Flavan-3-ols and Vascular Health: Clinical Evidence and Mechanisms of Action

Author:

Godos Justyna1ORCID,Romano Giovanni Luca2ORCID,Laudani Samuele1ORCID,Gozzo Lucia3ORCID,Guerrera Ida1ORCID,Dominguez Azpíroz Irma456ORCID,Martínez Diaz Raquel478ORCID,Quiles José L.4910ORCID,Battino Maurizio41112ORCID,Drago Filippo1,Giampieri Francesca411ORCID,Galvano Fabio1ORCID,Grosso Giuseppe113ORCID

Affiliation:

1. Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy

2. Department of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy

3. Clinical Pharmacology Unit/Regional Pharmacovigilance Centre, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-S. Marco”, 95123 Catania, Italy

4. Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain

5. Research Group on Food, Nutritional Biochemistry and Health, Universidade Internacional do Cuanza, Cuito EN250, Angola

6. Research Group on Food, Nutritional Biochemistry and Health, Universidad de La Romana, La Romana 22000, Dominican Republic

7. Research Group on Food, Nutritional Biochemistry and Health, Universidad Internacional Iberoamericana, Campeche 24560, Mexico

8. Research Group on Food, Nutritional Biochemistry and Health, Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA

9. Department of Physiology, Institute of Nutrition and Food Technology “José Mataix Verdú”, Biomedical Research Centre, University of Granada, 18016 Armilla, Spain

10. Research and Development Functional Food Centre (CIDAF), Health Science Technological Park, Avenida del Conocimiento 37, 18016 Granada, Spain

11. Department of Clinical Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy

12. International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang 212013, China

13. Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, 95123 Catania, Italy

Abstract

Cardiovascular diseases (CVDs) are one of the main causes of mortality and morbidity worldwide. A healthy diet rich in plant-derived compounds such as (poly)phenols appears to have a key role in improving cardiovascular health. Flavan-3-ols represent a subclass of (poly)phenols of great interest for their possible health benefits. In this review, we summarized the results of clinical studies on vascular outcomes of flavan-3-ol supplementation and we focused on the role of the microbiota in CVD. Clinical trials included in this review showed that supplementation with flavan-3-ols mostly derived from cocoa products significantly reduces blood pressure and improves endothelial function. Studies on catechins from green tea demonstrated better results when involving healthy individuals. From a mechanistic point of view, emerging evidence suggests that microbial metabolites may play a role in the observed effects. Their function extends beyond the previous belief of ROS scavenging activity and encompasses a direct impact on gene expression and protein function. Although flavan-3-ols appear to have effects on cardiovascular health, further studies are needed to clarify and confirm these potential benefits and the rising evidence of the potential involvement of the microbiota.

Publisher

MDPI AG

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