Review Article - Journal of Food Science and Nutrition (2025) Volume 8, Issue 3

Effect of berries on cardiovascular health.

Mahrukh Imran^*, Syeda Ameena Haider

Department of Advance Research and Biostatistics in Nutrition, Kinnaird College for Women University, Lahore, Pakistan

Corresponding Author:

Mahrukh Imran
Department of Advance Research and Biostatistics in Nutrition,

Kinnaird College for Women University,
Lahore,
Pakistan,
E-mail: mahrukhimran3012@gmail.com

Received: 22-May-2024, Manuscript No. AAJFSN-24-136760; Editor assigned: 24-May-2024, AAJFSN-24-136760 (PQ); Reviewed: 07-Jun-2024, QC No. AAJFSN-24-136760; Revised: 11-Jul-2025, Manuscript No. AAJFSN-24-136760 (R); Published: 18-Jul-2025, DOI: 10.35841/AAJFSN.8.2.288

Citation: Imran M, Haider SA. Effect of berries on cardiovascular health. J Food Nutr Health. 2025;8(3):268.

Abstract

This review article examines the potential impact of berry consumption on cardiovascular health, with a focus on berries' rich content of anthocyanins and other polyphenols. Drawing upon a comprehensive synthesis of human intervention studies, systematic reviews, meta-analyses, and randomized controlled trials, the review aims to provide insights into the role of berries in mitigating Cardiovascular Disease (CVD) risk factors and improving vascular function. The findings suggest that berries, including blueberries, strawberries, and wolfberries, possess bioactive compounds with promising cardiovascular benefits. Specifically, berry consumption has been associated with improvements in vascular function, including endothelial function and arterial stiffness, as well as reductions in cardiovascular risk factors such as inflammation, oxidative stress, and dyslipidemia. Notably, certain berries, particularly those rich in anthocyanins, have demonstrated a protective effect against Coronary Heart Disease (CHD) and cardiovascular mortality. However, the review highlights several gaps and limitations in the existing literature, including variations in study designs, populations studied, berry types and forms used, dosages administered, and outcome measures assessed. While preclinical studies have provided insights into potential mechanisms underlying the cardiovascular benefits of berries, further mechanistic research and long-term clinical trials are warranted to confirm these findings and translate them into actionable recommendations for cardiovascular disease prevention and management. In conclusion, while berries show promise as part of a heart-healthy diet, continued research efforts are needed to fully elucidate their role in cardiovascular health and to optimize their incorporation into dietary strategies for CVD prevention and management.

Keywords

Berries, Oxidative stress, Inflammation, Vascular function, Cardiovascular markers, Flavonoids, Anthocyanidins.

Introduction

Cardiovascular Diseases (CVDs) pose a significant global health challenge, contributing substantially to morbidity and mortality rates worldwide. Despite advances in medical treatment and preventive strategies, the prevalence of CVDs continues to rise, emphasizing the urgent need for effective interventions to mitigate risk factors and improve cardiovascular health outcomes. In recent years, dietary approaches have garnered increasing attention as potential avenues for CVD prevention and management.

Polyphenol-rich foods, particularly berries, have emerged as promising candidates for their potential cardioprotective effects. Berries, such as blueberries, cranberries, and strawberries, are renowned for their high content of bioactive compounds, including anthocyanins, flavonoids, and polyphenols. These compounds possess antioxidant, anti-inflammatory, and vasculoprotective properties, which may contribute to cardiovascular health [1].

Epidemiological studies have demonstrated an inverse association between berry consumption and the risk of CVDs [2]. However, while observational data provide valuable insights, intervention studies are necessary to establish causality and elucidate the mechanisms underlying the cardiovascular benefits of berry consumption.

