**Blog post by Puya Yazdi, MD, new Medical Director for Cyvex Nutrition

For years physicians, nutritionists, and even our televisions, have warned us against the risks associated with eating high fat diets, specifically, the risk of cardiovascular disease (CVD). Cardiovascular disease continues to be a leading cause of morbidity and mortality among adults in Western countries. By now, many of us are fully aware of the leading risk factors: cigarette smoking, high blood pressure, high serum total cholesterol and LDL-cholesterol, low serum HDL-cholesterol, diabetes mellitus, high fat diet and advanced age. Yet there has always been one small but important caveat to the standard medical doctrine. Dr. Serge Renaud, a scientist from Bordeaux University in France, even coined a term for this caveat: the “French Paradox.” The French people eat an extremely high fat diet, have higher rates of cigarette smoking, get less exercise than an average American, and yet have substantially lower rates of cardiovascular disease. The question remains: why? Over the last twenty years, we have been slowly approaching our answer.

Over the years, numerous studies have linked a diet rich in fruits and vegetables with a reduction in CVD risk factors. This is presumably due to the presence of, in plant foods and certain beverages, a variety of compounds including an array of antioxidants, such as vitamin C, vitamin E, polyphenols and carotenoids. Polyphenols in particular have been associated with a reduction to the risk of different diseases in several studies. The French Paradox has been ascribed to the consumption of red wine. This effect has been attributed mainly to the presence of polyphenols, a large group of compounds present in plant foods and beverages that have demonstrated strong antioxidant capacity. Furthermore, the alcohol in wine (Ethanol) can also improve the bioavailability of polyphenols, as well as play a specific cardioprotective role.*

These observations and hypotheses have led to physicians and scientists conducting numerous studies involving cells, animals, and human subjects to try to determine what the true power of grape extracts on cardiovascular health are.  So what have we learned about the true power of grape extracts? A lot, and the scientific data and conclusions point to a definite role that grape extracts can play in improving cardiovascular health.

First, numerous animal and human studies have demonstrated that grape extracts can reduce blood pressure. This is mainly a result of the polyphenols found in grape extracts. Specifically, it has been suggested that grape polyphenols promote the release of Nitric Oxide (NO), a compound with vasorelaxing and anti-aggregating effects and, that in the long term, induces the expression of protective genes for the cardiovascular system. Said less scientifically, polyphenols help the body release NO which leads to veins relaxing, thus lowering blood pressure, while also entering the body’s cellular workings and hence causing DNA to start expressing, i.e. making mRNA that becomes proteins, genes that help protect your body.*

Second, grape extracts have been shown to have a hypolipidaemic (by that we mean they help reduce the numerous fats circulating in your blood) effect, reducing levels of plasma total cholesterol and LDL-cholesterol, which is the body’s bad cholesterol. This effect of polyphenols would be related to the fact that these compounds may absorb cholesterol, bile acids and other dietary lipids and hence help the body get rid of them.*

Third, grape extracts have a definite anti-atherosclerotic effect in the early stages of development of atherosclerosis, observed as a reduction in atheromatous plaque and in LDL oxidation. This just means that grape extracts can fight the dangerous plaques that build up in our arteries before they form. Simply stated, oxidation of LDL can lead to plaque formation in our arteries, which is accompanied by smooth muscle cells proliferating and increasing the plaque. Grape extracts appear to prevent LDL from being oxidized and prevent the smooth muscle cells from increasing, fighting atherosclerosis by means of two different but equally powerful mechanisms.*

Finally, grape extracts show an improvement in antioxidant status measured in terms of plasma antioxidant capacity, oxidation biomarkers, antioxidant compounds and antioxidant enzymes. It has become increasingly clear over the last twenty years that our bodies comprise a delicate balance between the reactive oxidation products that form as a result of necessary biochemical processes and our bodies’ antioxidant capabilities to prevent these reactive oxidation products from causing damage to cells, proteins, and even our DNA. Grape extracts help the body defend against these dangerous products that have been implicated in such conditions as cardiovascular disease, diabetes, and even cancer.*

What started as a simple observation by Dr. Renaud over twenty years ago has led to an explosion of clinical and scientific research conducted by some of the leading scientists and physicians from around the world on the inherent power found in grape extracts. There will be many future studies to discover even more about the mechanisms behind grape extracts’ ability to aid in cardiovascular health, but from a health standpoint it is clear that they represent an extremely powerful ingredient to help protect us from the risks and dangers associated with cardiovascular disease.

