Functional foods, cardiovascular disease and diabetes

Hardback  384 pages  ISBN 1855737353      £165.00

Cardiovascular disease and Type II diabetes are a growing problem for the developed world, putting an ever greater strain on healthcare systems. Edited by a leading authority, this important collection reviews the role of functional foods in helping to prevent these chronic diseases.

Two introductory chapters provide a context for the rest of the book by assessing the potential of functiona foods to prevent disease and the key issues concerning health claims. Part 1 examines the importance of diet in the prevention of cardiovascular disease and diabetes, with chapters on fat soluble nutrients, antioxidants and iron intake. Part 2 focuses on the role of phytochemicals in preventing cardiovascular disease, including chapters on isoflavones and plant sterols. Part 3 addresses the control of dietary fat, including the use of polyunsaturated fatty acids and fat replacers. The final part of the book reviews the use of starch and other functional ingredients in controlling cardiovascular disease, with individual chapters on cereal beta-glucans, grain legumes and food fermentation by lactic acid bacteria.

Functional foods, cardiovascular disease and diabetes will be a standard reference for all those concerned with the role of functional foods in the prevention and control of cardiovascular disease and diabetes.

About the editors

Dr. Anna Arnoldi is Professor of Food Chemistry in the Faculty of Pharmacy at the University of Milan, Italy.

The contributors

N M de Roos, University Medical Centre Utrecht, The Netherlands
G Nowicka, National Food and Nutrition Institute, Poland
M Naruszewicz, National Food and Nutrition Institute, Poland
M de Lorgeril, Université Joseph Fourier de Grenoble, France
P Salen, Université Joseph Fourier de Grenoble, France
W Stone, East Tennessee State University, USA
G Krishnaswamy, East Tennessee State University, USA
H Yang, Yunnan College of Traditional Chinese Medicine, People's Republic of China
F Violi, University of Rome 'La Sapienza', Italy
R Cangemi, University of Rome 'La Sapienza', Italy
L Lofredo, University of Rome 'La Sapienza', Italy
A Kartikasari, University Medical Centre Utrecht, The Netherlands
N Georgiou, University Medical Centre Utrecht, The Netherlands
J Marx, University Medical Centre Utrecht, The Netherlands
Y Khazrai, University Campus Bio-Medico - Rome, Italy
S Manfrini, University Campus Bio-Medico - Rome, Italy
P Pozzilli, University Campus Bio-Medico - Rome, Italy
S Virtanen, University of Tampere, Finland
S Rasmussen, Danish Veterinary and Food Administration, Denmark
W Hall, The University of Reading, UK
A Vafeiadou, The University of Reading, UK
A Minihane, The University of Reading, UK
G Rimbach, The University of Reading, UK
C Williams, The University of Reading, UK
E Brink, TNO Nutrition and Food Research, The Netherlands
H Hendriks, TNO Nutrition and Food Research, The Netherlands
H Collin, University of Liverpool, UK
C Galli, University of Milan, Italy
E Herrera, Imperial College London, UK
P Dodds, Imperial College London, UK
C Jacobsen, Danish Institute for Fisheries Research, Denmark
L Sijtsma, Agrotechnological Research Institute, The Netherlands
H-J Chung, The Ohio State University, USA
D B Min, The Ohio State University, USA
K Autio, VTT Biotechnology, Finland
L Niskanen, Kuopio University Hospital, Finland
K Poutanen, University of Kuopio and VTT Biotechnology, Finland
G Önning, Lund University, Sweden
A Arnoldi, University of Milan, Italy
W F Sybesma, NIZO Food Research and Wageningen Centre for Food Sciences, The Netherlands
J Hugenholz, NIZO Food Research and Wageningen Centre for Food Sciences, The Netherlands

Contents

The potential and limits of functional foods in preventing cardiovascular disease
N M de Roos, University Medical Centre Utrecht, The Netherlands

Introduction: diet and cardiovascular disease
Functional foods defined
The use of functional foods to meet dietary guidelines
Do functional foods reach the populations at risk?
References

Assessing health claims for functional foods
G Nowicka and M Naruszewicz, National Food and Nutrition Institute, Poland
Introduction
Differing types of claim: nutrition and health claims
Criteria for demonstrating functional effects
Evidence required to support a health claim
Future trends

