For many years, heart disease was thought of as a clogged pipe. That is, the more dietary fat you ate, the more would stick to your arteries and create a sticky plaque.

This story was, unfortunately, an oversimplification, popularized by the low-fat craze during the ’80s and ’90s. (2) Since then, clinical evidence has demonstrated how uncontrolled inflammation and oxidative stress are linked to the early progression of many cardiovascular and metabolic diseases, such as type 2 diabetes, hypertension, and atherosclerosis, now described as “cardiometabolic disease.” (7)(11)(23) 

While uncontrolled oxidative stress is detrimental to health, not all oxidation is bad! In the right amount, free radicals called reactive oxygen species (ROS) actually help your body function properly by acting as signaling molecules. It’s only when your body’s natural anti-oxidant defense system cannot keep up that ROS and other oxidants become harmful. (28)

In the conventional approach of treating metabolic disease, the emphasis is to control cardiovascular risk with multiple drugs that improve common lab measurements, such as blood pressure, blood glucose, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol.

While prescription drugs are certainly necessary for some patients, this approach has been unsuccessful in slowing the metabolic syndrome (METs) and obesity epidemic. (1) Given the relationship between uncontrolled oxidation and metabolic disease, strategies aimed at improving oxidative metabolism are becoming exciting additions to traditional therapies. (27)

The endothelium and oxidative vascular dysfunction

The endothelium is the one-cell-thick lining of blood vessels that acts as an interface for the blood and the rest of our body. Once thought of as a simple barrier, the endothelium is considered one of our largest organ systems, maintaining vascular tone through a variety of intricate mechanisms including nitric oxide (NO) production. (4)(13) Recognized as one of the most important molecules for vascular health, NO is the primary molecule that causes vascular relaxation, as well as being a protective anti-oxidant. (13)

Endothelial dysfunction (ED), now viewed as the earliest event of cardiometabolic diseases, occurs when NO levels fall to the point when your body is unable to properly dilate its blood vessels, which increases blood pressure. (13)(15) LDL particles in the bloodstream are also vulnerable to oxidative damage, becoming oxidized LDL (oxLDL), which are deposited in the artery wall and form fatty streaks and plaque. (15) High amounts of sugar in the blood react with proteins and lipids to form advanced glycation end products (AGEs), which increase ROS production and tissue damage, and are associated with diabetes and many age-related diseases. (12)

Foods for heart health and oxidation issues

Perhaps the most powerful way to balance inflammation and oxidative stress is through the foods you eat. As one of the most researched dietary patterns, the Mediterranean diet is commonly recommended for cardiovascular health. (24) Characterized by a high anti-oxidant and polyphenol concentration, clinical trials show that the Mediterranean diet was able to increase anti-oxidant levels in patients with high cardiovascular risk and significantly reduce heart attack, stroke, and death from CV outcomes over a 4.8-year follow-up compared with a low-fat diet. (3)

Supplements for heart health and oxidation issues

Several foods found in the Mediterranean diet have shown improvements in many cardiometabolic risk factors, prompting scientists to extract and concentrate these health-promoting molecules into researched, standardized supplements. Let’s explore how the following four supplements can help protect your endothelium, support the anti-oxidant defense system, and balance oxidative metabolism.

1. Bergamot

Citrus fruits are very high in anti-oxidant vitamin C, but they also contain numerous polyphenols that have many diverse mechanisms beneficial to cardiometabolic disease. Citrus flavonoids possess both anti-inflammatory and anti-oxidant abilities, as well as improve glucose tolerance and insulin sensitivity. (16)

One Mediterranean citrus fruit, known as bergamot, has a unique spectrum of polyphenols that not only lower inflammation and oxidative stress, but also naturally lower cholesterol production without side effects. (5)(18) Human clinical trials using bergamot extract show significant improvements in both lipid and glucose levels, making bergamot extract a powerful supplement for overall cardiometabolic health. (18)(21)

2. French maritime pine

During a French sea expedition in the 1500s, pine bark and needles were used as a tea to prevent scurvy. Since then, French maritime bark extract has been shown to contain not only vitamin C, but also powerful bioactive polyphenols called oligomeric procyanidins with strong anti-oxidant activity. (14) Clinical research shows this extract improves many aspects of cardiometabolic and vascular health, including lowering blood pressure and oxLDL levels, as well as increasing HDL, or “good” cholesterol. (25)

3. Pomegranate

Used as a symbol of fertility throughout history, pomegranates have long been viewed as possessing health-promoting properties. (19) Packed with potent anti-oxidant polyphenols called punicalagins, pomegranates and pomegranate extracts have been clinically studied to improve blood pressure and cholesterol levels, as well as improve endothelial function. (20)(22)(26)

4. Olives

As a staple of the Mediterranean diet, olives and olive oil have been investigated for their role in the diet’s beneficial effects. (6) And while olive oil is a rich source of healthy monounsaturated fatty acids (MUFAs), it also contains beneficial polyphenols shown to benefit many aspects of general health due to their anti-oxidant and anti-inflammatory activities. (6)(10)

Due to the low concentration of polyphenols found in many olive oils, standardized olive extracts were developed. (9)(20) Clinical trials examining standardized olive extract have shown reductions in markers of oxidative stress, inflammation, and increases in endothelial function. (20)

The bottom line

While the foundation for addressing any metabolic disease is a healthy diet, lifestyle practices, and exercise, specific polyphenol-rich foods and supplements are emerging as powerful tools to balance oxidation and support cardiometabolic health. Ask your healthcare practitioner which options are best for you before beginning a new treatment plan!

Disclosure: This article was written in partnership with Ortho Molecular. All supplier partnerships have been approved by doctors on our Integrative Medical Advisory team, and this content adheres to all guidelines outlined in our content philosophy. Fullscript has not been compensated financially for the publication of this article.