The Cardiovascular Benefits of Polyphenol Compounds

doi:10.4236/aa.2013.34025

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Advances in Anthropology

2013. Vol.3, No.4, 183-187

Published Online November 2013 in SciRes (http://www.scirp.org/journal/aa) http://dx.doi.org/10.4236/aa.2013.34025

Open Access 183

The Cardiovascular Benefits of Polyphenol Compounds

Anthony San Luis

University of North Carolina at Cha pel Hill, Chapel Hill, USA

Email: [email protected]

Received February 28th, 2013; revised M arch 29th, 2013; accepted May 1st, 2013

tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the

original work is properly cited.

In comparison, polyphenols are one of the most diverse to most other groups of bioactive phytochemicals.

Polyphenols can be found in a wide range of foods that are derived from plants. Polyphenols are made up

of various subgroups, but it’s the phenolics, stillbenes, and flavonoids that engender positive impacts on

cardiovascular health. These three phytochemical compounds can reduce cardiovascular conditions such

as hypertension and coronary heart disease. Remarkably, polyphenols and its subgroups can be found

ubiquitously in most human diets. As a result, many studies have effectively illustrated the positive im-

pacts polyphenols can induce when processed by the human body. Furthermore, research efforts have

shown that modern diets and more “traditional” diets have unknowingly promoted the consumption of

foods rife with polyphenols. These findings are starting to be incorporated into the public health discipline

as a more practical option for more sustainable nutritional interventions. In all, polyphenols can produce a

myriad of positive developments on at the micro and macro level.

Keywords: Phytochemicals; Stillbenes; Phenolics; Flavonoids Formatting; Style; Styling

Introduction

With great success, humans have been able to manage an ex-

ceptional level of coevolution with an extensive array of neigh-

boring organisms. Of the myriad of extant relationships that

humans have experienced throughout our history, the most in-

triguing and important to our survival has been the association

with our botanical counterparts. It is this particular instance of

symbiosis that is probably the most visible, as well as one of

the oldest co-evolutionary relationships that humans have culti-

vated. Plants have been central to the survival of our ancestral

species, and in a sense many species of plants echo these same

sentiments. If not for the arrival of the human species, the evo-

lutionary trajectory of many species of plants would not have

been able to survive. As humans have evolved into the “ulti-

mate” survivalists over several millennia, plants have been uti-

lized in a way central to their survival.

Historically speaking, humans have been afforded a high le-

vel of achievement when it comes to the modification of plants

in some fashion. It is not out of the realm of possibility that da-

ting as far back as our australopithecine ancestors were able to

effectively deduce and segregate ideally ripe fruits and vegeta-

bles based on phenotypically desirable characteristics. This sim-

ple relationship is the genesis of a communicative relationship

between humans and plants that have engendered subsequent

interactions that would benefit both organisms for centuries. As

early as the agricultural revolution, humans have favorably ma-

nipulated this dyadic relationship to a point that the question

emerges as to whom is actually manipulating whom. For in-

stance, human cultures have manipulated grapes and yeast to

make wine close to seve n thousan d years ago (Th ompson, 20 05).

The question remains as to whether humans are using the fer-

mentation process to benefit them or are the grapes and yeasts

using humans to cultivate and till more fields dedicated for their

own progress to perpetuate their species. However, the extent

of human and plant coevolution resonates deeper than merely

farming techniques, rather it requires a look at the molecular le-

vel.

At the molecular level plants contain bioactive phytochemi-

cals and when in contact with the human body can produce

adverse and beneficial reactions. Plants have developed bioac-

tive phytochemicals as a chemical defense response to the en-

vironmental pressures and stresse s (Kryzyzanowska et al., 2010).

