Formulas for vascular health


Tomato and vessel health


Can pizza improve your vascular health?


Maybe not, if it’s loaded down with pepperoni and cheese. But the concentrated tomato puree in pizza sauce may very well be healthy!


Tomatoes and certain other red fruits are rich in a substance known as lycopene, a bright red carotenoid pigment linked to prevention of prostate and other cancer, and to endothelial health. As noted previously, the endothelium is a single-cell layer lining blood vessels, and it is crucial to regulating vascular health. Lycopene is a potent antioxidant, counteracting free radicals that attack the endothelium.


While lycopene or other beneficial compounds taken individually as supplements may improve health, it may be even better to eat tomatoes or other foods rich in a variety of these substances. The “Mediterranean diet,” emphasizing tomatoes, other fruits and vegetables, olive oil, and fish, appears to protect against cardiovascular disease.1

So careful attention to healthy dietary changes, such as skipping sausage on your pizza but cooking with tomato sauce, may help prevent atherosclerosis and heart disease even more so than taking dietary supplements.


Lycopene Improves Endothelial Function


In a trial in which participants were randomly assigned to receive 7 mg lycopene or placebo daily for 2 months, without knowing which treatment they were receiving, lycopene supplementation improved endothelial function in patients with cardiovascular disease, but not in healthy volunteers.1
Although blood pressure and lipids did not change in either group, the heart disease patients had a 53% increase in blood vessel dilation regulated by the endothelium, improving this measurement to levels seen in healthy volunteers! This was especially impressive as these patients were already on maximal medical preventive treatment including statins.1


In an analysis of six studies examining the effects of lycopene supplementation on blood pressure, 2 it significantly lowered systolic blood pressure (SBP; the higher number) by about 5 points, with no effect on diastolic blood pressure (the lower number). A higher dosage of lycopene supplement (over 12 mg/day) reduced SBP more significantly, especially in participants with high blood pressure at study entry and in Asians.


Product Serving Size Lycopene (mg/serving)
Tomato juice 250 mL (1 cup) 25.0
Tomato ketchup 15 mL (1 tbsp) 2.7
Spaghetti sauce 125 mL (1/2 cup) 28.1
Tomato paste 30 mL (2 tbsp) 13.8


As Good As Statins?


A separate analysis 3 of twelve studies of the effect of lycopene on serum lipids, and four studies of its effect on blood pressure, showed that lycopene, 25mg daily or more, lowered LDL (bad) cholesterol by about 10% which is similar to the effect of low doses of statins in patients with slightly elevated cholesterol levels.

As in the other analysis,2 lycopene supplementation significantly lowered SBP by about 5 points, but more studies are needed to prove potential benefits on SBP and on total serum cholesterol.3


Are Tomatoes Better?


A different analysis4 of 21 studies confirmed that lycopene supplementation significantly lowered SBP by about 5 points. Adding tomatoes to the diet significantly lowered LDL-cholesterol and IL-6, a marker of inflammation, while improving endothelial function measured by blood vessel dilation in response to blood flow. The researchers suggest that individualized nutritional strategies involving tomatoes may help combat cardiovascular disease.


Not all the evidence is positive, however. Moderately overweight, otherwise healthy, middle-aged individuals randomly assigned to a relatively high daily intake of tomato-based products (32-50 mg lycopene/day) or to lycopene supplements (10 mg/d) did not experience improvements in conventional risk markers of cardiovascular disease.5


Could it be that the right combination of dietary ingredients is needed to bring out the vascular benefits of tomatoes? A study 6 of nearly 40,000 middle-aged and older women initially free of cardiovascular disease showed that dietary lycopene was not strongly associated with cardiovascular risk. However, higher levels of tomato-based products, especially two or more servings weekly of tomato sauce and pizza, had a protective effect. This suggests that dietary lycopene or other healthful plant compounds eaten as oil-based tomato products have cardiovascular benefits.6


Except for blood pressure control, where lycopene supplementation may be more effective, clinical research supports eating more tomato-based foods as a first-line strategy for heart health.7,8


Let’s Get Cooking!


