But my thinking since then has changed dramatically. I recommend very few supplements and regularly take only one myself. Several large clinical trials are responsible for this turnaround, as is a new appreciation for the myriad micronutrients in whole foods that interact to benefit us in ways that we do not yet understand. But even much of that research is in its early stages. Until we have better guidance from large, long-term studies, here are my verdicts on some popular supplements you’ve undoubtedly heard much about: Fish Oil: This is the only supplement I really recommend (and the only one I take regularly). Its omega-3 fatty acids have withstood rigorous study as a heart protector. In fact, because of the high levels of mercury in some fresh fish, the refined supplement can be the safest way to get this nutrient. If you have documented heart disease, the American Heart Association recommends getting 1 gram daily of EPA and DHA, preferably from oily fish, although it says that an omega-3 fatty acid supplement could be considered in consultation with your physician. I agree with these recommendations. For people with markedly elevated triglycerides (bad blood fats), higher doses of prescription fish oils (2 to 4 grams daily) can be quite effective when used under a doctor’s care. Updated February 2014 [pagebreak] Vitamin D: More positive studies on the cardiovascular benefits of vitamin D have been turning up, and I will occasionally recommend 1,000 IU daily to patients. But that’s only if their bloodwork shows a deficiency despite eating D-fortified foods and getting 10 to 15 minutes of unprotected sunlight daily. Resveratrol: This nutrient, a polyphenol found primarily in red grape skins and red wine, has been widely touted as heart-healthy, but isn’t ready for a general recommendation as a supplement. That’s because data from human studies is extremely limited and inconsistent and the issue of appropriate resveratrol doses requires further study. Turmeric: I have been intrigued by recent findings on turmeric, the curry spice that contains a polyphenol called curcumin, which has been shown to have antioxidant and anti-inflammatory properties in animal studies. Inflammation has been linked to cardiovascular disease, as well as other health problems such as Alzheimer’s disease, from which my father suffered. While you can enjoy turmeric in your cooking, I don’t recommend that you start taking this spice in pill form to protect your heart or your brain until more research in humans, documenting its benefits, is available. Antioxidants: Skip them. A trial with tens of thousands of participants who were given vitamins E and C and beta-carotene supplements failed to confirm early findings that were positive; other research concluded they may even be harmful (acting as pro-oxidants) if taken in large amounts. Many more studies are needed to draw a definite conclusion about the real role of antioxidants in the body. Updated February 2014 [pagebreak] B Vitamins: Unless you have a specific deficiency measured by your physician, skip these, too. There is no definitive evidence that taking B6, B12, or folic acid supplements alone, or as part of a multivitamin, can actually help prevent heart disease, despite lowering levels of the amino acid by-product homocysteine, a documented risk marker for cardiovascular events. Remember: A varied and wholesome diet is still the best multivitamin. The secret to vibrant health is not consuming isolated nutrients like antioxidants in pill form but, rather, eating more foods that contain them. One thing that remains bedrock is the health benefit of eating vegetables, fruits, legumes, and whole grains. Overall, I try to make sure my lunch and dinner plates are always colorful with fruits and vegetables, and I recommend that my patients do the same. That’s one bit of advice you can bet won’t change. *If you decide to take fish oil or vitamin D, look for a brand with the US Pharmacopeia label, indicating it’s been tested for accuracy, safety, and effectiveness. Updated February 2014
