One of the most common questions I am asked in my clinic is what supplements do you recommend to protect against heart disease. The answer is both simple…NONE… and complex… depends on what you mean by a supplement.A landmark study entitled INTERHEART showed that 90% of heart disease risk can be predicted by 9 risk factors.
The six risk factors that increased risk include abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, and psychosocial factors. The 3 risk factors that decrease cardiovascular risk include regular physical activity, moderate alcohol intake, and regular consumption of fruits and vegetables.
Many large trials looking at supplements such as vitamin B 12, folic acid, niacin, vitamin C, vitamin E and most recently vitamin D have failed to reduced cardiovascular risk and in some cases increased risk of other complications slightly. The concept of using supplements results from a lifestyle that has become more sedentar and stressful, and a diet that has become more processed and calorie decadent. Supplements are felt to help neutralize these adverse changes.
I would counter that the best supplements one can take come from proper dietary choices. There is ample evidence that antioxidants reduce the risk of heart disease. Finding the right mixture of supplements is more diffi cult than choosing the right foods such as vegetables rich in fl avinoids, (tomatoes, berries, chocolate and even caffeine).
The highly touted Mediterranean diets’ success is largely in part to the incorporation of such foods.Another important supplement (dietary choice) are omega-3 fats. The American Heart Association recommends 2 grams of omega 3-containing foods or supplements on a daily basis while eliminating all trans fats.
Multiple studies have shown that alcohol in moderation reduces cardiovascular risk in part by raising good (HDL) cholesterol. This amounts to 1 drink for women and 2 drinks for men daily, without the luxury of saving up all consumption for the weekend! Red wine confers the added bennefi t of antioxidants such as resveratrol.
Foods rich in dietary fiber and having a low glycemic index (nuts, legumes and whole grains) work by reducing total caloric intake, improving diabetes control, and protecting against both heart disease and cancer risk.
So …other than a simple multivitamin…the path to a healthier heart is not in supplementing with tablets but rather with a richer choice of food and drinks in your daily lives!
