Cardiovascular disease (CVD) risk is rising in ever younger demographics. According to the comparative study, “Health Across the Life Span in the United States and England” (Melissa Martinson, Ph.D., et al.; Princeton University, Princeton, N.J., 2010), by the age of 19, nearly 5% of female children and nearly 10% of males have high cholesterol, long considered one of the most significant markers of cardiovascular disease risk. For women, those rates double by age 34; for men, they nearly triple in the same time span.

Cardiovascular health

 Also by age 34, the percentage of Americans with high C-reactive protein levels, a second important indicator of CVD risk, reaches nearly one in five for men and four in 10 for women. Clearly, establishing heart-friendly habits early on is critical to avoiding the number one killer of Americans later. It is not news that nutrition consistently emerges as a key component of just such a goal.

 What is news, however, is the growing list of nutrients that can help Americans reach these goals and their availability to be formulated into heart-healthy foods and beverages that consumers will like. Specifically, the role of micro-ingredients, such as phytosterols, vitamin D, cal­cium, omega 3-oils and coenzyme Q-10, as well as macro-ingredients, such as fruits, nuts and fiber, are being looked at strongly as early interveners for cardiovascular health.

 Phytosterols for Lower Cholesterol
Phytosterols show great promise for helping to lower serum cholesterol. By chemically resembling cholesterol enough to bind to cholesterol receptors, they block the body’s ability to take up dietary cholesterol. Although the ability for dietary cholesterol to induce a clinically significant impact on serum (blood) cholesterol displays wide variation between individuals, for those at high risk for CVD, lowering cholesterol has proven to be an important part of the strategic arsenal. Just 1-2g of plant sterols daily have been shown to drop serum cholesterol by as much as 15%--making them nearly as powerful as pharmaceutical preparations.

Food and beverage makers began to recognize this a little more than 10 years ago. This resulted in producers, such as Unilever and Lakewood Organic Premium Juices, introducing margarine, yogurts and juice beverages boasting phytosterols for heart health; this contributed to the half-billion dollar (plus) worldwide phytosterols market.

Soy products, such as Silk brand soymilk, are especially rich in phytosterols. Many soy-based products include their benefits, such as cholesterol reduction and lowered CVD risk, in their labeling and marketing. In their natural, extracted form, phytosterols are a colorless, odorless, fat-soluble and firm vegetable oil product with properties similar to shortening. However, phytosterols also have been available in a water-soluble format for more than five years (as a microencapsulated beadlet), ideally suited to beverage formulations.

 Omegas, from Alpha to Omega
In a field crowded with claims of miracle health ingredients, only one type has weathered the litmus test of science, to prove its value as exceeding expectations: omega-3 fatty acids. Literally thousands of research studies going back several decades have shown omega-3s can protect against cancer and also promote growth and development of neural tissues in the brain and body--from gestation through senescence. Omegas also show strong evidence for relieving symptoms of joint diseases, diabetes, asthma, depression and cognitive decline. When it comes to cardiovascular health, omegas are known to help keep arteries free of plaque and regulate blood pressure, making for healthy hearts throughout the lifespan.

 While the value of these compounds has been known for quite some time, one recently published study is among several core studies that add confirmation to the value of omegas. Abeywardena and Patten, in a report by the Australian food and nutrition science research group CSIRO (Commonwealth Scientific and Industrial Research Organisation), conclude definitively that dietary supplementation with long-chain polyunsaturated omega-3 fatty acids “will lead to improvements in cardio-metabolic health parameters.”

As an oil-based ingredient derived predominantly from fish and krill, it was difficult for manufacturers to include omegas in foods and beverages. Two paradigm shifts in the past few years have changed that. The first was microencapsulation technology, allowing for fine beadlets that delivered DHA and EPA from fish oil, with little negative impact on taste and aroma. Omegas from plant sources, such as flax and walnuts, benefited from technology as well, becoming strong players in the marketplace. However, those omegas are in the alpha-linolenic acid (ALA) form, which the body converts to DHA and EPA; this occurs at a loss of between 50-90% of the fatty acid’s capacity. But, ALA has the advantage of no fishy organoleptic qualities.

 The second breakthrough was deriving DHA and EPA from algae, which is where the fish get it, anyway. This had the secondary benefit of being ecologically better, because algae can be farmed, whereas fish and krill populations suffered from the high demand. Currently, there are only a couple of providers of algae-derived omegas for food and beverage applications, but India has seen a new venture positioned to take up the slack. Moreover, unlike some nutraceutical ingredients that lose efficacy once converted to pills and tablets, omegas translate very well to supplement form as gelcaps or chews.

 Vitamin D:  A New Silver Bullet

Recently, vitamin D has seen a huge wave of interest for mitigating a host of diseases and dysfunctions, such as weight management, diabetes and depression. Similar to omega oils, the trend corresponds with a sudden flood of studies bearing out its benefits. And, heart health is also included. As a hormone critical to kidney function, vitamin D plays its role in regulating blood pressure which, in turn, is part of the overall cardiovascular health picture. But, the fat-soluble vitamin also has a direct role. Calcium, too, plays a role in heart health via regulation of blood pressure and endothelial and heart muscle impulses. Calcium is often paired with vitamin D in both supplements and food and beverage items.

 Among a number of recent studies connecting vitamin D to heart health, one published this summer in the journal Clinical Endocrinology1 points to the existence of vitamin D receptors and the presence of vitamin D-metabolizing enzymes in the heart and blood vessels as proof of the need for the vitamin to help prevent CVD throughout the lifespan.

