ABSTRACT

Although established cardiovascular disease (CVD) risk factors such as dyslipidemia, hypertension, and type 2 diabetes are the primary focus of lifestyle modiœcation, emerging clinical evidence indicates that lifestyle factors such as poor dietary habits, mental stress, inactivity, and excess body weight can also increase endothelial dysfunction in healthy people, which may accelerate early atherosclerosis progression (Marin et  al., 2011; USDA and HHS, 2010; Caballero et  al., 2008; Hamilton et al., 2007; Ignarro et al., 2007; Mozaffarian et al., 2005; Desideri et al., 2005; Aggoun et al., 2005; Spieker et al., 2002; Ghiadoni et al., 2000; McGill et al., 2000; Duffy et al., 1999; Hashimoto et al., 1998; Clarkson et al., 1996). There is growing clinical evidence that dietary and other lifestyle factors can help to maintain healthy endothelial function (Pase et al., 2011; Marin et al., 2011; Raghuveer, 2010; Heiss et al., 2010; Yeboah et al., 2009; Aggoun et al., 2008; Caballero et  al., 2008; Juonala et  al., 2008; Mozaffarian et  al., 2008; Kato et al., 2006; Mancini, 2004;

25.1 Introduction .......................................................................................................................... 435 25.2 Vascular Endothelium and Cardiovascular Health ............................................................... 436

25.2.1 Noninvasive Measures of Endothelial Dysfunction ................................................. 437 25.3 Meal Patterns and Endothelial Dysfunction ......................................................................... 438

25.3.1 High-Calorie and High-Saturated Fat Meals Patterns ............................................. 438 25.3.2 High-Sodium Meals .................................................................................................. 439 25.3.3 Low Antioxidant Dietary Patterns ............................................................................ 439 25.3.4 Low Fruit and Vegetable Meal Patterns ...................................................................440