Circulation and Heart Health


Cardio talk generally turns to cholesterol and blood pressure. But circulation should also factor into any heart health discussion.

Like a three-legged stool, a strong cardiovascular platform rests on several points: cholesterol, blood pressure-and circulation. All three intertwine, and a steady heart health plan will factor in each.

So far, the natural products industry has done a good job addressing the first two areas, cholesterol and blood pressure. For cholesterol management, the list of ingredients promoted to help is long: omega-3 fatty acids, red yeast rice, niacin, plant sterols, gugulipid, policosanol extracted from beeswax, fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil are just a few. Anyone using prescription statin drugs to lower cholesterol should also be taking daily doses of CoQ10, since statins appear to leech this critical nutrient from the body. For blood pressure, natural initiatives include reducing sodium and applying such ingredients as grape seed extract, vitamin C, vitamin E, magnesium, garlic, hawthorn, and flaxseed oil.

This catalog of natural remedies is great news for cholesterol and blood pressure. But what about circulation? Reto Rieder, senior marketing manager for DSM Nutritional Products (Parsippany, NJ), contends that this area of heart health has been largely overlooked by the dietary supplements industry.

However, there are some ingredients, a few discussed ahead, for which suppliers say evidence has shown specific circulation benefits.


Fruitflow, an ingredient researched and developed by Provexis plc (Windsor Berkshire, UK) and manufactured and marketed by DSM, is a water-soluble tomato extract that is said to be the first ingredient to specifically address increased blood platelet aggregation.

As Stephen Moon, CEO of Provexis, describes, “Abnormal blood platelet aggregation can be described as a ‘stickiness’ or spikiness of platelets in the blood vessel. This change in the formation of the blood platelets increases the risk of blood clots and of cardiovascular events such as heart attack, stroke, or arterial disease. Fruitflow actively smoothes blood platelets, facilitating the flow of blood around the body.”

In fact, Fruitflow has proven to be effective in 97% of subjects tested in published studies, leading the European Food Safety Authority (EFSA) to grant Fruitflow the first Article 13.5 health claim, which reads “Fruitflow helps maintain normal platelet aggregation, which contributes to healthy blood flow.” The ingredient also has GRAS status in the United States.

Given this success, DSM and Provexis are working together to further expand applications for Fruitflow in the nutraceuticals market.

Rieder says that until mid-spring, Fruitflow had been offered in liquid form only-even though one of the ingredient’s eight clinical studies featured a specially prepared powder version. (In that study, he notes, the powder started working to maintain healthy platelet aggregation and improve blood flow after just 90 minutes, and lasted in the body for 12 to 18 hours.) Fruitflow’s original liquid version, called Fruitflow I, is a water-soluble syrup for food and beverage applications, including juice- and water-based beverages as well as dairy. In liquid form, the recommended dosage is 3 g.

DSM and Provexis are now working on developing a powder format that is further refined, concentrated, and better suited for use in dietary supplements, at a recommended dose of 150 mg. The company says the decision to develop Fruitflow powder stems from strong commercial interest from the supplements sector. By the end of last year, the companies had tested a small-scale production run of Fruitflow powder for bioavailability, and this January, they completed an industrial-scale production run of the powder. Market availability of this powder version was expected to come on stream near the time of this article’s publication-or perhaps even sooner.

The joint effort between Provexis and DSM has been a good one to date. Moon remarks, “The synergy between the two companies has allowed us to create highly functional and profitable health and nutrition ingredients.”

In addition, Moon says, future work between the companies may also take a look at other health categories in which Fruitflow’s benefits may translate. Sports supplementation is one. “Provexis scientists are currently investigating how Fruitflow can be used in sports applications. It is little known among consumers that problematic blood platelet aggregation can occur after highly strenuous exercise. This is especially true for people who aren’t used to intense physical activity. Unlike trained endurance athletes, they don’t produce enough platelet-calming nitric oxide to maintain healthy blood flow.”

According to Moon, “The effects of strenuous physical exercise can be fatal for those with underlying health conditions, such as atherosclerosis or cardiac health problems. Approximately 70% of exercise-induced sudden deaths and heart attacks in the over-35 age group are attributed to obstruction of arteries by platelet clots.” (Baertsch et al., 1999.)

Other Ingredients

Meanwhile, Rieder also takes care to emphasize that DSM is not putting all its cardio “eggs” in one Fruitflow basket. The company offers a wide range of other ingredients for cardiovascular health, including vitamins C and E, which act as antioxidants; B vitamins (B2, B6, B12, folate), which can help lower homocysteine levels, a CVD risk factor; vitamin D, because low blood concentrates of vitamin D correlate with an increased risk of CVD, in particular hypertension; and Resvida resveratrol, which helps to improve endothelial function.


