Lipoprotein(a): Current Evidence for a Physiologic Role and the Effects of Nutraceutical Strategies

Santos, Heitor O.; Kones, Richard; Rumana, Umme; Earnest, Conrad P.; Izidoro, Luíz Fernando Moreira; Macedo, Rodrigo Cauduro Oliveira

doi:10.1016/j.clinthera.2019.06.002

Cited by 37 publications

(25 citation statements)

References 138 publications

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“…This review has focused on evidence from human clinical trials examining the effect of well-defined diets on Lp(a). Other studies have investigated the effect of dietary supplements (L-carnitine, and coenzyme Q10) and specific foods (coffee, tea and alcoholic beverages, especially red wine) and have shown decreases in Lp(a) with these interventions; this research, however is beyond the scope of this review and was summarized recently by Santos et al [ 98 ]. Collectively, the studies reviewed herein and the additional studies that have been conducted with supplements and certain foods demonstrate a modulating effect of diet on Lp(a).…”

Section: The Effect Of Dietary Intervention On Lp(a)mentioning

confidence: 99%

Diet and Lp(a): Does Dietary Change Modify Residual Cardiovascular Risk Conferred by Lp(a)?

et al. 2020

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Lipoprotein(a) [Lp(a)] is an independent, causal, genetically determined risk factor for cardiovascular disease (CVD). We provide an overview of current knowledge on Lp(a) and CVD risk, and the effect of pharmacological agents on Lp(a). Since evidence is accumulating that diet modulates Lp(a), the focus of this paper is on the effect of dietary intervention on Lp(a). We identified seven trials with 15 comparisons of the effect of saturated fat (SFA) replacement on Lp(a). While replacement of SFA with carbohydrate, monounsaturated fat (MUFA), or polyunsaturated fat (PUFA) consistently lowered low-density lipoprotein cholesterol (LDL-C), heterogeneity in the Lp(a) response was observed. In two trials, Lp(a) increased with carbohydrate replacement; one trial showed no effect and another showed Lp(a) lowering. MUFA replacement increased Lp(a) in three trials; three trials showed no effect and one showed lowering. PUFA or PUFA + MUFA inconsistently affected Lp(a) in four trials. Seven trials of diets with differing macronutrient compositions showed similar divergence in the effect on LDL-C and Lp(a). The identified clinical trials show diet modestly affects Lp(a) and often in the opposing direction to LDL-C. Further research is needed to understand how diet affects Lp(a) and its properties, and the lack of concordance between diet-induced LDL-C and Lp(a) changes.

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Section: The Effect Of Dietary Intervention On Lp(a)mentioning

confidence: 99%

Diet and Lp(a): Does Dietary Change Modify Residual Cardiovascular Risk Conferred by Lp(a)?

et al. 2020

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“…Scurvy manifests clinically because vitamin C is a reducing agent or cofactor, playing a central role in collagen synthesis, prostaglandin and prostacyclin metabolism, reduction of free radicals, and iron absorption. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Vitamin C Deficiency: An Under-Recognized Condition in Crohn's Disease

et al. 2020

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Although many nutritional deficiencies are associated with Crohn's disease (CD), vitamin C deficiency is less frequently diagnosed and reported despite its prevalence. Vitamin C deficiency may be more difficult to diagnose in patients with CD because symptoms from active CD may overlap with scurvy. Identification of the deficiency is vital, however, because treatment can lead to swift, marked resolution of symptoms. We present a patient with long-standing CD who presented with gum bleeding and was found to have scurvy.

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“…Cardiovascular diseases remain a major Public Health concern, with lipid-associated biomarkers being trusted predictors of major cardiovascular events [ 1 , 2 ]. Added to the pharmacological strategies and conscious effort to improve the patients’ lifestyle by adequate nutrition and physical activity, nutraceutical strategies which include certain supplements, herbal extracts and functional foods, may be a helpful complementary approach for individuals with cardiovascular disease and dyslipidaemia [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Beyond Fish Oil Supplementation: The Effects of Alternative Plant Sources of Omega-3 Polyunsaturated Fatty Acids upon Lipid Indexes and Cardiometabolic Biomarkers—An Overview

2020

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Cardiovascular diseases remain a global challenge, and lipid-associated biomarkers can predict cardiovascular events. Extensive research on cardiovascular benefits of omega-3 polyunsaturated fatty acids (n3-PUFAs) is geared towards fish oil supplementation and fish-rich diets. Nevertheless, vegetarianism and veganism are becoming more popular across all segments of society, due to reasons as varied as personal, ethical and religious values, individual preferences and environment-related principles, amongst others. Due to the essentiality of PUFAs, plant sources of n3-PUFAs warrant further consideration. In this review, we have critically appraised the efficacy of plant-derived n3-PUFAs from foodstuffs and supplements upon lipid profile and selected cardiometabolic markers. Walnuts and flaxseed are the most common plant sources of n3-PUFAs, mainly alpha-linolenic acid (ALA), and feature the strongest scientific rationale for applicability into clinical practice. Furthermore, walnuts and flaxseed are sources of fibre, potassium, magnesium, and non-essential substances, including polyphenols and sterols, which in conjunction are known to ameliorate cardiovascular metabolism. ALA levels in rapeseed and soybean oils are only slight when compared to flaxseed oil. Spirulina and Chlorella, biomasses of cyanobacteria and green algae, are important sources of n3-PUFAs; however, their benefits upon cardiometabolic markers are plausibly driven by their antioxidant potential combined with their n3-PUFA content. In humans, ALA is not sufficiently bioconverted into eicosapentaenoic and docosahexaenoic acids. However, evidence suggests that plant sources of ALA are associated with favourable cardiometabolic status. ALA supplementation, or increased consumption of ALA-rich foodstuffs, combined with reduced omega-6 (n6) PUFAs intake, could improve the n3/n6 ratio and improve cardiometabolic and lipid profile.

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Lipoprotein(a): Current Evidence for a Physiologic Role and the Effects of Nutraceutical Strategies

Cited by 37 publications

References 138 publications

Diet and Lp(a): Does Dietary Change Modify Residual Cardiovascular Risk Conferred by Lp(a)?

Diet and Lp(a): Does Dietary Change Modify Residual Cardiovascular Risk Conferred by Lp(a)?

Vitamin C Deficiency: An Under-Recognized Condition in Crohn's Disease

Beyond Fish Oil Supplementation: The Effects of Alternative Plant Sources of Omega-3 Polyunsaturated Fatty Acids upon Lipid Indexes and Cardiometabolic Biomarkers—An Overview

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