Vitamins, minerals and phytonutrients in cardiovascular diseases

Fundamental nutrients for humans include carbohydrates (sugars), fats, proteins, minerals and vitamins.

Vitamins

Vitamins are organic substances that must be obtained in small quantities from the environment (food, sun) because man cannot synthesize them or you can't do it at the speed necessary to maintain health.

The vitamins involved in cardiovascular disease are:

• Antioxidants: vitamin A (in its beta-carotene form), vitamin E (in its alpha-tocopherol form) and vitamin C (as ascorbic acid).
• Folic acid or folate to lower high homocysteine ​​levels.
• niacin for its role in modifying the amount of fat in the blood (lowering "bad" cholesterol, raising "good" cholesterol, and lowering triglycerides).

1. Antioxidant vitamins

They exert a protective action by blocking the radicals that are continuously produced in the arterial wall and that oxidize LDL. Oxidized LDL accelerates atherosclerosis in the vascular wall and the presentation of cardiovascular disease.

• Vitamin E is the most powerfulDue to its fat nature, it is usually located inside the LDL avoiding its oxidation, as well as in the cell membranes, avoiding its injury. Vitamin E is widely distributed in food, but it is especially abundant in vegetable oils and nuts.
• Beta-carotenes (precursors of vitamin A) would have a similar role. Beta-carotenes are abundant in fruits (skin), vegetables and greens.
• Vitamin C, which is not fatty in nature, in addition to its antioxidant role, it would act in the regeneration of vitamin E. Vitamin C is found in citrus fruits, leafy vegetables, vegetables and potatoes. Vitamin C is easily destroyed in heat

It must also be taken into account that antioxidants slow down the oxidation reaction, but at the cost of destroying themselves. These natural antioxidants are found mostly in fruits and vegetables.

In experimental studies the antioxidant effect and the protection of the arterial wall are demonstrated. However, supplementation with pills of these vitamins it has not been shown to reduce the occurrence of cardiovascular disease and even produces a higher incidence of it and cancer.

Thus, a varied diet rich in these foods will provide us with sufficient amounts of these vitamins, which will protect us from cardiovascular disease.

2. Folic acid

Folic acid is essential in the metabolism of homocysteine. High figures of homocysteine have been recognized as a risk factor for the presentation of cardiovascular disease.

The increase in homocysteine ​​is inversely related to the levels of folic acid in the blood. However supplementation with pills containing folic acid It has not been conclusively shown to reduce the occurrence or recurrence of cardiovascular disease.

Thus, the best way to take folic acid supplements is take natural foods that contain it in abundance, such as green leafy vegetables (chard and spinach), cereals and nuts, and liver. Milk and dairy products, and meat and fish are poor sources of folic acid. Although the liver is a very abundant source of folic acid, its consumption may not be recommended from a global cardiovascular point of view.

On the other hand, it must be taken into account that foods rich in folic acid can be affected in their nutritional quality and vitamin richness by maneuvers in their preparation and cooking. The folic acid is sensitive to light; and they can also be lost in the cooking water of the food. It is estimated that practically 50% of the initial content of folic acid in food gets lost in culinary processes. Processing by boiling or frying leads to losses of the initial folic acid content, which can reach 90%. Vegetables lose almost 70% of their folic acid content when boiled for 8 minutes, largely by dissolving in the cooking water.

3. niacin

niacin is found in liver, meat, poultry and fish, cereals and legumes, but the doses obtained from food have no effect on blood fats. At much higher doses than those provided by food, higher than a gram, produce a decrease in LDL cholesterol, triglycerides, lipoprotein (a) and increased HDL cholesterol. We have a commercially available drug, nicotinic acid, which achieves these effects at these high doses.

Minerals

The minerals are inorganic substances which must be obtained in small quantities from food because man cannot synthesize them.

The minerals involved in cardiovascular disease are magnesium, zinc and selenium. These minerals could play an antioxidant role. Magnesium intake could also reduce the risk of type 2 diabetes. A varied diet will provide us with these minerals in sufficient quantity.

The selenium is found in cereals, mushrooms, liver, artichokes and other products). The greatest sources of magnesium are green leafy vegetables, but we also find it in dried fruits (walnuts), legumes, some shellfish, and whole grains. Foods of animal origin are poor in magnesium: meat, poultry, fish, milk and most fruits, with the exception of bananas. The main dietary sources of zinc are: meat, fish, poultry, milk, and dairy products.

Phytonutrients

Phytonutrients are substances that come from the plant kingdom but they are not nutrients in themselves, that is, they are not necessary for the functioning of our body but whose consumption offers benefits for certain diseases, including cardiovascular diseases.

Within the group of phytonutrients we include the following

1. Polyphenols

Substances that reduce the onset of cardiovascular disease and which we know as polyphenols are identified in numerous vegetables. Some are, for example, lycopene from tomatoes or resveratrol from grapes.

