Managing Cardiometabolic Risk
Managing Cardiometabolic Risk in Abdominally Obese Patients
Nutrition
- 1Key Points (1 page)
- 2Managing abdominally obese patients at increased cardiometabolic risk: the nutritional perspective (1 page)
- 3Targeting excess body weight (1 page)
- 4CVD and its nutritional components (2 pages)
- 5Reducing blood pressure (1 page)
- 6Moderate alcohol consumption (1 page)
- 7The Mediterranean diet (1 page)
- 8Other dietary measures to lower CVD risk and cholesterol levels (2 pages)
- 9References (1 page)
Other dietary measures to lower CVD risk and cholesterol levels
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Oxidative stress significantly increases the atherogenicity of cholesterol-enriched LDL particles through LDL oxidation, which initiates a series of reactions resulting in atherosclerosis (38, 39). Dietary antioxidants may contribute to cardiovascular protection and CVD risk reduction by inhibiting LDL oxidation and preserving endothelial function (5, 38, 40). Carotenoids are lipid-soluble antioxidants found in high concentrations in many yellow and green fruits and vegetables. Lycopene is a carotenoid found mainly in tomato-based foods, which account for approximately 80% of the lycopene intake in the American diet. Lycopene is heat resistant and may play a beneficial role in the early stages of atherogenesis and CVD (40-42). For the time being, there is insufficient evidence to recommend antioxidant supplementation. Some trials have documented an increased risk of heart failure and total mortality from high doses of vitamin E (43, 44). However, consuming antioxidants from a variety of plant-derived foods (vegetables, fruits, whole grains, and vegetable oils) is recommended (9).
Soy protein consumption—in the form of whole foods such as tofu and soymilk, or as soy protein added to foods—has been shown to be associated with a significant decrease in CHD risk. Soy protein has been linked to a 5 to 6% reduction in LDL cholesterol levels when substituted for animal protein (45). This reduction in total and LDL cholesterol may be explained by the fact that soy products are naturally low in saturated fat and cholesterol, unlike animal products. Eating a diet high in vegetable protein instead of one high in animal protein can lower total cholesterol, LDL cholesterol, and triglycerides by 4 to 7% without affecting HDL cholesterol (46). The isoflavone fraction present in soy products also has other lipid-independent benefits, such as lowering BP and increasing LDL oxidation resistance (45, 47). In addition, phytoestrogen isoflavones have been shown to lower cholesterol (48).
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