1 Introduction

Lipid control is critical in the prevention of cardiovascular disease, as elevated lipid levels are a risk factor for CVD independent of all other factors. Elevated levels of total cholesterol, LDL cholesterol, and triglycerides can lead to the development of atherosclerosis, i.e., the deposit of fats, cholesterol, and other materials in and on the artery walls. It is this status that may lead to heart attacks, strokes, and other cardiovascular diseases (Xin et al., 2024). Such effective regulation of the levels of lipids is therefore paramount in avoiding CVD as well as overall heart health.

Lipid-lowering treatment with drugs such as statins is also used globally to lower elevated cholesterol levels. Such drugs act by inhibiting the enzyme HMG-CoA reductase, a key enzyme in the biosynthesis of cholesterol in the liver. Though beneficial, such drugs are not without side effects and this has triggered the search for natural agents. Natural products, e.g., omega-3 fatty acids contained in fish oils and certain sea animals like mussels, have been proven to be beneficial in improving lipid profiles. For instance, it has been demonstrated that lipid extracts from blue mussel can decrease total cholesterol and triacylglycerol levels significantly, suggesting their potential as natural lipid-lowering agents (Kuang et al., 2022; Liu et al., 2023).

The aim of the current research is to explore the synergistic effect of mussel and other nutrients on lipid reduction and cardiovascular well-being. It will highlight the merits of mussel lipid extract in correcting lipid status and glycemic in type 2 diabetic patients and its role in the management of cardiovascular risk factors. It seeks to establish improved lipid management practices, which may be a natural alternative to traditional lipid-lowering drugs and enable the development of novel nutritional foods or supplements.

2 Nutritional Composition of Purple Mussels

2.1 Key bioactive components in purple mussels

Purple mussels have bioactive substances such as omega-3 polyunsaturated fatty acids (PUFAs), proteins, and antioxidants. Omega-3 PUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are significant to human health because of their capacity to lower the risk of chronic conditions such as cardiovascular diseases and insulin resistance (Vaidya and Cheema, 2014; Biandolino et al., 2023). These fatty acids are typically in the form of phospholipids in mussels and are therefore more biologically potent than the triglyceride form found in fish oil (Vaidya and Cheema, 2014).

Apart from omega-3 fatty acids, purple mussels contain proteins and antioxidants. Proteins like bioactive peptides are associated with a range of beneficial health impacts, for example, anti-inflammatory actions and the improvement of metabolic processes (Grienke et al., 2014). Antioxidants in mussels are credited with reducing oxidative stress that is critical in maintaining the health of cells and preventing chronic diseases (Villasante et al., 2015).

2.2 The health benefits of purple mussels

Purple mussels contain a number of health benefits, particularly in lipid-lowering functions. Mussels contain high levels of omega-3 PUFAs, which possess a correlation with improved lipid profiles with reduced levels of triglycerides and cholesterol, which are crucial components in maintaining cardiovascular health (Kuang et al., 2022). Kuang et al. (2022)'s work have proved that the lipid extracts from mussels can significantly lower fasting serum insulin levels and improve insulin resistance, thus being a useful maintenance of type 2 diabetes mellitus.

Moreover, the anti-inflammatory property of mussel bioactive compounds is also the reason for their lipid-lowering effect. Inflammation reduction by these compounds makes it possible to use them in the treatment of conditions like rheumatoid arthritis as well as in lowering the vulnerability to cardiovascular diseases (Grienke et al., 2014; Kuang et al., 2022). The combination of the above effects demonstrates the worth of purple mussels as a functional food for cardiovascular health and metabolic wellness support.

2.3 A comparison of purple mussels with other marine foods in lipid management

Compared to other products from seafood, the purple mussel is unique in terms of their specific lipid content and nutrient value. While fish oils continue to be the most popular source for omega-3 fatty acids, the phospholipid-bound conformation of mussels offers greater bioavailability and activity for lipid control (Vaidya and Cheema, 2014). This type of mussel variety is better for reducing the content of triglycerides and improving lipid profiles, thereby making mussels a substitute for conventional fish oils.

In addition, mussels provide more bioactive substances like proteins and antioxidants, whose occurrence is lower in other types of seafood like fish oils. These types of substances contribute to the overall health impact of mussels as a more combined approach to lipid management and cardiovascular health (Grienke et al., 2014; Villasante et al., 2015). This makes purple mussels a healthy component of the diet for people seeking to improve their lipid profiles as well as prevent chronic disease risk.

