Study under review: Anti-Inflammatory Effects of a Vegan Diet Versus the American Heart Association-Recommended Diet in Coronary Artery Disease Trial.
Coronary artery disease (CAD) is the leading cause of cardiovascular disease (CVD) related death in the U.S. It is characterized by a reduction of blood flow to the heart due to atherosclerosis (hardening and plaque buildup) of at least one coronary artery (blood vessel supplying blood to the heart). This can lead to the heart tissue getting fewer nutrients and less oxygen than it requires. In an era where LDL cholesterol can be controlled with medications (predominantly statins), but CVDs are still the number one cause of mortality, researchers and clinicians are seeking additional tools to reduce risk. Anti-inflammatory therapy is one tool that appears promising, especially when oxidized LDL is a primary component of atherosclerotic blockage.
The link between oxidized LDL and atherosclerosis is inflammation, which is also a mechanistic link between other traditional risk factors for CAD (i.e. obesity, smoking) and endothelial (blood vessel inner lining) dysfunction that drives CAD. Indeed, people with CAD generally have elevated levels of C-reactive protein (CRP), a protein produced during the acute phase of inflammation that helps the body recognize and remove foreign pathogens and damaged cells, and whose levels correlate with CAD presence and severity. Reductions in high sensitivity CRP (hsCRP, where high sensitivity refers to a more sensitive measurement method) have been noted as a potent marker of reduced adverse cardiovascular events in people with established CAD. While evidence suggests that CRP does not play a causal role in CAD, its presence is nonetheless predictive of CAD risk, since it shares a pathway with the inflammatory process that does cause CAD, which you can see in Figure 1.
Various dietary components, primarily from whole plant-based foods, appear to reduce inflammation and CVD risk factors. A dietary inflammatory index has even been developed that might be able to predict hsCRP levels and has shown a positive association with several cardiovascular risk factors. While the American Heart Association (AHA) has a very specific set of lifestyle and dietary recommendations in place to combat CVD, multiple diets (i.e. Mediterranean, DASH, and vegetarian) have demonstrated CVD-protective and/or anti-inflammatory potential.
Few studies have compared the anti-inflammatory effects of different dietary strategies. The study under review compared the influence of a vegan (whole plant-based food) diet against the AHA-recommended diet on hsCRP and related CVD risk factors.
People with coronary artery disease have elevated levels of an inflammatory marker CRP. Anti-inflammatory therapy has demonstrated promise for prevention of adverse cardiovascular events. Whole plant-based foods appear to reduce inflammation and CVD risk factors. While the American Heart Association recommends a diet for CVD prevention, it has not been compared to other diets with similar anti-inflammatory potential. The study under review compared the effect of a vegan versus AHA-recommended diet on hsCRP and related CVD risk factors and markers.
Other Articles in Issue #52 (February 2019)
Individual differences in cardio-metabolic response to caffeine may not predict its benefits on endurance performance
Caffeine doesn't benefit every athlete to the same extent. This study aimed to discover if the ergogenic effects of caffeine could be predicted by certain physiological responses to it.
Carnivores convert carnitine, but can vegetarians?
Trimethylamine N-oxide (TMAO) is associated with an increased disease risk. It's manufactured with the help of the gut microbiome from L-carnitine. Vegetarians make less TMAO from L-carnitine than omnivores do. The question is: why?
Can lemon balm help manage type 2 diabetes mellitus?
Lemon balm is a plant that may have antidiabetic and cardiovascular effects. This study explored how it impacts glycemic control and cardiovascular risk factors in people with type 2 diabetes.
Do low carbohydrate diets increase cardiovascular risk?
This meta-analysis found that low carb diets bump up LDL-C levels slightly. What's less clear is how much this matters.
Interview: Jason M. Valadão, MD, MA, MLS, Lieutenant Commander, US Navy
We chat with physician, naval officer, and author Jason Valadão about the nutritional strategies he uses with his patients, his top tip for gaining control of exercise and diet routines, and more.
Does a post-workout high GI meal improve sleep and next day training performance?
This study aimed to explore how a high glycemic index meal after an evening training bout affects both sleep and performance.
Interview: Shavawn M. Forester PhD, RDN
In this chat with the Chief Science Officer of The Nutrient Institute, we discuss science communication, her take on some popular nutrition topics, and more.