References:

Ferrieres, J. (2004). “The French Paradox; Lessons for other countries”. Heart 90 (1): 107–111.

Arts, IC & Hollman, PC (2005) Polyphenols and disease risk in epidemiologic studies. Am J Clin Nutr 78, Suppl. 1, 559S–569S

Lekakis, J, Rallidis, LS, Andreadou, I, et al.. (2005) Polyphenolic compounds from red grapes acutely improve endothelial function in patients with coronary heart disease. Eur J Cardiovasc Prev Rehabil 12, 596–600.

Zern, TL, Wood, RS, Greene, C, et al.. (2005) Grape polyphenols exert a cardioprotective effect in pre- and post-menopausal women by lowering plasma lipids and reducing oxidative stress. J Nutr 135, 1911–1917.

*These statements have not been evaluated by the Food and Drug Administration.  This product is not intended to diagnose, treat, cure or prevent any disease.

Author’s bio:  Puya Yazdi, MD, Medical Director for Cyvex Nutrition, has nearly six years of experience in the medical and scientific fields in addition to working in the business sector as an advisor and consultant. He holds an MD degree from The University of Southern California and a BS degree from the University of California, Irvine in Biological Sciences. Puya underwent medical and scientific training at Stanford University and is currently undergoing further training at UC Irvine.

**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.

You may have heard by now that it is a great idea to enjoy a glass – or two at most – of delicious, satisfying red wine. In fact, doing so regularly may add a little more zest to your life and keep your heart healthy.

This knowledge came from an initial study in 1992, when the term French Paradox was introduced after researchers showed in an epidemiological study that the French, despite higher incidence of smoking, less exercise and a diet relatively higher in fatty foods than Americans, have a lower incidence of heart disease, heart attacks and strokes. The researchers correlated this health paradox to the French love of red wine.

French red wine grapes contain two main constituents shown to be of significant antioxidant value: polyphenols (flavonoids) and resveratrol. Animal studies of red wine polyphenols have demonstrated effects in cardioprotection, supporting healthy cholesterol levels, vision improvement and general free-radical scavenging.

Resveratrol is produced by grapes to protect against fungal infection. It has been shown in studies to exert potent cardioprotection by inhibiting LDL oxidation and reducing platelet aggregation. In a rat model study, researchers found that resveratrol had a dramatic effect against ischemia-reperfusion-induced arrhythmias. Resveratrol reduced both the incidence and duration of ventricular dysrhythmias, including ventricular tachycardia and ventricular fibrillation. What this means is that is supports healthy heart function.

A significant study, published in 2006 in the journal Nature, demonstrated that obese mice fed red wine extract (resveratrol) were in better health and lived longer than obese mice that were not fed the red wine extract. In the supplement group, deaths dropped 31%, compared to the control group. Study authors also concluded that the red wine extract group of mice lived longer than what they normally should have given their obesity.

David Sinclair, co-author of the study, told Newsweek, “At the genetic level, we saw alterations in all the known longevity pathways that we looked at. It would appear this molecule triggers our natural genetic defenses against aging. That’s probably why resveratrol is such a potent molecule. It’s no mere antioxidant.”

In addition, Sinclair said that his team saw benefits in the supplement group that are associated with healthy longevity, specifically lower insulin, body temperature and blood sugar.

References:

Rao AV, et al.  Bioabsorption and invivo antioxidant properties of the grape extract BioVin® polyphenols: a human intervention study.  Journal of Medicinal Food 200; 3:15-22.

Renaud S, et al.  Wine, alcohol, platelets and the French paradox for coronary heart disease.  The Lancet 1992; 339:1523-6.

Baur J, et al.  Resveratrol improves health and survival of mice on a high calorie diet.  Nature.  2006; 444:337-342

For more information click on the links to see some articles about resveratrol:

Mayo Clinic: “Red wine and resveratrol: Good for your heart?”

60 Minutes: “Fountain of Youth in A Wine Rx?”

Total Health for Longevity: “Resveratrol: Unique Nutrient for Extending Health Into Old Age”