3 Lipid-Lowering Mechanisms of Purple Mussels

3.1 The impact of purple mussels on cholesterol metabolism, including LDL reduction and HDL enhancement

Purple mussels have also been shown to affect cholesterol metabolism greatly by reducing the level of low-density lipoprotein (LDL) and enhancing the level of high-density lipoprotein (HDL). Blue mussel lipid extracts and others have been noted to reduce animal model and human LDL levels of cholesterol in one study. For instance, in a study involving C57BL/6 mice, it was determined that the high blue mussel diet led to the significant reduction of plasma and hepatic concentrations of LDL cholesterol. This was achieved by inhibiting the cholesterol biosynthesis pathway and activation of the LDL-receptor gene expression resulting in the clearance of LDL from the bloodstream (Vaidya et al., 2017). Similarly, in type 2 diabetes mellitus clinical trial, blue mussel lipid extract (BMLE) lowered total cholesterol level, once again vouching for the therapeutic efficacy of mussels in cholesterol management (Kuang et al., 2022; Li, 2024).

In addition to the lowering of LDL, purple mussels also contribute to better HDL cholesterol. Much of the primary reason for this lies in the composition of omega-3 polyunsaturated fatty acids (PUFAs) in mussels. Omega-3 PUFAs have been found to increase HDL cholesterol levels, which are beneficial to cardiovascular conditions. Mussel lipid extracts, rich in these fatty acids, have been reported to improve the lipid profile by increasing HDL levels and thereby exert a protective effect against atherosclerosis, among other cardiovascular diseases (Vaidya and Cheema, 2014; Vaidya et al., 2017).

3.2 Their effect on triglyceride levels and overall lipid profiles

Purple mussels play a beneficial part in triglycerides in the way that they enhance a more favorable overall lipid profile. Lipid extracts of mussel, and particularly high levels of omega-3 PUFAs, were capable of lowering the levels of triglycerides remarkably. In a hyperlipidemic trial, the combined action of omega-3 PUFAs with other lipid-lowering medications led to an incredible decline in plasma triglycerides, thus showcasing the therapeutic potential of mussel lipids for the management of hyperlipidemia (Micallef and Garg, 2008). Zebrafish models were also used to reveal that plasmalogens from mussel can lead to a decrease in hepatic triglycerides, thus indicating their role in lipid metabolism (Feng et al., 2023).

The overall lipid profile is also bettered by the consumption of purple mussels. The bioactive molecules in mussels, such as antioxidants and anti-inflammatory agents, contribute to the modulation of lipid metabolism pathways. They help decrease the levels of total cholesterol and triglycerides and enhance the level of HDL cholesterol, thus forming a favorable lipid profile. This broad effect on lipid metabolism indicates the functional food potential of purple mussels in maintaining dyslipidemia and associated metabolic disturbances (Gorinstein et al., 2008; Abshirini et al., 2021).

3.3 Possible biological mechanisms, such as antioxidant and anti-inflammatory effects

The lipid-lowering effect of purple mussels results from a variety of biological mechanisms, and among these are their anti-inflammatory and antioxidant effects. Mussels have a high level of antioxidants that play a critical role in the protection of lipids against oxidative breakdown. The antioxidant effect of mussels largely results from phenolic compounds and other bioactive compounds, which function as free radical scavengers and reduce oxidative stress. In rat feeding experiments, mussel-supplemented diets prevented the rise in plasma lipid levels and maintained plasma antioxidant activity, evidencing the protective role of mussel-derived antioxidants on lipid metabolism (Gorinstein et al., 2008).

In addition to their antioxidant activity, purple mussels possess deep anti-inflammatory activities that are implicated in their lipid-lowering effect. Recurrent inflammation is inevitably linked with dyslipidemia and cardiovascular disease. The anti-inflammatory effect of mussels, particularly by regulating inflammatory cytokines, lowers systemic inflammation and improved lipid profile. For example, in type 2 diabetes mellitus patients, lipid extract of blue mussel lowered pro-inflammatory biomarkers tumor necrosis factor-alpha and interleukin-1 beta, thereby enhancing lipid metabolism and reducing cardiovascular risk (Kuang et al., 2022; Liu et al., 2023). These findings suggest that purple mussel's anti-inflammatory and antioxidant activities are the key points behind its lipid-lowering effect.

4 Synergistic Effects of Purple Mussels with Other Ingredients

4.1 Interactions between purple mussels and other common lipid-lowering foods

Purple mussels, like their blue cousins, also hold high levels of beneficial lipids like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that have been proven to improve lipid profiles and stop inflammation (Kuang et al., 2022). Taken with other foods that are high in lipids like garlic, olive oil, and plant compounds, their advantages can be optimized. Garlic, an agent that lowers cholesterol, may synergistically combine with mussel lipids' anti-inflammatory activity to further reduce cholesterol and also improve cardiovascular function.

