Dietary Fibre Protective against Colorectal Cancer Patients in Asia: A Meta-Analysis

The Role of Adipocytes Recruited as Part of Tumor Microenvironment in Promoting Colorectal Cancer Metastases

Adipose tissue dysfunction, which is associated with an increased risk of colorectal cancer (CRC), is a significant factor in the pathophysiology of obesity. Obesity-related inflammation and extracellular matrix (ECM) remodeling promote colorectal cancer metastasis (CRCM) by shaping the tumor microenvironment (TME). When CRC occurs, the metabolic symbiosis of tumor cells recruits adjacent adipocytes into the TME to supply energy. Meanwhile, abundant immune cells, from adipose tissue and blood, are recruited into the TME, which is stimulated by pro-inflammatory factors and triggers a chronic local pro-inflammatory TME. Dysregulated ECM proteins and cell surface adhesion molecules enhance ECM remodeling and further increase contractibility between tumor and stromal cells, which promotes epithelial-mesenchymal transition (EMT). EMT increases tumor migration and invasion into surrounding tissues or vessels and accelerates CRCM. Colorectal symbiotic microbiota also plays an important role in the promotion of CRCM. In this review, we provide adipose tissue and its contributions to CRC, with a special emphasis on the role of adipocytes, macrophages, neutrophils, T cells, ECM, and symbiotic gut microbiota in the progression of CRC and their contributions to the CRC microenvironment. We highlight the interactions between adipocytes and tumor cells, and potential therapeutic approaches to target these interactions.

The association between dietary folate intake and risk of colorectal cancer incidence: A systematic review and dose‒response meta-analysis of cohort studies

Background

Dietary components can influence the incidence of colorectal cancer (CRC). Folate is one of the compounds that plays an essential role in the formation of DNA structures, which can lead to or prevent tumorigenesis. The present study is the first systematic review and dose-response meta-analysis of cohort studies evaluating the association between dietary folate intake and the risk of CRC.

Methods

The PubMed/Medline, Scopus, and ISI Web of Science databases were systematically searched for cohort studies that assessed the association between folate intake and CRC up to January 2024. Summary relative risks (RRs) and 95 % confidence intervals (CIs) were calculated using a random effects model. Also, linear and nonlinear dose-response analyses were conducted for the dose-response associations between folate intake and risk of CRC.

Results

Eighteen prospective cohort studies with 931,469 participants, 14,860 CRC patients, 3536 colon cancer (CC) patients, and 1075 rectal cancer (RC) patients were included in the analysis. The summary RR of CRC for each 100-μg increase in dietary folate intake was 0.97 (95 % CI: 0.95-0.99, I2: 0.0 %, P-heterogeneity: 0.616), which can be related to BMI (0.97 (95 % CI: 0.95-0.99)); a more protective effect was also observed in subjects who drank alcohol (0.97 (95 % CI: 0.95-0.99)) and those who smoked (0.97 (95 % CI: 0.95-0.99)). Additionally, it was positively related to a 7 % lower risk of CC (0.93 (95 % CI: 0.87-0.99, I2: 33.7 %, P-heterogeneity: 0.159)), and the null relation for RC was 0.98 (95 % CI: 0.90-1.08), I2: 16.6 %, P-heterogeneity: 0.309). There was evidence of nonlinearity in which up to 500 μg/day dietary folate intake was inversely associated with CC (P nonlinearity = 0.04).

Conclusion

The findings showed an inverse association between dietary folate intake and the risk of CRC, especially in high-risk persons, those who have a higher BMI, alcohol drinkers, and smokers.

Dietary Inflammatory Index and diabetic retinopathy risk in US adults: findings from NHANES (2005-2008)

BACKGROUND

Inflammation is associated with the pathophysiology of diabetic retinopathy (DR). Within the framework of complete dietary patterns, the Dietary Inflammatory Index (DII) was formulated to evaluate the inflammatory properties inherent in a diet. The main purpose of the current study was to assess the relationship between DII and DR using National Health and Nutrition Examination Survey (NHANES).

METHODS

The original sample size included 1,148 diabetes patients out of 2005-2008 NHANES surveys. Twenty-four-hour dietary consumptions were used to calculate the DII scores. Demographic characteristics and retina examinations were collected for the comparison between DR and non-DR groups in diabetes patients. The relationship between DII and DR was analyzed by a logistic regression model.

