Functional Foods, Cardiovascular Disease and Diabetes

505 Pages·2004·4.714 MB·English

by  A Arnoldi

Functional foods, cardiovascular disease and
diabetes
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Functional foods,
cardiovascular disease
and diabetes
Edited by
A. Arnoldi
Published byWoodhead PublishingLimited
Abington Hall, Abington
Cambridge CB1 6AH
England
www.woodhead-publishing.com
Published in NorthAmerica byCRC PressLLC
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(cid:223) 2004,Woodhead Publishing Limited
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Contents
Contributor contact details .............................................. xii
1 The potential and limits of functional foods in
preventing cardiovascular disease ............................... 1
N. M. de Roos, University Medical Centre Utrecht, The Netherlands
1.1 Introduction: diet and cardiovascular disease ................ 1
1.2 Functional foods defined ..................................... 2
1.3 The use of functional foods to meet dietary guidelines ...... 3
1.4 Do functional foods reach the populations at risk? ........... 6
1.5 References ................................................... 6
2 Assessing health claims for functional foods .................... 10
G. Nowicka and M. Naruszewicz, National Food and Nutrition
Institute, Poland
2.1 Introduction .................................................. 10
2.2 Differing types of claim: nutrition and health claims ........ 11
2.3 Criteria for demonstrating functional effects ................. 13
2.4 Evidence required to support a health claim ................. 14
2.5 Future trends ................................................. 15
2.6 References ................................................... 16
vi Contents
Part I Diet, cardiovascular disease and diabetes ................... 19
3 Diet and the prevention of coronary heart disease ............. 21
M. de Lorgeril and P. Salen, Universite´ Joseph Fourier
de Grenoble, France
3.1 Introduction .................................................. 21
3.2 Dietary prevention of sudden cardiac death (SCD):
the role of dietary fatty acids, alcohol and antioxidants ...... 22
3.3 Dietary prevention of chronic heart failure (CHF):
the role of micronutrients, dietary fatty acids and reduced
sodium intake ................................................ 30
3.4 Dietary strategies to prevent the development of heart
disease ....................................................... 34
3.5 Dietary prevention of post-angioplasty restenosis ............ 37
3.6 Dietary control of conventional risk factors: cholesterol,
blood pressure, type 2 diabetes and obesity .................. 38
3.7 Conclusion: using the ‘Mediterranean diet’ to prevent
coronary heart disease ....................................... 45
3.8 References ................................................... 46
4 The role of fat-soluble nutrients and antioxidants in preventing
heart disease ...................................................... 56
W. L. Stone and G. Krishnaswamy, East Tennessee State University,
USA and H. Yang, Yunnan College of Traditional Chinese Medicine,
People’s Republic of China
4.1 Introduction: oxidative stress and cardiovascular disease ..... 56
4.2 The functional properties of vitamin E in preventing
heart disease ................................................. 59
4.3 The functional properties of vitamin D in preventing
heart disease ................................................. 66
4.4 The functional properties of ubiquinone (CoQ10) in
preventing heart disease ...................................... 70
4.5 Future trends ................................................. 72
4.6 References ................................................... 73
5 Vitamin E and other antioxidants in the prevention of
cardiovascular disease ............................................ 77
F. Violi, R. Cangemi and L. Loffredo, University of Rome
‘La Sapienza’, Italy
5.1 Introduction .................................................. 77
5.2 Risk factors for coronary heart disease (CHD):
the role of oxidative stress ................................... 78
5.3 Dietary antioxidants and the prevention of CHD:
epidemiological evidence .................................... 83
Contents vii
5.4 Dietary antioxidants and the prevention of CHD: evidence
from clinical trials ........................................... 87
5.5 Conclusion and future trends: reconciling the evidence ...... 93
5.6 Sources of further information and advice ................... 94
5.7 References ................................................... 94
6 Iron intake and cardiovascular disease .......................... 99
A. E. R. Kartikasari, N. A. Georgiou and J. J. H. Marx, University
Medical Centre Utrecht, The Netherlands
6.1 Introduction .................................................. 99
6.2 Dietary iron intake, absorption and metabolism .............. 100
6.3 Iron homeostasis disorders: primary and secondary
haemochromatosis ........................................... 107
6.4 The role of iron in cardiovascular disease ................... 108
6.5 Measuring iron toxicity ...................................... 113
6.6 Methods of preventing iron damage ......................... 114
6.7 Conclusion and future trends ................................. 115
6.8 Sources of further information and advice ................... 116
6.9 Acknowledgement ........................................... 117
6.10 References ................................................... 117
7 Diet and diabetes: prevention and control ...................... 126
Y. M Khazrai, S. Manfrini and P. Pozzilli, University
Campus Bio-Medico, Italy
7.1 Introduction: classifying diabetes ............................ 126
7.2 Dietary strategies for preventing the onset of diabetes ....... 127
7.3 Dietary strategies for the control of diabetes:
carbohydrates and lipids ..................................... 130
7.4 Dietary strategies for the control of diabetes: proteins,
fibre and other dietary components .......................... 135
7.5 Future trends ................................................. 137
