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Molecules 2020, 25, 4613 4 of 36 2.2. Cardioprotection Activity Cardiovascular disease (CVD), also known as circulatory disease, is a range of diseases that involve the circulatory system, including coronary artery disease, stroke, heart failure and high blood pressure. Numerous studies have shown that polyphenols have beneficial effects on cardiovascular health, and consuming foods rich in polyphenols can reduce the risk of these diseases [54–57]. Wang et al. [58] reported that anthocyanins, proanthocyanidins, flavonoids, and flavan-3-ols in polyphenols are closely related to the incidence of CVD. Increasing the daily intake of flavonols by 10 mg can reduce the risk of cardiovascular disease by 5%. The meta-analysis by Menezes et al. [59] also showed that the intake of flavonols reduced the risk of CVD, but the impact of flavonols intake on lipid levels may vary depending on the country and health status of individuals. Tang et al. [60] demonstrated in a study on the risk of stroke that ingesting 100 mg of flavonoids per day reduced the stroke rate by approximately 10%. A similar study conducted by Wang et al. [61] demonstrated that an intake of 20 mg of flavonols per day was associated with a 14% reduction in stroke risk. Studies have shown that the main polyphenolic compounds that can significantly reduce the risk of hypertension are flavonoids [62–64]. Through a meta-analysis of randomized controlled trials, Huang and coworkers concluded that participants who took quercetin for 8 weeks or longer showed significant changes in HDL cholesterol and triglyceride levels [65]. Important evidence from epidemiological investigations suggests that dietary polyphenols may treat and prevent type 2 diabetes. Cao and coworkers have demonstrated that resveratrol can improve blood glucose control in subjects with insulin resistance, and anthocyanins can lower blood glucose or optimize insulin secretion and resistance [66]. It is reported that genistein could significantly improve glycemic control and sensitivity to insulin in postmenopausal women [67]. Atherosclerosis is a chronic inflammatory disease that occurs in vulnerable areas of middle arteries. It may have existed for many years before it develops and produces physiological states, such as acute myocardial infarction, unstable angina, or sudden cardiac death [68]. Anthocyanins can increase blood lipids, inhibit inflammation, and improve endothelium-dependent vasodilation by activating NO-cGMP signaling pathway [69]. It is also demonstrated that, by inhibiting the activity of phosphodiesterase-5, the blood vessels can be relaxed, thus reducing the risk of cardiovascular disease [70]. The formation of thrombosis is one of the main causes of myocardial infarction, ischemic heart disease and other diseases. Plenty of evidence has proven that dietary polyphenols can reduce the formation of thrombus [71,72]. Red wine, rich in polyphenols (such as resveratrol, proanthocyanidins, etc.), is known to have the function of protecting the heart. Extensive data have shown that resveratrol can prevent thrombosis by reducing oxidative stress and platelet aggregation, thereby protecting blood vessels [73,74]. 2.3. Anticancer Activities Cancer is a cell proliferative disease caused and controlled by genetic mutations, resulting from various factors, such as diet, radiation, unhealthy life habits (such as regular drinking and smoking) and infectious microorganisms [75]. Considerable evidence has proven that it is the plant secondary metabolites, polyphenols, that make a significant contribution to anticancer activity [76–79]. Polyphenols are mainly used to prevent cancer by inhibiting cancer cell activation, promotion, angiogenesis, and strengthening the immune system [80–82]. Polyphenols have preventive and therapeutic effects on many cancers, such as esophageal, gastric, colon, liver, lung, breast, ovarian and skin cancer (Table 2) [83–85]. Grosso et al. [86] conducted a systematic evaluation of the role of polyphenols in cancer prevention, and the analysis showed that isoflavones significantly reduced the risk of gastric, lung, breast and colorectal cancers, by directly inhibiting oxidative stress, oxidative damage, anti-angiogenesis and anti-metastasis, while total flavones had little effect on the risk of breast cancer. Another study reviewed the role of flavonoids in colon cancer risk and found that the sustained consumption of flavonoidsPDF Image | Nanoformulations to Enhance the Bioavailability and Physiological Functions of Polyphenols
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