**By Anh Thu V. Tran, MS, MD – Medical Director & Nutrition Consultant, Cyvex Nutrition**

As the #1 global cause of death at 29% of all causes, an estimated  1 out of 3 American adults, equating to ~81 million, have at least one or more forms of Cardiovascular Disease (CVD) (American Heart Association CDC-DHDSP, WHO 2010 updates).  With technological advances being more effective and less invasive, along with having a more concrete understanding of such conditions, why do we still fall behind in preventing such numbers?

Indeed the answer is not simple.  What is certain, however, is that there are major elements that we can control against CVD.  Namely, diet, physical activity, and mental health are major players.  Consumption of polyphenol-rich diets alone has been associated with a reduced risk of cardiovascular disease, particularly foods and beverages with high oligomeric procyanidins (OPC) and flavonoids (such as anthocyanidins).

Yet again the spotlight shines on the ever so tiny and delicate, yet packed with heart-healthy benefits: berries.  Their unique composition of carbohydrates counterbalanced by organic acids (citric, malic, phenolic acids) and enzymes (polyphenolic substrates such as phenolic acids & flavonoids), high solubility of cell wall components (pectin, cellulose, and hemicellulose), rich in pigments (anthocyanins, carotenoids, and other polyphenols), vitamins and minerals are universally recognized to accentuate their sweet flavor, enticing aroma, and healthy benefits.

From reds to blues to purple and even blackberries,  berries are rich sources of essential nutrients and phytochemicals demonstrated epidemiologically and clinically.  Heart healthy diets that include a variety of berries improve cardiovascular performance or activity in both healthy subjects and those with underlying and preexisting conditions.

High density lipoprotein cholesterol (HDL) is the “good” cholesterol that works against cholesteryl ester transfer protein (CETP) in its facilitation of low-density-lipoprotein (LDL) and triglycerides (“bad” cholesterol and blood fat respectively).  The latter being the culprit to cardiovascular insults.  In a recent single-blinded, randomized, placebo-controlled intervention trial, middle aged healthy and un-medicated subjects consumed a moderate amount of berries against a control product.  Moderate consumption demonstrated favorable modulation in platelet function, HDL-cholesterol and blood pressure.  Of all the nutritional biomarkers, it was that of vitamin C and polyphenols in berries that made the most impact (Erlund I et al., 2008).  Clinical correlations as such were also found in those with poor cardiovascular profiles.

In a double-blind, randomized, placebo-controlled trial of dyslipidemic adults, participants consumed either 160gm berry-derived anthocyanin supplements versus a placebo.  There was a statistically significant increase of HDL-cholesterol and decrease in mass and activity of plasma CETP, decreasing insults from LDL-cholesterol and triglycerides (p<0.001) (Qin et al 2009).  The proposed mechanisms of actions are as follows: (1) Upregulation of endothelial nitric oxide synthase, (2) decreased activities of carbohydrate digestive enzymes & oxidative stress, and (3) inhibition of inflammatory gene expression and foam cell formation.

Served fresh, juiced, freeze-dried and/or as purified extract such as anthocyanins, anyway you like it – the blackberry, black currant, blueberry, cranberry, escobillo, lingonberry, strawberry to name a few not only nourish the taste buds, but also the heart.

References:

Basy A et al, “Berries: Emerging impact on cardiovascular health,” Nutr Rev, 2010; 68:168-77

Erlund I et al., “Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol,” Am J Clin Nutr, 2008; 87:323-31.

Seeram Np, “Recent trends and advances in berry health benefits research,” J Agric Food Chem, 2010; 58:3869-70

Qin Y et al., “Anthocyanin supplementation improves serum LDL- and HDL-cholesterol concentrations associated with the inhibition of cholesteryl ester transfer protein in dyslipidemic subjects,” Am J Clin Nutr, 2009; 90:485-492.

Author’s bio: Dr. Anh Thu V. Tran is the Medical Director & Nutrition Consultant for Cyvex Nutrition, PGY-1 Resident with  UC Davis Family Medicine Residency Network, and Founder of Strive to Live Well.  She holds a M.D. from St. George’s University, a M.S. in Nutrition from Loma Linda University, and a B.Sc. in Biology & Women’s Studies from UC Irvine.