Cruciferous Vegetable Intake Associated with Abdominal Aortic Calcification

by | Oct 13, 2020 | 2020, Cardiovascular Health, Fruits and Vegetables

Written by Joyce Smith, BS. This study further validates the hypothesis that higher intake of cruciferous vegetables may protect against vascular calcification.

broccoliCardiovascular disease (CVD), due to the continual accumulation of fatty deposits, inflammatory cells and calcium in the intimal layer of the arterial wall 1, remains the leading cause of death in the world today 2. Calcium deposition with in the intimal and medial layers of the arterial walls is an indication of advanced atherosclerotic plaques 3 and can occur independently of atherosclerotic lesions 4.

In their previous work, Blekkenhorst and team validated an association between higher intake of cruciferous vegetables and lower carotid artery intima-media thickness and a lower risk of death due to atherosclerotic vascular disease 4. Abdominal arterial calcification (ACC) is an indicator of subclinical atherosclerotic disease and an independent predictor of subsequent death. ACC can be detected on bone density screening and is used to determine the severity of plaque deposition 5.

To further test their hypothesis 6 that an increased consumption of cruciferous vegetables protects against CVD, the Blekkenhorst team investigated whether higher intake of cruciferous vegetables is associated with lower odds of having AAC and to determine the mechanisms involved. They analyzed data from 684 older women who were part of a cohort of 1500 Western Australian women from the 1998 Calcium Intake Fracture Outcome Study and who met the inclusion criteria for this study. The criteria required the availability of previous study data relating to abdominal aortic calcification, dietary information, and energy intake and no previous diagnosis of atherosclerotic-related disease or diabetes mellitus. ACC scores were based on the Kauppila AAC24 scale on dual-energy X-ray absorptiometry lateral spine images and were adjusted to include two categories of ACC: “not extensive” (ACC scores 0-5) and extensive (ACC scores 6-24). Dietary intake was assessed via self-administered semi-quantitative FQQ that had also been adjusted to include a good estimate of total vegetables and classified types of vegetables. Included were four cruciferous vegetables: cabbage, Brussels sprouts, cauliflower, and broccoli.

According to data analysis, mean age of the 684 participants was 74.9 and their median cruciferous vegetable intake per day was 28.2 (IQR, 15.0-44.7) grams. ACC scores of 128 women (18.7%) were classified as “extensive AAC” with AAC scores of 6-24 and 495 of the women (72.4%) had evidence of AAC with scores of 0-6. After adjusting for lifestyle, dietary, and cardiovascular risk factors, those who consumed the  highest amount (≥44.6 g/day) of cruciferous vegetables had 46% lower odds of having extensive ACC when compared to those consuming ≤15 g/day (OR, 0.54; 95% CI, 0.30-0.97; P=.036). In fact, every 20 g/d of higher cruciferous vegetable intake lowered the odds of having extensive AAC by 19 % (OR 0·81, 95 % CI 0·66, 0·99, P = 0·042).Total vegetable intake and intake of each of the other types of vegetables in the food frequency questionnaire were not associated with extensive ACC (P for all >.05).

The positive effect of cruciferous vegetables may be due to their abundance of phylloquinone (vitamin K1) found in leafy green vegetables, broccoli and Brussels sprouts 7 and menaquinones (vitamin K2) found primarily in animal-based foods 8. Phylloquinone can breakdown to menadione, an intermediate which is then converted to menoquinone-4 9; which may reduce or prevent vascular calcification.

This study does not prove causality, may have residual confounding and cannot be extrapolated to younger adults or ethnicities other than Caucasian. Further studies are warranted.

Source: Blekkenhorst, Lauren C., Marc Sim, Simone Radavelli-Bagatini, Nicola P. Bondonno, Catherine P. Bondonno, Amanda Devine, John T. Schousboe et al. “Cruciferous vegetable intake is inversely associated with extensive abdominal aortic calcification in elderly women: a cross-sectional study.” British Journal of Nutrition (2020): 1-9.

© The Author(s), 2020. Published by Cambridge University Press on behalf of the Nutrition Society. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/)

Click here to read the full text study.

Posted October 13, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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