In this review, we aim to synthesize and critically evaluate the existing literature on the effects of blueberry consumption and other anthocyanin-rich berries on cardiovascular health. Through a comprehensive examination of epidemiological studies, clinical trials, and mechanistic investigations, we seek to elucidate the potential cardioprotective mechanisms of berries, including their effects on oxidative stress, inflammation, lipid metabolism, and vascular function. Furthermore, we will identify gaps and inconsistencies in the current literature, providing insights into areas for future research and the development of evidence-based dietary strategies for the prevention and management of CVDs. By consolidating the latest scientific evidence, this review aims to contribute to our understanding of the role of berries in cardiovascular health and inform clinical practice and public health policies aimed at reducing the burden of CVDs globally [3].

Literature Review

Cardiovascular Diseases (CVDs) stand as a formidable global health challenge, contributing significantly to premature mortality and placing substantial burdens on healthcare systems worldwide. Given the multifactorial nature of CVDs, there's an increasing emphasis on identifying dietary interventions that could mitigate associated risk factors and potentially reduce the incidence and severity of these conditions.

A growing body of evidence highlights the potential of dietary patterns rich in bioactive compounds, particularly polyphenols and flavonoids, in promoting cardiovascular health. Among these compounds, anthocyanins-an abundant subclass of flavonoids found in various fruits, particularly berries—have received considerable attention due to their purported cardioprotective effects [4].

Blueberries and beyond: Exploring the cardiovascular benefits of berries

Blueberries, renowned for their high polyphenol content, especially anthocyanins, have been the focus of numerous studies investigating their potential cardiovascular protective effects.

However, the cardiovascular benefits of berries extend beyond blueberries alone. Other berries, including wolfberry (Lycium barbarum), cranberries, strawberries, and barberries, also boast rich polyphenol profiles and have demonstrated potential in improving cardiovascular health.

Mechanisms of action: How berries protect cardiovascular health

Polyphenol-rich berries exert their cardioprotective effects through a myriad of mechanisms, including reducing inflammation, improving vascular reactivity, and modulating lipid metabolism [5]. Intervention studies have provided compelling evidence of the beneficial outcomes associated with berry consumption, such as increased antioxidant capacity, decreased LDL oxidation, and improvements in glucose and lipid profiles.

Additionally, berries have been shown to improve arterial stiffness, a measure of vascular health. Reduced arterial stiffness implies better blood flow and lower cardiovascular strain.

Berries also improve endothelial function, which is crucial for maintaining vascular health. The endothelium, a thin membrane lining the inside of the heart and blood vessels, plays a vital role in this regard. Berries enhance endothelial function by increasing the bioavailability of Nitric Oxide (NO), a potent vasodilator that relaxes blood vessels, improves blood flow, and reduces blood pressure. Additionally, berries protect endothelial cells from apoptosis (programmed cell death), maintaining the integrity of the vascular lining.

Recent studies further illuminate the comprehensive impact of berry consumption on cardiovascular health. For example, the polyphenolic compounds in berries can improve insulin sensitivity, which plays a significant role in managing diabetesrelated cardiovascular complications. Improved insulin sensitivity helps maintain blood glucose levels, thereby reducing the risk of diabetes-related cardiovascular issues.

Moreover, berries have demonstrated the ability to counteract postprandial oxidative stress and reduce blood pressure, particularly in individuals with metabolic risk factors such as diabetes mellitus, dyslipidemia, or metabolic syndrome. These findings underscore the potential of berries as a dietary intervention for the prevention and management of CVD. Flavonoids, another key group of compounds found in berries, have been linked to a reduction in the incidence of cardiovascular events [6]. These compounds improve endothelial function, reduce blood pressure, and enhance vascular elasticity. The consistent intake of flavonoid-rich foods, such as berries, has been associated with a lower risk of coronary heart disease and stroke.

In addition to polyphenols, dietary fiber in berries contributes to cardiovascular health. Fiber aids in reducing cholesterol levels by binding to cholesterol in the digestive system and promoting its excretion. Berries also contribute to blood pressure regulation through various mechanisms. The increased production of nitric oxide leads to vasodilation and lower blood pressure.