High monounsaturated fat and antioxidant content olive oil can replace the polyunsaturated fat of mussels. They can complement each other to accomplish enhanced lipid-lowering action by optimizing the nutritional profiles of desirable fats, resulting in even further reductions in total cholesterol and triacylglycerol levels. Phyto bioactive molecules such as flavonoids can also combine with mussel lipids in forming an integrative approach in lipid level regulation through both their antioxidant abilities in scavenging oxidative stress and inflammation (Kuang et al., 2022).

4.2 Examples of successful synergistic effects from existing studies

Experiments have further indicated that a combination of mussel lipids with other dietary intervention is effective. For instance, in the blue mussel lipid extract (BMLE), significant improvement in lipid levels and inflammation indices in type 2 diabetes mellitus (T2DM) patients has been observed, suggesting it might be effective if supplemented with other lipid-lowering foods (Kuang et al., 2022). The reduction of both triacylglycerol level and total cholesterol in the BMLE group indicates that synergistic actions are achievable when mussel lipid is taken as part of an integrated diet regimen.

The second article was focused on clarifying the effect of BMLE on gut microbiota, which is intrinsically linked with lipid metabolism and blood glucose management. The findings revealed that BMLE would regulate gut microbiota and was associated with improved glycemic indices and lipid profiles of T2DM patients (Liu et al., 2023). This indicates that the supplementation of mussel lipids in prebiotic or probiotic diets would be able to elevate the above-mentioned effects through a healthier gut environment, which is of utmost concern in lipid metabolism.

4.3 The potential mechanisms of synergy and their practical applications in lipid-lowering

The synergistic effect of purple mussels with other lipid-lowering foods has been through multiple mechanisms. The anti-inflammatory effect of mussel lipids combined with the cholesterol-lowering effect of garlic can lead to a more significant reduction in inflammatory cytokines and lipids (Kuang et al., 2022). It can be used in patients with metabolic disease, where inflammation plays a notable role in disease.

On actual consumption, the intake of purple mussels in a diet rich in olive oil and phytochemicals can guarantee balanced absorption of healthy fatty acids and antioxidants. The diet can enhance lipid regulation through fighting oxidative stress and increasing lipid metabolism. In addition, the regulation of gut microbiota by mussel lipids suggests the conjunction with gut-friendly foods has an even stronger lipid-lowering effect, offering an integrative strategy for dyslipidemia management (Liu et al., 2023).

5 The Role of Omega-3 Fatty Acids in Lipid-Lowering

5.1 The content and specific effects of Omega-3 fatty acids in purple mussels

Purple mussels are also rich in omega-3 fatty acids, primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with beneficial properties on lipid profiles. These fatty acids have been documented to improve the activity of high-density lipoprotein (HDL) by increasing its size and altering its lipid structure so as to decrease the risk of cardiovascular disease (Figure 1) (Cartolano et al., 2022). In addition, omega-3 fatty acids found in purple mussels can possibly decrease the triglyceride levels, one of the most crucial components engaged in dyslipidemia treatment and cardiovascular disease prevention (Wang et al., 2023).

The specific functions of omega-3 fatty acids in purple mussels extend beyond lipid profile improvement. They have been associated with the reduction of biomarkers of inflammation, which are typically elevated in the case of cardiovascular and metabolic disease (Natto et al., 2019). Their anti-inflammatory function also made them a valuable component of dietary interventions for improved cardiovascular function.

5.2 Advantages of Omega-3s from mussels compared to other sources

Mussels' omega-3 fatty acids have some benefits over others such as fish oil and flaxseed. The largest benefit is the bioavailability of mussels' EPA and DHA, and potentially higher than in plant-based products such as flaxseed that are largely alpha-linolenic acid (ALA), a precursor to EPA and DHA (Abdelhamid et al., 2018). This higher bioavailability will most probably lead to higher absorption of these fatty acids into cell membranes and thus more enhanced increase in their lipid-lowering and anti-inflammatory action (Simopoulos, 1991).

In addition, mussels are a more ecological and sustainable source of omega-3s than fish oil, whose production is normally accompanied by overfishing and environmental degradation. Mussel farming has a minimal environmental impact and, as such, are a better alternative for those who wish to strike a balance between health gain and environmental friendliness (Choi et al., 2021). Second, mussels also have lesser chances of containing contaminants such as heavy metals and polychlorinated biphenyls (PCBs) in fish oil supplements that can be a safer alternative to the consumption of omega-3 (Sherratt et al., 2023).

