Cover
Foreword
List of Common Abbreviations
About the Companion Website
Terms of Reference
Task Force Membership
1 The Aetiology and Epidemiology of Cardiovascular Disease
1. 1.1 Introduction
2. 1.2 Aims
3. 1.3 Definitions
4. 1.4 Pathogenesis
5. 1.5 Epidemiology of Cardiovascular Disease
6. 1.6 Risk Factors for Cardiovascular Disease
7. 1.7 Role of Diet
8. 1.8 Structure of the Report
9. 1.9 Key Points
2 The Fetal and Childhood Origins of Cardiometabolic Disease
1. 2.1 Introduction
2. 2.2 Aims
3. 2.3 Cohort Studies
4. 2.4 Cohort Studies in Low‐ and Middle‐Income Countries
5. 2.5 Other Early Life Factors
6. 2.6 Famine Studies
7. 2.7 Gestational Diabetes, Maternal Overweight, and Excess Pregnancy Weight Gain
8. 2.8 Research in Animal Models, Underpinning and Driving DOHaD Concepts
9. 2.9 Randomised Controlled Trials of Interventions in Pregnancy, Infancy, and Childhood
10. 2.10 Genetic Markers Linking Birthweight and Adult Disease
11. 2.11 Mechanisms of Programming and Epigenetics
12. 2.12 Conclusion
13. 2.13 Key Points
14. 2.14 Recommendations for Future Research
3 Obesity, Metabolic Syndrome and Type 2 Diabetes
1. 3.1 Introduction to Obesity, Metabolic Syndrome, and Type 2 Diabetes
2. 3.2 Aims
3. 3.3 Obesity
4. 3.4 Fat Distribution
5. 3.5 Metabolic Syndrome and Cardiometabolic Risk
6. 3.6 Insulin Resistance
7. 3.7 Type 2 Diabetes
8. 3.8 Obesity, Metabolic Syndrome, and Their Links with Other Risk Factors
9. 3.9 Key Points
10. 3.10 Recommendations for Future Research
4 Lipid‐Related Factors
1. 4.1 Introduction
2. 4.2 Aims
3. 4.3 Background
4. 4.4 LDL‐Cholesterol
5. 4.5 Interventions to Reduce LDL‐Cholesterol
6. 4.6 Atherogenic Lipoproteins
7. 4.7 Plasma Triglycerides
8. 4.8 Postprandial Lipaemia: Atherogenic Lipoprotein Phenotype
9. 4.9 Small, Dense LDL
10. 4.10 HDL‐Cholesterol and HDL Subfractions
11. 4.11 Remnant‐Like Particles
12. 4.12 Lipoprotein(a)
13. 4.13 Non‐Esterified Fatty Acids
14. 4.14 Genetic Variability and Cardiovascular Risk
15. 4.15 Conclusion
16. 4.16 Key Points
17. 4.17 Recommendations for Future Research
5 Inflammation‐Related Factors
1. 5.1 Introduction
2. 5.2 Aims
3. 5.3 Biology and Hypotheses
4. 5.4 The Immune System
5. 5.5 Inflammation and Atherosclerosis
6. 5.6 Risk Factors: What Is Currently Known?
7. 5.7 Other Emerging Risk Markers for Cardiovascular Disease
8. 5.8 Multiple Inflammatory Markers in Risk Prediction
9. 5.9 Influence of Chronic Inflammatory Disease on Cardiovascular Disease Risk
10. 5.10 Infectious Burden, Inflammation, and Atherosclerosis
11. 5.11 Pharmacological Agents with Anti‐Inflammatory Effects in Cardiovascular Disease
12. 5.12 Dietary Factors and Inflammation
13. 5.13 Conclusion
14. 5.14 Key Points
15. 5.15 Recommendations for Future Research
6 Adipose Tissue‐Derived Factors
1. 6.1 Obesity, Adipose Tissue, and Cardiovascular Disease
2. 6.2 Aims
3. 6.3 Adipose Tissue Distribution
4. 6.4 Types of Adipose Tissue
5. 6.5 Adipose Tissue‐Derived Signals and Cardiovascular Disease
6. 6.6 Leptin
7. 6.7 Acylation‐Stimulating Protein
8. 6.8 Adiponectin
9. 6.9 Adipose Tissue‐Derived Cytokines
10. 6.10 Cytokine Receptors
11. 6.11 Role of TNF‐alpha in Adipose Tissue
12. 6.12 Acute and Chronic Release of IL‐6
13. 6.13 Angiotensinogen
14. 6.14 Resistin
15. 6.15 Peroxisome Proliferator‐Activated Receptors
16. 6.16 MicroRNA
17. 6.17 Other Adipose Factors Associated with Cardiovascular Disease
18. 6.18 Nutritional Regulation of Adipocyte Factors
19. 6.19 Physical Activity and Adipokines
20. 6.20 Genetic Determinants of Adipokines
21. 6.21 Conclusion
22. 6.22 Key Points
23. 6.23 Recommendations for Future Research
7 Endothelial and Vascular Function
1. 7.1 Introduction
2. 7.2 Aims
3. 7.3 Vascular Function and the Endothelium
4. 7.4 Estimates of Endothelial and Vascular Dysfunction
5. 7.5 Aetiology of Endothelial Damage: Association with Classical and Novel Risk Factors
6. 7.6 Endothelial Dysfunction as an Integrated Pathway for Cardiovascular Disease Risk
7. 7.7 Endothelial Function Measures as Independent Predictors of Coronary Heart Disease
8. 7.8 Relevant Genetic Studies
9. 7.9 Prevention and Reversibility of Endothelial Dysfunction
10. 7.10 Effects of Coronary Heart Disease Preventative Modalities on Other Risk Factor Pathways
11. 7.11 Dietary Modulations ofEndothelial Function
12. 7.12 Do Nutrient‐Induced Endothelial Effects Correlate with Results from Endpoint Studies?
13. 7.13 Key Points
14. 7.14 Recommendations for Future Research
8 The Haemostatic System: Coagulation, Platelets, and Fibrinolysis
1. 8.1 Introduction
2. 8.2 Aims
3. 8.3 The Haemostatic System
4. 8.4 The Fibrinolytic System
5. 8.5 The Concept of Hypercoagulability
6. 8.6 Haemostatic Risk Factors for Vascular Disease
7. 8.7 Genetics and Cardiovascular Disease Risk
8. 8.8 Dietary Characteristics and Haemostasis
9. 8.9 Key Points