DSM also offers its ROPUFA/Life’s DHA long-chain omega-3 fatty acids, which help to reduce the risk of coronary heart disease, lower triglyceride levels, and maintain overall healthy heart function

In fact, most would say that omega-3 fatty acid should be an essential component of any heart-healthy supplementation program-including one focusing on circulatory health. Mary Ann Siciliano, national sales director for Arista Industries Inc. (Wilton, CT), says, “Researchers have found that supplemental intake of omega-3 helps in lowering blood pressure, levels of inflammation, relaxing blood vessels, and lowering cholesterol levels.”

Cranberry and Chokeberry

Ocean Spray, famous for its humorous television commercials, is absolutely serious when it comes to extolling the cardiovascular virtues of cranberry and cranberry byproducts. In mid-March, the Lakeville, MA–based agricultural cooperative called industry and consumer attention to a new study published in the American Journal of Clinical Nutrition.

The crossover, double-blind, placebo-controlled study measured a range of cardiovascular indicators, including arterial blood pressure and blood flow. According to Ocean Spray, “The study found that participants who consumed double-strength cranberry juice cocktail experienced significant reduction in arterial stiffness, an indicator of cardiovascular disease. These findings are in line with previous research, which has shown that polyphenol-containing foods like cranberry can support vascular health.”

Lead researcher Joseph A. Vita, MD, professor of medicine at Boston University School of Medicine, commented, “Our study found a significant effect of cranberry juice on central aortic stiffness, which is increasingly recognized as an important measure of vascular function with relevance to cardiovascular disease.” Arterial stiffness was measured using carotid-femoral pulse wave velocity, an emerging measure of vascular function and a strong indicator of CVD risk.

Christina Khoo, senior manager of research sciences at Ocean Spray, added, “Cranberry has been found to be beneficial for whole-body health. We look forward to future research to investigate the precise mechanisms involved in this process.”

Of note, another berry, the aroniaberry, also known as chokeberry, is noted for its antioxidant properties. In addition to the potential to reduce blood pressure, improve blood lipid profiles, and reduce markers of inflammation, it is said to be able to improve circulation.

Melanie Bush, director of science for Artemis International Inc. (Fort Wayne, IN), cites a human pilot study in which subjects who consumed aroniaberry anthocyanins experienced an increase in flow-mediated dilation of the brachial artery, indicative of improved circulation (Bell et al., 2001).

She also noted, “A new 2011 human study showed that aroniaberry supplementation for one month resulted in the normalization of hemostasis parameters in patients with metabolic syndrome as well as favorable changes in regard to the overall potential for plasma clotting, clot formation, and lysis, and in the lipid profiles of the subjects (Sikora, 2011).”

Vitamin K

Ingredients supplier NattoPharma ASA (Lysaker, Norway) says that vitamin K2 may also offer circulatory benefits. By activating a protein called osteocalcin, vitamin K2 can help attract calcium into skeletal tissue, where it is needed to make bones stronger and less brittle, and bring calcium out of soft tissues like arteries and veins, where it is unwanted and can cause cardiovascular disease. “As people age,” says Bertil Andersson, NattoPharma’s vice president of sales, “arteries become increasingly harder and can endanger the heart by prohibiting vital blood flow to the heart muscle fibers.” NattoPharma offers MenaQ7, a branded version of natural vitamin K2.

Andersson cites the 10-year-long Rotterdam Study, in which 4,807 initially healthy men and women over 55 years of age took part. Findings released in 2004 showed that eating foods rich in natural vitamin K2 (at least 32 mcg per day) resulted in 50% reduction of arterial calcification, 50% reduction in cardiovascular death, and 25% reduction of all-cause mortality. Because K2 is not commonly gotten in the Western diet, Andersson says it is “beneficial to take supplements to make up for this deficit.”

Morristown, NJ–based P.L. Thomas, distributor of MenaquinGold branded K2, also is high on vitamin K2 for cardiovascular benefits. In a 2011 article appearing in NutraCos, Vladimir Badmaev, the company’s director of scientific and medical affairs, and four co-authors stated, “Natural vitamin K2 as menaquinone MK-7 has been recently clinically demonstrated as having a fundamentally important role in calcium utilization in both bones and the cardiovascular system. Osteocalcin and matrix-GLA protein involved in building bone matrix and keeping calcium from accumulating in the arterial walls respectively need sufficient vitamin K2 to function properly.”

Grape Seed Extract, Pycnogenol

MegaNatural-BP is another product distributed by P.L. Thomas. Manufactured by Polyphenolics (Madera, CA), it is a “patented, distinct form of grape seed extract” that is aimed at maintenance of blood pressure that is already within the appropriate range. It also may offer benefits to blood vessels.