5.3 Mechanisms by which Omega-3 fatty acids influence lipid metabolism

Omega-3 fatty acids modulate lipid metabolism by various mechanisms. One of the principal mechanisms is decreasing triglyceride levels by inhibiting hepatic very-low-density lipoprotein (VLDL) production and enhancing the clearance of triglycerides from the blood (Bornfeldt, 2021). The mechanism is mediated by the activation of lipoprotein lipase (LPL), an enzyme that catalyzes the hydrolysis of triglycerides in blood (Vors et al., 2020).

In addition, omega-3 fatty acids can also modulate the expression of lipid metabolism genes leading to decreased lipogenesis and increased oxidation of fatty acids. Regulation of genes is also responsible for decreasing low-density lipoprotein (LDL) cholesterol and improving lipid profiles as a whole (Wang et al., 2020). Further, omega-3s have also been found to alter the lipid structure of the cell membrane, impacting membrane-bound receptors and lipid metabolism enzymes, and hence being accountable for their lipid-lowering effect (Simopoulos, 1991).

6 The Role of Antioxidant and Anti-Inflammatory Effects in Lipid Regulation

6.1 The impact of antioxidants in purple mussels on lipid oxidation and overall health

Antioxidants are known to prevent lipid oxidation, one of the primary offenders in the development of most of the chronic diseases. Purple mussels, being antioxidant plants, can prevent oxidative modification of lipids, thereby preventing inflammation and associated complications. Antioxidant activity of high-density lipoproteins (HDL) was observed to repress the oxidation of low-density lipoproteins (LDL), a crucial step in the development of atherosclerosis (Nègre-Salvayre et al., 2006). Similarly, microbe-derived antioxidants were observed to repress oxidative stress and lipid derangement in high-fat diet-induced models, suggesting that purple mussel antioxidants are capable of yielding similar desirable results (Gao et al., 2023).

Moreover, purple mussel antioxidant activity may enhance general wellness through body defense enhancement against oxidative stress. This is supplemented by findings that antioxidants can modulate inflammation and oxidative stress, the major etiologies of chronic conditions such as cardiovascular diseases and NAFLD (Dludla et al., 2020; Djuricić and Calder, 2021). Through inhibition of oxidative stress, purple mussel antioxidants may be capable of maintaining lipid homeostasis and enhancing metabolic health.

6.2 The anti-inflammatory effects that improve lipid metabolism and cardiovascular health

Anti-inflammatory action is also essential for improvement in cardiovascular health and lipid metabolism. Since purple mussels are anti-inflammatory in nature, they can modulate inflammatory pathways that are generally impaired in metabolic diseases. For instance, anti-inflammatory effects of lipid oxidation products have been shown to modulate inflammatory processes, which may lead to improved lipid metabolism and reduced cardiovascular risk (Bochkov and Leitinger, 2003). In addition, crosstalk between the nitric oxide and lipid signaling pathways indicates the potential of anti-inflammatory nitro-fatty acids to modulate immune responses and metabolic homeostasis (Baker et al., 2009).

Purple mussel anti-inflammatory activity can also be credited with cardiovascular wellness through the inhibition of pro-inflammatory cytokines and reduction of oxidative stress. This is paralleled with the activity of omega-3 polyunsaturated fatty acids, where the incidence of chronic diseases with increased inflammation, including cardiovascular disease, is reduced (Djuricić and Calder, 2021). Through the inhibition of inflammation, purple mussels are able to enhance lipid profiles and avert cardiovascular events.

6.3 The synergistic effects between the antioxidants in purple mussels and other anti-inflammatory foods

The synergistic effects that occur when purple mussels are combined with other foods that are anti-inflammatory can enhance lipid-lowering activities. For example, mixing flax lignans and sinapic acid, antioxidative and anti-inflammatory phytochemicals, was shown to regulate lipid homeostasis and inhibit inflammation in mice that were fed on high-fat diets (Wu et al., 2021). It would mean that lipid-lowering and healthy function of purple mussels may be enhanced by mixing them with foods of the same category.

Besides, the synergetic collaboration of anti-inflammatory molecules and antioxidants can facilitate more effective modulation of lipid metabolism as well as inhibition of oxidative stress. The cross-talk of NADPH oxidase 4-anti-inflammatory signaling pathways, such as IL-4 and IL-13, gives evidence of how the dual antioxidant and anti-inflammatory action is capable of managing lipid storage and delivery with beneficial effects on metabolic well-being (Szanto, 2023). Supplementing a diet otherwise filled with other anti-inflammatory nutrients with purple mussels can facilitate the addition of further protection against lipid disorders, as well as overall health improvements.

