A diet rich in fruit, vegetables, complex carbohydrates, monounsaturated fat and fish, moderate alcohol consumption but poor in salt, saturated fat and simple sugars, can play a fundamental role in protect against cardiovascular disease, or CVD. Cocoa, coffee and tea, unfairly not included in the “traditional healthy food basket”, have received much attention over the past few years.
Can drinks like chocolate, coffee and tea help reduce the risk of cardiovascular disease?
If for no other reason, tea, coffee and cocoa, have been recognized within the medical field because, not only are they consumed worldwide, they are also important dietary sources of polyphenols (flavonols and cathechins). Several in vitro and in vivo studies have tried to elucidate the role of these foods, as well as various other compounds like pomegranate juice, and a large amount of experimental studies clearly indicated a beneficial effect of polyphenols in influencing cardiovascular disease. However, some data from epidemiological studies has not been entirely conclusive.
The Drinks: Tea, Coffee, and Cocoa
Green tea, black tea and extracts of active elements in both have shown reduction in blood pressure, or BP, in humans. In a double blind placebo-controlled trial of 379 hypertensive individuals whom were given green tea infusion 370 mg/d for approximately 3 months, their blood pressure was reduced significantly at 4/4 mmHg with simultaneous decrease in HS CRP, TNF-?, glucose and insulin levels.
Dark chocolate (100 g) and cocoa with a high content of polyphenols (30 milligrams or more) are demonstrated to significantly reduce BP in people. A meta-analysis of 173 hypertensive subjects given cocoa for a mean duration of 2 weeks had a substantial decrease in BP 4.7/2.8 mmHg (p = 0.002 for SBP and 0.006 for DBP). Fifteen subjects given 100 grams of dark chocolate with 500 mg of poly-phenols for 15 days had a 6.4 mmHg decrease in SBP (p < 0.05) with a non-significant shift in DBP. Cocoa in 30 mg of poly-phenols reduced BP at pre-hypertensive and stage I hypertensive patients by 2.9/1.9 mmHg at 18 weeks (p < 0.001). Two more recent meta-analysis of 13 trials and 10 trials with 297 patients found a substantial decrease in BP of 3.2/2.0 mmHg and 4.5/3.2 mmHg respectively. BP decreases with cocoa doses of 6 to 100. Cocoa also improves insulin resistance and endothelial function.
Polyphenols, chlorogenic acids (CGAs), the ferulic acid metabolite of CGAs and di-hydro-caffeic acids decrease BP at a dose dependent fashion, enhance eNOS and enhance endothelial function in humans. CGAs in green coffee been extract at doses of 140 reduced SBP and DBP in 28 subjects in a placebo-controlled randomized trial. A dose response was demonstrated by A study of 122 male subjects with doses of CGA in DBP and SBP from 46. The group that received the 185 mg dose had a substantial decrease in BP of 5.6/3.9 mmHg (p < 0.01) over 28 days. Hydroxyhydroquinone is just another element of coffee beans that reduces the effectiveness of CGAs in a dose-dependent way which partly explains the conflicting outcomes of coffee intake on BP. What’s more, there is genetic variation in the enzyme responsible for the modified metabolism of caffeine between coffee intake, amount of coffee consumed and the risk of hypertension, heart rate, MI, arterial stiffness, arterial wave reflections and urinary catecholamine levels. Percent of the population has theIF/IA allele of their CYP1A2 genotype which confers metabolism of caffeine. Heavy coffee drinkers who are slow metabolizers had a 3.00 HR for developing hypertension. By comparison, rapid metabolizers with theIA/IA allele have a 0.36 HR for incident hypertension.
Melatonin effects were demonstrated in a randomized placebo controlled clinical trials among several chosen individuals. The typical reduction in blood pressure is 6/3 mmHg. Melatonin stimulates GABA receptors in the CNS and vascular nitric oxide, inhibits plasma A II levels, improves function, raises NO, vasodilates, enhances lowers cortisol and is additive with ARBs. Beta blockers reduce melatonin secretion.
Hesperidin significantly reduced DBP 3-4 mmHg (p< 0.02) and improved microvascular endothelial reactivity in 24 obese hypertensive male subjects in a randomized, controlled crossover study over 4 weeks for all three treatment groups consuming 500 mL of orange juice, hesperidin or placebo. Pomegranate juice is rich in tannins and has numerous other properties which improve cardiovascular disease and overall heart health, as well as reducing the SBP by 5 percent to 12 percent. An analysis of 51 healthy subjects given 330 mg/d of pomegranate juice had a decrease in blood pressure of 3.14/2.33 mmHg (p < 0.001). Pomegranate juice also suppresses the increase in SBP after a high-fat meal.
Pomegranate juice reduces serum ACE activity by 36 percent, and has anti-inflammatory, antioxidant and anti-atherogenic consequences. Pomegranate juice at 50 mL/d reduced carotid IMT by 30 percent over one year, increased PON 83 percent, diminished oxLDL by 59 percent to 90 percent, decreased antibodies to oxLDL by 19 percent, increased overall antioxidant status by 130 percent, decreased TGF-?, improved catalase, SOD and GPx, increased eNOS and NO, and improved endothelial function. Pomegranate juice works just like an ACEI.
Grape seed extract (GSE) was administered to subjects in nine randomized trials, meta-analysis of 390 subjects and demonstrated a significant reduction in SBP of 1.54 mmHg (p < 0.02). Substantial decrease in BP of 11/8 mmHg (p < 0.05) were seen in a different dose response study with 150 to 300 mg/d of GSE over 4 wk. GSE has high content which activates the PI3K/Akt signaling pathway that phosphorylates increases and eNOS NO.
The Bottom Line
In conclusion, drinks, such as tea, coffee and cocoa, and additional compounds, such as melatonin, hesperidin, pomegranate juice and grape seek extract, have been widely researched in many studies, primarily due to their worldwide popularity, several of which demonstrated positive outcomes towards naturally preventing and treating cardiovascular disease, among other health issues, by improving blood pressure levels. Pycnogenol, These drinks and additional compounds, have been noted to help improve CVD by reducing the risk hypertension, as well as improving endothelial function, an important factor in the regulation of blood circulation, among many other health benefits.
Although the above drinks and compounds have shown to have many health benefits, it’s important to seek medical advice from a qualified healthcare professional before starting any new supplementation for an existing condition or disease.The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
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