This document discusses cardiovascular disease and protective nutrition. It describes the four main types of cardiovascular disease and lists modifiable and non-modifiable risk factors. It then outlines several dietary components and nutritional models that can help prevent cardiovascular disease, including omega-3 fatty acids, plant sterols, vitamins, polyphenols, fiber, and the Mediterranean, DASH, and MIND diets. The document emphasizes consuming foods like fatty fish, nuts, vegetables, fruits, and whole grains while limiting sugar, saturated fat, and red meat.

1. Cardiovascular Disease
and Protective Nutrition
PROFESSOR NIKHAT SIDDIQI, BIOCHEMISTRY DEPARTMENT
COLLEGE OF SCIENCE, KING SAUD UNIVERSITY, RIYADH
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2. The cardiovascular system consists of the heart and its blood vessels.
Cardiovascular disease, also known as heart disease, refers to the following 4 entities:
Coronary artery disease (CAD) which is also referred to as coronary heart disease (CHD),
Cerebrovascular disease,
Peripheral artery disease (PAD), and
Aortic atherosclerosis.
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3. CAD results from decreased myocardial perfusion that causes angina due to ischemia and can
result in myocardial infarction (MI).
Cerebrovascular disease is the entity associated with strokes, also termed cerebrovascular
accidents, and transient ischemic attacks (TIAs).
Peripheral arterial disease (PAD) is arterial disease predominantly involving the limbs that may
result in claudication.
Aortic atherosclerosis is the entity associated with thoracic and abdominal aneurysms.
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5. Factors
Non-modifiable cardiovascular risk factors - gender, age, ethnicity, and family history of
cardiovascular disease.
Modifiable risk factors - body weight, dietary pattern, physical activity, smoking, alcohol
consumption, and exposure to stress.
Factors that can be partially considered modifiable are hypertension, hyperlipidemia, diabetes,
and obesity.
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6. Influence of Dietary Components on the
Occurrence of Cardiovascular Diseases
Irregularity of meal consumption
High dietary atherogenicity
Snacking on sweets between meals,
Low supply of dietary fiber, unsaturated fatty acids,
legume seeds, and
High supply of meat and meat products
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7. Cardioprotective Food Ingredients
Foods can prevent the onset of cardiovascular disease.
Coenzyme Q10 (CoQ10)-Its oxidized form, ubiquinone, takes an active part in energy production
in mitochondria by transporting electrons between protein complexes in the respiratory chain.
The reduced form, ubiquinol, by taking up oxygen, reduces stress. These properties of CoQ10
make it an essential component for the function of all cells, especially cardiomyocytes.
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8. The antioxidant properties of this coenzyme improve endothelial function and have a beneficial
effect on the lipid profile.
Sources- fatty fish, soy products, nuts, and green vegetables such as spinach.
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9. Omega-3 fatty acids
Essential unsaturated fatty acids show activity in support of the cardiovascular system
Omega-3 fatty acids belonging to this group are distinguished by specific cardioprotective
properties.
Lowering the concentration of pro-inflammatory interleukins, contribute to improving the
functioning of the endothelium of blood vessels, reducing the degree of platelet aggregation
and clot formation, as well as lowering the concentration of triglycerides.
They have also been shown to have a hypotensive effect.
Sources-Marine fish (especially fatty fish such as salmon), as well as seaweeds, chia seeds, and
linseed.
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10. Plant-derived sterols - Antioxidant and lipid profile-enhancing effects are also attributed to
sitosterol.
Plant phytosterols are abundant in oils, vegetables, fruits, (especially sprouts), nuts, and pulses.
Vitamin E - cardiovascular protection by acting at several stages of the thrombotic process.
1. Counteracts hyperlipidemia, atherosclerosis, and endothelial dysfunction by reducing foam
cell infiltration and decreasing lipid peroxidation.
2. Reduces platelet aggregation thus preventing thrombosis.
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11. Polyphenols-
1. Lowering blood pressure
2. Endothelial function improvement
3. Lipid profile improvement
4. Reducing the risk of CVD development
Sources- fruits, vegetable oil, berries, nuts, tea, coffee, and chocolate
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12. Tea polyphenols, known as catechins, are the main bioactive substances responsible for the
beneficial effects of tea on CVD risk.