7 Clinical and Preclinical Evidence of Synergistic Effects

7.1 Animal studies on the synergistic lipid-lowering effects of purple mussels and other ingredients

Animal experiments have indicated that mussels, specifically here the Mediterranean mussel (Mytilus galloprovincialis), are capable of affecting lipid profiles. Environmental stress such as glyphosate exposure and temperature were found to be responsible for having a significant influence on altering the lipids and fatty acid profile of mussels. In particular, glyphosate, at various temperatures, reduced the levels of desirable n-3 PUFAs, which contribute significantly to lipid-reducing activity. This suggests that mussels themselves are endowed with natural lipid-lowering trait but extrinsic conditions can modulate such action, which will also be reflected on their synergistic activity if mixed with other nutrients (Biandolino et al., 2023).

Later studies on the lipid-lowering activity of mussels showed that for maintaining their nutrient content, they must be provided with right environmental conditions. Mytilus galloprovincialis studies showed that such stressors as glyphosate and temperature not only decreased the levels of desirable fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) but also altered the whole indices of nutrition. They emphasize the necessity of using controlled conditions in animal models for accurate assessment of the synergistic action of mussels on other lipid-lowering agents (Table 1) (Biandolino et al., 2023).

7.2 A summary of relevant human clinical trials and data

Human clinical trials exhibited the lipid-lowering activity of mussel extracts. Blue mussel lipid extract (BMLE) showed a remarkable improvement in the lipid profile of type 2 diabetes mellitus (T2DM) patients. BMLE recipients showed a remarkable decrease in total cholesterol and triacylglycerol compared to fish oil or corn oil recipients. This suggests that BMLE has a particular lipid-lowering activity that is most likely due to the outstanding fatty acid profile with very high levels of EPA and DHA (Kuang et al., 2022; Liu et al., 2023).

Besides, the same trial determined the anti-inflammatory action of BMLE, which may be responsible for its lipid-lowering action. Lower concentrations of inflammatory cytokines such as tumor necrosis factor-alpha and interleukin-1β in the BMLE group suggest a dual mode of action, where lipid modulation and inhibition of inflammation also have roles to play. These findings imply that BMLE, and potentially other mussel extracts, are potentially useful ingredients in synergistic foods designed to improve the lipid profiles of people (Kuang et al., 2022; Liu et al., 2023).

7.3 A comprehensive analysis of existing research findings, exploring the actual effects of purple mussels and their combinations in lipid-lowering

The recent literature highlights the potentiality of mussels, and particularly through their lipid extracts, to lipid-lowering applications. The experiments have proven that mussel extracts are effective in modulating lipid profiles favorably by reduced total cholesterol and triacylglycerol. This could be because of the omega-3 fatty acid content of mussels such as EPA and DHA, which are extremely valued for their cardiovascular effects. The unique fatty acid pattern of mussels and their anti-inflammatory activity define them as potential lead compounds for synergistic lipid-lowering preparations (Kuang et al., 2022; Biandolino et al., 2023; Liu et al., 2023).

Apart from their direct effect, mussels may also synergize with other lipid-lowering medications to augment their impact. That BMLE regulates gut microbiota in clinical trials suggests another pathway through which mussels can exert their effect. This possibility is that mussels can alter the metabolic markers by changing gut health, once again providing a rationale for the use of mussels in combination lipid-lowering treatment. The importance of these studies cannot be overstated as they demand additional inquiry into the complete potential of mussels as adjunct treatments for lipid management (Kuang et al., 2022; Liu et al., 2023).

8 Challenges and Limitations in Research

8.1 The diversity of study designs and standardization issues

Examination of the synergistic activities between purple mussels and other constituents on lipid-lowering activity is complicated by study design heterogeneity. Heterogeneous research designs, ranging from randomized controlled trials to observational studies, can have varying results such that it's not easy to infer consistent results. For instance, the blue mussel lipid extract (BMLE) trial utilized a double-blind randomized controlled trial in assessing its impact on glycemic features and lipid profiles in type 2 diabetes mellitus (T2DM) patients, which is a good research design but will not be readily comparable with other research designs (Kuang et al., 2022; Liu et al., 2023).

Standardization issues also complicate studies in this area. Variations in the production and constitution of mussel extracts, and the heterogeneity of populations under study, could lead to the absence of comparable results. The lack of standardized methods for the extraction and donation of mussel lipids leads to varying wildly between research, which prohibits an explicit understanding of their lipid-lowering activity (Kuang et al., 2022; Liu et al., 2023).