10. 8.10 Recommendations for Future Research
9 Oxidative Stress and Cardiovascular Disease
1. 9.1 Introduction
2. 9.2 Aims
3. 9.3 Biology and Hypotheses
4. 9.4 The Role of Lipoproteins in Normal Biology
5. 9.5 The Nature and Origin of Free Radicals and Reactive Oxygen and Nitrogen Species
6. 9.6 Molecular Targets for Oxidative Stress
7. 9.7 Oxidative Stress in the Early Stages of Cardiovascular Disease
8. 9.8 Oxidation of LDL and Uptake by Macrophages
9. 9.9 Oxidation of LDL in the Artery Wall
10. 9.10 The Nature of the Oxidising Species for LDL
11. 9.11 Oxidative Stress at Later Stages in Cardiovascular Disease
12. 9.12 Evidence for the Presence of Oxidation Products in the Artery Wall and the Circulation
13. 9.13 Oxidative Stress and Thrombosis
14. 9.14 Alternative Mechanisms for Oxidative Stress
15. 9.15 Oxidative Stress in Other Conditions Related to Cardiovascular Disease
16. 9.16 The Importance of Diet and Dietary Antioxidants
17. 9.17 Measurable Factors for Oxidative Stress in Cardiovascular Disease
18. 9.18 Relationships of the Markers of Oxidant Stress to Intake of Dietary Antioxidants
19. 9.19 Conclusion
20. 9.20 Key Points
21. 9.21 Recommendations for Future Research
10 Vitamins and Risk of Cardiovascular Disease
1. 10.1 Introduction
2. 10.2 Aims
3. 10.3 Homocysteine, B Vitamins, and Cardiovascular Diseases
4. 10.4 Vitamin D
5. 10.5 Vitamin E
6. 10.6 Vitamin C
7. 10.7 Beta‐Carotene
8. 10.8 Key Points
9. 10.9 Recommendations for Future Research
11 Influences of the Human Gut Microbiome
1. 11.1 Introduction
2. 11.2 Aims
3. 11.3 Microbiota of the Gastrointestinal Tract
4. 11.4 Substrates and Products of Microbial Fermentation
5. 11.5 The Gut Microbiome, Physical Activity, and the Importance in Athletes
6. 11.6 Impact of Prebiotics, Probiotics, and Synbiotics on the Colonic Microbiome
7. 11.7 Cholesterol Assimilation, Binding, and Bile Acid Deconjugation
8. 11.8 Gut Microbiome and Metabolic Conditions
9. 11.9 Faecal Microbiome Transplant
10. 11.10 Organic Acids
11. 11.11 Gut Wall Integrity
12. 11.12 Key Points
13. 11.13 Recommendations for Future Research
12 Physical Fitness and Physical Activity: Effects on Risk ofCardiovascular Disease
1. 12.1 Introduction
2. 12.2 Aims
3. 12.3 Definitions and Recommendations
4. 12.4 Role of Physical Activity and Physical Fitness in Promoting Cardiovascular Health
5. 12.5 Sedentary Behaviour and Cardiovascular Health
6. 12.6 Interactions Between Physical Activity, Sedentary Behaviour, and Eating Behaviour, and Potential Effects on Cardiovascular Risk Factors
7. 12.7 Interventions to Increase Physical Activity, Improve Physical Fitness, and Reduce Sedentary Behaviour
8. 12.8 Conclusion
9. 12.9 Key Points
10. 12.10 Recommendations for Future Research
13 Diet and Cardiovascular Disease: Where Are We Now?
1. 13.1 Introduction
2. 13.2 Aims
3. 13.3 Diet, Nutrition and Emerging Risk Factors for Cardiovascular Disease: Findings of the Task Force
4. 13.4 Changes in Emphasis Regarding Macronutrients
5. 13.5 Change in Emphasis: Dietary Patterns
6. 13.6 Dietary Patterns with a Focus on Change in Macronutrients
7. 13.7 Current Dietary Recommendations for Primary Prevention in the UK
8. 13.8 How Do the UK Recommendations Compare with Recommendations in Other Countries?
9. 13.9 Current Dietary Trends in the UK and Comparison of These with the Current Guidelines: What Are the Biggest Successes and Challenges?
10. 13.10 Other Lifestyle Factors Relating to Cardiovascular Disease Risk
11. 13.11 Need for Behaviour Change
12. 13.12 Key Points
13. 13.A Emerging Risk Factors: Synthesis of the Available Information on Diet and Cardiovascular Disease
14 Conclusions of the Task Force
1. 14.1 Chapter 1
2. 14.2 Chapter 2
3. 14.3 Chapter 3
4. 14.4 Chapter 4
5. 14.5 Chapter 5
6. 14.6 Chapter 6
7. 14.7 Chapter 7
8. 14.8 Chapter 8
9. 14.9 Chapter 9
10. 14.10 Chapter 10
11. 14.11 Chapter 11
12. 14.12 Chapter 12
13. 14.13 Chapter 13
15 Recommendations of the Task Force
1. 15.1 Priorities for Future Research
2. 15.2 Priorities for Future Research: Identifying Effective Interventions to Encourage Physical Activity
3. 15.3 Priorities for Future Research: Identifying Effective Dietary Interventions
4. 15.4 General Recommendations
16 Cardiovascular Disease
1. 16.1 Epidemiology of Cardiovascular Disease
2. 16.2 Main Factors Influencing Cardiovascular Disease Risk
3. 16.3 Nutrition During Pregnancy and Fetal Growth
4. 16.4 Diabetes, Obesity, and the Metabolic Syndrome
5. 16.5 Lipid‐Related Factors
6. 16.6 Inflammation
7. 16.7 Factors Relating to Adipose (Fat) Tissue
8. 16.8 The Role of the Endothelium
9. 16.9 Diet and Blood Clotting
10. 16.10 Diet and Oxidative Stress
11. 16.11 Vitamins
12. 16.12 The Gut Microbiome
13. 16.13 Physical Activity
14. 16.14 Diet and Cardiovascular Disease
References
Index
End User License Agreement

