Effects of Total Polyphenol Intakes on Cardiovascular Disease Risk Factors in an Elderly Population at High Cardiovascular Risk

Abstract

There is a consensus that CVD has been the leading cause of death worldwide in recent decades, and it is predicted that will raise from 17.5 million in 2012 to 22.2 million in 2030. Besides, CVD is a heavy economic burden on the health care system at both global and national scales. For the primary prevention, prediction models based on established risk factors are useful tools in the prevention of CVD. In this study, the cardiovascular risk factors among the elderly population have been assessed, which used to set up associations between total polyphenol intakes from a Mediterranean diet and prevention of CVD.

The Mediterranean diet is a nutritional recommendation that has recently shown beneficial effects on human health. Numerous studies have demonstrated there is a negative association between consumption of the Mediterranean diet and the prevalence of CVD. The evidence concerning the potential mechanisms of action which underlie the cardio-protective effects may be attributed to a high amount of dietary fiber, vitamins, folic acid, natural antioxidants, monounsaturated fat; moderate amounts of animal protein, moderate amount of alcohol mainly in the form of wine; and low amount of saturated and trans fat. However, only limited studies have focused on the observed protection from the most abundant antioxidants in nature, polyphenol. Therefore, in this study, we hypothesized that a high dietary polyphenol intakes, recorded by urinary polyphenol excretion, could be associated with low CVD risk parameters, diabetes, and obesity in an elderly population with high cardiovascular risk.

Traditional methods of obtaining information on polyphenol intakes, such as from dietary recalls, FFQs, and databases on the polyphenol content of foods, are not accurate enough to reflect polyphenol concentration after metabolism. To solve this problem, we used excretion of urine as a reliable and effective biomarker to track polyphenol after digestion.

High glucose levels, TG concentration, DBP are classic cardiovascular risk factors for developing of CVD. In this thesis, we found significant inverse correlations between changes in TPE and plasma TG concentration, glucose concentration, and DBP after adjustment for potential confounders after a 5-year of intervention.

Overweight and obesity are also important risk factors for developing of CVD. Inverse correlations were observed between TPE at 5 years of follow-up and BW, BMI, WC and WHtR after adjustment for potential confounders, indicating higher polyphenol intakes improve body weight managements.

Prevalence of T2D is positively associated with incidence of CVD. We found a high intake of total polyphenols, calculated by FFQs and the Phenol-Explorer database, was associated with a reduced risk of diabetes in elderly people at high risk of CVD.

To conclude, we suggest that a high consumption of polyphenol-rich foods in the frame of a Mediterranean diet could potentially help to reduce multiple risk factors of CVD.

Las enfermedades cardiovasculares (CVD) representan la principal causa de mortalidad en el mundo. Numerosos estudios han demostrado una asociación negativa entre el consumo de la dieta mediterránea y la prevalencia de las CVD. Sin embargo, sólo algunos estudios se han centrado en evaluar la protección que pueden ejercer los polifenoles. En este trabajo se propuso la siguiente hipótesis de que una ingesta elevada de polifenoles a través de la dieta, podría estar asociada a una disminución de parámetros de bajo riesgo de CVD, diabetes y obesidad en una población de edad avanzada con alto riesgo de enfermedades cardiovasculares.

Se observó que una alta ingesta de polifenoles totales, calculado por las encuestas de frecuencia de consumo (FFQ) y la base de datos de Phenol-Explorer, se asoció con un menor riesgo de diabetes en personas de edad avanzada con alto riesgo de CVD.

Los métodos tradicionales para obtener las informaciones de la ingesta de polifenoles, como los recordatorios de la dieta, las encuestas de frecuencia de consumo y bases de datos, no son suficientemente precisos. Para resolver este problema, se utilizó la además la excreción de los polifenoles en la orina (TPE) como un biomarcador fiable, robusto y eficaz para realizar un seguimiento del consumo de polifenoles.

Hemos observado correlaciones inversas significativas entre los cambios en la concentración plasmática de TPE a los 5 años de seguimiento y triglicéridos plasmáticos, la concentración de glucosa y la presión sanguínea diastólica después de ajustar por posibles factores de confusión.

El sobrepeso y la obesidad también son importantes factores de riesgo cardiovascular. Se observaron correlaciones inversas entre TPE a los 5 años de seguimiento y peso corporal (BW), índice de masa corporal (BMI), circunferencia de la cintura (WC) y cintura a la altura (WHtR) después del ajuste por posibles factores de confusión. Para concluir, se sugiere que un alto consumo de alimentos con alto contenido en polifenoles en el marco de una dieta mediterránea podría reducir múltiples factores de riesgo de CVD.