Recent studies further illuminate the comprehensive impact of berry consumption on cardiovascular health. For example, the polyphenolic compounds in berries can improve insulin sensitivity, which plays a significant role in managing diabetesrelated cardiovascular complications. Improved insulin sensitivity helps maintain blood glucose levels, thereby reducing the risk of diabetes-related cardiovascular issues.

Bridging gaps: Challenges and opportunities in berry research

Despite the promising findings, several gaps exist in the current literature. Variations in study designs, populations, and forms of fruit consumption make direct comparisons challenging [7-9]. Additionally, while some studies have reported significant benefits associated with berry consumption, others have yielded inconsistent findings, highlighting the need for further research to elucidate optimal doses and forms of consumption for maximizing cardiovascular health benefits.

Methodology

Databases and search strategy

A comprehensive search strategy was devised to gather a diverse range of relevant information from multiple electronic databases. The following databases were utilized: PubMed, Scopus, Web of Science, Google Scholar, and Sci-Hub. The search strategy included a combination of keywords and controlled vocabulary terms related to blueberry consumption, anthocyanin-rich berries, and cardiovascular health.

Keywords: The keywords used in the search strategy encompassed terms related to blueberries, anthocyanins, cardiovascular diseases, polyphenols, and human studies. These keywords were tailored to each database's search syntax to ensure optimal retrieval of relevant articles.

Inclusion criteria

The review focused on scrutinizing peer-reviewed journal articles published between 2019 and 2024, with a specific emphasis on human studies investigating the effects of blueberry consumption and other anthocyanin-rich berries on cardiovascular health outcomes. Only articles written in the English language were considered eligible for inclusion.

Exclusion criteria

Studies written in languages other than English, as well as animal studies, reviews, and research not explicitly focused on blueberry consumption and cardiovascular health, were excluded from the review. Additionally, articles older than five years were excluded from the review.

Selection of articles

Following the initial search, retrieved articles were screened for duplicates, which were subsequently removed. The remaining unique articles underwent a preliminary screening based on titles and abstracts against predefined inclusion and exclusion criteria. This process resulted in the identification of a subset of articles eligible for full-text assessment. Two independent reviewers conducted a thorough evaluation of the full texts of these articles. Any discrepancies in their evaluations were resolved through discussion until a consensus was reached. After meticulous scrutiny, a final set of 10 articles, deemed most pertinent to the research objectives, was selected for inclusion in the review.

Data extraction

Information pertinent to the research objectives was systematically extracted from the selected articles. Key aspects extracted included study design, participant characteristics, intervention details, outcomes assessed, and main findings. Data extraction was performed meticulously to ensure accuracy and completeness [10-14].

Results and Discussion

Results were mentioned in below Table 1.

Table 1. Review article examines.

Recommendations

Further research: Conduct more Randomized Controlled Trials (RCTs) to explore the effects of different types and forms of berries on cardiovascular health across diverse populations. This could include investigations into optimal dosages, durations, and combinations of berries.

Mechanistic studies: Undertake mechanistic studies to elucidate the underlying pathways through which berries and their bioactive compounds exert their cardiovascular benefits. Understanding these mechanisms can help develop targeted interventions.

Long-term studies: Conduct long-term studies to assess the sustained effects of berry consumption on cardiovascular outcomes, including disease incidence and mortality rates.

Standardization: Standardize methodologies for assessing berry intake, cardiovascular outcomes, and biomarkers across studies to enable better comparison and synthesis of findings.

Clinical translation: Translate research findings into clinical practice and public health recommendations, considering factors such as feasibility, cultural preferences, and barriers to berry consumption.

Conclusion

The review of the literature suggests that berries, particularly those rich in anthocyanins and other polyphenols, hold promise as dietary components for promoting cardiovascular health. Evidence from human intervention studies, systematic reviews, meta-analyses, and randomized controlled trials indicates potential benefits of berry consumption in improving vascular function, reducing cardiovascular risk factors, and mitigating the risk of Coronary Heart Disease (CHD) and cardiovascular mortality.