List of Tables

Chapter 1
1. Table 1.1 Causes and risk factors commonly associated with hypertension....
2. Table 1.2 Conventional risk factors for cardiovascular disease (CVD)....
3. Table 1.3 Emerging risk factors for cardiovascular disease covered in...
4. Table 1.4 Committee on Medical Aspects of Food Policy (COMA) recommen...
Chapter 2
1. Table 2.1 Maternal, infant, and adult characteristics according to ti...
Chapter 3
1. Table 3.1 World Health Organization adult body mass index (BMI) class...
2. Table 3.2 Major co‐morbidities of obesity.
3. Table 3.3 Diagnostic criteria for metabolic syndrome.
4. Table 3.4 Factors contributing to hypertension in obesity.
Chapter 4
1. Table 4.1 Food sources of commonly consumed fatty acids.
2. Table 4.2 Methods used to determine lipid‐related cardiovascular risk...
3. Table 4.3 Functions of the major apolipoproteins in plasma.
4. Table 4.4 Typical plasma concentrations and approximate residence tim...
5. Table 4.5 Summary of the relationship between CVD, diet, and novel li...
Chapter 5
1. Table 5.1 Relative evaluation of inflammatory risk factors.
2. Table 5.2 Associations between hs‐CRP and cardiovascular outcomes fro...
Chapter 6
1. Table 6.1 Signals derived from adipose tissue (Karastergiou and Mohamed‐A...
2. Table 6.2 Adipokines: cellular source and main functions.
Chapter 7
1. Table 7.1 Assessment of endothelial dysfunction in humans.
2. Table 7.2 Measures of endothelial function showing promise as potenti...
3. Table 7.3 Results of prospective studies employing direct endothelial...
4. Table 7.4 Influence of dietary factors on estimates of endothelial fu...
Chapter 8
1. Table 8.1 Circulating and cell‐bound proteins.
2. Table 8.2 Haemostatic risk factors for cardiovascular disease: streng...
3. Table 8.3 Associations between dietary factors and haemostatic risk f...
4. Table 8.4 Examples of micronutrients with platelet function modulator...
Chapter 9
1. Table 9.1 Common diseases in which oxidative damage has been demonstr...
2. Table 9.2 Typical fatty acid and antioxidant content of low‐density l...
3. Table 9.3 Oxygen‐centred free radicals and reactive oxygen species.
4. Table 9.4 Effects of free radical damage on cellular components.
5. Table 9.5 Nitrogen‐centred free radicals and reactive nitrogen specie...
6. Table 9.6 Oxidative modifications of proteins.
7. Table 9.7 Products formed during the oxidation of low‐density lipopro...
8. Table 9.8 Sources of dietary antioxidants.
9. Table 9.9 Basic structures of phenolic and polyphenolic compounds....
10. Table 9.10 Properties of an ideal assay method to measure lipid perox...
Chapter 10
1. Table 10.1 Dietary reference values and safe upper levels of vitamin ...
2. Table 10.2 Completed randomised trials of vitamin D for prevention of...
3. Table 10.3 Selected characteristics of ongoing trials of high dose vi...
4. Table 10.4 Selected characteristics of antioxidant vitamin trials for...
Chapter 11
1. Table 11.1 Typical estimated daily amounts of dietary nutrients persi...
Chapter 12
1. Table 12.1 The six most commonly reported physical activities reporte...
Chapter 13
1. Table 13.1 Recommendations for cardiovascular disease risk reduction ...
2. Table 13.2 Summary of practical dietary advice to reduce risk of coro...
3. Table 13.3 Summary of global recommendations for dietary fat and carb...
4. Table 13.4 Levels of energy under‐reporting from the National Diet and Nu...
5. Table 13.5 Sources of saturates in the UK diet (adults aged 19–64 yea...
6. Table 13.6 Comparison of average daily intakes of macronutrients by a...
7. Table 13.7 Changes in contributions (percentage of total intake per p...
8. Table 13.8 Recommendations for intake of oil‐rich fish.
9. Table 13.9 Household purchase trends (g/person/week) in Britain for c...
10. Table 13.10 Average daily consumption of fruits and vegetables (g/day...
11. Table 13.11 European Commission‐authorised health claims relating to ...
12. Table 13.12 Intakes of salt and sodium among young people in the UK c...

