Precision Nutrition and Cardiovascular Disease Risk Reduction: the Promise of High-Density Lipoproteins

Abstract

Purpose of Review Emerging evidence supports the promise of precision nutritional approaches for cardiovascular disease (CVD) prevention. Here, we discuss current findings from precision nutrition trials and studies reporting substantial inter-individual variability in responses to diets and dietary components relevant to CVD outcomes. We highlight examples where early precision nutrition research already points to actionable intervention targets tailored to an individual’s biology and lifestyle. Finally, we make the case for high-density lipoproteins (HDL) as a compelling next generation target for precision nutrition aimed at CVD prevention. HDL possesses complex structural features including diverse protein components, lipids, size distribution, extensive glycosylation, and interacts with the gut microbiome, all of which influence HDL’s anti-inflammatory, antioxidant, and cholesterol efflux properties. Elucidating the nuances of HDL structure and function at an individual level may unlock personalized dietary and lifestyle strategies to optimize HDL-mediated atheroprotection and reduce CVD risk. Recent Findings Recent human studies have demonstrated that HDL particles are key players in the reduction of CVD risk. Our review highlights the role of HDL and the importance of personalized therapeutic approaches to improve their potential for reducing CVD risk. Factors such as diet, genetics, glycosylation, and gut microbiome interactions can modulate HDL structure and function at the individual level. We emphasize that fractionating HDL into size-based subclasses and measuring particle concentration are necessary to understand HDL biology and for developing the next generation of diagnostics and biomarkers. These discoveries underscore the need to move beyond a one-size-fits-all approach to HDL management. Precision nutrition strategies that account for personalized metabolic, genetic, and lifestyle data hold promise for optimizing HDL therapies and function to mitigate CVD risk more potently. Summary While human studies show HDL play a key role in reducing CVD risk, recent findings indicate that factors such as diet, genetics, glycosylation, and gut microbes modulate HDL function at the individual level, underscoring the need for precision nutrition strategies that account for personalized variability to optimize HDL’s potential for mitigating CVD risk.

The impact of dietary fat type on lipid profiles in lean mass hyper‐responder phenotype

“…The presence of these genetic variants may indicate that optimal treatment would be dietary intervention rather than oral therapy. For instance, APOE4 carriers are more sensitive to dietary restrictions on cholesterol, total fat, and especially saturated fatty acids compared to APOE3 homozygotes, and may benefit from dietary therapy 20–22 . The genetic variants described above may have similar results, and further research is needed.…”

“…For instance, APOE4 carriers are more sensitive to dietary restrictions on cholesterol, total fat, and especially saturated fatty acids compared to APOE3 homozygotes, and may benefit from dietary therapy. 20 , 21 , 22 The genetic variants described above may have similar results, and further research is needed. Establishing the appropriate approach may reduce the risk of unsuitable medical treatment.…”

Photodynamic Therapy for Atherosclerosis

“…It is also worth noting that atherosclerosis susceptibility is influenced by genetic factors, with polymorphisms in genes related to lipid metabolism (e.g., APOE), inflammation (e.g., IL-6), and vascular function (e.g., eNOS) playing significant roles. Epigenetic modifications, including DNA methylation and histone acetylation, further regulate the expression of genes associated with atherosclerosis [60][61][62].…”

Exploring the Impact of Personalized Nutritional Approaches on Metabolism and Immunity: A Systematic Review of Various Nutrients and Dietary Patterns

“…The cardiovascular system, with its intricate network of vessels and organs, is a key player in the regulation of the immune response. Emerging evidence suggests that personalized nutritional interventions can influence cardiovascular health and subsequently affect immune function [ 32 ]. In a crossover trial, Basu et al measured a diverse array of serum metabolites, including both targeted and untargeted compounds, at multiple time points throughout the study.…”