PASSCLAIM - Diet-related cardiovascular disease.
Cardiovascular disease (CVD) has a multifactorial aetiology and many potential risk markers are known. As it was not feasible to discuss all markers and their possible interactions in relation to all aspects of CVD, selections had to be made in this paper. In the context of claims and functional foods, emphasis was placed on those aetiological processes and risk markers that have been shown previously to be modified by diet: lipid and lipoprotein metabolism, haemostatic function, oxidative damage, homocysteine metabolism, and blood pressure. Except for methodological and biological characteristics of these biomarkers, their relationships with the risk of CVD are discussed. For LDL and HDL cholesterol, fasting triacylglycerol, homocysteine, and blood pressure well-validated, easy applicable, and generally accepted biomarkers exist. For haemostatic function and oxidative damage validation of markers with respect to CVD or intermediate clinical markers is recommended. For diet-related CVD, however, the ultimate question is whether changes in the biomarker are truly related to changes in risk. Only for LDL cholesterol and blood pressure does consensus exist among scientists for a possible application as enhanced function claims. For HDL, triacylglycerol, and homocysteine, and in particular for haemostatic function and oxidative damage, however, formal proof is lacking that diet-induced changes in these biomarkers alter the risk of CVD. At the same time, it should be emphasised that CVD is multifactorial. Therefore it does not seem justified that a change in one particular biomarker is enough evidence to substantiate a claim. There are examples of food components or drugs that one biomarker is changed in a favourable way, but at the same time another biomarker is changed in an unfavourable way. Therefore, studies to further validate generic predictors for the CVD risk should be initiated.
Mensink
Ronald P
RP
Maastricht University, Department of Human Biology, P. O. Box 616, 6200 MD Maastricht, The Netherlands.
Aro
Antti
A
Den Hond
Elly
E
German
J Bruce
JB
Griffin
Bruce A
BA
ten Meer
Hans-Ulrich
HU
Mutanen
Marja
M
Pannemans
Daphne
D
Stahl
Wilhelm
W
D000818:Animals; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002791:Cholesterol, Dietary / Q000009:adverse effects*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003245:Consensus Statements as Topic; D019649:Food Industry; D006487:Hemostasis; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D009753:Nutritive Value; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D002791:Cholesterol, Dietary; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D006710:Homocysteine