However, while the existing body of research provides valuable insights, several gaps and limitations remain. These include variations in study designs, populations studied, berry types and forms used, dosages administered, and outcome measures assessed. Moreover, while preclinical studies have elucidated potential mechanisms underlying the cardiovascular benefits of berries, further mechanistic research and clinical trials are needed to confirm these findings and translate them into actionable recommendations for cardiovascular disease prevention and management.

In conclusion, while berries show promise as part of a hearthealthy diet, continued research efforts are warranted to fully understand their role in cardiovascular health and to optimize their incorporation into dietary strategies for disease prevention and management.

References

1. Basu A, Izuora K, Betts NM, et al. Dietary strawberries improve cardiometabolic risks in adults with obesity and elevated serum LDL cholesterol in a randomized controlled crossover trial. Nutrients. 2021;13(5):1421.

   [Crossref] [Google Scholar] [PubMed]

2. Basu A, Rhone M, Lyons TJ. Berries: Emerging impact on cardiovascular health. Nutr Rev. 2010;68(3):168-77.

   [Crossref] [Google Scholar] [PubMed]

3. Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics—2019 update: A report from the American Heart Association. Circulation. 2019;139(10):e56-28.

   [Crossref] [Google Scholar] [PubMed]

4. Emamat H, Zahedmehr A, Asadian S, et al. The effect of barberry (Berberis integerrima) on lipid profile and systemic inflammation in subjects with cardiovascular risk factors: A randomized controlled trial. BMC Complement Med Ther. 2022;22(1):59.

   [Crossref] [Google Scholar] [PubMed]

5. Kimble R, Keane KM, Lodge JK, et al. Dietary intake of anthocyanins and risk of cardiovascular disease: A systematic review and meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2019;59(18):3032-43.

   [Crossref] [Google Scholar] [PubMed]

6. Martini D, Marino M, Angelino D, et al. Role of berries in vascular function: A systematic review of human intervention studies. Nutr Rev. 2020;78(3):189-206.

   [Crossref] [Google Scholar] [PubMed]

7. Martini D, Marino M, Venturi S, et al. Blueberries and their bioactives in the modulation of oxidative stress, inflammation and cardio/vascular function markers: A systematic review of human intervention studies. The J Nutr Biochem. 2023;111:109154.

   [Crossref] [Google Scholar] [PubMed]

8. Najjar RS, Schwartz AM, Wong BJ, et al. Berries and their polyphenols as a potential therapy for coronary microvascular dysfunction: A mini-review. Int J Mol Sci. 2021;22(7):3373.

   [Crossref] [Google Scholar] [PubMed]

9. Richter CK, Skulas-Ray AC, Gaugler TL, et al. Effects of cranberry juice supplementation on cardiovascular disease risk factors in adults with elevated blood pressure: A randomized controlled trial. Nutrients. 2021;13(8):2618.

   [Crossref] [Google Scholar] [PubMed]

10. Toh DW, Xia X, Sutanto CN, et al. Enhancing the cardiovascular protective effects of a healthy dietary pattern with wolfberry (Lycium barbarum): A randomized controlled trial. Am J Clin Nutr. 2021;114(1):80-9.

    [Crossref] [Google Scholar] [PubMed]

11. Wang Y, Gallegos JL, Haskell-Ramsay C, et al. Effects of blueberry consumption on cardiovascular health in healthy adults: A cross-over randomised controlled trial. Nutrients. 2022;14(13):2562.

    [Crossref] [Google Scholar] [PubMed]

12. Woolf EK, Lee SY, Ghanem N, et al. Protective effects of blueberries on vascular function: A narrative review of preclinical and clinical evidence. Nutr Res. 2023;120:20-57.

    [Crossref] [Google Scholar] [PubMed]

13. WHO. Cardiovascular Diseases (CVDs). World Health Organization. 2021.
14. Xu L, Tian Z, Chen H, et al. Anthocyanins, anthocyanin-rich berries, and cardiovascular risks: Systematic review and meta-analysis of 44 randomized controlled trials and 15 prospective cohort studies. Front Nutr. 2021;8:747884.

    [Crossref] [Google Scholar] [PubMed]