Linda Ohr

Linda Milo Ohr

When it comes to coronary heart disease (CHD), high cholesterol, high blood pressure, and blood flow are just some factors addressed by today’s reported heart-healthy ingredients. From mainstream soy protein and phytosterols to lesser-known carnitine and dairy peptides, here are some of the latest research and ingredient developments.

NutraceuticalsSoy Protein
Since 1999, soy protein has carried an FDA-approved health claim, linking it to a reduced risk of cardiovascular disease (CVD). This is based on FDA’s conclusion that foods containing soy protein included in a diet low in saturated fat and cholesterol may reduce the risk of CHD by lowering blood cholesterol levels. Most recently, McDonald (2008) summarized the results from 5 studies published from 1998 to 2008, which examined the effects of soy protein on cholesterol levels. She found that even moderate consumption of soy products—in the range of 20–50 g of soy protein/day—reduced low-density lipoprotein (LDL) cholesterol levels by 4–6% and total cholesterol by 3–5% beyond what can be achieved through a fat-modified diet alone. She also found that the lipid-lowering effects of soy protein were observed when it was consumed as a powder mixed with beverages or incorporated into foods, and when it was consumed from native food sources such as whole soybeans, soymilk, tofu, and soy nuts. In addition, lipid-lowering effects did not depend on the presence of isoflavones.

Larkin et al. (2009) also demonstrated that a dietary combination of soy with either a probiotic (yogurt) or a prebiotic (resistant starch) resulted in significant lipid lowering, not related to isoflavone bioavailability, in mildly hypercholesterolemic subjects (men and postmenopausal women) older than 45 years. Soy + probiotic significantly decreased total cholesterol and soy + prebiotic significantly decreased total and LDL cholesterol. The bioavailabilities of soy isoflavones daidzein, genistein, or equol were not affected by probiotic or prebiotic consumption or associated with lipid changes.

Fatty Acids
According to an American Heart Association survey (AHA, 2007), consumers know which fats are “bad fats,” but fewer know the “better fats.” For example, 72% of consumers associate saturated fats and 68% associate trans fats with an increased risk of heart disease. In comparison, significantly fewer consumers are aware of the positive effects of the better fats on the risk of heart disease. AHA reports that 41% of consumers associate monounsaturated fats and 44% of consumers associate polyunsaturated fats with beneficial effects on heart health. Only 20% correctly believe they should consume some fat for good health.

According to an American Heart Association survey (AHA, 2007), consumers know which fats are “bad fats,” but fewer know the “better fats.” For example, 72% of consumers associate saturated fats and 68% associate fats with an increased risk of heart disease. In comparison, significantly fewer consumers are aware of the positive effects of the better fats on the risk of heart disease. AHA reports that 41% of consumers associate monounsaturated fats and 44% of consumers associate polyunsaturated fats with beneficial effects on heart health. Only 20% correctly believe they should consume some fat for good health.

Studies show that the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) contribute to cardiovascular health in a variety of ways, such as relaxing blood vessels, lowering blood pressure, and reducing blood fat levels. AHA recommends that people without documented CHD eat a variety of fish, preferably oily fish, at least twice a week. People with documented CHD are advised to consume about 1 g of EPA and DHA/day, although EPA+DHA supplements could be considered in consultation with their physicians.

AHA also supports an omega-6 polyunsaturated fatty acid (PUFA) intake of at least 5–10% of energy in the context of other AHA lifestyle and dietary recommendations. Harris et al. (2009) indicated that the consumption of at least 5–10% of energy from omega-6 PUFAs reduces the risk of CHD relative to lower intakes. Their data also suggested that higher intakes appear to be safe and may be even more beneficial (as part of a low–saturated fat, low-cholesterol diet).

