Micronutrient Vitamin Deficiencies and Cardiovascular Disease Risk: Advancing Current Understanding

Abstract

Cardiovascular diseases are responsible for one-third of all deaths in the world. Several factors contribute to the current trend including micronutrient vitamin deficiencies (MVDs), however, opinions regarding the role of MVDs in CVDs are inconsistent; this could impact on micronutrient vitamins intake. The aim of this review was to provide a brief overview of published evidence on the associations between MVDs and CVDs, assess the interactions between micronutrients and cardiovascular endpoints, and identify current related research needs. Literature search conducted on studies published between 1963 and 2016 indicates that MVDs are common and are related to adverse cardiovascular endpoints through various mechanisms, including impaired antioxidant and immune response mechanisms; and anti-inflammatory activities. Some micronutrients directly impact on CVDs; others act as critical cofactors in several biochemical processes. Several methodologic flaws, environmental and individual susceptibility factors, lack of determination of baseline serum levels of complementary micronutrients, absence of uniformly accepted cut-off values, and interactions between micronutrients may partly account for discordant results across studies. Although MVD is a significant risk factor for CVDs, supplementation with single or paired micronutrients for primary prevention of CVDs in healthy adults with no special nutritional needs is discouraged; there is insufficient evidence to determine the benefit/harm of such supplementation.

Plasma metabolomics of children with aberrant serum lipids and inadequate micronutrient intake

“…It is not possible to conclude from the current study if these deficiencies are a phenomena specific Northern Colorado children, however, previous reports have indicated that approximately a third of the U.S. population (including children and adults) are at risk for micronutrient deficiencies [ 52 ]. Oxidation of LDL-cholesterol, an initiating step in atherosclerosis, is often concurrent with the production of inflammatory cytokines and decreased nitric oxide levels which lead to vasoconstriction and compromised vascular structure [ 22 ]. Micronutrients with documented anti-inflammatory, anti-oxidant, and/or immune modulatory effects (e.g., vitamin A, C, D, E, nicotinamide, folate, riboflavin) play significant roles in cardioprotection [ 22 ].…”

“…Oxidation of LDL-cholesterol, an initiating step in atherosclerosis, is often concurrent with the production of inflammatory cytokines and decreased nitric oxide levels which lead to vasoconstriction and compromised vascular structure [ 22 ]. Micronutrients with documented anti-inflammatory, anti-oxidant, and/or immune modulatory effects (e.g., vitamin A, C, D, E, nicotinamide, folate, riboflavin) play significant roles in cardioprotection [ 22 ]. The anti-oxidant vitamin E has demonstrated protection via reduced atherosclerotic plaque formation in animal models, and dietary consumption of foods rich in vitamin E has been associated with lower CVD outcomes in clinical studies [ 53 ].…”

“…Conversely, nutrient intakes exceeding the Tolerable Upper Level (UL), as a result of overnutrition, contributes to metabolic disturbances [ 21 ]. Multiple micronutrients have central roles in metabolism, and the associated anti-oxidant and anti-inflammatory properties of micronutrients can infer cardioprotection [ 22 ]. Adequate intakes of riboflavin and niacin are critical to fuel the electron transport chain, and zinc is a cofactor to hundreds of biological enzymes [ 23 ].…”

Micronutrient deficiency, a novel nutritional risk factor for insulin resistance and Syndrom X

“…Recent evidence indicates that VA regulates metabolic pathways central to the pathogenesis of metabolic syndrome clusters including obesity [71], diabetes mellitus [72], dyslipidemia [73] and cardiovascular disease [7]. Central to the metabolic pathways is the improvement in β-cell mass and function, hence insulin secretion and responses.…”

“…Micronutrients consist of vitamins and minerals which are required in small amounts to enhance normal physiological and biochemical processes in the body. They include, but are not limited to, vitamins A, B, C, D and E, calcium, folate, iodine, iron, zinc, chromium, biotin, thiamine, magnesium and selenium as well as many others [7]. They are classi ied as micronutrients not by virtue of functional importance but by virtue of the amount required by the body.…”