8.2 The difficulty of translating animal study results into clinical applications

Application of conclusions from animal studies to human clinical application is very difficult. While animal models may provide information on action mechanisms of mussel extracts, their physiological difference from human beings can lead to disparity in efficacy and safety reactions. For example, while BMLE demonstrated anti-inflammatory activities in animal models of arthritis, its activities among human T2DM patients can be varied due to variability in metabolism and immune response (Kuang et al., 2022).

Moreover, the multifactorial and multicellular etiology of human diseases such as T2DM makes it difficult to replicate animal study results in clinic settings. The case of mussel extracts and human gut microbiota interaction, for instance, could not be adequately predicted with the help of animal models, as found in studies on the relationship between BMLE and gut microbiota in patients with T2DM (Liu et al., 2023).

8.3 Limitations in dosage selection, ingredient ratios, and other factors in current research

Past studies on mussel extract lipid-lowering activity are also plagued with the limitations of determining ideal dosages and the proportion of components. Fixed dosages like 1.6g/day BMLE consumed during trials are adopted by most studies, which might not be ideal or safe dosages for different groups and conditions (Kuang et al., 2022). This limitation is likely to lead to the underestimation or overestimation of the risk and benefits of consuming mussel extracts.

In addition, the interaction of mussel extracts with other food constituents is not known and may influence research findings. The bioactive potency of active compounds like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in mussel extracts may decide efficacy but are scarcely optimized or even standardized in research (Kuang et al., 2022). Absence of standardization could make it challenging to conclude and provide adequate dietary recommendations.

9 Future Research Directions and Conclusion

The future of purple mussels in lipid management products is bright, but additional research is needed to capture their synergistic benefits when combined with other ingredients. Current research presents the bioactive compounds found in mussels, such as polyunsaturated fatty acids (PUFAs), which are well known for their medicinal properties, such as for their lipid-lowering effects. Future research should focus on the discovery of particular combinations of mussel-derived compounds with other phyto- or marine-derived compounds, which can produce synergistic action to further enhance these lipid-lowering effects. Elucidation of the mechanisms through which such combinations affect lipid metabolism and cardiovascular risks may be enlightening. Identification of the role of mussel lipids in prebiotic modulation of gut microbiota and their consequent effect on lipid profiles and glycemic features may be one area of future studies.

Functional food and health product development with purple mussels is highly promising. Mussels are rich in bioactive compounds like proteins, lipids, and carbohydrates, which are useful for health-promoting products. Formulation of functional foods with mussel-based ingredients may be a natural and effective means of lipid regulation and the promotion of cardiovascular health. On top of that, sustainable utilization of mussel by-products to such ends could minimize their environmental impact and improve economic sustainability. Maximizing the extraction and processing techniques to maximize bioavailability and functionality in functional foods needs to be the area of research in the future.

Synergistic activity of purple mussels and other natural products has significant promise for lipid lowering as well as cardiovascular health. Current research accentuates the potential of bioactive molecules present in mussels, namely PUFAs, towards realizing health benefits. By synergetic combination of these molecules with other natural products, future research can lead to the discovery of novel functional foods and health ingredients. Such innovations can help bring effective and sustainable solutions for lipid control and cardiovascular well-being and hence affect the public health positively.

Acknowledgments

I sincerely thank Mr. Wei from the Horticultural and Herbal Research Center for her valuable support in data analysis and material collection, which contributed to the successful completion of this study.

Conflict of Interest Disclosure

The authors affirm that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

References

Abdelhamid A., Brown T., Brainard J., Biswas P., Thorpe G., Moore H., Deane K., AlAbdulghafoor F., Summerbell C., Worthington H., Song F., and Hooper L., 2018, Omega‑3 fatty acids for the primary and secondary prevention of cardiovascular disease, Cochrane Database of Systematic Reviews, 11: 3177.

https://doi.org/10.1002/14651858.CD003177.pub4

Abshirini M., Cabrera D., Fraser K., Siriarchavatana P., Wolber F., Miller M., Tian H., and Kruger M., 2021, Mass spectrometry‑based metabolomic and lipidomic analysis of the effect of high fat/high sugar diet and Greenshell™ mussel feeding on plasma of ovariectomized rats, Metabolites, 11(7): 754.

https://doi.org/10.3390/metabo11110754

Micallef M.A., and Garg M.L., 2008, The lipid‑lowering effects of phytosterols and n‑3 polyunsaturated fatty acids are synergistic and complementary in hyperlipidemic men and women, Journal of Nutrition, 138(6): 1086-1090.

https://doi.org/10.1093/jn/138.6.1086

Baker P., Schopfer F.J., O’Donnell V.B., and Freeman B.A., 2009, Convergence of nitric oxide and lipid signaling: anti‑inflammatory nitro‑fatty acids, Free Radical Biology & Medicine, 46(8): 989-1003.