RESULTS

227 subjects (110 non-DR and 117 DR) were selected in the analyses by using undersampling method to balance the sample size. Compared with non-DR group, DR group had higher DII values (1.14 ± 0.29 vs. 1.49 ± 0.21, p = 0.32), higher levels of HbA1c (6.8 ± 1.1% vs. 7.7 ± 2.6%, p < 0.001), longer duration of diabetes (6.52 ± 12 years vs. 14 ± 11 years, p < 0.001). The odds rate (OR) of DII for DR from the logistic regression was 1.38 (95%CI 1.06-1.81, p < 0.001). HbA1c, diabetes duration and obesity were important influencing factors, and their ORs were 1.81 (95% CI:1.31-2.50), 1.12 (95%CI:1.04-1.20), 4.01 (95%CI:1.12-14.32), respectively. In addition, the most important dietary indices for DR were different across males and females.

CONCLUSIONS

The current study demonstrates that a higher DII is associated with an increased risk of DR in US adults. Considering diet as a modifiable factor, limiting pro-inflammatory diets or encouraging an anti-inflammatory diet may be a promising and cost-effective method in the management of DR.

Methodological Challenges and Confounders in Research on the Effects of Ketogenic Diets: A Literature Review of Meta-Analyses

Several meta-analyses have found a positive association between a popular type of "fad diet", ketogenic diets, and their effect on anthropometric and blood parameters. However, the non-specific inclusion criteria for meta-analyses may lead to incorrect conclusions. The aim of this literature review is to highlight the main confounders and methodological pitfalls of meta-analyses on ketogenic diets by inspecting the presence of key inclusion criteria. The PubMed, Embase, and Web of Science databases and the Cochrane Database of Systematic Reviews were searched for meta-analyses. Most meta-analyses did not define the essential parameters of a ketogenic diet (i.e., calories, macronutrient ratio, types of fatty acids, ketone bodies, etc.) as inclusion criteria. Of the 28 included meta-analyses, few addressed collecting real, re-measured nutritional data from the ketogenic diet and control groups in parallel with the pre-designed nutritional data. Most meta-analyses reported positive results in favor of ketogenic diets, which can result in erroneous conclusions considering the numerous methodological pitfalls and confounders. Well-designed clinical trials with comparable results and their meta-analyses are needed. Until then, medical professionals should not recommend ketogenic diets as a form of weight loss when other well-known dietary options have been shown to be healthy and effective.

Low-Carbohydrate Diet Score and the Risk of Colorectal Cancer: Findings from the Singapore Chinese Health Study

BACKGROUND

Colorectal cancer is common cancer with a high mortality rate. Low-carbohydrate diet (LCD) score holistically evaluates the LCD pattern from carbohydrate, protein, and fat intake. Epidemiologic data of LCD-colorectal cancer association are sparse.

METHODS

We evaluated the associations between LCD (i.e., total, animal- and plant-based) and colorectal cancer risk in the Singapore Chinese Health Study, a population-based prospective cohort study including 61,321 Chinese in Singapore who were 45 to 74 years old at baseline. Cox proportional hazard regression model was used to determine the HRs and respective 95% confidence intervals (CI) for colorectal cancer associated with LCD after adjusting for potential confounders, including age, sex, BMI, physical activity, family history of colorectal cancer, etc.

RESULTS

After an average of 19.5 years of follow-up, 2,520 participants developed colorectal cancer (1,608 colon cancer and 912 rectal cancer). Overall, the association between total or plant-based LCD scores with the risk of colorectal, colon, or rectal cancer was null (all Ptrend ≥ 0.28). The animal-based LCD was modestly associated with colon cancer risk (Ptrend = 0.02), but not with rectal cancer. Compared with the lowest quartile, HRs (95% CIs) of colon cancer for quartiles 2, 3, and 4 of animal-based LCD were 1.12 (0.98-1.29), 1.27 (1.10-1.46), and 1.14 (0.99-1.31), respectively.

CONCLUSIONS

A low-level carbohydrate diet with a high level of animal protein and fat was associated with a moderate increase in the risk of colon cancer among Chinese Singaporeans.

IMPACT

High consumption of animal protein/fat and low consumption of carbohydrates may increase colon cancer risk.