List of Illustrations

Chapter 1
1. Fig. 1.1 Outline of the development of the atherosclerotic plaque. Low‐density ...
2. Fig. 1.2 Mechanism of blood clotting. Key: a, activated; ADP, adenosine diphosp...
3. Fig. 1.3 Proportion of global deaths under the age of 70 years, by cause of dea...
4. Fig. 1.4 CVD death rates per 100 000 by sex in selected countries, 2008.
5. Fig. 1.5 Deaths by cause in men and women aged under 75 years in the UK, 2010.
6. Fig. 1.6 Percentage change in coronary heart disease death rates, by sex, in se...
7. Fig. 1.7 Death rates from stroke, men, and women of all ages, latest available ...
8. Fig. 1.8 Age‐specific death rates from stroke, 1968–2006, in England and Wales,...
9. Fig. 1.9 Prevalence of cardiovascular disease reported by the General Household...
10. Fig. 1.10 Trends in coronary heart disease death rates per 100 000 population i...
11. Fig. 1.11 Proportions of deaths by cause in UK and South Asian men, 2008 in Eng...
12. Fig. 1.12 Mortality from coronary heart disease versus serum total cholesterol ...
13. Fig. 1.13 Obesity prevalence of adults (16 years and over) in England from 1993...
14. Fig. 1.14 A schematic diagram depicting a proposed model for research into nutr...
Chapter 2
1. Fig. 2.1 General schema for the developmental origins hypothesis.
2. Fig. 2.2 Hazard ratios for death from coronary heart disease for men born in He...
3. Fig. 2.3 Associations of birthweight, and conditional height and relative weigh...
4. Fig. 2.4 Subscapular skinfold among girls born to mothers who developed gestati...
5. Fig. 2.5 In animal experiments, a wide range of fetal exposures, including unde...
6. Fig. 2.6 Hypothalamic pathways regulating appetite and feeding behaviour. NPY, ...
Chapter 3
1. Fig. 3.1 Components of daily energy expenditure.
2. Fig. 3.2 Relationship between body mass index (BMI) and all‐cause mortality. Da...
3. Fig. 3.3 Effect of body mass index (BMI) on coronary heart disease (CHD) risk d...
4. Fig. 3.4 Subcutaneous and intra‐abdominal fat imaged by magnetic resonance imag...
5. Fig. 3.5 Characterisation of the two extremes of body fat distribution as ‘appl...
6. Fig. 3.6 Opposite relationships of waist and hip circumference with risk (odds ...
7. Fig. 3.7 Different degrees of fat accumulation in the liver, imaged by magnetic...
8. Fig. 3.8 Prevalence of metabolic syndrome by quintiles of cardiorespiratory fit...
9. Fig. 3.9 Insulin resistance in abdominally obese men. Data are shown for abdomi...
10. Fig. 3.10 Postulated schema by which high fat diets produce metabolic and cardi...
Chapter 4
1. Fig. 4.1 Relationship between plasma triglycerides and the related atherogenic/...
2. Fig. 4.2 Relation between proportional reduction in incidence of major vascular...
3. Fig. 4.3 Effects of statins on different sub‐types of major vascular event. In ...
4. Fig. 4.4 Major lipoproteins in plasma responsible for cholesterol transport. Ve...
5. Fig. 4.5 Pathway for production of small, dense low‐density lipoprotein (LDL). ...
6. Fig. 4.6 Modulation of high‐density lipoprotein (HDL) subclasses, movement of c...
7. Fig. 4.7 The isolation of remnant‐like particles (RLP) is based on an imm...
8. Fig. 4.8 Total plasma cholesterol response to a low‐fat diet (US National Chole...
Chapter 5
1. Fig. 5.1 Diagrammatic representation of the development of an atherosclerotic l...
2. Fig. 5.2 Interrelationships between inflammatory risk factors. CRP, C‐reactive ...
3. Fig. 5.3 Roles of key adhesion molecules in the attachment and transendothelial...
Chapter 6
1. Fig. 6.1 Adipose tissue types. Brown adipose tissue is abundant at birth and st...
2. Fig. 6.2 Adipose tissue hypertrophy and its local effects in obesity. COX, cycl...
3. Fig. 6.3 Endocrine paracrine effects of adipose microRNA (miRNA) on cardiovascu...
