Part One: Plant Pigment Power of Phytonutrients and Vascular Health

By Jody Bergeron, MS, RN

Phytochemicals, also known as phytonutrients (phyto=plant) are plant based compounds with certain biological actions that sustain human health.  There are literally thousands of theses non-nutritive compounds that can potentially reduce the risk of chronic conditions.   Phytonutrients stimulate enzymes that assist in toxin removal, enhance immunity, contribute to cardiovascular/brain health, promote healthy estrogen metabolism, and stimulate the death of cancer cells. (5)  A plant-based diet rich in a variety of fruits, vegetables, whole grains, legumes, herbs, spices, nuts, seeds, tea, and cocoa can reduce the risk of chronic disease and contribute to healthy aging. (1)  

Vascular Health

In my practice, I encourage an all-foods-fit approach to nutrition and that includes sugar. And yes, even when managing diabetes. But, while some sugar fits, studies show most of us are eating way too much of it. In fact, the CDC estimates that between 2005 -2010 US adults were consuming as much as 15% of their total daily calories from added sugars(1).  According to recommendations from Healthy People 2020 this should be under 10%. Studies show excess sugar consumption can lead to undesirable increases in lipid profile, excess weight gain, fatty liver, and limit intake of essential nutrients (4,7,8).

Cardiovascular disease (CVD) contributes to about 17.5 million deaths per year globally. (3)  Endovascular dysfunction is one of the contributing factors that can lead to the development of atherosclerosis and hypertension thereby contributing to the risk of myocardial infarction and stroke.  Other risk factors include; obesity, dyslipidemia, insulin resistance, hypertension, menopause (loss of estrogen) and smoking which all can obviously accelerate this process.  The vascular endothelium is a single layer of cells in the wall of the blood vessels that functions in the regulation of vascular tone (vasoconstriction and vasodilation), thrombosis, fibrinolysis, and angiogenesis (1, 3) Nitric oxide is produced in endothelial cells from L-arginine by the enzyme endothelial nitric oxide synthase (eNOS).  Tetrahydrobiopterin (BH4) is a necessary cofactor in the production of nitric oxide.  The job of nitric oxide is to diffuse into the smooth muscle cell layer causing relaxation and dilatation.  A primary cause of vascular endothelial dysfunction is the reduction of nitric oxide bioavailability due to increased oxidative stress and inflammation. (1)  Oxidative stress is related to an imbalance between antioxidant defenses and reactive oxygen species (ROS).  Inside the vessel wall, oxidized LDLs are a stimulus that contributes to vascular inflammation and proatherogenic events that lead to the development of atherosclerosis.  (3)   Excessive amounts of Superoxide which is a reactive oxygen species (ROS) leads to the formation of peroxynitrite a reactive nitrogen species that inactivates BH4 and damages cellular components.  Arterial stiffness is a consequence of this process due to increased collagen and the degradation of elastin (fibrosis), damaged proteins and the formation of advanced glycation end-products (AGEs). The arterial stiffness increases the workload on the heart contributing to isolated systolic hypertension and left ventricular hypertrophy.

When we think about vascular health and aging we also need to take into consideration metabolic syndrome.  This is a specific cluster of cardiometabolic risk factors which includes abdominal obesity, elevated blood pressure, impaired glucose and insulin metabolism, dyslipidemia, and elevated systemic inflammation.  This syndrome does not only increase the risk of cardiovascular disease and diabetes but also it is associated with cognitive impairment, dementia and the development of Alzheimer’s disease.  Alzheimer’s is the most prevalent of all types of dementia accounting for between 60-80%.  Alzheimer disease is associated with the presence of amyloid-b protein plaques, intracellular neurofibrillary tangles, and excessive damage and loss of neurons and synapses, specifically in the hippocampus and cortex.   The alteration of peripheral insulin signaling and inflammation appear to be contributing factors in Alzheimer’s pathology. (3)

Strategic dietary interventions to minimize vascular endothelial dysfunction and the development of cardiovascular disease include the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean style dietary patterns. (1)  In next month’s post, we will explore some bioactive food components and functional foods; specifically polyphenols and how they can exert physiological health effects that may possibly maintain and/or improve vascular function with aging.  

References:

1. Johnson, Sarah A. et al. Age-Related Vascular Dysfunction: What Registered Dietitian Nutritionists Need to Know Journal of the Academy of Nutrition and Dietetics, Volume 119, Issue 11, 1790 – 1796 <https://jandonline.org/article/S2212-2672(18)32071-9/fulltext>
2. Sabine Weiskirchen, Ralf Weiskirchen, Resveratrol: How Much Wine Do You Have to Drink to Stay Healthy?, Advances in Nutrition, Volume 7, Issue 4, July2016, Pages 706–718 <https://www.ncbi.nlm.nih.gov/pubmed/?term=Resveratrol%3A+How+Much+Wine+Do+You+Have+to+Drink+to+Stay+Healthy%3F>
3. Britt M Burton-Freeman, Amandeep K Sandhu, Indika Edirisinghe, Red Raspberries and Their Bioactive Polyphenols: Cardiometabolic and Neuronal Health Links, Advances in Nutrition, Volume 7, Issue 1, January 2016, Pages 44–65 <https://www.ncbi.nlm.nih.gov/pubmed/26773014>
4. Wilhelmina Kalt, Aedin Cassidy, Luke R Howard, Robert Krikorian, April J Stull, Francois Tremblay, Raul Zamora-Ros, Recent Research on the Health Benefits of Blueberries and Their Anthocyanins, Advances in Nutrition July  2019  <https://academic.oup.com/advances/advance-article/doi/10.1093/advances/nmz065/5536953>
5. Phytonutrient Spectrum Comprehensive Guide.  2014 The Institute For Functional Medicine. The Health Edge.  <http://www.thehealthedgepodcast.com/wp-content/uploads/2015/07/Phytonutrient-Spectrum-Comprehensive-Guide.pdf>
6. Taylor C Wallace, M Monica Giusti, Anthocyanins, Advances in Nutrition, Volume 6, Issue 5, September 2015, Pages 620–622 <https://academic.oup.com/advances/article/6/5/620/4616693>

Jody Bergeron, RN, BSN, MS, CEN, works in critical care for Cape Cod Healthcare. She obtained her Masters in Human Nutrition from the University of Bridgeport and was enrolled at the University of Alabama’s College of Human Environmental Sciences Online Dietetics program. She has 30 years of experience working in healthcare with the past 20 years in critical care nursing. She served 9 years in the Army Reserve as a military officer in a Combat Support Hospital as a critical care RN. During her service she was in charge of the weight control program. She currently has interests in phytonutrient research, disease prevention with a focus on heart and brain health and healthy aging. She enjoys time with her family, skiing, scuba diving, traveling, knitting, cooking/baking/recipe development, and sharing science based nutrition information on social media and food photography. Instagram: @jody_bergeron Twitter: @BergeronJodyA

Revolutionizing Performance Nutrition

The 36th Annual Sports, Cardiovascular, and Wellness Nutrition (SCAN) Symposium, Revolutionizing Performance Nutrition, will be held in Boston, Massachusetts, March 21-23, 2020. The 2020 symposium will explore, challenge, and discuss revolutionizing evidence-based nutrition science, practice, and policy. Visit www.scandpg.org for more info.