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 Researchers examined data from 277 trials with a total of almost one
million participants to assess the effects of 16 different
nutritional supplements and 8 dietary interventions on the risk of
heart problems and strokes.
Most of the vitamins, minerals, supplements and diets didn't protect
against heart attack or stroke or reduce the risk of death from
heart-related causes, researchers report in Annals of Internal
Medicine.
"People should focus on healthy diet from nutritional food sources,
not vitamins or supplements, in combination with healthy lifestyle
which includes regular physical activity and not smoking," said Dr.
Safi Khan, lead study author and a researcher at West Virginia
University School of Medicine in Morgantown.
Current U.S. dietary guidelines recommend several healthy eating
patterns, including Mediterranean and vegetarian diets, but they do
not recommend routine supplement use to reduce the risk for
cardiovascular disease or other chronic diseases, researchers note.
Previous research has linked a Mediterranean diet rich in fruits,
vegetables, legumes, whole grains, fish and healthy fats to a
healthier heart and brain, particularly as people age. Vegetarian
diets have also been tied to a lower risk of heart disease.
Despite the lack of evidence proving a clear benefit for most
supplements, roughly half of U.S. adults take some type of
supplement they think will help improve their health, the study team
writes.
In the current study, researchers did find some evidence that
reduced salt intake was associated with a lower risk of premature
death from all causes among patients with normal blood pressure.
Omega-3 fatty acids, meanwhile, appeared to lower the risk of heart
attacks and coronary heart disease.
And folic acid appeared to help lower the risk of strokes.
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But supplements with a combination of calcium and vitamin D intake
were associated with a higher risk for stroke, the analysis also
found.
In addition, there seemed to be no significant effect on mortality
or cardiovascular outcomes from other supplements, such as
multivitamins, selenium, vitamin A, vitamin B6, vitamin C, vitamin
E, vitamin D alone, calcium alone, folic acid, and iron, or from
dietary interventions such as the Mediterranean diet, reduced
saturated fat intake, modified fat intake, reduced dietary fat
intake, and increased intake of fish oil supplements.
Even though the analysis looked at data from clinical trials that
randomly assigned some patients to take supplements while others did
not - the gold standard for testing the effect of specific
interventions - there are still some limitations.
The biggest drawback is that the smaller studies in the analysis
used a variety of methods for testing the effect of supplements and
examined different doses and formulations of these products for
varied lengths of time.
Still, the authors conclude that there's enough evidence to suggest
that people shouldn't start taking supplements just because they
want to prevent heart problems.
"There are no convincing data that any vitamin or supplement reduces
heart attacks," said Dr. Eric Topol, coauthor of an editorial
accompanying the study and executive vice president of Scripps
Research in La Jolla, California.
"Don't take supplements," Topol said by email.
SOURCE: http://bit.ly/30tyMWm Annals of Internal Medicine, online
July 8, 2019
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