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Nuts
Nuts such as walnuts, almonds, pistachios, and cashews also boast an FDA-approved qualified health claim, acknowledging nuts’ role in reducing heart disease risk. Rajaram et al. (2009) recently showed that walnuts and fish may work differently in protecting against heart disease. In a randomized crossover feeding trial, 25 normal to mildly hyperlipidemic adults consumed three isoenergetic diets (30% total fat and <10% saturated fat) for 4 weeks each: a control diet (no nuts or fish), a walnut diet (42.5 g of walnuts/10.1 mJ), or a fish diet (113 g of salmon/2 times a week). Serum total cholesterol and LDL cholesterol concentrations in adults who followed the walnut diet were lower than in those who followed the control diet and fish diet. The fish diet resulted in decreased serum triglyceride and increased HDL-cholesterol concentrations.

Two new studies examined the potential impact of almonds in people with type 2 diabetes and cardiovascular factors (ABC, 2009). Researchers from Taipei Medical University and Tufts University collaborated on research that examined the effects of almonds among 20 type 2 diabetic Chinese subjects with mild hyperlipidemia and treated with oral hypoglycemics. The 12-week clinical trial had subjects randomly assigned to receive either a NCEP Step II diet or the almond-based diet (NCEP Step II diet with almonds replacing 20% of the total calorie intake). At the end of the study, researchers found that the almond diet led to a decrease in body fat by 1%, total cholesterol by 8%, and LDL cholesterol by 13%. Most importantly, researchers found that inclusion of almonds decreased blood glucose and insulin and inflammation.

Another study funded by the International Tree Nut Council Nutrition and Research and Education Foundation examined the impact of nuts, including almonds, on not only CVD risk factors, but also hemoglobin A1C (HbA1c) levels. HbA1c is a test used to estimate the management of blood sugar. In this 3-mo study, 117 non-insulin-dependent subjects with diabetes treated with oral medication to help manage their blood sugar levels were randomly assigned to receive one of three diets: a full-dose mixed-nut diet (75 g), a half-dose mixed-nut diet (38 g), and half portion of muffins or muffin diet (control). Researchers found that the subjects who consumed the full-dose mixed-nut diet had a significant improvement in glycemic control as indicated by a reduction in HbA1C levels. They also had a significant decrease in cardiovascular risk factors, total cholesterol, and LDL cholesterol.

Barley
Barley beta-glucan is a soluble fiber that has been shown to lower cholesterol. Most recently, it has been added to Bolthouse® Farms’, San Joaquin Valley, Calif. (phone 800-467-4683, www.bolthouse.com), new Heart Healthy Pear Merlot fruit juice blend. One serving of the juice contains 0.75 g of Barlív™ barley betafiber from Cargill, Minneapolis, Minn. (phone 866-456-8872, www.cargillhft.com). A University of Minnesota study indicated that adding barley beta-glucan to the diet can significantly improve multiple CVD risk markers and after-meal metabolism in individuals with metabolic syndrome (Cargill, 2006). In the double-blind study, 155 generally healthy adults with LDL cholesterol levels between 130–190 mg/dL, half of whom met the criteria for metabolic syndrome, followed a low-saturated-fat, low-cholesterol diet for 4 weeks. Then they consumed ready-to-eat cereal and a juice drink containing barley beta-glucan twice daily for 6 weeks, while they continued on the diet. The test subjects’ intake of barley beta-glucan was either 3 g/day or 5 g/day. Blood levels of glucose and free fatty acids improved after meals. The findings indicated that adding barley beta-glucan to the diet can significantly improve multiple CVD risk markers and after-meal metabolism among individuals with the metabolic syndrome.

