Department of Nutrition, University of California, Davis, Davis, CA, 95616, USA.
Curr Atheroscler Rep. 2023 Oct;25(10):663-677. doi: 10.1007/s11883-023-01148-5. Epub 2023 Sep 13.
Emerging evidence supports the promise of precision nutritional approaches for cardiovascular disease (CVD) prevention. Here, we discuss current findings from precision nutrition trials and studies reporting substantial inter-individual variability in responses to diets and dietary components relevant to CVD outcomes. We highlight examples where early precision nutrition research already points to actionable intervention targets tailored to an individual's biology and lifestyle. Finally, we make the case for high-density lipoproteins (HDL) as a compelling next generation target for precision nutrition aimed at CVD prevention. HDL possesses complex structural features including diverse protein components, lipids, size distribution, extensive glycosylation, and interacts with the gut microbiome, all of which influence HDL's anti-inflammatory, antioxidant, and cholesterol efflux properties. Elucidating the nuances of HDL structure and function at an individual level may unlock personalized dietary and lifestyle strategies to optimize HDL-mediated atheroprotection and reduce CVD risk.
Recent human studies have demonstrated that HDL particles are key players in the reduction of CVD risk. Our review highlights the role of HDL and the importance of personalized therapeutic approaches to improve their potential for reducing CVD risk. Factors such as diet, genetics, glycosylation, and gut microbiome interactions can modulate HDL structure and function at the individual level. We emphasize that fractionating HDL into size-based subclasses and measuring particle concentration are necessary to understand HDL biology and for developing the next generation of diagnostics and biomarkers. These discoveries underscore the need to move beyond a one-size-fits-all approach to HDL management. Precision nutrition strategies that account for personalized metabolic, genetic, and lifestyle data hold promise for optimizing HDL therapies and function to mitigate CVD risk more potently. While human studies show HDL play a key role in reducing CVD risk, recent findings indicate that factors such as diet, genetics, glycosylation, and gut microbes modulate HDL function at the individual level, underscoring the need for precision nutrition strategies that account for personalized variability to optimize HDL's potential for mitigating CVD risk.
新出现的证据支持了精准营养方法在预防心血管疾病（CVD）方面的前景。在这里，我们讨论了精准营养试验的当前发现以及报告与 CVD 结果相关的饮食和饮食成分的个体间反应存在显著差异的研究。我们强调了一些早期的精准营养研究已经指向针对个体生物学和生活方式的可操作干预目标的例子。最后，我们认为高密度脂蛋白（HDL）作为预防 CVD 的精准营养的下一代有吸引力的目标。HDL 具有复杂的结构特征，包括不同的蛋白质成分、脂质、大小分布、广泛的糖基化以及与肠道微生物组的相互作用，所有这些都影响 HDL 的抗炎、抗氧化和胆固醇流出特性。阐明个体水平上 HDL 结构和功能的细微差别可能会解锁个性化的饮食和生活方式策略，以优化 HDL 介导的动脉保护作用并降低 CVD 风险。
最近的人体研究表明，HDL 颗粒是降低 CVD 风险的关键因素。我们的综述强调了 HDL 的作用以及改善其降低 CVD 风险潜力的个性化治疗方法的重要性。饮食、遗传、糖基化和肠道微生物组相互作用等因素可以调节个体水平上的 HDL 结构和功能。我们强调，将 HDL 按大小分类为亚类并测量颗粒浓度是理解 HDL 生物学和开发下一代诊断和生物标志物所必需的。这些发现强调了需要超越一刀切的 HDL 管理方法。考虑到个性化代谢、遗传和生活方式数据的精准营养策略有望优化 HDL 治疗和功能，以更有效地降低 CVD 风险。虽然人体研究表明 HDL 在降低 CVD 风险方面发挥着关键作用，但最近的发现表明，饮食、遗传、糖基化和肠道微生物等因素在个体水平上调节 HDL 功能，这凸显了需要制定考虑个性化变异性的精准营养策略，以优化 HDL 降低 CVD 风险的潜力。
