Role of Fiber in Cardiovascular Diseases: A Review M. Viuda-Martos, M.C. L ´ opez-Marcos, J. Fern ´ andez-L ´ opez, E. Sendra, J.H. L ´ opez-Vargas, and J.A. P ´ erez- ´ Alvarez ABSTRACT: Worldwide, cardiovascular disease is estimated to be the leading cause of death and loss of disability- adjusted life-years. Effective prevention needs a global strategy based on knowledge of the importance of risk fac- tors, including diet. Recent years have seen increased interest on the part of consumers, researchers, and the food industry into how food products can help maintain the health of an individual. Extracts rich in dietary fiber obtained from plants could be used as functional ingredients because they provide numerous health benefits that go far be- yond supporting bowel regularity. These benefits may include not only digestive health, but weight management, cardiovascular health, and general wellness. The objective of this review is to present an overview of the potential of different types of fiber as a technological tool for its application to functional foods to reduce the incidence of cardiovascular disease through diet. Introduction Recent knowledge supports the hypotheses that, besides fulfill- ing nutrition needs, diet modulates various functions in the body and may exhibit detrimental or beneficial roles in some diseases (Sarkar 2007). The increase in consumer demand for high-quality food products has led to growth in the use of new technologies and ingredients. Several factors that influence changes in con- sumer demand, including: health concerns such as cholesterol, cancer, obesity; changes in demographic characteristics such as ethnicity, population aging; changes in distribution systems and price; and the need for convenience (P´ erez-Alvarez 2008a). In recent years, a considerable growing interest towards natural and wholesome foods has been developed among consumers throughout the world, leading to nutrition science research re- lating to the association between diet and dietary constituents and health benefits, favorable regulatory environment, consumer self-care phenomena, and rapid growth in the market for health and wellness products (Hasler 2002). Actually, considerable im- portance is given to functional foods, which, in principle, apart from their basic nutritional functions, provide physiological ben- efits, play an important role in disease prevention, or slow the progress of chronic diseases. Functional foods either contain (or add) a component with a positive health effect or eliminate a component with a negative one. The relationship between diet and health has focused on the role of food choices and diseases MS 20091034 Submitted 10/17/2009, Accepted 11/5/2009. Authors Viuda- Martos, L ´ opez-Marcos, Fern ´ andez-L ´ opez, Sendra, and P ´ erez- ´ Alvarez are with IPOA Research Group (UMH-1 and REVIV-Generalitat Valenciana), AgroFood Technology Dept., Escuela Polit´ ecnica Superior de Orihuela, Univ. Miguel Hern´ andez, Crta, Beniel km. 3,2, E-03312 Orihuela Alicante, Spain. Author L´ opez-Vargas is with Inst. de Ciencia y Tecnologia de Alimentos ICTA, Univ. Nacional de Colombia Sede Bogot ´ a 3465000 ext. 19225, Bogota, Colombia. Direct inquiries to author P ´ erez-Alvarez (E-mail: ja.perez@umh.es ). like cancer, cardiovascular disease, and allergies (Lambert 2001). The market for functional foods is increasing at an annual rate of 15% to 20% (Hilliam 2000). To develop these types of products, one must evaluate consumer perceptions, the most important quality aspects being that they taste good, appear wholesome, and have nutritional value (Garc´ ıa-Segovia and others 2007). Also, P´ erez-Alvarez (2008a) describes that any functional food must be safe, healthy, and tasty. Many components may be added to foods to make them “functional” including ω-3 fatty acids (Hjaltason and Haraldsson 2006), vitamins (Baro and others 2003), probiotics (Salem and others 2006), prebiotics (Brink and others 2005), symbiotics (D’Antoni and others 2004), phytochemicals (Wolfs and others 2006), bioactive peptides (Thoma-Worringer and others 2006), fiber (Fern´ andez-Gin´ es and others 2004; Fern´ andez-L ´ opez and others 2007, 2008, 2009), and so on. Dietary fiber intake in Western countries is currently estimated to be 25 g per person per day. However, nutritionists recommend an intake of 35 g per person per day (Lairon 1990). The devel- opment of fiber-enriched foods would help consumers to meet such recommendations. Since the roles of dietary fibers in pre- venting and treating some diseases have been well documented, the addition of purified dietary fibers to foods has become pop- ular. Different types of dietary fibers, such as pea, apple, sugar beet, soy, and citrus fibers, as well as inulin and gums, are now incorporated into foods for their nutritional properties or for their functional and technological properties (Thebaudin and others 1997). From a functionality point of view, fiber can play a num- ber of roles: (i) it may be used as a tool for improving texture, (ii) as a bulking agent in reduced-sugar applications, (iii) to manage moisture in the replacement of fat, (iv) to add color, and (v) as natural antioxidant. Although fiber itself may be invisible in food products, it is fast becoming one of the most appreciated ingredients in today’s 240 COMPREHENSIVE REVIEWS IN FOOD SCIENCE AND FOOD SAFETY—Vol. 9, 2010 c  2010 Institute of Food Technologists R 