By: Joya Johnson, CSUN Dietetic Intern Cohort 2021-2022 

Did you know that every 36 seconds, one person dies from cardiovascular disease (CVD) in the United States?¹ According to the Centers for Disease Control and Prevention, CVD is highly prevalent in the United States and is the leading cause of death for men and women.¹ CVD encompasses the multiple conditions that affect the function of the heart and blood vessels, including blood vessel disease, heart valve disease, heart infection, congenital heart defects, heart rhythm problems, and disease of the heart muscle.¹ Coronary artery disease (CAD) happens to be the most common form of heart disease in the United States.¹ Physical inactivity, poor diet, obesity, and use of tobacco are the leading risk factors that contribute to heart disease.¹ Diet is of significant importance since it can impact CAD by mitigating or encouraging the progression of heart disease.  

Overall, a diet rich in fruits and vegetables has been correlated with a decreased risk of CVD. The American Heart Association (AHA) emphasizes a dietary pattern with whole fruits, vegetables, whole grains, lean protein, non-tropical vegetable oil, and low-fat or nonfat dairy.² A vegan diet is also ideal since it contains an abundance of plant-based foods such as fruit, vegetables, whole grains, and legumes while not containing common sources of saturated fat such as meat, dairy, and eggs. A randomized trial conducted by AHA had 100 participants with CAD randomly assigned to a vegan diet or the AHA diet for 8 weeks. A linear regression model was used to measure the participants’ high-sensitivity C-reactive protein (hsCRP).² hsCRP is a marker of inflammation and elevated hsCRP levels indicate higher risk of developing CAD. The results of the study indicated that there was a 32% reduced rate of hsCRP among participants that consumed a vegan diet compared to the participants in the AHA diet groups.² The study also noted that the lower-density lipoprotein (LDL) levels were reduced by 13% among the vegan diet group compared to the AHA group.² LDL is part of total cholesterol and is known as “bad cholesterol” because it transports cholesterol to the arteries.² High levels of LDL cause buildup of plaque in the arteries, increasing one’s risk for heart disease.² This study suggests that CVD can be prevented by eating a healthy, well-balanced diet rich in fruits and vegetables. Berries, in particular, are a noteworthy fruit since research suggests that they have a range of biological activities that help in lowering one’s risk of CVD.² 

Nutrients in Berries 

Berries are a common fruit that can be consumed fresh, dried, and cooked and are often used in jams and preserves. Different types of berries include raspberries, blueberries, strawberries, cranberries, and blackberries. Berries are a great source of fiber, vitamin C, and polyphenols (compounds found in plants).² Anthocyanins, a type of polyphenol, are the superstar biological property in berries. Anthocyanins are a type of water soluble flavonoid that gives fruits and vegetables their purple, red, and blue color pigmentation.² Anthocyanins are also antioxidants that help to protect our cells from free radical damage, which can prevent tissue damage, and are associated with a reduced risk for chronic diseases.² These antioxidants have anti-inflammatory properties due to their ability to decrease certain inflammatory markers.² The properties of berries in conjunction can help reduce one’s risk for CVD by preventing oxidation and inflammation.  

Impact of Berries on CVD 

In epidemiological and clinical studies, berries have been associated with decreasing the risk of CVD due to their nutritional properties. A study published by the American Journal of Clinical Nutrition demonstrated that eating 1 cup of blueberries daily can reduce one’s risk of CVD by 15%.³ This 6-month clinical trial was conducted with 138 overweight and obese participants between the ages 50 and 75 who had metabolic syndrome. The control group consumed 1 cup of freeze-dried blueberries while the placebo group consumed a purple alternative. The results of the study indicated that participants who consumed 1 cup of blueberries daily had improvements in vascular function and arterial stiffness.³ Researchers contribute the anthocyanins in the blueberries to the overall improved vascular function and reduced risk for CVD. Strawberries have also demonstrated the ability to reduce CVD due to their anthocyanin content. In a randomized controlled clinical trial, twenty-seven participants with metabolic syndrome consumed 3 cups of strawberries daily for 8 weeks.⁴ The results of the study indicated that strawberries lowered the LDL cholesterol and vascular cell adhesion molecule-1 (VCAM-1) compared to the control group.⁴ VCAM-1 is a cell adhesion molecule and is expressed in endothelial cells at sites of inflammation.⁵ High levels of VCAM-1 have been associated with an increased risk for CVD.⁵ Overall, there was a reduced risk for plaque buildup in arteries and dyslipidemia in the participants who consumed the strawberries for 8 weeks.  

Both strawberries and blueberries are a concentrated source of polyphenols, fiber, and micronutrients. Anthocyanins contain antioxidant and anti-inflammatory properties. Oxidative stress can lead to tissue injury and increase one’s risk for CVD.⁶ Anthocyanins have a phenolic structure that allows them to donate protons to free radicals, thus inhibiting the oxidation caused by free radicals.⁶ Both the strawberries and blueberries in their respective studies were shown to decrease VCAM-1 by 18%. Hopefully the results of these studies convince you to include more berries in your diet so you can benefit from their antioxidant and anti-inflammatory properties.  

Recipe 

Want to try a recipe rich in berries? Check out the MMC’s Mandarin Honey Yogurt & Oats Recipe on the MMC’s Youtube Channel. https://www.youtube.com/watch?v=ztnKUmI_Y9c 

Individual Counseling  

Need help incorporating more fruit and vegetables into your diet? Meet with a Registered Dietitian Nutritionist at the MMC Wellness Clinic for additional nutrition advice and guidance tailored toward heart health. 

References 

1. Centers for Disease Control and Prevention. Underlying Cause of Death, 1999–2018. CDC WONDER Online Database. Atlanta, GA: Centers for Disease Control and Prevention; 2018. Accessed March 12, 2020 

2. Shah B, Newman JD, Woolf K, et al. Anti-Inflammatory Effects of a Vegan Diet Versus the American Heart Association-Recommended Diet in Coronary Artery Disease Trial. J Am Heart Assoc. 2018;7(23):e011367. doi:10.1161/JAHA.118.011367 

3. Kalt W, Cassidy A, Howard LR, et al. Recent Research on the Health Benefits of Blueberries and Their Anthocyanins. Adv Nutr. 2020;11(2):224-236. doi:10.1093/advances/nmz065 

4. Basu A, Fu DX, Wilkinson M, et al. Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome. Nutr Res. 2010;30(7):462-469. doi:10.1016/j.nutres.2010.06.016 

5. Kong DH, Kim YK, Kim MR, Jang JH, Lee S. Emerging Roles of Vascular Cell Adhesion Molecule-1 (VCAM-1) in Immunological Disorders and Cancer. Int J Mol Sci. 2018;19(4):1057. Published 2018 Apr 2. doi:10.3390/ijms19041057 

6. Basu A, Rhone M, Lyons TJ. Berries: emerging impact on cardiovascular health. Nutr Rev. 2010;68(3):168-177. doi:10.1111/j.1753-4887.2010.00273.x