Barley beta-glucan is a soluble fiber that has been shown to lower cholesterol. Most recently, it has been added to Bolthouse® Farms’, San Joaquin Valley, Calif. (phone 800-467-4683, ), new fruit juice blend. One serving of the juice contains 0.75 g of ™ barley betafiber from Cargill, Minneapolis, Minn. (phone 866-456-8872, ). A University of Minnesota study indicated that adding barley beta-glucan to the diet can significantly improve multiple CVD risk markers and after-meal metabolism in individuals with metabolic syndrome (Cargill, 2006). In the double-blind study, 155 generally healthy adults with LDL cholesterol levels between 130–190 mg/dL, half of whom met the criteria for metabolic syndrome, followed a low-saturated-fat, low-cholesterol diet for 4 weeks. Then they consumed ready-to-eat cereal and a juice drink containing barley beta-glucan twice daily for 6 weeks, while they continued on the diet. The test subjects’ intake of barley beta-glucan was either 3 g/day or 5 g/day. Blood levels of glucose and free fatty acids improved after meals. The findings indicated that adding barley beta-glucan to the diet can significantly improve multiple CVD risk markers and after-meal metabolism among individuals with the metabolic syndrome.

SunOpta Ingredients Group, Chelmsford, Mass. (phone 800-353-6782, www.sunopta.com/ingredients), offers Barley Balance™ beta-glucan concentrate. It is a fine, light flour that has at least 25% beta-glucan and more than 35% total dietary fiber. Starting with North American waxy, hull-less barley, Barley Balance is made using a proprietary dry milling and separation process that is solvent-free and ideal for clean-label products.

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Phytosterols
Phytosterols are gaining recognition through co-branding programs. For example, last year George Weston Bakeries Inc., Horsham, Pa. (phone 800-984-0989, www.gwbakeries.com), launched new breads containing Heart Choice® natural plant sterols from Cognis Nutrition & Health, LaGrange, Ill. (phone 708-579-6150, www.cognis.com). Cognis’ Heart Choice® logo is prominently displayed on the front package. New Grains & MoreDouble Oat Hearty Oatmeal Bread was formulated to promote heart health, and it contains 0.4 g of plant sterols/serving. Cognis also offers other heart-healthy ingredients such as Omevital™ omega-3 fatty acids and Covitol® natural vitamin E.

Phytosterols are gaining recognition through co-branding programs. For example, last year George Weston Bakeries Inc., Horsham, Pa. (phone 800-984-0989, ), launched new breads containing ® natural plant sterols from Cognis Nutrition & Health, LaGrange, Ill. (phone 708-579-6150, ). Cognis’ ® logo is prominently displayed on the front package. ™ was formulated to promote heart health, and it contains 0.4 g of plant sterols/serving. Cognis also offers other heart-healthy ingredients such as ™ omega-3 fatty acids and ® natural vitamin E.

ADM, Decatur, Ill. (phone 800-637-5843, www.adm.com), offers plant sterols through its CardioAid™ line. CardioAid-S plant sterol esters are derived by esterifying plant sterols with canola oil fatty acids. CardioAid-XF is derived from vegetable oils. The company also offers natural-source vitamin E and NutriSoy® soy protein ingredients.

Chocolate
Chocolate flavonoids are gaining notoriety for their heart-health benefits. Barry Callebaut, Zurich, Switzerland (phone 41-43-204-04-04, www.barry-callebaut.com), presented research at last year’s Health Ingredients Europe exhibition, showing Acticoa™ to help maintain healthy blood pressure. The study demonstrated that daily consumption of 17 g of Acticoa dark chocolate (which contains 500 mg of cocoa flavanols) for 2 weeks helped to maintain healthy blood pressure. Two test groups consumed a small portion of dark Acticoa chocolate daily for two weeks. The portion of cocoa flavanols given to the first group was 500 mg and the portion given to the second group was 1,000 mg. After two weeks, both groups, independent of the dose, displayed significantly reduced blood pressure(Barry Callebaut, 2008).

Allen et al. (2008) evaluated the efficacy of daily consumption of a cocoa flavanol-containing dark chocolate bar with added phytosterols (PS), CocoaVia chocolate bars, from Mars Inc., Hackettstown, N.J. (phone 866-290-6849, www.cocoavia.com), in subjects with elevated serum cholesterol. Following a 2-week lead-in utilizing the AHA-style diet, 49 adults (32 women, 17 men) were randomized into two groups and instructed to consume two cocoa flavanol (CF)-containing dark chocolate bars per day. There were two types of bars: one with 1.1 g of sterol esters and one without PS. Each bar was nutrient-matched and contained 180 mg of CF. Participants consumed one bar 2 times per day for 4 weeks then switched to the other bar for an additional 4 weeks. Regular consumption of the PS-containing chocolate bar resulted in reductions of 2.0% and 5.3% in serum total and LDL cholesterol, respectively. Consumption of CF also reduced systolic blood pressure at 8 weeks.

