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Nutraceuticals and atherosclerosis: human trials.

机译:营养保健品和动脉粥样硬化:人体试验。

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The high prevalence of obesity, atherosclerosis, and cardiovascular disease (CVD) is largely attributable to the contemporary lifestyle that is often sedentary and includes a diet high in saturated fats and sugars and low ingestion polyunsaturated fatty acids (PUFAs), fruit, vegetables, and fiber. Epidemiological studies have confirmed a strong association between fat intake, especially saturated- and transfatty acids, plasma cholesterol levels, and rate of coronary heart disease (CHD) mortality. In counterpart, beneficial cardiovascular effects have been reported in populations consuming the "healthy" Mediterranean-type diet. Indeed, many nutrients and phytochemicals in fruits, vegetables, and wine, including fiber, vitamins, minerals, antioxidants, have shown to be independently or jointly responsible for the apparent reduction in CVD risk. Therefore, in patients with overt CVD, efforts have focused on combining both drug treatments and nutrition interventions. Undoubtedly, the advances in the knowledge of both the disease processes and healthy dietary components have provided new avenues to develop pharmaceutical and/or dietary strategies to halt the development of vascular disease. In this regard, within the last years, pioneering nutritional strategies, such as nutraceuticals, have been developed aimed at reducing the main atherosclerotic risk factors and promoting cardiovascular health. Furthermore, a growing body of clinical evidence has demonstrated positive cardiovascular effects associated with dietary fibers, cholesterol-lowering natural agents, olive oil, omega-3 PUFAs, antioxidants, and polyphenols intake. Moreover, monounsaturated fatty acids intake has shown to modulate the expression of key atherosclerotic-related genes. Yet, in the case of antioxidants, some large clinical trials have failed to confirm such atheroprotective effects. Furthermore, there might be interactions between these natural food supplements and cardiovascular medications that cannot be overlooked. Hence, there is a need for a better understanding and more scientific evidence of the relative contribution of major nutraceutical constituents to the inhibition of the progression of atherosclerosis and its clinical consequences.
机译:肥胖,动脉粥样硬化和心血管疾病(CVD)的高患病率很大程度上归因于经常久坐的现代生活方式,其中包括饮食中富含饱和脂肪和糖类以及低摄入的多不饱和脂肪酸(PUFA),水果,蔬菜和纤维。流行病学研究证实,脂肪摄入(尤其是饱和脂肪酸和反式脂肪酸),血浆胆固醇水平和冠心病(CHD)死亡率之间存在密切的联系。与此相对,据报道,食用“健康”地中海式饮食的人群有有益的心血管作用。确实,水果,蔬菜和葡萄酒中的许多营养素和植物化学物质,包括纤维,维生素,矿物质,抗氧化剂,已被证明可独立或共同导致明显降低CVD风险。因此,对于明显的CVD患者,研究工作集中在药物治疗和营养干预相结合。毫无疑问,疾病过程和健康饮食成分的知识进步为开发药物和/或饮食策略以制止血管疾病的发展提供了新途径。在这方面,在过去的几年中,已经开发了开创性的营养策略,例如营养保健品,旨在减少主要的动脉粥样硬化危险因素并促进心血管健康。此外,越来越多的临床证据表明,膳食纤维,降低胆固醇的天然药物,橄榄油,omega-3 PUFA,抗氧化剂和多酚的摄入具有积极的心血管作用。此外,单不饱和脂肪酸的摄入已显示出调节与动脉粥样硬化相关的关键基因的表达。然而,就抗氧化剂而言,一些大型临床试验未能证实这种抗动脉粥样硬化的作用。此外,这些天然食品补充剂和心血管药物之间可能存在相互作用,不能忽视。因此,需要对主要营养成分对抑制动脉粥样硬化进展及其临床后果的相对贡献的更好的理解和更科学的证据。

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