Plant-Based Foods and Vascular Function: A Systematic Review of Dietary Intervention Trials in Older Subjects and Hypothesized Mechanisms of Action

Nutrients. 2022 Jun 24;14(13):2615. doi: 10.3390/nu14132615.


Cardiovascular diseases, still the leading cause of mortality in the world, are closely related to vascular function. Older subjects are more susceptible to endothelial dysfunction and therefore it is important to define possible preventive or support strategies, such as consumption of foods with health-promoting effects. This systematic review aims to summarize the currently available evidence on acute or chronic trials testing the effect of selected plant-based foods on vascular function parameters in older subjects, and consider plausible mechanisms that may support the main findings. A total of 15 trials were included and analyzed, testing the effects of beetroot, plum, blueberry, and vegetable oils. We found some interesting results regarding markers of vascular reactivity, in particular for beetroot, while no effects were found for markers of arterial stiffness. The amelioration of vascular function seems to be more related to the restoration of a condition of nitric oxide impairment, exacerbated by diseases or hypoxic condition, rather than the enhancement of a physiological situation, as indicated by the limited effects on healthy older subjects or in control groups with young subjects. However, the overall set of selected studies is, in any case, rather limited and heterogeneous in terms of characteristics of the studies, indicating the need for additional high-quality intervention trials to better clarify the role of vegetable foods in restoring and/or improving vascular function in order to better elucidate the mechanisms through which these foods may exert their vascular health benefits in older subjects.

Keywords: aging; dietary intervention; endothelial function; intervention studies; nitric oxide; plant-based foods; systematic review; vascular function; vegetable foods.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Blueberry Plants*
  • Cardiovascular Diseases* / prevention & control
  • Diet
  • Humans
  • Vascular Stiffness*
  • Vegetables

Grants and funding

Daniela Martini and Cristian Del Bo’ are grateful for the grant received from Piano di sostegno alla Ricerca-Linea 2, azione A-grant number PSR2020_DMART and PSR2020 CDELB. The authors thank the project MIND FoodS Hub (Milano Innovation District Food System Hub): Innovative concept for the eco-intensification of agricultural production and for the promotion of dietary patterns for human health and longevity through the creation in MIND of a digital Food System Hub (P.O.R. 2014–2020_BANDO Call HUB Ricerca e Innovazione _D.G.R. NR 727 del 5/11/2018).