https://doi.org/10.1016/j.freeradbiomed.2008.11.021

Biandolino F., Prato E., Grattagliano A., and Parlapiano I., 2023, Can glyphosate and temperature affect the nutritional lipid quality in the mussel Mytilus galloprovincialis?, Foods, 12(8): 1595.

https://doi.org/10.3390/foods12081595

Bochkov V., and Leitinger N., 2003, Anti-inflammatory properties of lipid oxidation products, Journal of Molecular Medicine, 81(11): 613-626.

https://doi.org/10.1007/s00109-003-0467-2

Bornfeldt K.E., 2021, Triglyceride lowering by omega‑3 fatty acids: a mechanism mediated by N‑acyl taurines, Journal of Clinical Investigation, 131(6): e147558.

https://doi.org/10.1172/JCI147558

Cartolano F., Dias G.D., Miyamoto S., and Damasceno N.R.T., 2022, Omega‑3 fatty acids improve functionality of high‑density lipoprotein in individuals with high cardiovascular risk: a randomized, parallel, controlled and double‑blind clinical trial, Frontiers in Nutrition, 8: 767535.

https://doi.org/10.3389/fnut.2021.767535

Choi H., Kim J., Lee K., Kim J.Y., Lee J.Y., Choi E.K., Seong H.J., Kim G., Park H., Jung E., Hong S. H., Kronbichler A., Eisenhut M., Koyanagi A., Jacob L., Yon D.K., Lee S.W., Kim M.S., Kostev K., Shin J.I., Yang J.W., and Smith L.A., 2021, Omega‑3 fatty acids supplementation on major cardiovascular outcomes: an umbrella review of meta‑analyses of observational studies and randomized controlled trials, European Review for Medical and Pharmacological Sciences, 25(4): 2079-2092.

https://doi.org/10.26355/eurrev_202102_25113

Djuricić I., and Calder P.C., 2021, Beneficial outcomes of omega‑6 and omega‑3 polyunsaturated fatty acids on human health: an update for 2021, Nutrients, 13(7): 2421.

https://doi.org/10.3390/nu13072421

Dludla P.V., Nkambule B.B., Mazibuko‑Mbeje S.E., Nyambuya T.M., Marcheggiani F., Cirilli I., Ziqubu K., Shabalala S.C., Johnson R., Louw J., Damiani E., and Tiano L., 2020, N‑acetyl cysteine targets hepatic lipid accumulation to curb oxidative stress and inflammation in NAFLD: a comprehensive analysis of the literature, Antioxidants, 9(12): 1283.

https://doi.org/10.3390/antiox9121283

Feng J., Chen X., Wang S., Zhang J., Wang Q., Guo S., and Shen Q., 2023, Transcriptomics integrated with metabolomics reveals the ameliorating effect of mussel-derived plasmalogens on high-fat diet‑induced hyperlipidemia in zebrafish, Food & Function, 14: 3690-3702.

https://doi.org/10.1039/d3fo00063j

Gao Q., Luo Z., Yu C., Shen C., Xu W., Zhang J., Zhang H., and Xu J., 2023, Microbe‑derived antioxidants alleviate liver and adipose tissue lipid disorders and metabolic inflammation induced by high fat diet in mice, International Journal of Molecular Sciences, 24(4): 3269.

https://doi.org/10.3390/ijms24043269

Gorinstein S., Leontowicz M., Leontowicz H., Namieśnik J., Jastrzebski Z., Drzewiecki J., Park Y., Ham K., Heo B., and Trakhtenberg S., 2008, Influence of mussels (Mytilus galloprovincialis) from polluted and non-polluted areas on some atherosclerosis indices in rats fed cholesterol, Food Chemistry, 111(2): 381-386.

https://doi.org/10.1016/j.foodchem.2008.03.082

Grienke U., Silke J., and Taşdemir D., 2014, Bioactive compounds from marine mussels and their effects on human health, Food Chemistry, 142: 48-60.

https://doi.org/10.1016/j.foodchem.2013.07.027

Kuang X., Shao X., Li H., Jiang D., Gao T., Yang J., Li K., and Li D., 2022, Lipid extract from blue mussel (Mytilus edulis) improves glycemic traits in Chinese type 2 diabetic mellitus patients: a double-blind randomized controlled trial, Journal of the Science of Food and Agriculture, 102(13): 5623-5630.