Steve Kupina, Polyphenolics’s director of technical sales, cites two human clinical trials conducted at UC Davis. He says these studies showed that grape seed extract activates the enzyme endothelial nitric oxide synthase (eNOS). When nitric oxide is increased in the endothelial cells of blood vessels, the vessels are vasodilated, blood flow improves, and blood pressure is reduced.

Pycnogenol, the French maritime pine bark extract from Horphag Research (Geneva), has also shown good results for activating NOS and thus improving blood flow and preventing blood platelet aggregation.

As the company describes, “Nitric oxide is synthesized by endothelial cells which line the interior wall of blood vessels. NO molecules diffuse through the blood vessel wall to finally interact with a specific receptor in smooth muscle enveloping the vessel. This causes the muscle to relax, and in turn, the vessel lumen increases. This self-regulation mechanism allows for relieving insufficient tissue perfusion and pressure build-up in blood vessels.”

A 2007 double-blind, placebo-controlled study on 16 young, healthy adults showed that after two weeks of Pycnogenol supplementation, blood flow (measured by forearm artery dilatation) increased by up to 46% from baseline (Nishioka et al.).

Olives for Life

Considering how much credit the Mediterranean diet receives for its contributions to heart health, it is not surprising to also find an olive-related substance among supplement ingredients. A product of Frutarom USA Inc. (North Bergen, NJ), Benolea is a clinically tested extract of olive leaf (Olea europa). Technical specialist Eden Somberg, MS, LAc, says, “The benefits of this ingredient are fourfold: beneficial blood pressure range, healthy cholesterol level, healthy blood sugar, and coronary and vascular protection from the antioxidants present.”

Somberg reports that a clinical trial with adult twins confirmed a dose-dependent blood pressure lowering effect as well as a significant reduction of LDL. The apparent mechanisms of action for the ingredient include ACE (angiotensin-converting enzyme) inhibition, interference of nitric oxide as a messenger substance, and vasodilator activity.


Sidebar: Also for Healthy Arteries

Promoted for healthy arteries, Artinia from Stratum Nutrition (St. Charles, MO) is a complex of two beneficial fiber compounds, chitin and 1,3 beta-glucans (chitin-glucan) that aims to prevent LDL cholesterol from oxidizing in the arteries. If not controlled, the company says, oxidation of LDL cholesterol can lead to the formation of fatty streaks in arterial tissue, which can turn into arterial plaque.

Nena Dockery, technical services manager for ESM Technologies (Carthage, MO), which developed Artinia in collaboration with Stratum, says that Artinia was evaluated in a placebo-controlled study utilizing hamsters fed a high-fat diet. According to Dockery, “The data revealed a significant increase in antioxidant activity (superoxide dismutase (SOD) and glutathione peroxidase (GPx)) in the liver, and a subsequent decrease in levels of reactive oxygen species. It also substantially decreased areas of aortic fatty streak deposition, a precursor to arterial plaque formation. A short pilot human study was conducted as a follow-up to the hamster study, revealing similar results in the reduction of oxidized LDL levels.” Some beneficial effects, she adds, may also result from Artinia’s prebiotic effect on particular strains of gut bacteria.

Artinia can be used in nearly any type of supplement or food application, including chewable tablets, gummies, powder mixes, functional bars, baked goods-even yogurts and smoothie beverages.

Kearny, NJ-based Proprietary Nutritionals Inc. (PNI) offers two established ingredients for cardiovascular support-Sytrinol and Benexia. According to company president Dean Mosca, “Sytrinol is a blend of powerful antioxidants including polymethoxylated flavones (PMFs) and a range of palm tocotrienols (alpha, delta and gamma).”

Three studies have investigated Sytrinol’s effects on high cholesterol levels. In the first, 60 participants with raised cholesterol levels took 300 mg of Sytrinol each day for four weeks. At the end of the study, researchers found that the participants had lowered total cholesterol by 25 percent, LDL cholesterol by 19 percent, and triglycerides by 24 percent.

In the second study, 10 subjects with elevated cholesterol were able to lower total cholesterol levels by 20 percent, LDL cholesterol by 22 percent, apolipoprotein B (a component of LDL) by 21 percent, and triglycerides by 28 per cent. Participants also had a significant 5 percent increase in apolipoprotein A1, an important structural protein of HDL cholesterol.

The third clinical trial was a 12-week placebo-controlled study involving 120 men and women with moderately elevated cholesterol levels. Compared to those in the placebo group, subjects taking Sytrinol had a 30 percent drop in total cholesterol, 27 percent in LDL cholesterol, and 34 percent in triglycerides. In addition, HDL levels increased by 4 percent, resulting in a significant 29 percent improvement in the LDL:HDL ratio.

Mosca describes Benexia Chia Seed as a gluten-free whole grain. “Organically grown and naturally harvested, it can be eaten right from the plant, mixed with food or drink, or ground into flour for baking. It is abundant in omega-3 EFAs, protein, dietary fiber, calcium and magnesium.”

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