Preventing Atherosclerosis Through Nutrition

By Dr. Melania Montes / Published on August 5, 2024

What Is Atherosclerosis?

Cardiovascular diseases (CVDs) represent a leading cause of morbidity and mortality, especially in developed countries where their prevalence continues to rise. A significant number of CVDs stem from a condition known as atherosclerosis, a chronic disease characterized by the gradual accumulation of arterial plaque (atheroma). This plaque is composed of fats, cholesterol, calcium, and other substances within the walls of arteries. The process commences with damage to the endothelial lining, followed by an immune response and the growth of plaque (1,2). As these plaques enlarge, they narrow arterial passages, impeding blood flow and proper tissue oxygenation. Furthermore, the persistent blood flow pressure can lead to plaque rupture, resulting in the formation of blood clots (thrombus). These clots can obstruct blood flow, potentially leading to heart attacks, strokes, and other CVDs, which are among the leading global causes of mortality (1,3).

Unfortunately, atherosclerosis develops insidiously, often manifesting no symptoms until complications related to CVDs become evident. According to the United States National Institutes of Health, approximately half of individuals aged 45 to 84 have atherosclerosis without their awareness (1). This underscores the critical importance of atherosclerosis prevention, early diagnosis, and treatment.

What Are the Risk Factors for Atherosclerosis?

Atherosclerosis is a multifactorial disease that initiates with the gradual, progressive damage to the endothelial lining of arteries. Non-modifiable risk factors include age, gender (male), and a family history of CVDs, while modifiable factors encompass elevated blood cholesterol and triglyceride levels, hypertension, diabetes, tobacco use, obesity, sedentary lifestyle, and an unhealthy diet high in saturated fats, sodium, and sugars—akin to the Western diet. These lifestyle factors can damage the endothelium, heightening the risk of developing atherosclerosis (1,4).

Scientific evidence indicates that implementing lifestyle changes, as detailed in Table 1, can diminish the risk of atherosclerosis and mitigate its consequences.

Table 1. Making Lifestyles Changes to Prevent Atherosclerosis

Avoid smoking or vaping, whether actively or passively

Embrace a nutrient-rich plant-based diet while reducing your consumption of salt, saturated fats and refined sugars

Incorporate regular exercise

Ensure you get sufficient and restful sleep

Manage medical conditions, especially those that increase the risk of atherosclerosis, such as type 2 diabetes, dyslipidemia, hyperglycemia, hypertension, obesity, and dysbiosis

Develop strategies to effectively manage stress

Atherosclerosis and Nutrition

Diet plays a pivotal role in preventing atherosclerosis. An imbalanced and unhealthy diet can precipitate conditions such as type 2 diabetes, hypercholesterolemia, hypertension, obesity, and dysbiosis, all of which increase the risk of atherosclerosis. Research has demonstrated that specific nutrients and bioactive compounds, primarily antioxidants, possess the capacity to thwart and decelerate the progression of atherosclerosis owing to their cardioprotective effects. Among the most extensively studied are omega-3 polyunsaturated fatty acids (PUFAs) and various phytochemicals derived from plants, including polyphenols, phytosterols, lycopene, and dietary fiber. Studies have underscored their potential to reduce inflammation, lower LDL cholesterol levels, and mitigate oxidative stress, all of which are implicated in the progression of atherosclerosis (5,7).

Foods rich in these bioactive compounds are primarily derived from plants and include nuts, whole grains, legumes, olive oil, tea, fruits, and vegetables. Another recognized source of omega-3 PUFAs is blue fish (5,7).

Furthermore, deficiencies in micronutrients such as magnesium, phosphorus, calcium, and vitamins A, B, D, and E have been linked to an increased risk of atherosclerosis (5).

Research has also highlighted the Mediterranean diet as a potent preventive measure against atherosclerosis and CVDs. This diet is characterized by a high consumption of foods low in refined carbohydrates and saturated fats, while emphasizing vegetables and fruits (6-8).

References

1. Cleveland Clinic. Atherosclerosis. (https://my.clevelandclinic.org/health/diseases/16753-atherosclerosis-arterial-disease). Accessed 14/09/2023.
2. Barreto Penié J, Estrada Alfonso AR. Papel de la nutrición en la prevención de la enfermedad aterosclerótica. Importancia de los suplementos dietéticos: nutracéuticos.(https://www.revespcardiol.org/es-papel-nutricion-prevencion-enfermedad-aterosclerotica–articulo-S1131358711150037). Revista Española de Cardiología Suplementos. 2011;(11): 13-17. Accessed 14/09/2023.
3. American Heart Association. What is atherosclerosis? (https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/atherosclerosis). Accessed 14/09/2023.
4. American Heart Association. Atherosclerosis and stroke. (https://www.stroke.org/en/about-stroke/stroke-risk-factors/atherosclerosis-and-stroke). Accessed 14/09/2023.
5. Casas R, Estruch R, Sacanella E. Influence of Bioactive Nutrients on the Atherosclerotic Process: A Review. ( https://pubmed.ncbi.nlm.nih.gov/30400153/). Nutrients. 2018;10(11):1630. Accessed 14/09/2023.
6. Vesnina A, Prosekov A, Atuchin V, Minina V, Ponasenko A. Tackling Atherosclerosis via Selected Nutrition. (https://pubmed.ncbi.nlm.nih.gov/35897799/). Int J Mol Sci. 2022;23(15):8233. Accessed 14/09/2023.
7. Wei T, Liu J, Zhang D, Wang X, Li G, Ma R, et al. The Relationship Between Nutrition and Atherosclerosis. (https://pubmed.ncbi.nlm.nih.gov/33959594/).Front Bioeng Biotechnol. 2021;9:635504. Accessed 14/09/2023.
8. Richardson LA, Izuora K, Basu A. Mediterranean Diet and Its Association with Cardiovascular Disease Risk Factors: A Scoping Review. (https://pubmed.ncbi.nlm.nih.gov/36232062/). Int J Environ Res Public Health. 2022;19(19):12762. Accessed 14/09/2023.