In particular, compounds such as phenolics, carotenoids, alka-

loids, and saponins etc. have played crucial functions in the sur-

vival of the plant species but simultaneously given humans an

opportunity to benefit from its consumption. Humans invaria-

bly have enjoyed high levels of advances when extracting these

bioactive phytochemicals for their own use. Furthermore, bio-

active phytochemical extraction has been exercised by humans

to produce a number of health benefits. Traditional Chinese me-

dicine is probably one of the first examples of its accomplish-

ments that have been present over several centuries and it is

starting to become common in cultures outside of China. The

interaction of bioactive phytochemicals and biomedicine has

engendered a litany of positive results that are being explored in

depth as it relates to the human species’ ability to survive. In al-

lopathic medicine, the phytochemical compounds extracted

from plants have played roles in traditional medicine and ethno-

pharmacology for humans to effectively alleviate and in some

cases, cure several diseases.

Specifically, bioactive phytochemical compounds have been

efficacious as serving in a cardio-protective capacity. Humans

have been able to derive positive influences in a number of set-

tings contributing to overall well-being. Several fruits and ve-

getables contain these bioactive compounds that directly influ-

A. S. LUIS

ence cardiovascular health and have been investigated intensely

to substantiate this notion. Epidemiological studies of the role

of tomatoes that are rich sources of lycopene were studied in a

comparison between a cohort of Lithuanian and Swedish popu-

lations (Tucker, 2004). This study showed that high lycopene

levels reduce morbidity and mortality from coronary heart dis-

ease (Kryzyzanowska et al., 2010). However, this is just the be-

ginning of the seemingly infinite range of effects that can lower

the risk of cardiovascular diseases. This is because many fruits

and vegetables have a diverse content of bioactive phytochemi-

cals compounds linked with the promotion of cardiovascular

health.

Aims and Purposes

In this paper, I discuss and review the literature on the effects

of certain bioactive phytochemicals found in a range of fruits

and vegetables that promote cardiovascular health. The role of

the phytochemical polyphenol and constituent subgroups phe-

nolics, stillbenes, and flavonoids are reviewed for their proper-

ties to promote cardiovascular health. In a sense, I will take a

pragmatic approach that will depart from the biochemistry lit-

erature to a review of the publications demonstrating research

efforts about types of dietary interventions that now focus on

phytochemicals. Specifically, this will entail a description of

modern and traditional dietary approaches addressing hyperten-

sion. A review of the Dietary Approach to Stop Hypertension

(DASH) model shows that research efforts focusing on the in-

corporation of bioactive phytochemicals has become wholly in-

tegrated into various dietary interventions. This paper review

will conclude with a recommendation towards public health in-

terventions. I will analyze public health benefits that can be

produced by the consumptive habits stemming from fruits and

vegetables that con ta i n significant cardio-protective properties.

Analysis

Introduction of Polyphenols

Polyphenols are one of the most diverse and as a result, one

of the most relevant groups of phytochemicals (Gonzales-Ca-

stejon & Rodriguez-Casado, 2011). Such diversity is illustrated

by the various subgroups that constitute the polyphenol family

due to being endowed with a wide range of beneficial impacts

on health. Additionally, research has shown that polyphenols

demonstrate strong protective effects on several pathological

conditions that are facilitated by oxidative stress like cardiova-

scular disease and metabolic syndrome through the aid of an-

tiangionic properties that suppress the growth of adipose tissue

and the modulation of adipocyte metabolism (Gonzales-Caste-

jon & Rodriguez-Casado, 2011). Polyphenols are mostly known

through its numerous subgroups having one hydroxyl-substitu-

ted aromatic ring (Gonzales-Castejon & Rodriguez-Casado,

2011). However, of all the variability that exists in the polyphe-

nol group, its particular subgroups have made the polyphenol

group all the more intriguing, namely phenolics, stillbenes, and

flavonoids all enjoy properties that are conducive to cardiovas-

cular health.

Phenolics

Within the polyphenol group, its subgroup phenolics (or sim-

ple phenolic acids) are the largest and arguably the most impor-

tant constituents of polyphenols when compared to its counter-

parts. While simple phenolic acids like caffiec acid, chologenic

acid, and feluric acid are some examples of the compounds that

makeup the phenolic subgroup have all been found in dietary

sources like coffee (Coffea Arabica) and soybeans (Glycine so-

ja) as well as fruits and vegetables in concentrated levels in

apples (Malus domestica), and pineapples (Anana comosus)

(Gonzales-Castejon & Rodrig uez-Casado, 2011). Although these

sources of phenolic acids have cardiovascular protective prop-

erties, catechin has been the most closely studied type of phe-

nolic and has been able to traverse geographical barriers into

the minds of individuals across several cultures and populations

because of the ubiquitous consumption of a green tea (Camellia

sinesis) that been discovered to be a source rich in catechin.

