Food and plant bioactives for reducing cardiometabolic disease: How does the evidence stack up?

Background The cornerstone of cardiovascular disease prevention is a healthy lifestyle. A large body of research indicated a number of food and plant bioactives potentially efficacious in reducing some highly prevalent cardiovascular disease risk factors, such as hypercholesterolemia, hypertension and insulin-resistance. Scope and approach The aim of this review focuses on reviewing the available data on food and plant components improving lipid level or lipid oxidation, with demonstrated benefit on human vascular health, in particular in regards to endothelial function and arterial stiffness. Key findings and conclusions Despite the availability of a large number of trials demonstrating short-term lipid-lowering effects of several food and plant bioactives, only a few of them have also demonstrated a direct positive effect for the prevention of vascular aging. In particular, promising data are available as regards green tea extract, red yeast rice, coenzyme Q10, soy, omega-3 polyunsaturated fatty acids, curcumin, and vitamin E. Supplementation with red yeast rice and omega-3 polyunsaturated fatty acids has also been associated with a decrease in cardiovascular mortality risk. Future clinical research will have to focus more on middle term modification of endothelial function and arterial stiffness (markers of vascular aging) rather than on short-term effects using indirect laboratory risk markers.