Dietary control of heart disease

Individual level risk factors for cardiovascular disease High Blood Pressure High Blood Cholesterol Tobacco Use Physical inactivity Poor nutrition Obesity Diabetes

Dietary control of heart disease Mediterranean diet - olive oil French Paradox - red wine Soy isoflavones

Dietary Fat Dietary fats – Saturated fats – Unsaturated fats Polyunsaturated Monounsatured – Trans fats High fat diets Dietary guideline

Unsaturated fatty acids

Dietary Alternatives Mediterranean diet Atkins diet Others

French Paradox What is the French Paradox? It has been hypothesized that this is due to the consumption of red wine with its resveratrol Resveratrol is a phenolic compound that occurs in the grapes, other berries, and a few other plants

Mode of Action Atherosclerosis (formation of plaque) in arteries caused by oxidation of LDL This blocks the reverse transport of cholesterol back to liver Phenolics are anti-oxidants - so they prevent oxidation of LDL in blood stream and therefore prevent clogged arteries and lower the risk of heart disease

More evidence needed In vitro, resveratrol has anti-oxidant properties In vivo, anti-oxidant properties not correlated with resveratrol concentration but with other phenolics such as gallic acid, catechin, myricetin, quercitin, and caffeic acid Phenolic cmpds (tannins and quercitin) also influence production of nitric oxide (NO) which affects vasodilation and adhesion of platelets

Another possible effect Resveratrol also inhibits in vitro synthesis of thromboxanes - prostaglandin involved in platelet aggregation

Clinical studies add confusion Clinical study with healthy male volunteers drinking 375 ml red or white wine each day Results showed BOTH red and white wine related to an increase of HDL levels and a decrease of platelet aggregation Surprising because resveratrol and other phenolics are all lower in white wine Supports hypothesis that alcohol itself involved

Soy Isoflavones Soy bean based foods have received much attention in nutrition research Contain isoflavones - polyphenols - called phytoestrogens Health benefits of isoflavones - – lower cholesterol levels, especially LDL – lower blood pressure – reduce osteoporosis and reduce symptoms of menopause