The highest concentrations of catechins are found in green

tea that has been known to exhibit positive impacts on cardio-

vascular health. Green tea is the most strikingly effective phe-

nolic directly linked with the prevention and/or alleviation of

conditions associated with cardiovascular disease through the

promotion of several biological mechanisms. A type of catechin,

epigallocatechin gallate (EGCG), has a large concentration in

green tea and has been substantiated to be more efficacious in

addressing these conditions. The mechanism of actions of green

tea and EGCG have been found to have direct impacts on the

biological function of the body to address cardiovascular dis-

eases. EGCG has shown to address obesity and lower the risk

of hypertension by reducing adipocyte differentiation and pro-

liferation, fat mass, body weight, fat absorption, insulin, while

simultaneously stimulating thermogenic activity (Tucker, 2004).

Comparatively speaking, the content of EGCG of green tea in

comparison to its next closest dietary source is impressive to

say the least. Dark chocolate is engendered with a large amount

EGCG with 53.5 mg/100 g but green tea more than doubles this

amount with a 132 mg/100 g making it a more desirable choice

when opting for purer sources of EGCG (Kryzyzanowska et al.,

2010: p. 84). The benefits of the consumption of plants and ve-

getables rich in catechins were validated by a trial studying the

intake of green tea. The ensuing results showed that a standard-

ized intake of catechins through the consumption of green tea

showed that there was a decrease in total body weight and waist

circumference caused by an increase in thermogenesis (Gonza-

les-Castejon & Rodriguez-Casado, 2011).

Stillbenes

Stillbenes, along with positive impacts on cardiovascular

health, also has a potent effect in-vitro and is found in a large

array of dietary plant sources. Similar to most polyphenolics,

stillbenes also occur naturally but in limited sources, it is most-

ly found in large quantities in several varieties of fruit like ap-

ples, cranberries, blueberries, and grapes. Resveratrol is found

in stillbenes and has been the key factor directly linked with the

prevention of hypertension. Resveratrol is often found in high

concentrations in grapes but levels are actually higher in wine

because of the production process and have been shown to limit

risk of cardiovascular diseases.

Although, it is the content of resveratrol that is found in wine

that produces positive effects on the heart, its biological proc-

esses are additionally influenced by the presence of a geogra-

phical component that alters its quantities. Stillbenes and its

constituent resveratrol are synthesized by the body through phe-

nolynpropanoid pathways in response to environmental stress,

infections, disease, and ultraviolet exposure (Gonzales-Castejon

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A. S. LUIS

& Rodriguez-Casado, 2011). Resveratrol levels found in wine

have are known to have direct cardiovascular effects as an an-

tihypertensive because of its anticoagulant properties that limit

platelet aggregation (Kryzyzanowska et al., 2010). Specifically,

resveratrol has been able to decrease LDL-cholesterol and pre-

vent lipid oxidation while producing favorable changes in gene

expression and enzyme activity involved in metabolic processes

(Gonzales-Castejon & Rodriguez-Casado, 2011). However, va-

rieties of wine (red vs. white) contain varying levels of resvera-

trol and are limited to certain constraints that influence its res-

veratrol levels and its impact because of the presence of limit-

ing factors that favor one country’s production over another.

Certain countries like Italy are endowed with an agricultural

component that increases resveratrol levels in wine because of

its production, and technological innovations that have im-

mense influence on the resveratrol levels in the wine coming

out of this area (Tucker, 2006). For example, wines consumed

by Italian males have significantly higher proportions of resve-

ratrol when compared to wines from other countries. In Italian

wines, resveratrol levels are nearly .5 - 10 ppm, whereas wine

produced in Japan for example, has resveratrol rates of .05 - .8

ppm (Tomera, 1999). Therefore, it can be assumed that Italians

and other consumers who have access to wine produced in Italy

would benefit from a greater antihypertensive effect compared

to the consumption of wine from elsewhere.