PART 1: DIET, CARDIOVASCULAR DISEASE AND DIABETES

Diet and the prevention of coronary heart disease
M de Lorgeril and P Salen, Université Joseph Fourier de Grenoble, France

Introduction
Dietary prevention of sudden cardiac death (SCD): the role of dietary fatty acids, alcohol and antioxidants
Dietary prevention of chronic heart failure (CHF): the role of micronutrients, dietary fatty acids and reduced sodium intake
Dietary strategies to prevent the development of heart disease
Dietary prevention of post-angioplasty restenosis
Dietary control of conventional risk factors: cholesterol, blood pressure, type 2 diabetes and obesity
Conclusion: using the 'Mediterranean diet' to prevent coronary heart disease
References

The role of fat soluble nutrients and antioxidants in preventing heart disease
W Stone and G Krishnaswamy, East Tennessee State University USA and H Yang, Yunnan College of Traditional Chinese Medicine, People's Republic of China
Introduction: oxidative stress and cardiovascular disease
The functional properties of Vitamin E in preventing heart disease
The functional properties of Vitamin D in preventing heart disease
The functional properties of ubiquinone (CoQ10) in preventing heart disease
Future trends
References

Vitamin E and other antioxidants in the prevention of cardiovascular disease
F Violi, R Cangemi and L Lofredo, University of Rome 'La Sapienza', Italy
Introduction
Risk factors for coronary heart disease (CHD): the role of oxidative stress
Dietary antioxidants and the prevention of CHD: epidemiological evidence
Dietary antioxidants and the prevention of CHD: evidence from clinical trials
Conclusion and future trends: reconciling the evidence
Sources of further information and advice
References

Iron intake and cardiovascular disease
A Kartikasari, N Georgiou and J Marx, University Medical Centre Utrecht, The Netherlands
Introduction
Dietary iron intake, absorption and metabolism
Iron homeostasis disorders: primary and secondary hemochromatosis
The role of iron in cardiovascular disease
Measuring iron toxicity
Methods of preventing hemochromatosis
Conclusion and future trends
Sources of further information and advice
Acknowledgement
References
Diet and diabetes: prevention and control
Y Khazrai, S Manfrini and P Pozzilli, University Campus Bio-Medico - Rome, Italy

Introduction: classifying diabetes
Dietary strategies for preventing the onset of diabetes
Dietary strategies for the control of diabetes: carbohydrates and lipids
Dietary strategies for the control of diabetes: proteins, fibre and other dietary components
Future trends
Sources of further information and advice
References

Nutritional risk factors in the development of type 1 and type 2 diabetes
S Virtanen, University of Tampere, Finland
Introduction
Nutritional risk factors in the onset and prevention of type 1 diabetes
Nutritional risk factors in the onset and prevention of type 2 diabetes
Conclusions
References

PART 2: PHYTOCHEMICALS AND CARDIOVASCULAR DISEASE

Flavonoids and cardiovascular disease
S Rasmussen, Danish Veterinary and Food Administration

Introduction: classification, chemical structures and occurrence of flavonoids in plant foods
Dietary sources and intake levels of flavonoids
Bioavailability and metabolism of flavonoids
Uptake and excretion of anthocyanins
The use of flavonoids as biomarkers
Flavonoids and the prevention of coronary heart disease
Future trends
References
Isoflavones and coronary heart disease
W Hall, A Vafeiadou, A Minihane, G Rimbach and C Williams, The University of Reading, UK

Introduction
Chemical structure of isoflavones
Dietary sources, bioavailability and metabolism of isoflavones
The effect of isoflavones on coronary heart disease (CHD)
Potential risks of isoflavones
Future trends
Sources of further information and advice
References

Plant sterols and cholesterol reduction
E Brink and H Hendriks, TNO Nutrition and Food Research, The Netherlands
Introduction: cholesterol as a risk factor in cardiovascular disease
The effects of plant sterols and stanols on lowering cholesterol levels
Factors influencing the effectiveness of plant sterols and stanols
Safety issues affecting plant sterols
Using plant sterols and stanols as functional foods
Conclusion and future trends
References

