simon BC, Noll B, Maisch B: Endothelial dysfunction-assessment of current status and approaches to therapy [in German]. Herz 1999, 24:62–71.

    PubMed  CAS  Article  Google Scholar 

  3. Verma S, Buchanan MR, Anderson TJ: Endothelial function testing as a biomarker of vascular disease. Circulation 2003, 108:2054–2059.

    PubMed  Article  Google Scholar 

  4. Hwang SJ, Ballantyne CM, Sharrett AR, et al.: Circulating adhesion molecules VCAM-1, ICAM-1, and E-selectin in carotid atherosclerosis and incident coronary heart disease cases: the Atherosclerosis Risk in Communities (ARIC) study. Circulation 1997, 96:4219–4225.

    PubMed  CAS  Google Scholar 

  5. Ridker PM, Hennekens CH, Buring JE, Rifai N: C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000, 342:836–843. Demonstrated that CRP is an independent and powerful marker of cardiovascular risk.

    PubMed  Article  CAS  Google Scholar 

  6. Brown AA, Hu FB: Dietary modulation of endothelial function: implications for cardiovascular disease. Am J Clin Nutr2001, 73:673–686. A very complete review paper that compiles the evidences relating nutrients and cardiovascular disease and endothelial dysfunction, until 2000.

    PubMed  CAS  Google Scholar 

  7. Hu FB, Willett WC: Optimal diets for prevention of coronary heart disease. JAMA 2002, 288:2569–2578.

    PubMed  Article  CAS  Google Scholar 

  8. Yli-Jama P, Seljeflot I, Meyer HE, et al.: Serum non-esterified very long-chain PUFA are associated with markers of endothelial dysfunction. Atherosclerosis 2002, 164:275–281.

    PubMed  Article  CAS  Google Scholar 

  9. Pischon T, Hankinson SE, Hotamisligil GS, et al.: Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 2003, 108:155–160. This cross-sectional study examined the association between omega-3 fatty acids and markers of inflammation in a healthy population.

    PubMed  Article  CAS  Google Scholar 

  10. Lopez-Garcia E, Schulze MB, Manson JE, et al.: Consumption of n-3 fatty acids is related to plasma biomarkers of inflammation and endothelial activation. J Nutr 2004, in press.

  11. Miles EA, Thies F, Wallace FA, et al.: Influence of age and dietary fish oil on plasma soluble adhesion molecule concentrations. Clin Sci (Lond) 2001, 100:91–100.

    CAS  Article  Google Scholar 

  12. Thies F, Miles EA, Nebe-von-Caron G, et al.: Influence of dietary supplementation with long-chain n-3 or n-6 polyunsaturated fatty acids on blood inflammatory cell populations and functions and on plasma soluble adhesion molecules in healthy adults. Lipids 2001, 36:1183–1193.

    PubMed  Article  CAS  Google Scholar 

  13. Berstad P, Seljeflot I, Veierod MB, et al.: Supplementation with fish oil affects the association between very long-chain n-3 polyunsaturated fatty acids in serum non-esterified fatty acids and soluble vascular cell adhesion molecule-1. Clin Sci (Lond)2003, 105:13–20.

    CAS  Google Scholar 

  14. Dichtl W, Ares MP, Jonson AN, et al.: Linoleic acid-stimulated vascular adhesion molecule-1 expression in endothelial cells depends on nuclear factor-kappaB activation. Metabolism 2002, 51:327–333.

    PubMed  Article  CAS  Google Scholar 

  15. De Caterina R, Spiecker M, Solaini G, et al.: The inhibition of endothelial activation by unsaturated fatty acids. Lipids 1999, 34(suppl):S191-S194.

    PubMed  Article  Google Scholar 

  16. De Caterina R, Zampolli A: n-3 fatty acids: antiatherosclerotic effects. Lipids 2001, 36(suppl):S69-S78.

    PubMed  Article  Google Scholar 

  17. Ascherio A, Katan MB, Zock PL, et al.: Trans fatty acids and coronary heart disease. N Engl J Med 1999, 340:1994–1998.

    PubMed  Article  CAS  Google Scholar 

  18. Salmeron J, Hu FB, Manson JE, et al.: Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr 2001, 73:1019–1026.

    PubMed  CAS  Google Scholar 

  19. Mozaffarian D, Hankinson SE, Rifai N, et al.: Dietary intake of trans-fatty acids and systemic inflammation among women. Am J Clin Nutr2004, 79:606–612.

