**4. Physical exercise**

Physical activity is currently recognized as a potent tool for the prevention of chronic degen‐ erative diseases, including CVDs and common tumors, such as those affecting the colon, breast, prostate and endometrium [28].

association cannot be established. The inconsistency of the results reflects the limitations of human studies, the diet differences, the pre-existing total anti-oxidant status, the stage of disease, the interaction between dietary modulation and genetic composition of indi‐ viduals, the dosage and duration of supplementation, the age and the sex. On the other hand, studies in animal models of atherosclerosis clearly show an atheroprotective effect of dietary anti-oxidants, however, they focus mainly on early atherosclerotic events and

Atherosclerosis and Current Anti-Oxidant Strategies for Atheroprotection

http://dx.doi.org/10.5772/53035

7

Cardiovascular prevention and treatment strategies should consider the simple, direct and inexpensive dietary approach as a first-line strategy to the burgeoning burden of CVDs,

In this review we focus our attention on the main natural anti-oxidants contained in food

Polyphenols are the most abundant anti-oxidants in human diet and are common constitu‐ ents of foods of plant origin and are widespread constituents of fruits, vegetables, cereals,

They are defined according to the nature of their backbone structures: phenolic acids, flavo‐ noids and the less common stilbenes and lignans. Among these, flavonoids are the most abundant polyphenols in the diet [34]. Despite their wide distribution, the health effects of dietary polyphenols have been attentively studied only in recent years [32] and several stud‐ ies, although not all, have found an inverse association between polyphenol consumption

Polyphenols exert anti-atherosclerotic effects in the early stages of atherosclerosis devel‐ opment, they decrease LDL oxidation, improve endothelial function, increase vasorelaxa‐ tion, modulate inflammation and lipid metabolism, improve anti-oxidant status and protect against atherothrombotic events including myocardial ischemia and platelet ag‐

Many polyphenols have direct anti-oxidant properties, acting as reducing agents, and may react with reactive chemical species forming products with much lower reactivity. Polyphenols may also affect indirectly the redox status by increasing the capacity of en‐ dogenous anti-oxidants or by inhibiting enzymatic systems involved in ROS formation [36]. The free-radical scavenging activity of many polyphenols has been reported to be much stronger than that of vitamin C, vitamin E or glutathione, the major anti-oxidants

In spite of their potent protective effects in the development of atherosclerosis, little is

olive, legumes, chocolate and beverages, such as tea, coffee and wine [32,33].

not in advanced atherosclerosis as in humans [27].

and on their primary diet source.

**6. Polyphenol**

and CVDs motality [35].

gregation [35].

present in the body.

known about aortic distribution of polyphenols [34].

alone or in combination with pharmalogic treatments [10].

There is a body of clinical and experimental evidence showing that voluntary and imposed physical exercise prevents the progression of CVDs and reduces cardiovascular morbidity and mortality. Therefore a physically active state is an appropriate and natural biological condition for human and most animal species [3].

It has been demonstrated that exercise slows the progression of atherosclerosis, promoting its stabilization and preventing plaque rupture in a variety of hypercholesterolaemic animal models, such as apolipoproteinE-deficient mice and LDL receptor-deficient mice, whereas physical inactivity accelerates it [3,29].

Exercise increases blood anti-oxidant capacity through elevating hydrophilic anti-oxi‐ dants (uric acid, bilirubin and vitamin C) and decreases lipophilic anti-oxidants (carote‐ noids and vitamin E) [28]. It is noteworthy that exercise prevents plaque vulnerability and atherosclerosis progression without necessarily correcting classic risk factors, such as hypercholesterolaemia, endothelial dysfunction and high blood pressure, suggesting that exercise can directly affect plaque composition and phenotype, thus preventing the ap‐ pearance of fatal lesions. Besides the effect of diet and drugs, the protective role of regu‐ lar exercise against atherosclerosis is well established and its beneficial atheroprotective effects are not limited to one particular cell, but to a variety of cells and tissues involved in the pathogenesis of atherosclerosis and metabolic disorders, such as macrophages and adipose tissue [3].

Regular exercise and a correct diet would be natural atheroprotective approaches which has been forgotten by modern societies.
