Thiamine in Heart Health

  • Thiamine (vitamin B1) is an essential water-soluble vitamin required for cellular energy production.
  • It plays a crucial role in cardiac function.
  • Thiamine deficiency is more prevalent in heart failure.

Mechanism of increased incidence of thiamine deficiency in heart failure

Thiamine deficiency impairs the production of adenosine triphosphate (ATP), leading to the accumulation of adenosine.

This increase causes a reduction in systemic vascular resistance via direct vasomotor depression, leading to a compensatory high-output state with increased blood volume.

Eventually, myocardial weakness develops, leading to systolic dysfunction and a low-output state.

  • Thiamine (vitamin B1) deficiency causes cardiovascular neurological damage that is present clinically as beriberi.
  • When the circulatory system is predominantly affected (wet beriberi), patients present with high-output biventricular heart failure, peripheral vasodilatation, volume overload, tachycardia, and wide pulse pressure, as well as relative depression of left ventricular function with low ejection fraction.

Monounsaturated Fatty Acids (MUFAs) in Heart Health

  • Diets that are high in MUFAs and low in SFAs lower total and LDL cholesterol to a degree similar to that observed for a lower-fat, cholesterol-lowering diet.

    High-MUFA diets have the added benefit of not increasing triacylglycerol concentrations.

  • Controlled clinical trials have shown that a 1% reduction in total and LDL-cholesterol concentrations results in a ~1.5% decrease in the incidence of cardiovascular disease (CVD).

    A 1 mmol/L increase in triacylglycerol is associated with a 14% increase in CVD risk in men and a 37% increase in women.

    MUFA diets have been shown to reduce low-density lipoprotein (LDL) oxidative susceptibility.

  • MUFAs also may decrease platelet aggregation, increase fibrinolysis, and increase bleeding time, thereby protecting against thrombogenesis.

    A very-high-MUFA diet (30% of energy from MUFAs) significantly reduced systolic (by 6 mmHg) and diastolic (by 6 mmHg) blood pressure in subjects with type 2 diabetes.

High Fiber and Heart Health

Fiber denotes the edible parts of plants or analogous carbohydrates that are resistant to digestion and absorption in the human small intestine with complete or partial fermentation in the large intestine.

Effect on Serum Cholesterol Concentration

 

Fibers decrease serum total and LDL-cholesterol concentrations. Approximately 3 g of soluble fiber is associated with a 0.13 mmol/L (5 mg/dL) decrease in total cholesterol and LDL-cholesterol concentrations.

 

Also, decrease the concentrations of small, dense LDL particles, which are considered to be more atherogenic than larger less dense LDL particles.

 

High intakes of oat bran are associated with increased bile acid synthesis, which increases cholesterol uptake from the circulation and decreases plasma cholesterol concentrations.

  • Insulin resistance is regarded as an important risk factor for CVD. Fiber intake is inversely proportional to rates of insulin resistance and improves insulin sensitivity resulting in reduced risk of CVD.
  • The viscous fiber is inversely related to the progression of carotid atherosclerosis in 40- to 60- year-old men and women without heart disease.
  • In postmenopausal women with established coronary artery disease, a higher intake of fiber is associated with less progression of coronary atherosclerosis.
  • Dietary-glucan supplementation results in total serum cholesterol reductions ranging between 5.1 to 23.2 mg/dL and LDL cholesterol reductions ranging between 7.3 to 25.5 mg/dL.
  • Psyllium supplementation results in total serum cholesterol reductions ranging between 9.3 to 14.7 mg/dL and LDL cholesterol reductions ranging between 10.8 to 13.5 mg/dL.

Role of Omega-3 Fatty Acids in Heart Health

The three main omega-3 fatty acids that are beneficial for cardiovascular health are alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).

Effects of Omega-3 Fatty Acids in Heart Health
  • Lower triglyceride levels, increase high-density lipoprotein (HDL) (i.e., good cholesterol)
  • Lower resting blood pressure
  • Decrease platelet aggregation and prevent blockage of coronary artery
  • Decrease risk of arrhythmias (abnormal heart rhythm)
  • Increase compliance of arteries
  • Decrease atherosclerosis
  • Reduce inflammatory markers

From 0.5 to 1.8 g/day of combined EPA and DHA, either as fatty fish or through supplement capsules, is recommended to consume and about 1.5 to 3 g/day of ALA is beneficial, either through plant-based foods or supplement capsules for a healthy heart.

Omega-3 fatty acid improves flow-mediated arterial dilation and the mechanical function of the heart.

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