Mancuso et al. 2024 — Food contamination and cardiovascular disease: narrative review
This narrative review synthesizes evidence linking food-borne contaminants to cardiovascular disease (CVD), covering heavy metals (arsenic, lead, cadmium, mercury, tungsten) alongside ultra-processed foods, artificial sweeteners, nitrates, dioxins and PCBs, and acrolein. The review contextualizes each contaminant within dietary exposure pathways, discusses proposed mechanisms of cardiovascular toxicity, and draws on both experimental and epidemiological literature. No primary concentration data are reported; the paper functions as a synthesis of existing literature rather than a new measurement study.
Key numbers
- Arsenic: epidemiological studies associate chronic dietary As exposure with hypertension, coronary artery disease, and peripheral arterial disease; fish and seafood are the dominant dietary As sources in most populations, though rice is the predominant source for populations with high grain consumption.
- Lead: narrative cites associations between blood Pb levels and hypertension, atherosclerosis, and increased cardiovascular mortality; fresh meat, bivalves, and vegetables are named as food sources.
- Cadmium: Cd is linked to arterial stiffness, hypertension, and endothelial dysfunction; cocoa, vegetables, and cereals are cited as dietary sources; the review notes EU regulatory limits for Cd in food.
- Mercury: the review discusses tHg in fish and seafood; focuses on atherosclerosis and arrhythmia associations; references the dose-dependent risk in frequent fish consumers.
- Tungsten: cited as an emerging contaminant associated with cardiovascular risk in NHANES analyses; less dietary-source specificity provided.
- The review does not report original concentration measurements; all values are drawn from cited epidemiological and toxicological literature.
Methods (brief)
Narrative review methodology; no systematic search protocol or PRISMA flow described. Literature synthesis drawing on PubMed-indexed primary studies, epidemiological cohorts, and regulatory agency documents (EU, WHO, FDA). No analytical methods, LODs, or sample collections involved.
Implications
Certification: Useful background framing that heavy metals in food are a recognized CVD risk factor in peer-reviewed literature, strengthening the regulatory and health rationale for HMT&C certification targets for Pb, Cd, iAs, and tHg. B-tier; not a primary data source for concentration limits. Courses: Good entry-level citation for modules on health consequences of heavy metal dietary exposure; covers multiple metals in a single readable source. App: Not directly usable for contamination_profile updates; no primary concentration data.