Chapter 7
1. Fig. 7.1 Role of the endothelium. The endothelium synthesises several molecules...
2. Fig. 7.2 Schematic drawing of ultrasound imaging of the brachial artery with up...
3. Fig. 7.3 An example of the recording obtained by the pulse wave velocity (PWV) ...
4. Fig. 7.4 Non‐contact assessment of skin perfusion using laser speckle contrast ...
5. Fig. 7.5 Normal endothelial vasodilator function. Representative recording of a...
6. Fig. 7.6 Measures of endothelial dysfunction may provide an amalgamation of ris...
Chapter 8
1. Fig. 8.1 The coagulation pathway. The suffix ‘a’ indicates the activated factor...
2. Fig. 8.2 Regulation of platelet activation through phosphorylation of vasodilat...
3. Fig. 8.3 Natural anticoagulant mechanisms. Thrombomodulin (TM) supports the act...
Chapter 9
1. Fig. 9.1 The origin of reactive oxygen species in human tissues. H₂O, water; H₂
2. Fig. 9.2 Reaction of nitric oxide (NO) with superoxide anion to form peroxynitr...
3. Fig. 9.3 Reactivity of peroxynitrite (ONOOH) with macromolecules.
4. Fig. 9.4 The nitration of tyrosine residues by peroxynitrite.
5. Fig. 9.5 Free radical attack on polyunsaturated lipids.
6. Fig. 9.6 Free radical reactions modify the lipids and proteins of low‐density l...
7. Fig. 9.7 Mechanisms of oxidation of low‐density lipoprotein (LDL) in atheroscle...
8. Fig. 9.8 Modification of high‐density lipoprotein (HDL) function by myeloperoxi...
9. Fig. 9.9 Contribution of plasma constituents to the antioxidant capacity using ...
Chapter 10
1. Fig. 10.1 Formulae of methionine, homocysteine, and related metabolites.
2. Fig. 10.2 Metabolism of homocysteine. BHM, betaine homocysteine methyltransfera...
3. Fig. 10.3 Odds ratios and 95% confidence intervals (CI) of coronary heart disea...
4. Fig. 10.4 Effects of folic acid on coronary heart disease (a) and stroke (b) in...
5. Fig. 10.5 Effects of methylenetetrahydrofolate reductase (MTHFR) on coronary he...
6. Fig. 10.6 Regulation of vitamin D status. UVB, ultraviolet B.
7. Fig. 10.7 Association of plasma 25(OH)D with vascular and non‐vascular mortalit...
8. Fig. 10.8 Association of plasma 25(OH)D with all‐cause mortality: meta‐analysis...
9. Fig. 10.9 The effect of supplementation with vitamin D on plasma levels of 25‐h...
10. Fig. 10.10 Effects of antioxidant vitamins on major vascular events. Source: My...
Chapter 11
1. Fig. 11.1 A schematic representation of diet:microbe interactions and how they ...
2. Fig. 11.2 Changes to the microbiota during ageing.
3. Fig. 11.3 Generalised view of levels of positive and negative bacteria in the h...
Chapter 12
1. Fig. 12.1 Schematic showing relationship between physical activity, physical fi...
2. Fig. 12.2 Risk of cardiovascular disease (CVD) and coronary heart disease (CHD)...
3. Fig. 12.3 Comparison of weight loss from randomised controlled trials with diet...
Chapter 13
1. Fig. 13.1 Fat, carbohydrates and heart disease: Estimated percentage changes in...
2. Fig. 13.2 Age‐adjusted mortality rates of coronary heart disease in North Karel...
3. Fig. 13.3 Comparison of two strategies for eating 1565 kcal during a day with d...
4. Fig. 13.4 UK Government's Eatwell Guide.
5. Fig. 13.5 Fatty acid composition of edible oils and fats.
6. Fig. 13.6 Recent trends in the percentage of food energy derived from saturates...
7. Fig. 13.7 Changes in intake of fat and saturates over time from dairy products ...
8. Fig. 13.8 Changes in intake of fat and saturates over time from fats and oils, ...
9. Fig. 13.9 Average daily consumption of fruits and vegetables (g/day), including...
10. Fig. 13.10 Average daily consumption of fruits and vegetables (g/day), includin...
11. Fig. 13.11 An example of the colour‐coded multiple traffic light scheme used in...