Microbial Metabolite Dysbiosis and Colorectal Cancer

The global burden of colorectal cancer (CRC) is expected to continuously increase. Through research performed in the past decades, the effects of various environmental factors on CRC development have been well identified. Diet, the gut microbiota and their metabolites are key environmental factors that profoundly affect CRC development. Major microbial metabolites with a relevance for CRC prevention and pathogenesis include dietary fiber-derived short-chain fatty acids, bile acid derivatives, indole metabolites, polyamines, trimethylamine-N-oxide, formate, and hydrogen sulfide. These metabolites regulate various cell types in the intestine, leading to an altered intestinal barrier, immunity, chronic inflammation, and tumorigenesis. The physical, chemical, and metabolic properties of these metabolites along with their distinct functions to trigger host receptors appear to largely determine their effects in regulating CRC development. In this review, we will discuss the current advances in our understanding of the major CRC-regulating microbial metabolites, focusing on their production and interactive effects on immune responses and tumorigenesis in the colon.

Beneficial insights into postbiotics against colorectal cancer

Colorectal cancer (CRC) is one of the most prevalent and life-threatening cancer types with limited therapeutic options worldwide. Gut microbiota has been recognized as the pivotal determinant in maintaining gastrointestinal (GI) tract homeostasis, while dysbiosis of gut microbiota contributes to CRC development. Recently, the beneficial role of postbiotics, a new concept in describing microorganism derived substances, in CRC has been uncovered by various studies. However, a comprehensive characterization of the molecular identity, mechanism of action, or routes of administration of postbiotics, particularly their role in CRC, is still lacking. In this review, we outline the current state of research toward the beneficial effects of gut microbiota derived postbiotics against CRC, which will represent the key elements of future precision-medicine approaches in the development of novel therapeutic strategies targeting gut microbiota to improve treatment outcomes in CRC.

Microbiota-Derived Natural Products Targeting Cancer Stem Cells: Inside the Gut Pharma Factory

Cancer stem cells (CSCs) have drawn much attention as important tumour-initiating cells that may also be crucial for recurrence after chemotherapy. Although the activity of CSCs in various forms of cancer is complex and yet to be fully elucidated, opportunities for therapies targeting CSCs exist. CSCs are molecularly distinct from bulk tumour cells, so they can be targeted by exploiting their signature molecular pathways. Inhibiting stemness has the potential to reduce the risk posed by CSCs by limiting or eliminating their capacity for tumorigenesis, proliferation, metastasis, and recurrence. Here, we briefly described the role of CSCs in tumour biology, the mechanisms involved in CSC therapy resistance, and the role of the gut microbiota in cancer development and treatment, to then review and discuss the current advances in the discovery of microbiota-derived natural compounds targeting CSCs. Collectively, our overview suggests that dietary intervention, toward the production of those identified microbial metabolites capable of suppressing CSC properties, is a promising approach to support standard chemotherapy.

Cationic cellulose nanocrystals as sustainable green material for multi biological applications via ξ potential

The present study aims to disclose the activity of cationic cellulose nanocrystals (CNCs) as a promising multifunctional green nanomaterial with applications in biological aspects. The basic reason behind multifunctional behavior is zeta potential and size distribution of nano biopolymers; exhibit a remarkable physical and biological activity compared to normal molecules.The preliminary characterized studied using absorption spectral analysis showed strong absorption peak indicating that spectrum curves can be screen by UV spectra at wavelength range 200-400nm. Ultrastructural studies (SEM-EDS and TEM), manifest that CNCs are elliptical particles in shape. Also, TEM show CNCs are the ideal illustration of zero-dimensional (0-D) NPs, less than 5.1 nm in diameter with Cationic charge and similar results in size distribution by TEM. Nonetheless, developed as antioxidant activity IC₅₀ was 1467 ± 25.9 µg/mL, antimicrobial activity tested G^-ve strains, but not affected on tested G^+ve strains and tested fungi. Evaluating toxicity effect of cationic CNCs against human blood erythrocytes (RBCs) and Lymphocyte Proliferation and the end point evaluate by comet assay, which proven no cytotoxic effect. Also, a high dose 500 µg/mL of CNCs highly significant (p < 0.05) reduction in cell viability of Caco-2 cancer cells after 24 h. incubation time, whereas the IC₅₀ was 1884 ± 19.46 µg/mL. Moreover, genotoxic assay indicates Caco-2 cells cause apoptosis with no fragmentation in DNA. Undoubtedly, the obtained results brought about by the interaction of layers carrying opposing charges. Additionally, there is a balance between hydrophilic contact and electrostatic attraction. That emphasizes how the cationic CNCs have excellent potential for use as antioxidants, antimicrobials, and anticancer agents.

