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Review
. 2019 Nov;58(Suppl 2):37-47.
doi: 10.1007/s00394-019-02066-6. Epub 2019 Sep 6.

Factors Influencing the Cardiometabolic Response to (Poly)phenols and Phytosterols: A Review of the COST Action POSITIVe Activities

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Free PMC article
Review

Factors Influencing the Cardiometabolic Response to (Poly)phenols and Phytosterols: A Review of the COST Action POSITIVe Activities

Eileen R Gibney et al. Eur J Nutr. .
Free PMC article

Abstract

Purpose: Evidence exists regarding the beneficial effects of diets rich in plant-based foods regarding the prevention of cardiometabolic diseases. These plant-based foods are an exclusive and abundant source of a variety of biologically active phytochemicals, including polyphenols, carotenoids, glucosinolates and phytosterols, with known health-promoting effects through a wide range of biological activities, such as improvements in endothelial function, platelet function, blood pressure, blood lipid profile and insulin sensitivity. We know that an individual's physical/genetic makeup may influence their response to a dietary intervention, and thereby may influence the benefit/risk associated with consumption of a particular dietary constituent. This inter-individual variation in responsiveness has also been described for dietary plant bioactives but has not been explored in depth. To address this issue, the European scientific experts involved in the COST Action POSITIVe systematically analyzed data from published studies to assess the inter-individual variation in selected clinical biomarkers associated with cardiometabolic risk, in response to the consumption of plant-based bioactives (poly)phenols and phytosterols. The present review summarizes the main findings resulting from the meta-analyses already completed.

Results: Meta-analyses of randomized controlled trials conducted within POSITIVe suggest that age, sex, ethnicity, pathophysiological status and medication may be responsible for the heterogeneity in the biological responsiveness to (poly)phenol and phytosterol consumption and could lead to inconclusive results in some clinical trials aiming to demonstrate the health effects of specific dietary bioactive compounds. However, the contribution of these factors is not yet demonstrated consistently across all polyphenolic groups and cardiometabolic outcomes, partly due to the heterogeneity in trial designs, low granularity of data reporting, variety of food vectors and target populations, suggesting the need to implement more stringent reporting practices in the future studies. Studies investigating the effects of genetic background or gut microbiome on variability were limited and should be considered in future studies.

Conclusion: Understanding why some bioactive plant compounds work effectively in some individuals but not, or less, in others is crucial for a full consideration of these compounds in future strategies of personalized nutrition for a better prevention of cardiometabolic disease. However, there is also still a need for the development of a substantial evidence-base to develop health strategies, food products or lifestyle solutions that embrace this variability.

Keywords: Bioactive; Cardiometabolic diseases; Diet; Gene expression; Health; Metabolism; Metabotype; Microbiome; Plant; Response; Variation.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

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Fig. 1
Factors influencing inter-individual variability in cardiometabolic response to plant food bioactive consumption

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References

    1. WHO . Noncommunicable diseases country profiles. Geneva: WHO; 2018.
    1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ. Heart disease and stroke statistics—2016 update a report from the American Heart Association. Circulation. 2016;133(4):e38–e48. - PubMed
    1. Satija A, Bhupathiraju SN, Rimm EB, Spiegelman D, Chiuve SE, Borgi L, Willett WC, Manson JE, Sun Q, Hu FB. Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies. PLoS Med. 2016;13(6):1. - PMC - PubMed
    1. Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, Greenwood DC, Riboli E, Vatten LJ, Tonstad S. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose–response meta-analysis of prospective studies. Int J Epidemiol. 2017;46(3):1029–1056. - PMC - PubMed
    1. Katz D, Meller S. Can we say what diet is best for health? Annu Rev Public Health. 2014;35:83–103. - PubMed
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