Lipids in functional foods in relation to cardiovascular disease

Food is considered 'functional' if it contains (often added) components tha t affect one or more targeted functions in the body in a beneficial way. Fo ods can also be functional if potential harmful components have been remove d by technological means. A food can be accepted to be functional only afte r its potentially beneficial effect has been proven by well-designed and pr operly executed intervention studies in humans. Cardiovascular disease has a multifactorial etiology, as is illustrated by the existence of numerous r isk indicators, many of which can be influenced by diet. It should be recal led, however, that only after a cause and-effect relationship has been esta blished between the disease and a given risk indicator (called a risk facto r in that case), modifying this factor can be expected to affect disease mo rbidity and mortality. In this presentation. effects of dietary lipids on c ardiovascular risk are re viewed, with special emphasis on modification of the plasma. lipoprotein profile and of hypertension. In addition, influence s of dietary lipids on arterial thrombotic processes and insulin resistance will be discussed. Dietary lipids are able to affect lipoprotein metabolism in a significant w ay, thereby modifying the risk of cardiovascular disease. However, more res earch is required concerning the possible interactions between the various dietary fatty acids, and between fatty acids and dietary cholesterol. In ad dition, more studies are needed with respect to the possible importance of the postprandial state. Certain aspects of blood platelet function, blood coagulability, and fibrin olytic activity are associated with cardiovascular risk. but causality has insufficiently been proven. Nonetheless, well-designed intervention studies should be initiated to further evaluate such promising dietary components as the various n-3 and n-6 fairy acids and their combination for their effe ct on processes participating in arterial thrombus formation. Although in the etiology of hypertension thr genetic component is definitel y stronger than environmental factors, some benefit on the development and coronary complications of atherosclerosis in hypertensive patients can be e xpected from fatty acids such as alpha-linolenic acid, eicosapentaenoic aci d and docosahexaenoic acid. This particularly holds for those subjects wher e the hypertensive mechanism involves the formation of thromboxane A2 and/o r alpha 1-adrenergic activities. However, large-scale trials are required t o test this contention. It seems feasible to modulate insulin sensitivity and subsequent cardiovasc ular risk factors by decreasing the total amount of dietary fat and increas ing the proportion of polyunsaturated fatty acids. However, additional stud ies on the efficacy of specific fatty acids, as well as on the mechanisms i nvolved are required to understand the real function of these dietary compo nents.