Eating right for healthier heart: food choice contributes to cardiometabolic benefit and reduction of carotid intima-media thickness

Abstract Background Diets may alter individual's metabolism and inflammation, collectively leading to the modulation of cardiovascular health and disease process. Objective We aimed to investigate the effects of diets and diet-associated metabolites on metabolic profiles, inflammatory status and severity of atherosclerosis. Methods and Results A cross-sectional study was conducted in 81 healthy adults in Taiwan. Food frequency questionnaire was obtained for evaluating dietary intake. Carotid intimal-media thickness (CIMT), a relevant marker of subclinical atherosclerosis, was measured by ultrasound. We found that consumption of instant noodles and sugary beverages was associated with worse metabolic profiles. In contrast, the intake of fresh fruit and green vegetables was correlated with better metabolic parameters. Sugary beverages were dose-dependently correlated with higher expressions of toll-like receptor (TLR) 2 and TLR4 on monocytes, while fresh fruit intake was associated with lower TLRs. Furthermore, consumption of green vegetables, brown rice and water more than 2000 ml per day was inversely correlated with CIMT. The diet-associated metabolites including trimethylamine N-oxide and S-adenosyl-L-homocysteine, were positively associated with CIMT, whereas L-Lysine and L-Carnitine was associated with decreased CIMT. Interestingly, intake of strict vegetarian foods resulted in a lower serum total cholesterol level without a detectable effect on inflammatory status or CIMT. Conclusions Independent of the pattern of strict vegetarian foods, people who consumed more vegetables, fresh fruit and water showed better cardiovascular health as evidenced by their metabolic and inflammatory status and CIMT results.