    PubMed  CAS  Google Scholar 

  20. Lopez-Garcia E, Schulze MB, Meigs JB, et al.: Consumption of trans fatty acids and plasma markers of inflammation and endothelial dysfunction. JAMA 2004, in press.

  21. de Roos NM, Bots ML, Katan MB: Replacement of dietary saturated fatty acids by trans fatty acids lowers serum HDL cholesterol and impairs endothelial function in healthy men and women. Arterioscler Thromb Vasc Biol 2001, 21:1233–1237.

    PubMed  Google Scholar 

  22. de Roos NM, Siebelink E, Bots ML, et al.: Trans monounsaturated fatty acids and saturated fatty acids have similar effects on postprandial flow-mediated vasodilation. Eur J Clin Nutr 2002, 56:674–679.

    PubMed  Article  CAS  Google Scholar 

  23. De Caterina R, Liao JK, Libby P: Fatty acid modulation of endothelial activation. Am J Clin Nutr 2000, 71(1 suppl):213S-223S.

    PubMed  Google Scholar 

  24. Wolever TM, Jenkins DJ, Jenkins AL, Josse RG: The glycemic index: methodology and clinical implications. Am J Clin Nutr 1991, 54:846–854.

    PubMed  CAS  Google Scholar 

  25. Liu S, Willett WC, Stampfer MJ, et al.: A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000, 71:1455–1461.

    PubMed  CAS  Google Scholar 

  26. Salmeron J, Manson JE, Stampfer MJ, et al.: Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 1997, 277:472–477.

    PubMed  Article  CAS  Google Scholar 

  27. Liu S, Manson JE, Buring JE, et al.: Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. Am J Clin Nutr 2002, 75:492–498.

    PubMed  CAS  Google Scholar 

  28. Ludwig DS: The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002, 287:2414–2423.

    PubMed  Article  CAS  Google Scholar 

  29. Title LM, Cummings PM, Giddens K, Nassar BA: Oral glucose loading acutely attenuates endothelium-dependent vasodilation in healthy adults without diabetes: an effect prevented by vitamins C and E. J Am Coll Cardiol 2000, 36:2185–2191.

    PubMed  Article  CAS  Google Scholar 

  30. Mather K, Anderson TJ, Verma S: Insulin action in the vasculature: physiology and pathophysiology. J Vasc Res 2001, 38:415–422.

    PubMed  Article  CAS  Google Scholar 

  31. Hu FB: Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002, 13:3–9. A very clear and concise review of the new dietary pattern approach to examining the effects of overall diet on health.

    PubMed  Article  CAS  Google Scholar 

  32. Hu FB, Rimm E, Smith-Warner SA, et al.: Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 1999, 69:243–249.

    PubMed  CAS  Google Scholar 

  33. Schulze MB, Hu FB: Dietary patterns and risk of hypertension, type 2 diabetes mellitus, and coronary heart disease. Curr Atheroscler Rep 2002, 4:462–467.

    PubMed  Google Scholar 

  34. Fung TT, Rimm EB, Spiegelman D, et al.: Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr 2001, 73:61–67.

    PubMed  CAS  Google Scholar 

  35. Lopez-Garcia E, Schulze MB, Fung TT, et al.: Major dietary patterns are related to plasma concentrations of inflammatory and endothelial dysfunction markers. Am J Clin Nutr 2004, in press.

  36. Vogel RA, Corretti MC, Plotnick GD: The postprandial effect of components of the Mediterranean diet on endothelial function. J Am Coll Cardiol 2000, 36:1455–1460.

    PubMed  Article  CAS  Google Scholar 

  37. Fuentes F, Lopez-Miranda J, Sanchez E, et al.: Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men. Ann Intern Med 2001, 134:1115–1119.

    PubMed  CAS  Google Scholar 

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Lopez-Garcia, E., Hu, F.B. Nutrition and the endothelium. Curr Diab Rep 4, 253 (2004). https://doi.org/10.1007/s11892-004-0076-7

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  • DOI: https://doi.org/10.1007/s11892-004-0076-7

Keywords

  • Endothelial Function
  • Dietary Pattern
  • Trans Fatty Acid
  • Mediterranean Diet
  • Glycemic Index