Garlic and cardiovascular disease
H Collin, University of Liverpool, UK
Introduction
Chemical composition of raw and cooked garlic
Commercial forms of garlic supplement
The influence of garlic compounds on cardiovascular disease
Future trends: developing new functional foods
Sources of further information and advice
References

PART 3: CONTROLLING DIETARY FAT

Diet, oxidative stress and cardiovascular disease
C Galli, University of Milan, Italy

Introduction: oxidative stress and cardiovascular disease
Antioxidants in food and their effects
Biomarkers of oxidative stress
The role of lipid oxidation in cardiovascular disease
Dietary fat consumption and lipid oxidation
Sources of further information and advice
References

Dietary fat, pregnancy and the prevention of heart disease
E Herrera and P Dodds, Imperial College London, UK
Introduction: pregnancy and foetal growth
Carbohydrate, amino acid and maternal lipid metabolism in gestation
Placental transfer of lipid metabolites
Foetal development: the role of dietary fatty acids
Dietary recommendations for the avoidance of heart disease later in life
Future trends
Sources of further information and advice
References

Developing polyunsaturated fatty acids as functional ingredients
C Jacobsen, Danish Institute for Fisheries Research
Introduction: long chain polyunsaturated fatty acids and cardiovascular disease
Problems in using fish oil in food products: lipid oxidation and off-flavours
Factors affecting lipid oxidation in complex food systems
The successful use of fish oil in food products: improving shelf-life and sensory properties
Future trends
Sources of further information and advice
References

Marine micro-organisms as new sources of n-3 polyunsaturated fatty acids (PUFAs)
L Sijtsma, Agrotechnological Research Institute, The Netherlands
Introduction: PUFAs and their health benefits
Sources of n-3 PUFAs and microbial production of PUFAs
Cultivation of microalgae for the production of n-3 PUFAs
DHA production from marine microorganisms
Applications and future trends
Acknowledgement
References

Developments in fat replacers
H-J Chung and D B Min, The Ohio State University, USA
Introduction: the role of fat replacers in reducing cardiovascular disease
Carbohydrate-based fat replacers
Protein-based fat replacers
Lipid-based fat replacers
Safety and regulatory issues
Future trends
References

PART 4: STARCH AND OTHER FUNCTIONAL INGREDIENTS

Starch in food, diabetes and coronary heart disease
K Autio, VTT Biotechnology, L Niskanen, Kuopio University Hospital and K Poutanen, University of Kuopio and VTT Biotechnology, Finland

Introduction: starch digestion and health
How starchy foods are digested
Factors affecting starch digestion, glucose and insulin response
Analysing the health effects of foods: the use of the glycaemic index (GI) and other measurements
Starch digestion, diabetes and cardiovascular disease: the metabolic syndrome
The role of low-GI carbohydrates in treating and preventing disease
The manufacture of cereal-based products that produce low blood postprandial insulin responses
References

The use of cereal beta-glucans to control diabetes and cardiovascular disease
G Önning, Lund University, Sweden
Introduction: the health benefits of soluble fibre/beta-glucans in cereals
Current limitations in using beta-glucans as food ingredients
Developing new oat beta-glucan enriched functional products
Testing the effectiveness of beta-glucans in preventing cardiovascular disease and diabetes
Future trends
Sources of further information and advice
References

Grain legumes and the prevention of cardiovascular disease
A Arnoldi, University of Milan, Italy
Introduction
The main components of grain legumes
The non-nutritional components of legumes
The use of soybean protein in the prevention of hypercholesterolemia
The hypocholesterolemic activity of other legumes
Future trends
References

Food fermentation by lactic acid bacteria for the prevention of cardiovascular disease
W F Sybesma and J Hugenholz, NIZO Food Research and Wageningen Centre for Food Sciences, The Netherlands
Introduction to food fermentation
Bioengineering of lactic acid bacteria
Microbial production of folate
Microbial production of riboflavin
Microbial production of vitamin B12 (cobalamin) and vitamin B6 (pyridoxine)
Low calorie substitutes for sugar: polyols and other sweeteners
Lactic acid bacteria, cholesterol control, lipase activity and antioxidant production
Conclusions
References