A study published in the Journal of the American College of Cardiology (6 November 2022) concluded that people should not use dietary supplements for heart health. In particular, the researchers were referring to red yeast rice, fish oil, plant sterols, cinnamon, garlic, and turmeric. Their precise words: “Patients should be informed of the lack of benefit of these supplements on important cardiovascular risk factors.” What about the things that people really do you care about heart attacks, strokes, stents or sudden death? To the dismay of some cardiologists, dietary supplements may actually be beneficial.
Digging into SPORT data:
This research was calledSPORT.” It means: The Supplements, Placebo, or Rosuvastatin Study. The sponsor was AstraZeneca, the manufacturer of Crestor (rosuvastatin). By sponsor, we mean the company that funded this research.
First, let’s look at what cardiologists at the Cleveland Clinic did in the latest heart health supplement study.
The research was designed to compare low-dose rosuvastatin (Crestor) to a placebo and a variety of dietary supplements. With eight different groups, there were approximately two dozen volunteers randomly assigned to each group.
The study lasted just less than a month. The researchers took “before” and “after” measurements of fats in each participant’s blood, including triglycerides as well as HDL, LDL and total cholesterol. Compared to other research, this was a very small study that lasted a very short time.
Not surprisingly, rosuvastatin reduced LDL cholesterol by an average of 38%. None of the dietary supplements reduced LDL significantly in this study.
Misleading Headlines About Heart Health Supplements:
Here are some of the headlines that sum up the SPORT study:
“Flunk Lipid Reduction Test for Cardiac Supplements” MedscapeNovember 20, 2022
“Are over-the-counter dietary supplements helpful or harmful?” New research that examined six of the most popular over-the-counter dietary supplements found that they are ineffective compared to heart medications and may even be harmful. CBS PhiladelphiaNovember 9, 2022
“Patients may want to think twice before relying on supplements to treat high cholesterol” WISHTV.com November 9, 2022
“Study on the flop of 6 ‘heart-healthy’ supplements in cholesterol” KOAM NewsNow.com November 17, 2022
‘Don’t bother with dietary supplements for heart health, study finds’ CNN HealthNovember 6, 2022
Cardiologists stigmatize supplements for heart health:
Now you get the picture. The message to consumers was that rosuvastatin (Crestor) works and dietary supplements don’t. Of course, everything depends on the definition we have of “works”.
The study was small and only lasted one month. It showed that rosuvastatin (Crestor) was quite effective in lowering LDL cholesterol. No surprise there. This is what statins were designed for.
Dietary supplements that have been tested during this period have not. Researchers do not appear to have consulted www.ConsumerLab.com to determine the most effective dietary supplements.
The quality of supplements can be an issue:
ConsumerLab.com actually tests dietary supplements such as red yeast rice for active ingredients (lovastatin or monacolins K and KA) and contaminants (citrinin). When it comes to Red Yeast Rice (RYR), this testing company recommends HPF Cholestene and notes that this was the only RYR product approved for quality.
Apparently the Cleveland Clinic researchers didn’t bother to test the red yeast rice product they used in their SPORT (Arazo Nutrition) research project. ConsumerLab noted in its review of red yeast rice products that in its testing of the Arazo Nutrition brand of red yeast rice, “no lovastatin could be detected.” As a result, ConsumerLab concluded it was “NOT APPROVED”.
It is therefore not surprising that the red yeast rice used in this trial did not reduce LDL cholesterol, total cholesterol, triglycerides or any other risk factors. It did not contain the active ingredient. In my opinion, that was a BIG oops!
Other Heart Health Supplement Studies:
The results of the SPORT trial do not mean that the “tested” dietary supplements are worthless. Larger studies that lasted longer showed different results for some of these natural compounds.
First, this study focused primarily on blood lipids, especially LDL cholesterol. It did not attempt to measure effects on heart health outcomes such as heart attacks or strokes. He was too short and too small to do that.
VITAL:
Other studies have looked at a few of these alternative compounds. A large randomized controlled trial of fish oil and vitamin D, the VITAL trial, followed nearly 26,000 Americans over age 50 for more than five years (New England Journal of Medicine, January 3, 2019). The researchers concluded that fish oil did not reduce major cardiovascular events.
On the other hand, a meta-analysis of 38 randomized controlled trials of omega-3 fatty acids like those found in fish oil concluded (eClinicalMedicineAugust 1, 2021):
“Omega-3 Fatty Acids Reduced Cardiovascular Mortality and Improved Cardiovascular Outcomes”
We have to conclude that the benefits of fish oil are complicated, but dismissing them completely can be a mistake.
Red yeast rice:
What about red yeast rice (RYR)? This medicinal food has been used for centuries in traditional Asian medical systems. The compounds produced by yeast that turn rice red work the same way as statins like rosuvastatin.
A review of several clinical trials found RYR to be safe and effective for people with high cholesterol (Journal of the American College of Cardiology, February 9, 2021). However, this review focused on blood lipids like LDL cholesterol. Of course, that’s exactly what the most recent SPORT trial also investigated.
The authors concluded:
“The RYR could represent a therapeutic tool to support lifestyle improvement in the management of mild to moderate hypercholesterolemia in low-risk patients, including those who cannot be treated with statins or other anti-LDL cholesterol therapies.”
A meta-analysis of 30 randomized controlled trials concluded that RYR lowers LDL and total cholesterol and reduces insulin resistance. More importantly, red yeast rice preparations reduced mortality and major adverse cardiovascular events (Frontiers in pharmacology, February 21, 2022). These are things that patients actually care about.
Another meta-analysis included seven studies involving more than 10,000 heart attack survivors (Scientific reports, February 17, 2020). The study showed that in these high-risk individuals, RYR over a period of four weeks to four years reduced the likelihood of another heart attack, stenting or sudden death. This is in addition to the helpful effects on blood lipids.
Turmeric (Curcumin):
Asian medical systems have also given turmeric to the world. While Cleveland researchers didn’t find it helpful in lowering cholesterol, other scientists looked at the effects of its main ingredient, curcumin. They found that it fights inflammation, reduces oxidation, and improves mitochondrial function.
There have been studies on curcumin supplements for heart health.
A meta-analysis of studies published in the Physiology and Biochemistry Archives (December 2022) concluded:
“This study suggests that curcumin can reduce blood lipid levels and can be used as a lipid-lowering agent.”
In other words, the authors report that the active ingredient in turmeric lowers blood lipids. This contrasts with the results of the SPORT study.
Heart Health Supplement Basics:
Heart disease is complex. There may be several ways to protect this critical organ. There are also many risk factors beyond LDL cholesterol. If you would like to learn more about them and a variety of ways to improve heart health, please check out our e-guide to cholesterol control and heart health. It can be found under the Health eGuides tab at this link. You can also find more detailed information about the SPORT trial at this link.
Please share your thoughts in the comments section below.
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