Flavonoids

Like its polyphenol counterpart’s stillbenes and phenols, fla-

vonoids also engender positive impacts on cardiovascular

health. Over 6000 distinct phytochemicals have been identified

in fruits and vegetables, with many current research efforts fo-

cusing on its anti-inflammatory properties that have can address

many chronic diseases (Gonzales-Castejon & Rodriguez-Casa-

do, 2011). As a result, the vegetable and fruit sources of flavo-

noids can vary greatly. Nonetheless, their positive impacts on

cardiovascular diseases are becoming known and providing

profound benefits from seemingly “common” vegetables and

fruits.

Alone, the content of flavonoids cannot explain the benefi-

cial effects derived from its consumption, but rather it is the

content of the compounds like quercetin, kaempferol, myricetin,

and anthocyanidin that provides flavonoids as viable com-

pounds to prevent and alleviate heart conditions. Some of the

more common sources of flavonoids are often found in fruit-

based sources like grapefruit (Citrus sinensis) and blueberries

(Cyanococcus vaccinum) but have also been found in high con-

centrations in vegetable-based sources like broccoli (Brassica

oleracea), and leeks (Allium porrum) (Gonzales-Castejon &

Rodriguez-Casado, 2011; Dillar & German, 2000). Flavonoid

biological function encompasses a variety of different mecha-

nisms with positive impacts in addressing cardiovascular condi-

tions such as obesity or diabetes. These compounds have been

linked to a decrease in platelet aggregation and thrombosis that

ultimately lowering the risk of coronary heart disease (Dillar &

German, 2000). Additionally, other outcomes have shown that

these flavonoid compounds can induce the inhibition of LDL

oxidation, and lowering blood pressure (Gonzales-Castejon &

Rodriguez-Casado, 2011).

Many studies have effectively substantiated these effects

through the identification, isolation, and administration of fla-

vonoid rich diets in a number of trials attempting to investigate

its beneficial properties. In a longitudinal trial in 1985 with 805

elderly males, recorded daily baseline intake of flavonoid levels

measuring 25.9 mg found that the relationship of the intake be-

tween flavonoid intake and coronary heart disease mortality

was inversely related (Dillar & German, 2000). The results con-

fidently claimed that a consistent consumption of a flavonoid-

rich diet ca n have positive effi cacy on not just mal es, but elder-

ly males specifically. Further, studies have also shown that the

cardiovascular health of women improved with a consistent le-

vel of consumption of broccoli and apples as well (Tucker,

2004).

In trials that were recently reviewed by Katherine Tucker for

the Human Nutrition Research Institute of Aging and Marta

Gonzales-Castejon & Arantxa Rodriguiz-Casado for the Phar-

macological Research have demonstrated the efficacy of flavo-

noids for its protective properties against cardiovascular diseas-

es have been widely demonstrated through various publications.

Diets emphasizing the consumption of flavonoids are becoming

gradually showing its viability in dietary options to promote

healthy well-being. The fact that flavonoids are relatively com-

mon in most dietary settings produces ostensibly easy access to

its consumption and its cardiovascular benefits barring any li-

miting extraneous variables. Specifically in most settings both

in a traditional and modern sense, fruits like grapefruit and ve-

getables like broccoli are pervasive in most market settings, and

ought to be consumed consistently for both their immediate and

long-term preventative impacts.