This edition first published 2019
© 2019 by John Wiley & Sons Ltd.
Edition History [John Wiley and Sons 1e, 2005]

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Library of Congress Cataloging‐in‐Publication Data

Names: Frayn, K. N. (Keith N.) | Stanner, Sara, and Coe, Sarah, editors.
Title: Cardiovascular disease : diet, nutrition and emerging risk factors / chaired by Professor Keith N. Frayn ; edited by Sara Stanner MSc RNutr FAfN, Science Director, British Nutrition Foundation, New Derwent House and Sarah Coe BSc ANutr, Nutrition Scientist, British Nutrition Foundation, New Derwent House.
Description: Second edition. | London : Published by Blackwell Publishing for the British Nutrition Foundation, 2019. | Series: British nutrition foundation | Includes bibliographical references and index. |
Identifiers: LCCN 2018029734 (print) | LCCN 2018031717 (ebook) | ISBN 9781118829905 (Adobe PDF) | ISBN 9781118829899 (ePub) | ISBN 9781118829912 (paperback) Subjects: LCSH: Cardiovascular system–
Diseases–Nutritional aspects. | Cardiovascular system–Diseases–Risk factors. |
BISAC: HEALTH & FITNESS / Nutrition.
Classification: LCC RC669 (ebook) | LCC RC669 .C2765 2019 (print) | DDC 616.1/0654–dc23 LC record available at https://lccn.loc.gov/2018029734