7.6 Sources of further information and advice ................... 139
7.7 References ................................................... 140
8 Nutritional risk factors in the development of type 1
and type 2 diabetes ............................................... 142
S. M. Virtanen, National Public Health Institute, Helsinki and
University of Tampere, Finland .....................................
8.1 Introduction .................................................. 142
8.2 Nutritional risk factors in the onset and prevention
of type 1 diabetes ............................................ 142
8.3 Nutritional risk factors in the onset and prevention
of type 2 diabetes ............................................ 146
8.4 Conclusions .................................................. 148
8.5 References ................................................... 149
viii Contents
Part II Phytochemicals and cardiovascular disease ................ 155
9 Flavonoids and cardiovascular disease .......................... 157
S. E. Rasmussen, Danish Institute for Food and Veterinary
Research, Denmark
9.1 Introduction: classification, chemical structures and
occurrence of flavonoids in plant foods ...................... 157
9.2 Dietary sources and intake levels of flavonoids .............. 159
9.3 Bioavailability and metabolism of flavonoids ................ 161
9.4 Uptake and excretion of anthocyanins ....................... 166
9.5 The use of flavonoids as biomarkers ......................... 169
9.6 Flavonoids and the prevention of coronary heart disease ..... 173
9.7 Future trends ................................................. 177
9.8 References ................................................... 179
10 Isoflavones and coronary heart disease ......................... 187
W. L. Hall, K. Vafeiadou, A. M. Minihane and C. M. Williams,
University of Reading, UK and G. H. Rimbach, Institute of
Human Nutrition and Food Science, Germany
10.1 Introduction .................................................. 187
10.2 Chemical structure of isoflavones ............................ 188
10.3 Dietary sources, bioavailability and metabolism of
isoflavones ................................................... 190
10.4 The effect of isoflavones on coronary heart disease (CHD) .. 194
10.5 Potential risks of isoflavones ................................. 201
10.6 Future trends ................................................. 203
10.7 Sources of further information and advice ................... 204
10.8 References ................................................... 205
11 Plant sterols and cholesterol reduction .......................... 215
E. J. Brink and H. F. J. Hendriks, TNO Nutrition and Food Research,
The Netherlands
11.1 Introduction: cholesterol as a risk factor in
cardiovascular disease ........................................ 215
11.2 The effects of plant sterols and stanols on lowering
cholesterol levels ............................................. 217
11.3 Factors influencing the effectiveness of plant sterols
and stanols ................................................... 223
11.4 Safety issues affecting plant sterols .......................... 226
11.5 Using plant sterols and stanols as functional foods .......... 231
11.6 Conclusion and future trends ................................. 233
11.7 References ................................................... 234
Contents ix
12 Garlic and cardiovascular disease ............................... 240
H. A. Collin, University of Liverpool, UK
12.1 Introduction .................................................. 240
12.2 Chemical composition of raw and cooked garlic ............. 241
12.3 Commercial forms of garlic supplement ..................... 243
12.4 The influence of garlic compounds on cardiovascular disease 246
12.5 Future trends: developing new functional foods .............. 254
12.6 Sources of further information and advice ................... 255
12.7 References ................................................... 257
Part III Controlling dietary fat ..................................... 261
13 Diet, oxidative stress and cardiovascular disease ................. 263
C. Galli and F. Visioli, University of Milan, Italy
13.1 Introduction: oxidative stress and cardiovascular disease .... 263
13.2 Antioxidants in food and their effects ........................ 265
13.3 Biomarkers of oxidative stress ............................... 268
13.4 The role of lipid oxidation in cardiovascular disease ......... 269
13.5 Dietary fat consumption and lipid oxidation ................. 275
13.6 Sources of further information and advice ................... 279
13.7 References ................................................... 280
14 Dietary fat, pregnancy and the prevention of heart disease .... 283
E. Herrera, Universidad San Pablo–CEU, Spain and
P. F. Dodds, Imperial College London, UK
14.1 Introduction: pregnancy and foetal growth ................... 283
14.2 Carbohydrate, amino acid and maternal lipid
metabolism in gestation ...................................... 284
14.3 Placental transfer of lipid metabolites ........................ 287
14.4 Foetal development: the role of dietary fatty acids ........... 289
14.5 Dietary recommendations for the avoidance of heart
disease later in life ........................................... 291
14.6 Future trends ................................................. 293
14.7 Sources of further information and advice ................... 293
14.8 References ................................................... 294
15 Developing polyunsaturated fatty acids as functional
ingredients ....................................................... 307
C. Jacobsen, Danish Institute for Fisheries Research
15.1 Introduction: long-chain polyunsaturated fatty acids and
cardiovascular disease ....................................... 307
15.2 Problems in using fish oil in food products: lipid oxidation
and off-flavours .............................................. 311
15.3 Factors affecting lipid oxidation in complex food systems ... 315
15.4 The successful use of fish oil in food products: improving
shelf-life and sensory properties ............................. 320