Table of Contents
ABSTRACT
Beyond total cholesterol, oxidative stress and inflammation as well as antiplatelet effects are additional approaches for reducing cardiovascular diseases (CVDs) [1-3]. Despite major advancements in the management of CVDs, these problems continue to increase and may be a major cause of mortality and morbidity [1]. Recent studies indicate that these risk markers develop due to increased intake of western-type diets characterized by ultra-processed foods, processed meat and red meat, which are known to predispose to all the biomarkers of CVDs [1-5]. Several studies have demonstrated that Mediterranean-style diets characterized by vegetables, fruits, whole grains, nuts and certain agents such as fish oil, mustard oil, rape seed oil, olive oil and fish as well as fish peptides have beneficial effects on morbidity and mortality due to CVDs without decreasing serum cholesterol [3, 6-10]. These benefits may be due to the presence of omega-3 and omega-6 fatty acids, alpha-linolenic acid (ALA) and poly-phenolics and fiber in the diet. This communication aims to emphasize that morbidity and mortality due to CVDs may be reduced by non-pharmacological interventions without the need for decreasing cholesterol.
REFERENCES
[1] Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang N-Y, Yaffe K, Martin SS; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2022, update: A Report from the American Heart Association. Circulation 2022; 145: e153e-669. DOI: 10. 1161/CIR.0000000000001052
[2] Tawakol A, Ishai A, Takx RAP, Figueroa AL, Ali A, Kaiser Y, Truong QA, Solomon CJ, Calcagno C, Mani V, Tang CY, Mulder WJ, Murrough JW, Hoffmann U, Nahrendorf M, Shin LM, Fayad ZA, Pitman RK. Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study. Lancet 2017; 389 (10071): 834-845.
[3] Singh RB, Fedacko J, Fatima G, Magomedova A, Watanabe S, Elkilany G. Why and how the Indo-Mediterranean diet may be superior to other diets: the role of antioxidants in the diet. Nutrients 2022; 14: 898. https://doi.org/10.3390/nu14040898
[4] Rico-Campà A, Martínez-González MA, Alvarez-Alvarez I, Mendonça RD, de la Fuente-Arrillaga C, Gómez-Donoso C, Bes-Rastrollo M. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ 2019; 365: l1949. doi:10.1136/bmj.l1949.
[5] Zhong VW, Van Horn L, Greenland P, Carnethon MR, Ning H, Wilkins JT, Lloyd-Jones DM, Allen NB. Associations of processed meat, unprocessed red meat, poultry, or fish intake with incident cardiovascular disease and all-cause mortality. JAMA Intern Med 2020; 180 (4): 503-512.
[6] Burr ML, Fehily AM, Gilbert JF. Effects of changes in fat, fish and fiber intakes on death and myocardial infarction: Diet and Reinfarction Trial (DART). Lancet 1989; ii: 757-761.
[7] Singh RB, Niaz MA, Sharma JP, Kumar R, Rastogi V, Moshiri M. Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival–4. Cardiovasc Drugs Ther 1997; 11 (3): 485-491.
[8] GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999; 354: 447–455.
[9] Singh RB, Kartikey K, Isaz A. Fish, fish oil and fish peptides and other sea foods. In: Singh RB, Watanabe S, Isaza A, eds. Functional Foods and Nutraceuticals in Metabolic and Non-Communicable Diseases. Elsevier, USA, 2022. 248 p.
[10] Singh RB, Kartikey K, Isaza A, Fish oil or fish peptides. World Heart J 2018; 10: 307-320.
[11] Müller TD, Finan B, Bloom SR, D’Alessio D, Drucker DJ, Flatt PR, Fritsche A, Gribble F, Grill HJ, Habener JF, Holst JJ, Langhans W, Meier JJ, Nauck MA, Perez-Tilve D, Pocai A, Reimann F, Sandoval DA, Schwartz TW, Seeley RJ, Stemmer K, Tang-Christensen M, Woods SC, DiMarchi RD, Tschöp MH. Glucagon-like peptide 1 (GLP-1). Mol Metab 2019; 30: 72-130. https://doi.org/10.1016/j.molmet.2019. 09.010.
[12] Yamaoka-Tojo M, Tojo T, Takahira N, Matsunaga A, Aoyama N, Masuda T, Izumi T. Elevated circulating levels of an incretin hormone, glucagon-like peptide-1, are associated with metabolic components in high-
risk patients with cardiovascular disease. Cardiovasc Diabetol 2010; 9: 17. doi:10.1186/1475-2840-9-17
[13] Bodnaruc AM, Prud’homme D, Blanchet R, Giroux I. Nutritional modulation of endogenous glucagon-like peptide-1 secretion: a review. Nutr Metab (Lond) 2016; 13: 92. https://doi.org/10.1186/s12986-016-0153-3
[14] Hira T, Trakooncharoenvit A, Taguchi H, Hara H. Improvement of glucose tolerance by food factors having glucagon-like peptide-1 releasing activity. Int J Mol Sci. 2021; 22:, 6623. https://doi.org/10.3390/ijms22126623.
[15] Guasch-Ferré M, Li Y, Willett WC, Sun Q, Sampson L, Salas-Salvadó J, Martínez-González MA, Stampfer MJ, Hu FB. Consumption of olive oil and risk of total and cause-specific mortality among U.S. adults. J Am Coll Cardiol 2022; 79 (2): 101-112. doi: 10.1016/j.jacc.2021.10.041.
[16] Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez-González MA; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or Nuts. N Engl J Med 2018; 378: e34. DOI: 10.1056/NEJM oa1800389.
[17] De Lorgeril M, Renaud S, Mamelle N, Salen P, Martin JL, Monjaud I, Guidollet J, Touboul P, Delaye J. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343 (8911): 1454-1459. doi: 10.1016/s0140-6736(94)92580-1.
[18] Singh RB, Dubnov G, Niaz MA, Ghosh S, Singh R, Rastogi SS, Manor O, Pella D, Berry EM. Effect of an Indo-Mediterranean diet on progression of coronary disease in high risk patients: a randomized single blind trial. Lancet 2002; 360: 1455–1461.
[19] Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, Doyle RT Jr, Juliano RA, Jiao L, Granowitz C, Tardif JC, Ballantyne CM; REDUCE-IT Investigators. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med 2019; 380: 11-22.