Effect of psyllium husk and wheat mill bran fractions on the microstructure and mixograph characteristics of Arabic bread

When psyllium husk, wheat bran and germ was added, Incorporation of psyllium and wheat bran may affect the dough structure, dough rheology as well as the final quality of baked Arabic flat bread, which, thus, became important for this study. Scanning Electron Micrographs (SEM) taken on Arabic bread, depicted both intact small and the large starch granules on the outer crust area. This was mainly due to the rapid loss of moisture from the Arabic bread surface during intense baking operation leaving less moisture for gelatinization to take place. With psyllium added to WWF at 0, 3, and 5 % level, the peak time was increased from 3 to 4.5 min. The ascending and descending angle values were more or less identical in all the samples except with wheat germ addition, whereas much lower values (51 to 58°) for these parameters were observed, indicating a faster rate of dough breakdown. With psyllium, fine- and coarse bran addition to WWF, a corresponding increase in peak time was observed. Ascending and descending angles showed similar trends to that of the WWF and psyllium combinations. Use of falling number apparatus is an indirect method of measuring the diastatic enzyme activity in cereal flours. WGF showed lower falling-number values (502 s) than the WWF (607 s). Addition of fine bran to WWF lowered the falling number (607 to 563 s) whereas with coarse wheat bran and germ, these values were increased.

The effect of FTO rs9939609 polymorphism on the association between colorectal cancer and dietary fiber

Background

Gene polymorphisms may explain the controversy on the association between colorectal cancer (CRC) and dietary fibers. The purpose of this study was to investigate the effect of fat mass and obesity-associated (FTO) rs9939609 polymorphism on the association between colorectal cancer and dietary fiber.

Methods

This case-control study was conducted on 160 CRC cases and 320 healthy controls in Tehran, Iran. The participants' food intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). The frequency of rs9939609 FTO polymorphism in the case and control groups was determined using the tetra-primer amplification refractory mutation (tetra-ARMS) method.

Results

In the participants with the TT genotype of the FTO rs9939609, the cases had higher BMI and lower intake of dietary fiber compared to the controls (P = 0.01). Among A allele carriers of FTO rs9939609 polymorphism, the cases had higher BMI (P = 0.04) and lower intake of total fiber (P = 0.02) and soluble fiber (P = 0.02). An inverse association was found between CRC and dietary fiber intake among those with the AA/AT FTO rs9939609 genotype after adjusting for age, sex, smoking, alcohol consumption, physical activity, BMI, and calorie intake (OR = 0.9, CI 95%:0.84-0.92, P < 0.05).

Conclusion

This study found a link between higher dietary fiber consumption and a lower risk of CRC in A-allele carriers of FTO rs9939609 polymorphism. Future studies are needed to identify the underlying mechanisms of the association between CRC and dietary fibers in people with different FTO genotypes.

Anti-inflammatory and Antioxidant Effect of Lycoperoside H against the 1,2-Dimethyl Hydrazine (DMH) Induced Colorectal Cancer in Rats

In many developed countries, colorectal cancer is a leading cause of morbidity and mortality and its etiology is familiar to be a grouping of nutritional and environmental factors, less physical activity and hereditary factors. Lycoperoside H (LH) is a steroidal alkaloid saponin commonly found in the tomato and exhibited the various pharmacological effects. The aim of the current study was to scrutinized the anticancer effect of LH against 1,2‑Dimethyl Hydrazine (DMH) induced colorectal cancer (CRC) in rats. Subcutaneous injection of DMH (20 mg/kg) was used for induction the CRC and rats were received the oral administration of LH (10, 20 and 40 mg/kg) for 16 weeks. At the end of the investigation, the tumor incidence, weight, and body weight were calculated. Antioxidant enzymes (phase I and II), inflammatory cytokines, lipids and inflammatory markers were all examined. DMH induced rats exhibited the increased tumor incidence, reduced body weight and LH treatment significantly (p < 0.001) suppressed the tumor incidence, and enhanced the body weight. LH treatment significantly (p < 0.001) boosted the level of SOD, GPx, GSH, CAT and suppressed the MDA level. LH treatment suppressed the level cytochrome b5 (Cyto b5), cytochrome P450 (Cyto P450) and boosted the level of glutathione S‑transferase (GST), uridine diphosphoglucuronyltransferase (UDP‑GT) in the liver and colon tissue. LH also decreased the level of cytokines includes interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α); inflammatory mediators like Inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), prostaglandin (PGE2) and nuclear factor kappa B (NF-κB) in the hepatic and colon tissue. We can conclude that LH revealed the anticancer effect against the DMH induced CRC via suppression of inflammation and oxidative stress.

