Future trends in preventing heart disease

Nutritional science has made enormous strides in the past few decades and has particularly benefited from a molecular approach combined with the use of specific animal models with well-defined genetic characteristics. The design of functional foods that go beyond basic nutritional needs and attempt to improve and optimize human health is now a realistic goal. Just as pharmaceuticals of the future will benefit from knowing a subject’s genetic background (i.e. pharmacogenetics), it is likely that optimizing an individual’s diet must also take into account possible genetic factors (i.e. nutrigenomics). The new science of nutrigenomics will provide a molecular basis for understanding how an individual’s diet could be changed, depending upon their specific genetic make­up, to optimize their long-term health status.

In earlier posts, we have reviewed the information relating three lipid-soluble nutrients (vitamin E, vitamin D, and coenzyme Q10) to heart disease and type II diabetes, diseases with a clear genetic predisposition. For all three nutrients, there is a clear need for more research in both animal models and in long-term, well-designed clinical studies. Some tentative conclusions can, however, be reached. The three lipid-soluble nutrients reviewed above all have antioxidant properties and antioxidants are, in general, anti-inflammatory. Dietary supplementation with vitamin E or vitamin D is associated with decreased levels of CRP, which is a marker for inflammation and increased risk of cardiovascular disease as well as in type II diabetes (Rodriguez-Moran and Guerrero-Romero, 1999, 2003; Arnalich et al., 2000). Surprisingly, there are no published studies on the potential role of CoQ10 in reducing plasma CRP levels.

In the case of vitamin E, there should be increased consideration for the non­alpha-tocopherol forms, particularly the potential anti-inflammatory properties of gamma-tocopherol. For CoQ10, the available data strongly supports a role for supplementation (along with conventional therapy) for the treatment of congestive heart failure. Vitamin D is remarkably under-researched considering its very promising role as an antiatherogenic factor. Lifestyle modifications, i.e. reasonable exposure to sunlight, may be more important than nutritional considerations in the case of vitamin D.