1. Lecture 5c 4 Feb 2013 Atherosclerosis - Functional Foods and Nutraceuticals

2. Functional foods are only marginally capable of modifying the factors involved in atherosclerosis relative to nutraceuticals -Are functional foods of any value regarding prevention or improvement of the atherosclerotic process?

3. Class activity - Factors that limit use of nutraceuticals

4. Nutraceuticals Note: none= no studies found in humans Lipids -fish oils -lowers triglycerides-mechanism is controversial -modest decrease or no impact on cholesterol and LDLc -may slightly increase or decrease or have no impact on HDLc what does that perhaps say about the mechanism of triglyceride lowering?

5. Lipids -evening primrose oil- -most effective at lowering cholesterol in hypercholesterolemic persons -rise in HDLc only in hypertriglyceridemics -inverse relationship in response between triglycerides and HDLc

6. Lipids -borage oil -no impact of up to 1.3 g GLA /day -5.24 g GLA/day no impact

7. Lipids -blackcurrant oil- -drops triglycerides, LDLc and total cholesterol and raises HDLc especially in hyperlipidemics -normolipidemics there is no effect to date

8. Lipids -fungal oil -very successful at lowering cholesterol and LDLc in animals -only human trial mixed in algal oil- problem with this? -rich in  -carotene- antioxidant potential

9. Lipids -garlic capsules -LDLc and cholesterol is lowered modestly 10–15 % -allicin fingered though mechanism is not clear -atheroma regression -reduction of oxidation of lipids -may play a role in reduced platelet activity since oxidized LDL has been suggested to more aggressively increase platelet reactivity- Jialal at UC-Davis disputes this

10. Lipids Beta-carotene, vitamin E, and vitamin C -antioxidant principles some have suggested an atheroma lessening though this is controversial

11. Platelets -fish oils platelet phospholipid -reduction of arachidonic acid -increased EPA-poor cyclooxygenase substrate -generates thromboxane A 3 weakly pro-aggregatory -PGI 3 –very antiaggregatory

12. Platelets -evening primrose oil -DGLA-generates PGI 1 -PGI 1 -antiaggregatory evening primrose oil-some show an increase in aggregation at higher GLA doses (300 mg/day) -at lower doses (<300 mg GLA/day)- decreased aggregation

13. Platelets -borage oil- no impact of up to 1.3 g GLA /day -5.24 g GLA/day increased aggregation -higher doses-hyper-reactivity – possibly due to formation of a hydroxy DGLA -blackcurrant oil-mix of omega 3 and 6 -none

14. Platelets -fungal oil-mix of omega 3 and 6 (some species omega 6 only) -lowers platelet aggregation in animals -garlic capsules -lower aggregation in vitro problem with in vitro -usually washed or platelet-rich plasma -bleeding times are better- Ivy bleeding time

15. Blood pressure - more elaboration when we get to hypertension Changes occurs in both systolic and diastolic where changes indicated -fish oils-modest blood pressure lowering – in part eicosanoid PGI 3 (possibly -no PGI 3 human studies found) related -also drops in AA- related eicosanoids

16. BLOOD PRESSURE -evening primrose oil -modest drops (possibly PGI 1 - no human PGI 1 studies found) -PGE 1 related -borage oil-more pronounced drops than evening primrose oil observed -blackcurrant oil- most pronounced drops of the studies done

17. Blood pressure -fungal oil -none- lowered in SHR rats -garlic capsules -lower blood pressure- see nitric oxide-allicin fingered

18. Obesity -olive oil -may result in weight loss -mechanism obscure -fish oils -none -evening primrose oil -one study-no effect

19. Obesity -borage oil -none -blackcurrant oil -none -fungal oil -decreased body fat content in animals- high oleic content in fungal oil -garlic capsules -none

20. Renal Disease Blood pressure lowering-more when we get to renal Various Pathogens -no nutraceuticals yet studied that specifically alleviate the problems of infection that are hypothetically linked to atherosclerosis Nitric oxide -garlic capsules- increase in nitric oxide production