Abstract
Cardiovascular disease is a leading cause of death around the world. Overall diet quality and dietary behaviors are core contributors to metabolic health. While therapeutic targets have traditionally focused on levels of lipoprotein cholesterol when evaluating cardiovascular risk, current perspectives on high-density lipoprotein (HDL) have shifted to evaluating the functionality of this lipoprotein particle. Effects of diet on cardiovascular health are mediated through multiple pathways, but the impact on HDL composition and function deserves greater attention. Potential areas of investigation involve changes in particle characteristics, distribution, microRNA cargo, and other functional changes such as improvements to cholesterol efflux capacity. Various dietary patterns like the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet have beneficial effects on cardiovascular health and may prevent cardiovascular events. These healthful dietary patterns tend to be rich in plant-based foods, with cardiovascular benefits likely resulting from synergistic effects of the individual dietary components. The purpose of this review is to summarize current perspectives on selected functions of HDL particles and how various dietary patterns affect cardiovascular health biomarkers, with a focus on HDL functionality.
Highlights
Cardiovascular disease (CVD) is the most common cause of mortality around the world, with approximately 17.9 million deaths attributable to CVD in 2015
Effects of diet and lipoprotein metabolism on cardiovascular health are mediated through multiple pathways and the biology of high-density lipoprotein (HDL) is complex
The beneficial effects of HDL in decreasing CVD risk are not fully reflected through the amount of cholesterol carried by the HDL (HDL-C)
Summary
Cardiovascular disease (CVD) is the most common cause of mortality around the world, with approximately 17.9 million deaths attributable to CVD in 2015. Ideal cardiovascular health is achieved by lack of clinical evidence of CVD as well as optimal levels of physiologic health factors and all health behaviors, including four to five components of a healthy diet [4]. Beyond the seven core health behaviors and health factors, the AHA recommends several secondary metrics for monitoring cardiovascular health One of these secondary metrics is the presence or absence of metabolic syndrome (MetS) [4]. While nutrition has long been a key component of cardiovascular health recommendations, the impact of diet quality on HDL function is less well studied.
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