Lovegrove Julie A, Stainer Alex, Hobbs Ditte A
Hugh Sinclair Unit of Human Nutrition,Department of Food and Nutritional Sciences,Reading RG6 6AP,UK.
Institute for Cardiovascular and Metabolic Research (ICMR),University of Reading,Whiteknights,Reading RG6 6AP,UK.
Proc Nutr Soc. 2017 Jan 19:1-13. doi: 10.1017/S0029665116002871.
CVD remain the leading cause of death globally. Effective dietary strategies for their reduction are of high priority. Increasing evidence suggests that phytochemicals, particularly dietary flavonoids and nitrates, are key modulators of CVD risk reduction through impact on multiple risk factors. The aim of this review is to explore the evidence for the impact of flavonoid- and nitrate-rich foods and supplements on CVD risk, with specific reference to their importance as mediators of vascular health and platelet function. There is accumulating evidence to support benefits of dietary flavonoids on cardiovascular health. Dose-dependent recovery of endothelial function and lowering of blood pressure have been reported for the flavanol (-)-epicatechin, found in cocoa, apples and tea, through production and availability of endothelial nitric oxide (NO). Furthermore, flavonoids, including quercetin and its metabolites, reduce in vitro and ex vivo platelet function via inhibition of phosphorylation-dependent cellular signalling pathways, although further in vivo studies are required to substantiate these mechanistic effects. Hypotensive effects of dietary nitrates have been consistently reported in healthy subjects in acute and chronic settings, although there is less evidence for these effects in patient groups. Proposed mechanisms of actions include endothelial-independent NO availability, which is dependent on the entro-salivary circulation and microbial conversion of dietary nitrate to nitrite in the mouth. In conclusion, flavonoid- and nitrate-rich foods show promising effects on vascular function, yet further randomly controlled studies are required to confirm these findings and to determine effective doses.
心血管疾病仍是全球主要死因。采取有效的饮食策略来降低心血管疾病风险是重中之重。越来越多的证据表明，植物化学物质，尤其是膳食类黄酮和硝酸盐，通过影响多种风险因素，是降低心血管疾病风险的关键调节因子。本综述的目的是探讨富含类黄酮和硝酸盐的食物及补充剂对心血管疾病风险影响的证据，特别提及它们作为血管健康和血小板功能调节因子的重要性。有越来越多的证据支持膳食类黄酮对心血管健康有益。已报道可可、苹果和茶中含有的黄烷醇（-）-表儿茶素可通过产生和释放内皮一氧化氮（NO）使内皮功能呈剂量依赖性恢复并降低血压。此外，包括槲皮素及其代谢产物在内的类黄酮可通过抑制磷酸化依赖性细胞信号通路来降低体外和离体血小板功能，不过还需要进一步的体内研究来证实这些作用机制。在健康受试者的急性和慢性试验中均一致报道了膳食硝酸盐的降压作用，尽管在患者群体中这些作用的证据较少。推测的作用机制包括不依赖内皮的NO生成，这取决于肠-唾液循环以及口腔中膳食硝酸盐经微生物转化为亚硝酸盐的过程。总之，富含类黄酮和硝酸盐的食物对血管功能显示出有前景的作用，但还需要进一步的随机对照研究来证实这些发现并确定有效剂量。
