Introduction

In a previous article, we examined the question "What are my chances of dying from chronic disease?". After defining what chronic diseases are (cardiovascular, neurodegenerative, metabolic, and autoimmune conditions), reviewing their prevalence and mortality rates, and exploring their common risk factors, we reached a sobering conclusion: "It is almost certain that either I, or someone close to me, will be impacted during my lifetime."

Given that our health is largely in our hands, it becomes crucial to do everything we can to maintain and improve it. In this article, we explore the effects of a simple dietary intervention - polyphenol consumption - on lowering our risk of developing heart disease.

Heart Disease: Overview

As a brief recap, heart diseases usually refers to atherosclerotic conditions and events such as heart attacks. We turn to heart disease first as it remains the world's leading cause of death (1). In America alone, it claims 845,000 lives annually - or about two per minute. 

Fortunately, heart disease has many modifiable risk factors, often presenting as subtle symptoms long before the heart attack occurs. Managing these risk factors is central to reducing our lifetime risk, so it is important to familiarise ourselves with them. 

The most common heart disease risk factors are:

• High blood pressure: A major risk factors for heart disease - often called the "silent killer" because, unless extremely elevated, it usually presents with no symptoms. Hypertension strains the heart and damages blood vessels.
• High cholesterol: Cholesterol-carrying particles can build up in the walls of arteries, including those supplying the heart. Over time, this triggers a cascade of inflammation, oxidation, and plaque formation, narrowing the vessels and reducing blood flow.
• Diabetes (or diabetes-related symptoms): Diabetes, insulin resistance, and metabolic syndrome lead to chronically elevated blood sugar. This damages the blood vessels and increases the risk of both high cholesterol and high blood pressure.
• Obesity: Defined as excess body fat, obesity is linked to elevated blood lipids (including cholesterol), which worsen atherosclerotic disease and serve as risk factors for diabetes and high blood pressure.
• Diet: Diets high in trans, and saturated fats, saturated in processed foods, and high in sugar - characteristic of the Standard American Diet - significantly increase the risk of heart disease.
• Physical inactivity: Lack of movement is a risk factor not only of heart disease, but for virtually all disease.
• Sleep: A risk factor that remained underappreciated until recently. Poor sleep hygiene disrupts the metabolism (it can, for example, make you insulin resistant (2)), raises blood pressure and heart rate, and disrupts hormonal cycles.
• Alcohol: Excessive alcohol consumption (e.g. binge or heavy drinking), raises blood pressure and blood lipids, both of which are elevate heart disease risk.
• Smoking: Everyone knows that smoking is bad for health. It causes widespread systemic damage and directly injures the heart and blood vessels. Nicotine elevates blood pressure, while the carbon monoxide in cigarettes reduces oxygen delivery to the organs - this strains the heart, who helplessly beats harder and faster to provide the missing oxygen.

Given these risk factors, it is clear that there are many habits we can adopt or eliminate to reduce our chances of developing heart disease. Namely, all of us should:

• Improve our diet: Reduce processed foods, sugary drinks, and unhealthy snacks. Avoid trans fats at all costs. Ideally, incorporate elements of the Mediterranean diet into daily life (3).
• Exercise more: Even simple daily walks can be transformative. Simple additions include:
  • Brisk walking or incline walking: These strengthen the heart and improve aerobic fitness.
  • Body weight or resistance training: These strengthen the muscles, which reduces the risk of numerous chronic conditions.
• Improve our sleep: Aim for at least 7 hours of sleep every night. Start by keeping a consistent sleep schedule, and try to limit screen time 60 to 90 minutes before bed. Optimize bedroom environment to be conducive to a good night's sleep: the room should be dark, cool, quiet, and the mattress and pillow should be comfortable.
• Quit smoking: This one is a no-brainer. Smoking kills - period. Understandably, it can be difficult to get rid of this addictive habit, but all who smoke should expend effort to control it. If medical or psychological assistance is required, so be it.
• Limit alcohol: Avoid binge and heavy drinking, and try not to drink alone. Research shows that unhealthy behaviours tend to be less harmful - and more compatible with long-term health - when they occur in a social context rather than in isolation (4). (But don't use this as an excuse to "drink to death" with drinking buddies).

Apart from these lifestyle changes, what else can we do to reduce our risk of heart disease? The title of the article suggest that polyphenols - the miracle nutrients found in olive oil and other phyto-products - can help. Let's see which these polyphenols are.

Polyphenols for Targeting Heart Disease Risk Factors

High blood pressure

Olive oil and olive leaf polyphenols - particularly oleuropein and hydroxytyrosol - have been shown to improve blood pressure (5). Similar benefits have been observed with grape polyphenols such as resveratrol (6). Anthocyanins in berries also contribute to lowering hypertension (7).