Herb and Spices in Colorectal Cancer Prevention and Treatment: A Narrative Review

Colorectal cancer (CRC) is the second most deadly cancer worldwide. CRC management is challenging due to late detection, high recurrence rate, and multi-drug resistance. Herbs and spices used in cooking, practised for generations, have been shown to contain CRC protective effect or even be useful as an anti-CRC adjuvant therapy when used in high doses. Herbs and spices contain many bioactive compounds and possess many beneficial health effects. The chemopreventive properties of these herbs and spices are mainly mediated by the BCL-2, K-ras, and MMP pathways, caspase activation, the extrinsic apoptotic pathway, and the regulation of ER-stress-induced apoptosis. As a safer natural alternative, these herbs and spices could be good candidates for chemopreventive or chemotherapeutic agents for CRC management because of their antiproliferative action on colorectal carcinoma cells and inhibitory activity on angiogenesis. Therefore, in this narrative review, six different spices and herbs: ginger (Zingiber officinale Roscoe), turmeric (Curcuma longa L.), garlic (Allium sativum L.), fenugreek (Trigonella foenum-graecum L.), sesame (Sesamum indicum L.), and flaxseed (Linum usitatissimum L.) used in daily cuisine were selected for this study and analyzed for their chemoprotective or chemotherapeutic roles in CRC management with underlying molecular mechanisms of actions. Initially, this study comprehensively discussed the molecular basis of CRC development, followed by culinary and traditional uses, current scientific research, and publications of selected herbs and spices on cancers. Lead compounds have been discussed comprehensively for each herb and spice, including anti-CRC phytoconstituents, antioxidant activities, anti-inflammatory properties, and finally, anti-CRC effects with treatment mechanisms. Future possible works have been suggested where applicable.

Dietary fiber in the prevention of obesity and obesity-related chronic diseases: From epidemiological evidence to potential molecular mechanisms

Obesity is a mostly preventable diet-related disease and currently a major challenge for human populations worldwide. Obesity is a major risk factor for diseases such as type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD) and certain cancers. Dietary fiber is a complex mixture of non-digestible molecules, mostly polysaccharides. Multiple epidemiological studies have demonstrated statistically significant reductions in risks of obesity, T2DM, CVD, colorectal cancer, and pre-menopausal breast cancer with higher dietary fiber intakes. Various direct and indirect mechanisms have been proposed including altered digestion and absorption, stimulation of gut hormones including glucagon-like-peptide-1 (GLP-1) and peptide YY (PYY), reduced appetite, and altered metabolism of bile and cholesterol. These may act via pathways involving G-protein-coupled receptors (GPRs), histone deacetylase (HDAC), and aromatase enzymes. Ultimately, fiber intake contributes to improving glucose levels and insulin sensitivity, lowering risk of T2DM, CVD and certain cancers. Therefore, diets rich in dietary fiber should be encouraged to prevent obesity and associated chronic disease.

Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies

Colorectal cancer (CRC) is the second most deadly cancer. Global incidence and mortality are likely to be increased in the coming decades. Although the deaths associated with CRC are very high in high-income countries, the incidence and fatalities related to CRC are growing in developing countries too. CRC detected early is entirely curable by surgery and subsequent medications. However, the recurrence rate is high, and cancer drug resistance increases the treatment failure rate. Access to early diagnosis and treatment of CRC for survival is somewhat possible in developed countries. However, these facilities are rarely available in developing countries. Highlighting the current status of CRC, its development, risk factors, and management is crucial in creating public awareness. Therefore, in this review, we have comprehensively discussed the current global epidemiology, drug resistance, challenges, risk factors, and preventive and treatment strategies of CRC. Additionally, there is a brief discussion on the CRC development pathways and recommendations for preventing and treating CRC.