The consumption of foods rich in polyphenols has clearly il-

lustrated its effects on the human cardiovascular system. Poly-

phenol-rich foods have pervaded the human diet with great suc-

cess with the arrival of globalization and mainstream media

promoting its benefits. Even in the face of certain barriers that

could limit its accessibility such as socioeconomic status or

food insecurity, products like Italian-made wine have been able

to make the journey across the Atlantic Ocean away from Italy

into the kitchens of many US residents. This sentiment is ech-

oed in green tea that originated in east Asia has also managed to

penetrate the restaurant and supermarket business with seeming-

ly relative ease in recent decades. It would come as great bene-

fit for humans to consistently utilize foods containing polyphe-

nols for their consumption because its impacts have been dem-

onstrated adequately by empirical research. It seems virtually

inevitable that more research illustrating its impact are on the

horizon as more studies begin to study the place of all known

bioactive phytochemicals in mainstream dietary interventions

that promote cardiovascular health.

Discussion

The Intersection of Phytochemicals with

Contemporary and Traditional Dietary Approaches

Promoting C a rdi ovascular Health

Several dietary interventions in various settings have been

tasked with directly addressing cardiovascular health. Many mo-

dern dietary interventions trying to address cardiovascular dis-

ease by lowering rates of obesity have been achieved but in tra-

ditional settings absent of westernized medicine have been ex-

plained also have been able to reduce the risk of cardiovascular

diseases. Few contemporary dietary interventions, if any have

used a comprehensive analysis that looks into the contribution

of bioactive phytochemicals compounds. There have been ex-

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A. S. LUIS

amples of modern approaches such as the Dietary Approaches

to Stop Hypertension (DASH) that promote the consumption of

diverse but specific range of foods that implicate a protection

against cardiovascular conditions. On the contrary, in the ab-

sence of modern science and research settings, rural traditional

communities have been recently found to utilize the extraction

phytochemical compounds from plants indigenous to that re-

gion to proliferate cardiovascular health.

The DASH diet has been able to lower the risk of hyperten-

sion in individuals who have adhered to its recommendations.

The DASH diet is starting to become more recognized by heal-

thcare officials as an adequate option in the dietary manage-

ment of hypertension. But research efforts have delved further

into the factors lending to its accomplishments beyond a simple

modification of diet by exploring the effects of the food that is

recommended in the DASH diet (Most, 2004). The composition

of the DASH diet promotes the consumption of fruits, vegeta-

bles, and low-fat dairy foods in order to reduce blood pressure

and is also known to protect against lipid peroxidation. Essen-

tially, the DASH diet is one such intervention that aims to ef-

fectively combat hypertension through sustained alterations of

an individual’s diet but not until recently, the phytochemical

content present in the DASH diet have been identified as key

factors in its ability to lower hypertension.

A recent study by the Department of Agriculture compiled a

database of the recommended foods in the DASH diet and its

phytochemical makeup to highlight their place as a key con-

tributor to preventing hypertension. The contents of phytoche-

mical compounds such as flavonoids, carotenoids, flavanones,

and phytoesterols were some of the focal points for their study

in comparison to a control diet. The results showed a drastic

disparity in the amounts of these phytochemical compounds

found in the DASH diet than in the control diet (Most, 2004,

1726). The results underscored that the DASH diet versus the

control diet had a higher concentration (mg/1000 kcal) of fla-

vonols (3.53 vs. 2.24), carotenoids (12.24 vs. 3.81), flavonones

(6.77 vs. .44), and phytoesterols (47.19 vs. 19.22) respectively

(Most, 2004).

On the other hand, without the use of modern scientific ap-

proaches characterized by modern interventions, more traditio-

nal communities have been just as rewarding with the utiliza-

tion of certain indigenous plants. In rural Uganda, the leaf of

the Moringa oleifera plant was initially touted by local Ugan-

dan media in the 1980’s as a purported cure to alleviate symp-

toms linked to HIV/AIDS. However, the Moringa oleifera plant

has found its uses expand into other areas of health, namely car-

diovascular health. In a trial studying its effects, have been able

to show that Moringa oleifera has a moderately high concentra-

tion of flavonols. Subsequently an impressive 90% of males in

these rural Ugandan communities have consistently consumed

its leaves to treat diabetes and hypertension without actually

knowing its effects that have been substantiated by research

efforts (Kasolo et al., 2010).

