What role do polyphenols play in reducing the risk of cardiovascular disease (CVD)?

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Kjeld Hermansen, Associate Professor at the Department of Endocrinology and Internal Medicine, Aarhus University, Denmark

Cardiovascular disease (CVD) is one of the world’s most pressing health problems. In Europe, it is the main cause of death, accounting for 45% of all deaths1,2. In recent years there has been growing academic interest in the potential role of polyphenols in reducing the risk of CVD, which is the topic of an ISIC report I authored and was published last week.

Polyphenols are plant-based compounds present in a variety of foods including fruit, vegetables, whole grains, tea, coffee, cocoa and wine3.

Research suggests that there is an association between the consumption of polyphenols and a reduction in CVD prevalence3,4. It has suggested that those with a higher intake of flavonoids had a 47% lower incidence of cardiovascular events compared to those with the lowest intake after adjusting for potential confounders. No significant associations were seen for other polyphenol types5.

Polyphenols may have a range of cardio protective functions. Although the precise mechanism of action is still not clarified, it is suggested that polyphenols in coffee could exert antioxidant and anti-inflammatory effects including having pivotal roles on lipid and glucose metabolism, potentially contributing to the reduced risk of CVD4,6,7.

Polyphenols may alter hepatic cholesterol absorption, triglyceride biosynthesis and lipoprotein secretion, the processing of lipoproteins in plasma, and inflammation. Polyphenols have also been shown to decrease the activity of specific enzymes, to improve endothelial function and blood pressure, and to counteract the development of atherosclerosis4,6,8,9.

Coffee is one of the main sources of polyphenols in the diet, and polyphenols in coffee contribute to the unique flavours and aromas that typify coffee beverages3. Polyphenols from coffee are highly bioavailable; about 30% are absorbed in the circulation10.

One of the main difficulties in drawing conclusions on the effect of coffee polyphenols on CVD risk is separating out the effects of the various components of coffee including caffeine. In the future, further research is required to better understand the potential roles for polyphenols on CVD prevention and treatment.

To read the ISIC report titled ‘Coffee, polyphenols and cardiovascular disease’ click here.

References

  1. Townsend N. et al. (2016) Cardiovascular disease in Europe: epidemiological update 2016.Eur Heart J, 0, 1–14.
  2. European Heart Network, ‘European Cardiovascular Disease Statistics 2017’. Available at: http://www.ehnheart.org/cvd-statistics/cvd-statistics-2017.html
  3. Williamson G. (2017) The role of polyphenols in modern nutrition. Nutr Bull, 42(3):226–235.
  4. Gomaz J.G. (2016) Potential Role of Polyphenols in the Prevention of Cardiovascular Diseases: Molecular Bases. Curr Med Chem, 23(2):115–28.
  5. Mendonca R.D. et al. (2019) Total polyphenol intake, polyphenol subtypes and incidence of cardiovascular disease: The SUN cohort study. Nutr Metab Cardiovasc Dis, 29(1):69–78.
  6. Tajik N. et al. (2017) The potential effects of chlorogenic acid, the main phenolic components in coffee, on health:a comprehensive review of the literature. Eur J Nutr, 56:2215–2244.
  7. Grosso G. (2017) Dietary polyphenols are inversely associated with metabolic syndrome in Polish adults of the HAPIEE study. Eur J Nutr, 56(4):1409–1420.
  8. Murillo A.G. (2017) The Relevance of Dietary Polyphenols in Cardiovascular Protection. Curr Pharm Des, 23(17):2444–2452.
  9. Giglio R.V. (2018) Polyphenols: Potential Use in the Prevention and Treatment of Cardiovascular Diseases. Curr Pharm Des,24(2): 239–258.
  10. Fukushima Y. (2014) Coffee and beverages are the major contributors to polyphenol consumption from food and beverages in Japanese middle-aged women. J Nutr Sci, 3:e48. doi: 10.1017/jns.2014.19.

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