Cardiovascular disease remains the leading cause of death worldwide, with risk factors including: smoking, physical inactivity, and an unhealthy diet. These factors have also been linked with specific chromosomal changes known as epigenetic changes. Recent research has shown that diet, environment, and behavior can result in epigenetic modifications. It has been suggested that the effect of dietary factors on epigenetic changes may hold the potential to prevent the progression to several disease states, including cardiovascular disease.
Epigenetics refers to secondary biological information present at the chromosomal level. It is independent of DNA sequence itself; however, epigenetic information can control the regulation and expression of the genes it is affecting. Some examples of epigenetic mechanisms include DNA methylation and histone modification. These epigenetic modifications can regulate and control gene expression and thereby exert effects on physiological processes. In addition to genetic mutations, epigenetic changes have been implicated in the development and progression of several diseases including: allergies, arthritis, asthma, diabetes, cancer, and cardiovascular disease.
It has been proposed that the negative epigenetic alterations which promote disease progression are acquired during neonatal life. A growing area of research is investigating whether reversal of these acquired changes can impact progression to a disease. An example that has received most of the research focus is cancer. There have been numerous studies identifying and reversing epigenetic changes that contribute to the progression of cancer, using bioactive phytochemicals found in food. In contrast, there are few studies that have identified epigenetic alterations and potential for reversal specifically relating to cardiovascular disease. A recent article compiled a list of bioactive phytochemicals that have been studied as epigenetic modifiers and found that of the 58 studied compounds, 53 were studied for cancer prevention, while only 5 were studied for prevention of cardiovascular disease. Epigenetic modification has been suggested as a possible link between diet and lifestyle and the risk for cardiovascular disease. Additionally, studies have shown that one of the epigenetic mechanisms, DNA hypo-methylation, is evident in advanced atherosclerotic lesions. These studies provide a basis for the growing field of epigenetic research and examining food as epigenetic modifiers. One study has even suggested that specific components of food could be ‘epigenetic medicine’.
There are clinical trials currently underway assessing the effects of soy, nuts, apples, cocoa, strawberries, oranges, and olive oil on cardiovascular risk factors. Each of these foods contain phytochemicals that have already been shown to induce epigenetic changes. The current studies however, are not designed to provide a direct link between the foods and specific epigenetic changes in cardiovascular disease.
Previous research has already demonstrated that diet and lifestyle changes such as: smoking cessation, reduced salt, increasing fruits and vegetables, and regular physical activity all reduce the risk of cardiovascular disease. The latest research on epigenetic modifications now provides a greater understanding of the physiological effects of a healthy lifestyle at the chromosomal level. It has even been suggested that further study could lead to prevention and therapy of age and lifestyle related diseases by individually tailoring epigenetic diets and/or supplements.
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Clinicaltrials.gov “Effect of Soy Intake on Cardiovascular Disease Biomarkers in Subclinical Hypothyroid Participants” Available from: http://www.clinicaltrials.gov/ct2/show/NCT02024906?term=NCT02024906&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “The Effect of Pecans on Biomarkers of Risk for Cardiovascular Disease and Diabetes” Available from: http://www.clinicaltrials.gov/ct2/show/NCT01950806?term=NCT01950806&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “A Study Examining Effects of Apples/ Apple Products on Heart Disease Risk (APPS)” Available from: http://www.clinicaltrials.gov/ct2/show/NCT01585519?term=NCT01585519&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “The Effects of Apple Derived Flavanols on Cardiovascular Disease Risk (FLAVASCULAR Study)” Available from: http://www.clinicaltrials.gov/ct2/show/NCT02013856?term=NCT02013856&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “Effects of Polyphenolic-rich Dark Chocolate/Cocoa and Almonds on Cardiovascular Disease Risk Factors (CAS)” Available from: http://www.clinicaltrials.gov/ct2/show/NCT01882881?term=NCT01882881&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “Effect of Strawberries on Cardiovascular Disease Risk” Available from: http://www.clinicaltrials.gov/ct2/show/NCT01989637?term=NCT01989637&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “The Effects of California Strawberries on Parameters of Cardiovascular Health” Available from: http://www.clinicaltrials.gov/ct2/show/NCT01705093?term=NCT01705093&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “Impact of Oranges on Cardiovascular Health” Available from: http://www.clinicaltrials.gov/ct2/show/NCT01935362?term=NCT01935362&rank=1 Last Accessed: Feb 25, 2014.
Clinicaltrials.gov “Olive Oil and Cardiovascular Health” Available from: http://www.clinicaltrials.gov/ct2/show/NCT01983943?term=NCT01983943&rank=1 Last Accessed: Feb 25, 2014.
WHO Cardiovascular Diseases Fact Sheet. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/ Last Accessed: Feb 25, 2014.
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Written by Deborah Tallarigo, PhD