 With so much interest in vitamin D, the nutrient is poised to break out of its long-standing position as a dairy denizen and a supplement. Already included in milk analogs (such as Pacific soymilk and So-Delicious Coconut milk) and juice beverages (especially orange juice), D fortification has increased dramatically in the past few years and now sees regular application in smoothie beverages (e.g., select Bolthouse Brands products), ice cream novelties (So-Delicious again, this time in its ice cream bars), and breakfast cereals, bars and baked goods (e.g., Vitalicious VitaBrownies and FiberOne bars).

 Coming Up CoQ
“One ingredient that plays a huge role in heart health, yet is too often overlooked, is coenzyme Q10,” according to Mark Anthony, Ph.D., and adjunct professor of health science at St. Edwards University, Austin, Texas. Coenzyme Q10 is a vitamin-like molecule that plays a fundamental role both as an antioxidant and in energy metabolism within the mitochondria of the cells, especially regarding energy output of cardiac muscle.

CoQ10 also is involved in protecting against the oxidation of cholesterol carried in the low-density lipoproteins (LDLs), which increases the risk factor for cardiovascular disease via the accumulation of atherosclerotic plaque.

“There are, in fact, many ongoing lines of research into additional beneficial effects of CoQ10 on cardiovascular disease in relation to its ability to stabilize membranes and reduce inflammation,” adds Anthony. He is also a former nutrition science researcher at the University of Texas, where he managed the research lab of Karl Folkers, Ph.D., who discovered CoQ10’s chemistry. “The drain on CoQ10 increases as we age, beginning as early as around age 30, making it a serious candidate for supplementation in the diet.”

Coenzyme Q10 was historically provided as crystals suspended in oil; thus, it was fat-soluble and difficult to use in food and beverage products. However, several nutraceutical manufacturers have created water-soluble forms, such as powders and microencapsulates, to be used in many consumer snacks or drink products.

Going Macro
On the macroingredient side, fruits, nuts and seeds have been big players in the cardio-health arena. The red and purple fruits and vegetables, such as blueberries, blackberries, cherries and other antioxidant powerhouses like them, including the now-ubiquitous açai and goji, keep arteries running clean via an anti-inflammatory action that prevents plaque build-up.

Nuts and seeds, such as walnuts, salba and flax, are high in ALA, and overall, tree nuts and peanuts are loaded with ALA and other polyunsaturated and monounsaturated fatty acids noted as necessary to keep heart trouble at bay, from cradle to grave. The best aspect of fruits and nuts is their ease of incorporation into formulations across the spectrum of food processing.

 Fiber is also easy to incorporate into products, and it helps lower cholesterol by binding to it and carrying it from the digestive system. But, one fiber ingredient recently recognized as a heart-health helper is worth noting—and it is not even a fiber. Resistant starch (RS) is a recently discovered form of starch that, when ingested, acts as a fiber by increasing satiety and resisting digestion (yielding a bit more than half the caloric value of other starch forms). Furthermore, it ferments in the lower digestive tract, as it feeds probiotic microorganisms. And, importantly to cardiovascular health, RS helps to clear cholesterol from the gut by increasing bulk and transit time of food during digestion, while also boosting lipid oxidation. However, in applications such as baked goods, RS behaves as a starch (in some formulations, it even increases fluffiness by a small percentage).

From omega fatty acids to phytosterols, fruit and nuts to fiber, it is easier for healthy food and beverage manufacturers to take a proactively beneficial role in providing heart-friendly products. The list of ingredients for heart health is ample; best of all, it is readily available for food and beverage manufacturers looking beyond Baby Boomers’ needs for heart-friendly products and hoping to target Generation X, Y and younger.  NS


1. Pilz S, et al. 2011. Vitamin D, cardiovascular disease and mortality. Clin Endocrinol (Oxf). Jun 17. doi: 10.1111/j.1365-2265.2011.04147.x. [Epub ahead of print].

What Not to Worry About, When Focusing on Heart Health

The aggressive international push to reduce sodium in foods as a path to reduce vascular disease risk secondary to hypertension is not only, due to the surprising dearth of science-based evidence, merely misguided; it turns out it could actually cause harm. “Salt reduction, as the primary strategy to lower blood pressure, is a very poor and possibly dangerous choice,” notes Morton Satin, M.Sc., vice president of Science and Research for the Alexandria, Va.-based Salt Institute.

The reason has to do with the Renin-Angiotensin System (RAS), the body’s blood-pressure regulator. Within the RAS, natural sensory mechanisms detect when humans are not eating enough salt, kicking in to make the kidney reabsorb sodium and water back into the blood. “This complex hormonal chain reaction, perfected through millions of years of biological evolution, is critical for maintaining balance in our circulatory system,” explains Satin. “Unfortunately, although the RAS helps us make up for too little salt consumption, it does so at a heavy cost to our health. Elevated RAS levels cause metabolic syndrome, insulin resistance, cardiovascular disease and a host of other serious conditions. There no longer is any doubt that an elevated RAS is a very serious risk factor for overall health.”

Satin further notes that adherence to previous USDA Dietary Guidelines of 2,300mg/sodium daily would put the body into a chronically elevated RAS state, and the more stringent 2010 Guideline levels of 1,500mg/day for approximately half the population could be downright dangerous. With that in mind, all the hype to the contrary, the actual research has yet to back the reduction of sodium in the diets of healthy people.