Cover Design: Wiley
Cover Image: © Attitude/Shutterstock

Foreword

Cardiovascular disease, including coronary heart disease, strokes, and diseases of other arteries, is a major cause of early death and disability. For many years, the major markers of disease risk have been well recognised; these include high blood cholesterol levels, high blood pressure, obesity, and smoking. But these markers do not account for all cardiovascular risk. Furthermore, treatments that are highly effective in altering these markers, for instance, the ‘statin’ drugs used to lower cholesterol, do not remove risk entirely; typically they reduce it by 30% or less. These observations have prompted a search for other indicators of risk of cardiovascular disease. A number of such risk markers have emerged. These include subtle alterations of types of fat in the bloodstream, factors associated with inflammation and with clotting, lowered resistance to oxidative stress and impaired functioning of blood vessels. In addition, it has been recognised that experiences throughout the life course, even before birth, may influence later disease risk. We still know little about how many of these so‐called ‘emerging’ or ‘novel’ risk markers may be altered to reduce risk of cardiovascular disease, especially how they may be influenced by diet, although the rapid changes in risk of cardiovascular disease that occurred throughout the twentieth century suggest that features of our lifestyle such as diet may play a fundamental role.

In 2005, the first report of this Task Force was published in an attempt to collate all the evidence relating to these emerging risk factors and the role of nutrition. This report has been popular and has been much cited. Since that time, however, the field has moved on. Some of the risk factors that we then considered ‘emerging’ are now well established. Other areas of interest have been added, in particular, the role of the organisms inhabiting the human gut, the ‘gut microbiota’. The British Nutrition Foundation felt that it would be appropriate to re‐convene the Task Force to look at the field again, updating and adding to our previous report.

Some of the authors of the first edition were not available to work on this second edition. We have therefore brought in new authors, but have been assured consistency by the presence of several of the original authors, as well as senior staff at the British Nutrition Foundation.

Each chapter in this report was written initially by between one to three the members of the Task Force, but then all members commented and may have contributed to each chapter. Some of the topics are similar to those considered in the previous edition, but others have been added. The topic of ‘early origins of adult disease’ has evolved into a consideration of life course events. The theme of homocysteine has widened and now we include a chapter on ‘vitamins’. A previous focus on ‘insulin resistance’ has been replaced by a consideration of the effects of obesity and the concept of the metabolic syndrome. We have entirely new chapters on the role of physical activity and inactivity, and on the gut microbiota. As in the previous edition, we have retained a chapter on ‘factors related to adipose tissue’, which we believe will be an important area in the future. The Report includes, as is standard for British Nutrition Foundation reports, a Question and Answer section and a Public Health chapter, in which we hope everyone will be able to find ‘take‐home messages’ emerging from our work, together with chapters summarising the conclusions and recommendations of the Task Force. In addition, a glossary and key references for each chapter can be found at http://www.wiley.com/go/bnf/cardiovascular_diseases.

I would like to thank all the members of the Task Force who worked hard and willingly on this project, and also others who corresponded with us. I extend special thanks to the British Nutrition Foundation staff who participated, both as authors and by providing administrative support. Sarah Coe has worked particularly hard on this project. Finally, on behalf of all members of the Task Force, I wish to pay tribute to George Miller, a contributor to the first edition, who has sadly died in the intervening period.

Professor Keith N. Frayn

Task Force Membership

British Nutrition Foundation

Chair

Professor Keith N. Frayn, Emeritus Professor of Human Metabolism, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7LJ.