Nuts are a rich source of phytochemicals (proanthocyanidins, flavonoids, and phenolic acids) and
fat-soluble bioactive and PUFA, tocols, carotenoids, phytosterols, and sphingolipid.
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13. Carbohydrates
Excessive consumption of simple carbohydrates (sugar, sweets, high glycemic index products)
increases the risk of developing diabetes and cardiovascular disease, and contributes to the
development of overweight and obesity.
The World Health Organization recommends limiting the intake of simple carbohydrates to 10%
of total caloric needs.
However, it is suggested to consume complex carbohydrates and products with a low glycemic
index, and provide dietary fiber.
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14. Dietary Fiber
Dietary fiber consists of vegetable substances, soluble and insoluble, whose digestion is made
possible by probiotic bacteria present in the gastrointestinal tract.
Sources- vegetables, fruits, whole-grain cereal products, and nuts. The daily fiber intake of 27–
40 g recommended by the WHO carries significant health benefits, for the cardiovascular
system.
Fiber - the slow digestion in the gastrointestinal tract, causing delayed gastric emptying, feeling
of satiety, thus reducing the amount of food consumed and preventing excessive body weight.
At the same time, fiber promotes improved intestinal motility.
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15. Fats
The risk of cardiovascular disease increases in situations of insufficient supply of
polyunsaturated fatty acids and supply of saturated fatty acids with trans-configuration.
Natural sources of omega-3 include mainly fatty marine fish, chia, flaxseed, and nuts. Therefore,
it is recommended to consume oily sea fish at least twice a week to provide the optimal amount
of essential fats.
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16. Selected Nutritional
Models in the Prevention
and Treatment of
Cardiovascular Disease
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17. The Mediterranean diet
Predominance of high-fiber products, whole grain cereals, vegetables, fruits, nuts, seeds such as
pumpkin, olive oil, and oily sea fish -products that provide ingredients that have a beneficial
effect on the functioning of the heart and blood vessels.
Intake of saturated fatty acids, trans-configured fatty acids, and animal meat, especially red
meat and meat products, is limited.
As it provides cardioprotective components, the Mediterranean diet reduces the risk of heart
failure and the risk of death, both primary and secondary, from cardiovascular disease.
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18. DASH (Dietary Approaches to Stop
Hypertension)
Created directly to counteract hypertension and reduce the risk of its complications.
Its main premise is to limit the daily intake of salt, which when supplied in excess leads to an
increase in the amount of water circulating in the vessels, causing an increase in blood pressure.
The DASH dietary model emphasizes the consumption of fruits and vegetables, nuts, dairy
products with limited fat, and plant-based proteins, mainly from legumes.
It has been shown that low amounts of sodium in the DASH diet mitigated the hypotensive
effects of potassium, or conversely, high potassium or calcium in the DASH diet mitigated the
effects of low amounts of sodium.
The diet results in a reduction in cardiovascular risk.
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19. MIND diet (Mediterranean–DASH
Intervention for the neurodegenerative
delay).
Dietary model is intended to counteract neurodegenerative processes, but at the same time, it
provides the diet food products showing cardioprotective effects.
The MIND dietary model is mainly based on the supply of green vegetables, berries, nuts, oil,
wine and fish, low-fat meat, and dairy.
The diet is rich in vitamin E, flavonoids, and folate which protect the cardiovascular system
through anti-inflammatory effects and prevent abnormal homocysteine metabolism.
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20. Health benefits of selected dietary
models in cardiovascular disease
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21. Influence of Non-
Nutritional Factors on the
Incidence of
Cardiovascular Disease
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22. Physical Activity
Smoking – Risk factor
Alcohol Consumption- Risk factor
Stress- Risk factor
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23. Reference
Szczepańska E, Białek-Dratwa A, Janota B, Kowalski O. Dietary Therapy in Prevention of
Cardiovascular Disease (CVD)-Tradition or Modernity? A Review of the Latest Approaches to
Nutrition in CVD. Nutrients. 2022 Jun 27;14(13):2649.
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