The best recipe for heart health may be Mamma’s home-cooked tomato sauce simmered for hours with extra virgin olive oil, onion and garlic! Cooking time and onion content result in greater availability of beneficial lycopenes in tomato sauce.9


Although tomatoes alone lower total cholesterol, triglycerides and markers of inflammation, while raising high-density lipoprotein (healthy) cholesterol, benefits are significantly greater when tomatoes are cooked in olive oil.10 So adding tomatoes to our diet, especially when slow-cooked in olive oil with onion, may please our health as well as our palate!


How do tomatoes improve Vascular health?
How Does Lycopene Protect the Endothelium?
Tomato Sauce Enhances Benefits
What about Humans?
What about Other Produce?


+ References

1.Gajendragadkar PR, Hubsch A, Mäki-Petäjä KM, Serg M, Wilkinson IB, Cheriyan J. Effects of oral lycopene supplementation on vascular function in patients with cardiovascular disease and healthy volunteers: a randomised controlled trial. PLoS One. 2014 Jun 9;9(6):e99070. doi: 10.1371/journal.pone.0099070. eCollection 2014.

2. Li X, Xu J. Lycopene supplement and blood pressure: an updated meta-analysis of intervention trials. Nutrients. 2013 Sep 18;5(9):3696-712. doi: 10.3390/nu5093696.

3. Ried K, Fakler P. Protective effect of lycopene on serum cholesterol and blood pressure: Meta-analyses of intervention trials. Maturitas. 2011 Apr;68(4):299-310. doi: 10.1016/j.maturitas.2010.11.018. Epub 2010 Dec 15.

4. Cheng HM, Koutsidis G, Lodge JK, Ashor A, Siervo M, Lara J. Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis. Atherosclerosis. 2017 Feb;257:100-108. doi: 10.1016/j.atherosclerosis.2017.01.009. Epub 2017 Jan 13.

5. Thies F, Masson LF, Rudd A, Vaughan N, Tsang C, Brittenden J, Simpson WG, Duthie S, Horgan GW, Duthie G. Effect of a tomato-rich diet on markers of cardiovascular disease risk in moderately overweight, disease-free, middle-aged adults: a randomized controlled trial. Am J Clin Nutr. 2012 May;95(5):1013-22. doi: 10.3945/ajcn.111.026286. Epub 2012 Apr 4.

6. Sesso HD, Liu S, Gaziano JM, Buring JE. Dietary lycopene, tomato-based food products and cardiovascular disease in women. Nutr. 2003 Jul;133(7):2336-41.

7. Burton-Freeman B, Sesso HD. Whole food versus supplement: comparing the clinical evidence of tomato intake and lycopene supplementation on cardiovascular risk factors. Adv Nutr. 2014 Sep;5(5):457-85.

8. Willcox JK, Catignani GL, Lazarus S. Tomatoes and cardiovascular health. Crit Rev Food Sci Nutr. 2003;43(1):1-18.

9. Rinaldi de Alvarenga JF, Tran C, Hurtado-Barroso S, Martinez-Huélamo M, Illan M, Lamuela-Raventos RM. Home cooking and ingredient synergism improve lycopene isomer production in Sofrito. Food Res Int. 2017 Sep;99(Pt 2):851-861. doi: 10.1016/j.foodres.2017.01.009. Epub 2017 Jan 11.

10. Valderas-Martinez P, Chiva-Blanch G, Casas R, Arranz S, Martínez-Huélamo M, Urpi-Sarda M, Torrado X, Corella D, Lamuela-Raventós RM, Estruch R. Tomato Sauce Enriched with Olive Oil Exerts Greater Effects on Cardiovascular Disease Risk Factors than Raw Tomato and Tomato Sauce: A Randomized Trial. Nutrients. 2016 Mar 16;8(3):170. doi: 10.3390/nu8030170.


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