Both of these recent findings produce a unique perspective

with implications on the evolutionary history of humans. The

DASH diet mostly concentrated on the diversified consumption

of foods containing macronutrients and micronutrients. But the

findings produced in the rural Ugandan example illustrate that

dietary interventions may have been part of the natural course

of human innovation regardless of the advances made in mod-

ern western medicine. Yet, the underlying sentiment remains,

that if diets knowingly or in the case of rural the Ugandan

community unknowingly, emphasizing a biochemical focus

would stand to have more positive impacts on overall well-

being. The DASH diet in particular, with a focus on phytoche-

micals can broaden its scope of the DASH philosophy to in-

clude the plants like Moringa oleifera among many other plants

that have yet been identified or are under current investigation.

A focus on the biochemical reactions of phytochemicals would

give not just the DASH diet but other dietary interventions new

opportunities to produce a level of affirmation generated by

empirical results that is often the basis for acceptance in many

institutional settings.

Public Health Implications of Using Phytochemicals

to Address Hypertension and Other Cardiovascular

Conditions

The public health paradigm have been extremely concerned

with the nutritional status of entire populations, and in recent

decades have tried to implement nutritional interventions with

varying levels of success. In the case of cardiovascular health,

public health has struggled mightily to effectively produce a

“universal” cure in the face of rising rates of obesity and mal-

nutrition. However, many of these interventions can be costly

for those involved, and at times have not been able to produce a

positively uniformed impact. However, a “universal” cure is not

necessarily what is needed, but perhaps a universal effort fo-

cused on future sustainability. It appears that there are cost-

effective techniques to address the extant cases of malnutrition

stemming from the existence of poor quality food in impover-

ished populations in countries that have experienced rapidly

development where rates chronic and infectious disease rising.

One recommendation would require the use of a more nu-

anced approach with a level of cultural sensitivity by public

health officials to integrate an “organic” or “natural” facet into

the diet, aiming towards a more agriculturally sustainable focus

on certain phytochemicals, while at the same time, avoiding

synthetic means of production such as genetically modified

organisms (GMO’s), steroids, etc. A combination of a public

health perspective and an anthropological approach geared to-

wards biochemistry could be implemented to effectively narrow

the gap in dietary management of hypertension. Examples

taken from the DASH diet or the Ugandan use of Moringo olei-

fera can demonstrate that there are other ways to address mal-

nutrition beyond the reliance of commercial pharmaceutical

companies producing synthetic products. A biological anthro-

pological approach would comprehensively consider the cultu-

ral specificities and tailor diets based on a particular popula-

tion’s consumption of certain vegetables and fruits. This would

call for the cultivation of native plants with phytochemicals in-

digenous to a particular region. Essentially cultivating fruits and

vegetables rich in certain bioactive phytochemicals with high

concentrations of polyphenol compounds like phenolics, still-

benes, and flavonoids could promote cardiovascular health with

the goal of also providing a level of sustainability for communi-

ties with high rates cardiovascular disease.

Concluding Remarks

The trajectory of human evolution has entailed the cultiva-

tion of various relationships with a sundry of organisms. Yet,

the relationship with plants has been one with the longest his-

tory whose dyadic association is still producing new results

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Open Access 187

seemingly every day but at the same time with a large remain-

der still a mystery in the eyes of modern science. Dating back

to prehistory with our ancestral hominids up till the agricultural

revolution thousands of years ago humans are often thought in

some circles to be selectively manipulating plants for the sur-

vival and proliferation of their biological fitness. Additionally,

recent research has shown that plants are composed of specific

phytochemicals often with a myriad of benefits to the human

body. As a result, the health implications associated with the

consumption of phytochemical compounds found in plants has

been studied intensely and largely continues in investigative

settings across the world. These findings have been able to tra-

verse several disciplines beyond agriculture into public health

and disciplines in between, where many efforts are beginning to

study the effectiveness of bioactive phytochemical compounds

for nutritional purposes on larger scales. It remains to be seen if

these efforts are going to be effective at broad level, but the fo-

cus remains on the betterment of the specie s not just society to-

wards a more sustainable environment for future generations to

comfortably exist.

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