The decrease in cardiovascular disease is due to the fact that they have antioxidant effects on the arterial wall and on LDL, that they favor the dilation of the arteries and that they reduce the thrombosis capacity of the blood. Thanks to that protect the arterial wall from damage, improve blood circulation through the arteries and improve blood pressure. These effects are achieved when they are consumed naturally, that is, incorporated into food and not as supplements. Food processing can significantly decrease the content of some polyphenols.

2. Flavonoids

Flavonoids are a type of polyphenols that give fruits and vegetables their aroma, flavor and color. They are found in different vegetables such as grapes, apples, cabbages, cocoa, garlic, and green tea. It is also present in beverages such as beer and wine, obtained by fermentation from barley and hops in the case of beer, and from grapes in the case of wine.

These substances would have vasodilator, antioxidant, antiplatelet, anti-inflammatory and blood pressure lowering effectsAll of these processes are at the origin and maintenance of atherosclerosis, that is, they exert a cardioprotective effect.

3. Plant sterols and stanols (phytosterols)

Sterols, such as beta-sitosterol, campesterol, stigmasterol, and others, are present in plant cell membranes. They would be like the cholesterol in plants. If we chemically modify the structure of the sterols, we can obtain compounds called stanols, which have been used in the manufacture of foods to lower cholesterol.

The chemical structure of phytosterols is similar to that of cholesterol. But despite all this, intestinal absorption into the blood of phytosterols ingested with food is almost nil (except in a very rare disease, familial Sitosterolemia).

In general, vegetable oils from corn, sunflower and olive, in this order, are the main source of plant sterols, followed by nuts, legumes and cereals, in this order. The daily intake of plant sterols depends on the type of diet; the usual Western diet can contain between 150-400 mg / day of plant sterols, the majority being beta-sitosterol, while a vegetarian diet could be up to 1 g / day. The intake in amounts of about 2-3 grams per day of phytosterols is what produces decreases in total cholesterol level by 5-10%, and in LDL cholesterol ("bad" cholesterol) by 10-15%, without affecting triglycerides or HDL cholesterol ("good" cholesterol).

Taking higher doses does not result in a greater decrease in cholesterol. To achieve these amounts of sterols / stanols they must be administered as supplements in fatty foods, such as margarines or yogurts, which is what the food industry has done. The effect of lowering cholesterol is complementary to that achieved with drugs that also lower cholesterol such as statins or ezetimibe. The administration of phytosterols / stanols at the indicated doses is safe. The only adverse effect of these compounds is a slight malabsorption and subsequent reduction in blood concentrations of some vitamins, such as beta-carotene, lycopene, and others, although generally without clinical impact. It is recommended, to counteract this effect, increasing the consumption of fruits and vegetables during treatment with plant sterols. The only strict contraindication to the administration of these compounds is the existence of a familial Sitosterolemia.

4. Soy

Soy is a widely consumed legume in Asian countries, from where it has been introduced into our culture for alleged beneficial effects on health that include a modest reduction in cholesterol and the relief of symptoms experienced by women with menopause; and also on the assumption that the high consumption of soy in Asian countries is at the base of their reduced prevalence of coronary heart disease.

In soy there are proteins, flavonoids (isoflavones) and fats, among other elements. Soy proteins, being of vegetable origin and replacing animal proteins, could have a modest cholesterol-lowering effect. The isoflavones in soy (genistein and daidzein) are similar in their chemical structure to estrogens, so they would alleviate the symptoms of hot flashes in post-menopausal women and would also help lower cholesterol.

However, and this is very important, the possible effects are highly dependent on people, so it is not possible to establish general rules regarding their benefit. By-products of soy, such as lecithin ("soy lecithin") may also have individual-dependent beneficial effects. Following some studies, international organizations are critical of the potential role of soy protein and isoflavone supplements on lipid profile and cardiovascular prevention.

5. Allicin from garlic

Garlic has a high content of substances with benefits on the cardiovascular system, such as flavonoids, saponins, organosulfur compounds (responsible for the characteristic smell and taste of these plants) and others. The beneficial effect of these substances is through their antioxidant properties, preventing thrombi and reducing homocysteinemia.

In addition, it would have a lowering effect on the amount of cholesterol in the blood and lowering blood pressure. Here we will refer to allicin, an organosulfur compound that when taken in the form of garlic capsules or a proportion equivalent to a clove of garlic per day, can lower LDL cholesterol concentrations by around 10%, through to limit the synthesis of cholesterol in the liver.

However, this effect is not evidenced in other studies. In experimental animals, it has been shown that a dietary supplement of pure allicin is capable of reducing the plaque of atheroma of the arterial wall.