Milk-derived Peptide
A milk-derived tripeptide, tensVida™ (formerly known as TensGuard™), from DSM Nutritional Products Inc., Parsippany, N.J. (phone 800-526-0189, www.nutraaccess.com), is a blood pressure management ingredient that won the NutrAward for most innovative, evidence-based health and nutrition ingredient. It also won the gold medal at last year’s Health Ingredients Europe exhibition. The product of advanced enzyme technology, the lactotripeptide helps to maintain healthy blood pressure within the normal range. According to the company, scientific studies show that milk-derived tripeptides with the bioactive amino acid sequence IPP (isoleucine-proline-proline) can maintain healthy blood pressure in people who have blood pressure within the normal range.

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Vitamin K
Dietary vitamin K is thought to decrease risk of CVD by reducing coronary calcification. Beulensa et al. (2009) investigated the association of intake of phylloquinone (vitamin K-1) and menaquinone (vitamin K-2), including its subtypes (MK4–MK10),with coronary calcification in a cross-sectional study among 564 post-menopausal women. Phylloquinone intake was not associated with coronary calcification while menaquinone intake was associated with decreased coronary calcification. MenaQ7, from PL Thomas, Morristown, N.J. (phone 973-984-0900, www.menaq7.com, www.plthomas.com), provides natural vitamin K-2 as an extract of natto, a fermented soy food from Japan. Natto is particularly rich in the highly bio-available form of vitamin K-2 called menaquinone-7.

Dietary vitamin K is thought to decrease risk of CVD by reducing coronary calcification. Beulensa et al. (2009) investigated the association of intake of phylloquinone (vitamin K-1) and menaquinone (vitamin K-2), including its subtypes (MK4–MK10),with coronary calcification in a cross-sectional study among 564 post-menopausal women. Phylloquinone intake was not associated with coronary calcification while menaquinone intake was associated with decreased coronary calcification. , from PL Thomas, Morristown, N.J. (phone 973-984-0900, , ), provides natural vitamin K-2 as an extract of natto, a fermented soy food from Japan. Natto is particularly rich in the highly bio-available form of vitamin K-2 called menaquinone-7.

Carnitine
L-carnitine is produced by the body and plays a critical role in fat and energy metabolism. Volek et al. (2008) recently provided evidence that flow-mediated dilation (FMD) in the brachial artery of study subjects increased significantly after a high-fat meal was consumed with Carnipure™ tartrate and preceded by supplementation of Carnipure, a special form of L-carnitine from Lonza, Allendale, N.J. (phone 800-955-7426 , www.carnipure.com, www.carnipure-for-you.com). Improved FMD corresponds to improved vascular function.

L-carnitine is produced by the body and plays a critical role in fat and energy metabolism. Volek et al. (2008) recently provided evidence that flow-mediated dilation (FMD) in the brachial artery of study subjects increased significantly after a high-fat meal was consumed with ™ tartrate and preceded by supplementation of , a special form of L-carnitine from Lonza, Allendale, N.J. (phone 800-955-7426 , , ). Improved FMD corresponds to improved vascular function.