Members

Bridget Benelam

Nutrition Communications Manager

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Professor Steven N. Blair

Faculty Affiliate, Prevention Research Center

University of South Carolina

Public Health Research Building, 225

921 Assembly Street

Columbia, SC 29208

Professor Richard Bruckdorfer

Emeritus Professor of Biochemistry

University College London

Bailey Cottage

Whipsnade

Bedfordshire

LU6 2LG

Professor Judith L. Buttriss

Director General

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Professor Robert Clarke

Professor of Epidemiology and Public Health Medicine

Nuffield Department of Population Health

Clinical Trial Service Unit, University of Oxford

Richard Doll Building

Roosevelt Drive

Oxford

OX3 7LF

Professor Caroline Fall

Professor of International Paediatric Epidemiology and Consultant in Child Health MRC Lifecourse Epidemiology Unit

University of Southampton

Southampton General Hospital

Southampton

SO16 6YD

Professor Gordon Ferns

Professor of Medical Education, Deputy Dean

Division of Medical Education,

Mayfield House

University of Brighton

BN1 9PH

Professor Leanne Hodson

Professor Leanne Hodson

Associate Professor of Diabetes and Metabolism

BHF Senior Research Fellow in Basic Science

Oxford Centre for Diabetes, Endocrinology and Metabolism

University of Oxford

Churchill Hospital

Oxford OX3 7LE

Professor Julie Lovegrove

Director of the Hugh Sinclair Unit of Human Nutrition

Food and Nutritional Sciences

University of Reading

PO Box 226

Whiteknights

Reading

Berkshire

RG6 6AP

Dr Vidya Mohamed‐Ali

Director

Life Sciences Research Division

Anti‐Doping Lab Qatar

Sports City Road

Doha

Qatar

Professor Marie Murphy

Professor of Exercise and Health

Sport and Exercise Sciences Research Institute

Room 15E08B

School of Sport

University of Ulster

Jordanstown campus

Shore Road

Newtownabbey

Co. Antrim

BT37 0QB

Professor Sumantra Ray

MRC‐EWL Senior Medical Advisor & Senior Clinician Scientist

Founding Chair, NNEdPro Global Centre for Nutrition and Health

MRC Elsie Widdowson Laboratory

120 Fulbourn Road

Cambridge

CB1 9NL

Sara Stanner

Science Director

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Professor Coen Stehouwer

Professor and Chair

Department of Internal Medicine

Maastricht University Medical Centre

6202 AZ Maastricht

The Netherlands

Professor Parveen Yaqoob

School Director of Research

Food and Nutritional Sciences

University of Reading

Whiteknights

PO Box 217

Reading

Berkshire

RG6 6AH

Contributors

Dr Mashael AlJaber

Senior Scientist

Life Sciences Research Division

Anti‐Doping Lab Qatar

Sports City Road

Doha

Qatar

Dr Lucy Chambers

Senior Scientist

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Sarah Coe

Nutrition Scientist

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Dr Moniek P.M. de Maat

Associate Professor, Head Haemostasis Laboratory

Erasmus University Medical Center Rotterdam

P.O. Box 2040

3000 CA Rotterdam

The Netherlands

Professor Glenn Gibson

Professor of Food Microbiology, Head of Food Microbial Sciences

University of Reading

Whiteknights

Reading

Berkshire

RG6 6AH

Dr Kalyanaraman Kumaran

Clinical Scientist/Senior Lecturer

MRC Lifecourse Epidemiology Unit

University of Southampton

Southampton General Hospital

Southampton

SO16 6YD

Dr Stacey Lockyer

Nutrition Scientist

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Professor Marlien Peters

Professor, Nutrition, Haemostasis and Cardiovascular diseases

Centre of Excellence for Nutrition (CEN)

North‐West University

Potchefstroom

2531

South Africa

Dr Gemma Walton

Lecturer in Metagenomics

Food and Nutritional Sciences

University of Reading

Whiteknights

PO Box 217

Reading

Berkshire

RG6 6AH

Professor Christine Williams OBE

Director, Food Agriculture and Health

University of Reading

Whiteknights

PO Box 217

Reading

Berkshire

RG6 6AH

Secretariat

Sarah Coe

Nutrition Scientist

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Bethany Hooper

Nutrition Scientist

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA(until April 2015)

Scientific Editor

Sara Stanner

Science Director

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

Technical Editor

Sarah Coe

Nutrition Scientist

British Nutrition Foundation

New Derwent House

69‐73 Theobalds Road

London

WC1X 8TA

We are grateful to members of the previous Task Force on Cardiovascular Disease: Diet, Nutrition and Emerging Risk Factors, whose chapters have been updated in this revised edition: Professor Fredrik Karpe, Dr Simon W. Coppack, and Professor George J. Miller.

Diet, Nutrition and Emerging Risk Factors

The Report of a British Nutrition Foundation Task Force

British Nutrition Foundation