Unstable atherosclerotic plaques have a necrotic core that is overlain by a thin fibrous cap, and have abundant macrophages but few vascular smooth muscle cells or collagen.  The principal cause of acute atherosclerotic events is from the rupture of these unstable plaques.  Existing literature suggests a Mediterranean dietary pattern can protect against atherosclerosis through its impact on intestinal permeability and microbial LPS production.  One typical vegetable in this dietary pattern is Brussels chicory, which has been shown to reduce formation of early stage atherosclerosis in mice, but it is not known whether it might inhibit disease progression.  Li and colleagues report on their current work to test this hypothesis in a paper published in the October 2022 issue of The Journal of Nutrition.

Male apoE-deficient mice with unstable atherosclerotic plaques were provided a control diet or one containing 0.5% freeze-dried Brussels chicory for 20 weeks.  Volume and stability of the plaques, macrophage polarization, fecal and serum LPS, serum lipids and inflammation-related cytokines, as well as gut microbial profiles were determined at termination.

Brussels chicory did not change plaque volume or serum lipid profiles, but reduced plaque necrotic core size, and increased the fibrous cap thickness and collagen content, all changes that should stabilize the plaque.  Intestinal permeability, fecal and serum LPS, serum IL1b and TNFa were reduced by Brussels chicory.  Brussels chicory also promoted plaque macrophage polarization towards the M2-like phenotype and altered gut microbial composition.  The microbial changes were indicative of improved intestinal permeability, fecal and serum LPS, serum proinflammatory cytokines, and plaque stability features.  These observations led the authors to conclude that Brussel chicory might help stabilize atherosclerotic plaques through its effects on microbial LPS production and intestinal permeability.

In an editorial, Johnson and Weir note the beneficial observations of Li and colleagues could be due to the inulin or bioactive compounds present in Brussels chicory, as both components are capable of influencing intestinal microbiota.  Based on the observations in the current study and previous work by these authors, Johnson and Weir suggest the responses to Brussels chicory may be dose dependent and contingent upon stage of disease development (ages of subjects), with higher doses needed when lesions are larger during advanced disease stages.  They conclude further work is needed to extend this labs observations, and to understand the differential effects obtained at different disease stages and the role of the gut environment on atherosclerosis progression.


Qing Li, Xu Zhang, Yushi Du, Xiuping Liu, Guanyu Chen, Panying Xiang, Hao Wu, Chaoqun Liu, Dongliang Wang, Brussels Chicory Stabilizes Unstable Atherosclerotic Plaques and Reshapes the Gut Microbiota in Apoe−/− Mice, The Journal of Nutrition, Volume 152, Issue 10, October 2022, Pages 2209–2217, https://doi.org/10.1093/jn/nxac103.

Sarah A Johnson, Tiffany L Weir, Fresh Take on the Relationship between Diet, Gut Microbiota, and Atherosclerosis: A Food-Based Approach with Brussels Chicory, The Journal of Nutrition, Volume 152, Issue 10, October 2022, Pages 2181–2183, https://doi.org/10.1093/jn/nxac147.

Images via canva.com.