High cholesterol

Olive oil and olive leaf polyphenols (oleuropein and hydroxytyrosol) help reduce cholesterol and improve lipid profiles (5, 8). Resveratrol promotes cholesterol efflux, inhibits HMG-CoA reductase, and reduces apoB production - all key processes in cholesterol homeostasis (9). Cocoa catechins also improve cholesterol by modulating apolipoprotein synthesis (9).

Diabetes

Olive oil secoiridoids are associated with improvements in fasting insulin and blood glucose (10). Pomegranate polyphenols help reduce blood sugar fluctuations (11).

Obesity

Oleocanthal - one of olive oil's most celebrated polyphenols - acts as a potent anti-inflammatory agent, reducing the systemic inflammation that perpetuates fat accumulation in obese individuals. Resveratrol reduces fat accumulation by enhancing fat oxidation (12). Curcumin (found in turmeric) inhibits fat cell formation (13).

Conclusion

Polyphenols offer simple, yet powerful interventions targeting multiple mechanisms and risks involved in heart disease. They support healthier blood pressure, cholesterol balance, insulin sensitivity, and body composition - in other words, they address the very roots of heart health.

Incorporating polyphenol-rich ingredients into your daily routine is thus one of the easiest and most natural ways to protect your heart. These may come from a polyphenol-rich diet or from concentrated sources such as olive leaf extract. But the simplest and most comprehensive approach remains the daily consumption of high-phenolic olive oil, which includes over 30 potent polyphenols working together to shield your heart and vascular system.

Figure 1: High-phenolic olive oil polyphenols target many of the risk factors for heart disease.

References

1) https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

2) Donga E, van Dijk M, van Dijk JG, Biermasz NR, Lammers GJ, van Kralingen KW, Corssmit EP, Romijn JA. A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects. J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8. doi: 10.1210/jc.2009-2430. Epub 2010 Apr 6. PMID: 20371664.

3) Widmer RJ, Flammer AJ, Lerman LO, Lerman A. The Mediterranean diet, its components, and cardiovascular disease. Am J Med. 2015 Mar;128(3):229-38. doi: 10.1016/j.amjmed.2014.10.014. Epub 2014 Oct 15. PMID: 25447615; PMCID: PMC4339461.

4) Skrzynski CJ, Creswell KG. A systematic review and meta-analysis on the association between solitary drinking and alcohol problems in adults. Addiction. 2021 Sep;116(9):2289-2303. doi: 10.1111/add.15355. Epub 2020 Dec 27. PMID: 33245590; PMCID: PMC7753695.

5) https://www.clinicaltrials.gov/study/NCT04874961

6) Li SH, Zhao P, Tian HB, Chen LH, Cui LQ. Effect of Grape Polyphenols on Blood Pressure: A Meta-Analysis of Randomized Controlled Trials. PLoS One. 2015 Sep 16;10(9):e0137665. doi: 10.1371/journal.pone.0137665. PMID: 26375022; PMCID: PMC4572713.

7) Grosso G, Godos J, Currenti W, Micek A, Falzone L, Libra M, Giampieri F, Forbes-Hernández TY, Quiles JL, Battino M, La Vignera S, Galvano F. The Effect of Dietary Polyphenols on Vascular Health and Hypertension: Current Evidence and Mechanisms of Action. Nutrients. 2022 Jan 27;14(3):545. doi: 10.3390/nu14030545. PMID: 35276904; PMCID: PMC8840535.

8) https://www.clinicaltrials.gov/study/NCT06490133

9) Zanotti I, Dall'Asta M, Mena P, Mele L, Bruni R, Ray S, Del Rio D. Atheroprotective effects of (poly)phenols: a focus on cell cholesterol metabolism. Food Funct. 2015 Jan;6(1):13-31. doi: 10.1039/c4fo00670d. Epub 2014 Nov 4. PMID: 25367393.

10) https://www.clinicaltrials.gov/study/NCT07144488

11) https://www.clinicaltrials.gov/study/NCT05915117

12) Castro-Barquero S, Lamuela-Raventós RM, Doménech M, Estruch R. Relationship between Mediterranean Dietary Polyphenol Intake and Obesity. Nutrients. 2018 Oct 17;10(10):1523. doi: 10.3390/nu10101523. PMID: 30336572; PMCID: PMC6213078.

13) Meydani M, Hasan ST. Dietary polyphenols and obesity. Nutrients. 2010 Jul;2(7):737-51. doi: 10.3390/nu2070737. Epub 2010 Jul 8. PMID: 22254051; PMCID: PMC3257683.