(Circulation. 1997;95:2591.)
© 1997 American Heart Association, Inc.
Articles |
Phytochemicals and Cardiovascular Disease
A Statement for Healthcare Professionals From the American Heart Association
, For the Nutrition Committee
Key Words: AHA Medical/Scientific Statements • cholesterol • atherosclerosis • lipoproteins
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Epidemiological studies have often shown relationships between vegetable/fruit intake and coronary heart disease that are not clearly attributable to major macronutrients or known vitamins and minerals. This suggests that other components of plants may be important in lowering risk of cardiovascular disease. Although the literature contains studies of a myriad of possible plant components, many of these studies are small or poorly controlled. Further, the supposition itself has led to claims of "miracle" ingredients with supposed mitigating effects on cardiovascular as well as other chronic diseases. A substantial body of evidence has accumulated in three areas: plant sterols, flavonoids, and plant sulfur compounds. This review summarizes the state of knowledge in these three areas and explores possibilities for future work.
Plant Sterols
The plant kingdom contains a number of sterols that differ
from cholesterol by having ethyl or methyl groups or
unsaturation in the side chain. The predominant ones—sitosterol,
stigmasterol, and campesterol—can be present in Western diets in
amounts almost equal to dietary cholesterol.1
The most prominent is ß-sitosterol, which differs from
cholesterol in that it has an ethyl group at carbon 24 of
the side chain. In the early 1950s it was noted that the addition of
sitosterol to the diet of cholesterol-fed chickens or
rabbits lowered cholesterol levels in both species and
inhibited atherogenesis in the latter.2 Sitosterol or
mixtures of soy sterols were studied extensively as
cholesterol-lowering agents between 1950 and
1960.3 The preparations achieved cholesterol
lowering of approximately 10%.4 The mode of action
appears to involve inhibition of
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