Targeting gut microbiota and bile acid metabolism: dual regulatory strategies of dietary polyphenols against atherosclerosis

Atherosclerosis (AS) is a leading cause of cardiovascular mortality, primarily driven by inflammation and lipid deposition. Emerging evidence implicates gut microbiota (GM) dysbiosis in AS pathogenesis. Dietary polyphenols, characterized by potent antioxidant and anti-inflammatory properties, demonstrate significant therapeutic potential by modulating GM and bile acid (BA) metabolism. This review comprehensively elucidates the molecular mechanisms by which polyphenols ameliorate AS via the "GM-BA" axis, highlighting GM and BAs as critical mediators. Furthermore, we discuss current limitations, including compositional heterogeneity and translational gaps between animal models and humans. Future research directions are proposed, focusing on the verification of active ingredients, receptor binding mechanisms, and the development of functional delivery systems. This work provides a theoretical foundation for advancing polyphenol-based precision nutrition strategies in AS management.