An Innovative Machine Learning Approach to Predict the Dietary Fiber Content of Packaged Foods

Underconsumption of dietary fiber is prevalent worldwide and is associated with multiple adverse health conditions. Despite the importance of fiber, the labeling of fiber content on packaged foods and beverages is voluntary in most countries, making it challenging for consumers and policy makers to monitor fiber consumption. Here, we developed a machine learning approach for automated and systematic prediction of fiber content using nutrient information commonly available on packaged products. An Australian packaged food dataset with known fiber content information was divided into training (n = 8986) and test datasets (n = 2455). Utilization of a k-nearest neighbors machine learning algorithm explained a greater proportion of variance in fiber content than an existing manual fiber prediction approach (R² = 0.84 vs. R² = 0.68). Our findings highlight the opportunity to use machine learning to efficiently predict the fiber content of packaged products on a large scale.

Rice Bran Makes a Healthy and Tasty Traditional Indonesian Goat Meatball, 'Bakso'

Meatballs are popular in Asia and traditionally made from beef or chicken with tapioca (≈8% wt/wt) as filler. Tapioca has a high glycaemic index (GI); therefore, rice bran was evaluated as a substitute to create a healthier meatball of acceptable quality. Substitution of tapioca with rice bran (100:0; 75:25, 50:50; 25:75; 0:100% tapioca: % rice bran) decreased the starch content (7.8 to 3.3%) and GI (56.08 to 43.85) whilst increasing the protein (10.9 to 12.8%) and fibre (8.1 to 10.3%) contents. Although consistency (995 to 776 N/mm) was affected, firmness (90.6 to 90.5 N) and shear force (300 to 312 N) were only slightly affected by the ratio of tapioca to rice bran. Sensory analysis revealed that the goat meatball with the substitution of tapioca with up to 25% rice bran was deemed acceptable by 40 Indonesian consumers.

A Critical Review of the Effect of Dietary Fiber Intake on the Prevention of Colorectal Cancer in Eastern Asian Countries

Background

Colorectal cancer has become the second most common type of cancer in females and the third most common type of cancer in males. The incidence rate of colorectal cancer is increasing along with the change of lifestyle and dietary habits in East Asia. The cause of colorectal cancer is complex; environmental factors and genetic factors affect each other. Dietary fiber is considered as the prevention of colorectal cancer. Epidemiological data in Europe and America have suggested that dietary fiber intake is negatively correlated with colorectal cancer incidence rate. However, the evidence among different populations is inconsistent, and little is known about these associations in Eastern Asian areas.

Objectives

To critically review all available human epidemiological data on the relationship between dietary fiber intake and colorectal cancer in Eastern Asian countries and make recommendations for these populations. Methodology. PubMed and Embase were used to search online research papers regarding the relationship between dietary fiber intake and the risk of colorectal cancer in Eastern Asian. We located 9 publications, of which the sample size ranged from 266 to 78, 326.

Results

Five case-control studies, as well as one prospective study, have examined significant preventive effects of dietary fiber intake on the risk of colorectal cancer while evidence from three prospective cohorts suggested no preventive effects of dietary fiber intake on colorectal cancer among these populations. There is no consistent conclusion on the protective effect of dietary fiber from different sources and types.

Conclusion

The association between dietary fiber intake and colorectal cancer risk in Chinese, Japanese, and Korean is considered to be plausible by the available literature. This current review cannot substantiate the preventive effect of dietary fiber intake on colorectal cancer due to the limited available evidence analyzed.

Bioactive Compounds and Their Effect on Blood Pressure-A Review

Elevated blood pressure affects a great part of the elderly population and is the leading risk factor for cardiovascular disease. New approaches have been taken in the fight against this growing problem, in the form of diets (Mediterranean, Dietary Approaches to Stop Hypertension (DASH) and intermittent fasting). Recent research has shown the promising results regarding diets and their effect on the prevention and improvement of elevated blood pressure. This review attempts to take this a step further, reviewing 26 studies in the search for dietary elements that may be causing this improvement. Although good evidence was found in favor of lycopene, Docosahexaenoic acid (DHA), fiber and anthocyanin, further evidence is needed before any conclusions can be made. In contrast, the evidence shows that licorice increases blood pressure.