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Which supplements are good for heart health, which are not?

Supplements with Omega-3 fatty acids, curcumin and co-enzyme Q10 can help decrease cardiovascular risk, says Dr Bimal Chhajer, Cardiologist and Director, SAAOL Heart Centre, and former consultant at AIIMS, Delhi

Bimal Chhajer, Indian Express, Dec 13, 2022

With a substantial rise in several cardio-metabolic diseases over the years, questions regarding which food supplements to take and which to avoid have become relevant, diet and nutrition being two of the most important factors in causing and preventing several long-term ailments. And it all begins with demolishing the devil called cholesterol.

Cardiometabolic diseases are a variety of common yet preventable ailments, including cardiovascular events like heart attack, stroke and metabolic disorders like diabetes, insulin resistance and non-alcoholic fatty liver disease among others. These present some of the most serious health challenges for the global healthcare system in the 21st century with cases rising rapidly every year. But research, technology and treatment modules have also evolved at a brisk pace over the years, making the conditions not only curable but also preventable.

Several studies have suggested that diets rich in antioxidants, minerals and vitamins lower the risk of cardiovascular diseases (CVD) and Type-2 diabetes. On the contrary, diets rich in saturated fat and sodium up the threat quotient. Micronutrients consist of various vitamins and minerals like Omega-3 and Omega-6 fatty acids, which tend to reduce the risk of CVD mortality, heart attacks and other heart diseases due to their anti-inflammatory effect while folic acid decreases the risk of strokes by lowering the blood total homocysteine (tHcy) concentrations. Being a key family of polyunsaturated fats, Omega-3 fats not only prevent heart diseases and strokes but also help in controlling lupus, eczema and rheumatoid arthritis while playing a major role in cancer and other conditions.

Polyphenols like curcumin, genistein and quercetin have shown health benefits for preventing cardiovascular diseases as well as reducing HbA1c (a measure of longer-term blood sugar levels) and fasting blood insulin levels. And although several micronutrients have various health benefits, others like vitamin C, E and selenium have a neutral effect on cardiovascular and metabolic diseases. It is also worth noting that Vitamin D reduces oxidative stress and improves cardiometabolic outcomes but still studies have been inconclusive about whether it can prevent heart disease.

In fact, Johns Hopkins researchers say that consuming too much of certain vitamins can be harmful. Too much calcium and vitamin D are associated with an increased risk of cardiovascular disease.

Nutrients like magnesium play a major role in muscle and nerve functioning. The heart is a muscle which requires a large amount of magnesium to keep the contractions and rhythms going. Magnesium supplements are known to boost everyday wellness along with better sleep, increased energy levels and improved mood. These also have specific health benefits like lower blood pressure, reduced risk of heart disease and improvement in migraines.

Prescription fish oils are used but they are more effective, according to Johns Hopkins researchers, for triglycerides than cholesterol. Omega-3 therapy with prescription fish oil can reduce triglycerides by 30 to 50 per cent in those with levels that are at 500 mg/dL or more, and who are at an increased risk of pancreatitis. Besides, over-the-counter fish oil supplements may contain large amounts of other unwanted saturated fats, which could increase your bad cholesterol.

But micronutrients like Beta-carotene, when taken in a supplement form, are known to raise the risk of CVD mortality. Beta-carotene is a precursor of Vitamin-A. The human body converts beta-carotene into Vitamin A when needed. Antioxidants like Beta-carotene, Vitamin C and E help in preventing the cell membrane from weakening, protecting it against rogue compounds trying to get inside. Oxidative damage can indirectly lead to diet-related chronic disease like CVD.

Also, beta-carotene is known to increase the risk of cardiometabolic diseases under certain circumstances. For example, if a person consumes higher than normal levels of beta-carotene, it becomes dangerous and can result in higher mortality. Also, beta-carotene is known to have a different effect on male and female patients, smokers and drinkers. Another reason could be that it runs the risk of converting into a pro-oxidant and becoming harmful for the body.

As beta-carotene supplements are also linked with an increased risk of lung cancer, especially among smokers, it is suggested that micronutrients should be taken as a whole food instead of a supplement. The human body can have several benefits when nutrients are consumed as a whole food compared to when they are isolated and put into a supplement form.

But as these studies are relatively new and done among a fixed number of people, it is important to characterise specific dosage.

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