Hemp Seed
Hemp provides a significant source of the omega-6 fatty acid, gamma-linolenic acid (GLA). Prociuk et al. (2008) investigated whether dietary hempseed inhibits platelet aggregation under normal and hypercholesterolemic conditions. Male New Zealand white rabbits were fed one of six dietary interventions: regular control diet (RG); control diet + 10% hempseed (HP); control diet + 10% partially delipidated hempseed (DHP); control diet + 0.5% cholesterol (OL); control diet + 0.5% cholesterol + 10% hempseed (OLHP); control diet + 5% coconut oil (CO). After 8 weeks, blood was collected for testing. The animals fed hempseed (HP and OLHP) displayed elevated plasma levels of PUFAs and a prominent enhancement in GLA levels. The results of this study demonstrated that when hempseed is added to a cholesterol-enriched diet, cholesterol-induced platelet aggregation returns to control levels. This normalization is not due to a reduction in plasma cholesterol levels, but may be partly due to increased levels of plasma GLA.

Linda Milo Ohr,
Contributing Editor,
Denver, Colo.
[email protected]

About the Author

Linda Milo Ohr, Contributing Editor, Nutraceuticals column
[email protected]
Linda Ohr

References

Allen, R.R., Carson, L., Kwik-Uribe, C., Evans, E.M., and Erdman, Jr., J.W. 2008. Daily consumption of a dark chocolate containing flavanols and added sterol esters affects cardiovascular risk factors in a normotensive population with elevated cholesterol. J. Nutr. 138: 725-731.

ABC. 2009. The traveling nut: researchers from around the world explore the impact of almonds on the body. Press release, Almond Board of California, Modesto, Calif., April 21.

AHA. 2007. Americans’ awareness, knowledge and behaviors regarding fats: 2006–2007. Consumer survey highlights, American Heart Association, Dallas, Texas.

Barry Callebaut. 2008. New research on Acticoa™ in the spotlight at HIE 2008: Barry Callebaut’s Acticoa chocolate helps to maintain healthy blood pressure. Press release, Barry Callebaut, Zurich, Switzerland, Nov. 4.

Beulensa, J.W.J., Botsa, M.L., Atsmaa, F., Bartelinka, M.-L.E.L., Prokopb, M., Geleijnsec, J.M., Wittemand, J.C.M., Grobbeea, D.E., and van der Schouwa, Y.T. 2009. High dietary menaquinone intake is associated with reduced coronary calcifi cation. Atherosclerosis 203: 489-493.

Cargill. 2006. Clinical study on Cargill’s Barliv™ Barley Beta-Glucan to be presented at American Diabetes Association’s 66th Scientific Sessions. Press release, Cargill Inc., Minneapolis, Minn., June 9.

Harris, W.S., Mozaff arian, D., Rimm, E., Kris-Etherton, P., Rudel, L.L., Appel, L.J., Engler, M.M., Engler, M.B., and Sacks, F. 2009. Omega-6 fatty acids and risk for cardiovascular disease: A science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 119: 902-907.

Larkin, T.A., Astheimer, L.B., and Price, W.E. 2009. Dietary combination of soy with a probiotic or prebiotic food significantly reduces total and LDL cholesterol in mildly hypercholesterolaemic subjects. Eur. J. Clin. Nutr. 63: 238-245.

McDonald, A. 2008. Effects of soy protein on total cholesterol and LDL-cholesterol. Review of published studies. 1998–2008. Radiant Research Group, Chicago, Ill., May 23.

Prociuk, M.A., Edel, A.L., Richard, M.N., Gavel, N.T., Ander, B.P., Dupasquier, C.M.C., and Pierce, G.N. 2008. Cholesterol-induced stimulation of platelet aggregation is prevented by a hempseed-enriched diet. Can. J. Physiol. Pharmacol. 86: 153-159.

Rajaram, S., Haddad, E.J., Mejia, A., and Sabaté, J. 2009. Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study. Am. J. Clin. Nutr. 89: 1657-1663.

Volek, J.S., Judelson, D.A., Silvestre, R., Yamamoto, L.M., Spiering, B.A., Hatfield, D.L., Vingren, J.L., Quann, E.E., Anderson, J.M., Maresh, C.M., and Kraemer, W.J. 2008. Effects of carnitine supplementation on flow-mediated dilation and vascular inflammatory responses to a high-fat meal in healthy young adults. American Journal Cardiology 102: 1413-1417.