https://doi.org/10.1002/jsfa.12346

Liu S., Kuang X., Song X., Li H., Shao X., Gao T., Guo X., Li S., Liu R., Li K., and Li D., 2023, Effects of lipid extract from blue mussel (Mytilus edulis) on gut microbiota, and its relationship with glycemic traits in type 2 diabetes mellitus patients: a double-blind randomized controlled trial, Food & Function, 14(20): 10021-10034.

https://doi.org/10.1039/d3fo01491f

Li M.M., 2024, Innate defense role of extracellular vesicles: the critical role of phosphatidylserine in combating apoptotic mimicry viruses, International Journal of Molecular Medical Science, 14(2): 100-105.

https://doi.org/10.5376/ijmms.2024.14.0013

Micallef M., and Garg M., 2008, The lipid-lowering effects of phytosterols and (n-3) polyunsaturated fatty acids, Current Opinion in Lipidology, 19(6): 573-579.

https://doi.org/10.1097/MOL.0b013e3283168e08

Natto Z., Yaghmoor W., Alshaeri H., and Van Dyke T., 2019, Omega-3 Fatty Acids Effects on Inflammatory Biomarkers and Lipid Profiles among Diabetic and Cardiovascular Disease Patients: A Systematic Review and Meta-Analysis, Scientific Reports, 9: 18867.

https://doi.org/10.1038/s41598-019-54535-x

Nègre-Salvayre A., Dousset N., Ferretti G., Bacchetti T., Curatola G., and Salvayre R., 2006, Antioxidant and cytoprotective properties of high-density lipoproteins in vascular cells, Free Radical Biology and Medicine, 41(7): 1031-1040.

https://doi.org/10.1016/j.freeradbiomed.2006.07.006

Sherratt S., Mason R., Libby P., Steg P., and Bhatt D., 2023, Do patients benefit from omega-3 fatty acids?, Cardiovascular Research, 119(14): 2884-2901.

https://doi.org/10.1093/cvr/cvad188

Simopoulos A.P., 1991, Omega-3 fatty acids in health and disease and in growth and development, The American Journal of Clinical Nutrition, 54(3): 438-463.

https://doi.org/10.1093/ajcn/54.3.438

Szanto I., 2023, 1587-P: The NADPH Oxidase 4 Regulates Anti-inflammatory Signals to Modulate Lipid Depot Distribution between Adipose Tissue and Liver, Diabetes, 72(1): 1587.

https://doi.org/10.2337/db23-1587-p

Vaidya H., and Cheema S., 2014, Sea cucumber and blue mussel: new sources of phospholipid enriched omega-3 fatty acids with a potential role in 3T3-L1 adipocyte metabolism, Food & Function, 5(12): 3287-3295.

https://doi.org/10.1039/c4fo00330f

Vaidya H., Gangadaran S., and Cheema S., 2017, An obesogenic diet enriched with blue mussels protects against weight gain and lowers cholesterol levels in C57BL/6 mice, Nutrition Research, 46: 31-37.

https://doi.org/10.1016/j.nutres.2017.07.004

Villasante A., Patro B., Chew B., Becerra M., Wacyk J., Overturf K., Powell M., and Hardy R., 2015, Dietary intake of purple corn extract reduces fat body content and improves antioxidant capacity and n-3 polyunsaturated fatty acid profile in plasma of rainbow trout (Oncorhynchus mykiss), Journal of the World Aquaculture Society, 46(4): 381-394.

https://doi.org/10.1111/jwas.12206

Vors C., Couture P., and Lamarche B., 2020, Omega-3 fatty acids: new insights into the impact of eicosapentaenoic and docosahexaenoic acids on lipid and lipoprotein metabolism, Current Opinion in Lipidology, 31(1): 38-39.

https://doi.org/10.1097/MOL.0000000000000660

Wang T., Zhang X., Zhou N., Shen Y., Li B., Chen B., and Li X., 2023, Association between omega‐3 fatty acid intake and dyslipidemia: A continuous dose-response meta‐analysis of randomized controlled trials, Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 12(11): e029512.

https://doi.org/10.1161/JAHA.123.029512

Wu Z., Wu B., Lv X., Xie Y., Xu S., Chen C., Xu J., Tu X., Wei F., and Chen H., 2021, Serumal lipidomics reveals the anti-inflammatory effect of flax lignans and sinapic acid in high-fat-diet-fed mice, Journal of Agricultural and Food Chemistry, 69(6): 1782-1791.

https://doi.org/10.1021/acs.jafc.0c07291

Xin R., Wang Q., and Zhao D.G., 2024, Hypotensive effects of Eucommia ulmoides and its mechanisms, International Journal of Clinical Case Reports, 14(5): 262-275.

https://doi.org/10.5376/ijccr.2024.14.0027