- A new study shows that claimed “heart-healthy” supplements are not effective at improving cardiovascular health.
- The study compared the impact of statins and various dietary supplements on “bad” cholesterol levels, or LDL levels.
- Experts share insights into lowering cholesterol and improving heart health without supplements.
For years dietary supplements like fish oil, plant sterols, and even garlic and cinnamon have been touted (and marketed) as a method for helping lower “bad” cholesterol levels and boosting heart health. Now, a new study has found that these alleged “heart-healthy” supplements are ineffective at improving cardiovascular health.
The study was presented at the American Heart Association’s Scientific Sessions 2022 and published in the Journal of the American College of Cardiology. It compared the effect of these particular dietary supplements to the impact of a low dose of a statin—a cholesterol-lowering medication like Lipitor or Crestor.
The study involved 190 participants, aged 40-75, with no prior history of cardiovascular disease. Different groups received a low-dose statin called rosuvastatin, a placebo, fish oil, cinnamon, garlic, turmeric, plant sterols, or red yeast rice for 28 days. The study compared statins with supplements and a placebo.
The participants who took a kind of dietary supplement saw no significant decrease in LDL cholesterol, total cholesterol, or blood triglycerides (fat that circulates in your blood), and their results were similar to those of people who took a placebo.
Researchers found that those who took statins had the greatest impact and significantly lowered their low-density lipoproteins (LDL), or “bad cholesterol.” The average LDL fell nearly 40% after 28 days of statin use. The group taking statins also saw improved total cholesterol, which dropped on average 24% and saw the number of blood triglycerides drop by 19%.
Millions of Americans take statins such as Lipitor, Crestor, or generic formulations to lower their cholesterol. Too much “bad” cholesterol can lead to fatty deposits that can block the flow of oxygen and blood that the heart needs to work—which can cause a blockage that can lead to a heart attack or stroke. Statins are typically prescribed for people who have known heart disease, genetically high cholesterol, or are at high risk for heart attack and stroke, according to Eugene Yang, M.D., chair of the American College of Cardiology Prevention of Cardiovascular Diseases Council.
It’s important to note that while this study does provide evidence against the alleged benefits of dietary supplements, there are some important limitations to consider. With only 190 participants whose levels were recorded after 28 days, this study was very short and very small, says Dr. Yang. It is also important to have diversity in the sample size which allows for the results to be general to all, says Melissa Prest, D.C.N, R.D.N., spokesperson for the Academy of Nutrition and Dietetics. “This study was from one center and with 190 participants so the results may not be generalizable to different groups of people.”
Another key limitation is that the researchers don’t address all outcomes. Aside from lowering cholesterol and triglyceride levels, Dr. Yang explains that what we really want to know is “does the statin have a benefit in lowering the risk of heart attack and stroke that you would not see with these over-the-counter supplements?” For future studies, Dr. Yang says that researchers would ideally have a larger pool of participants, a longer study duration, and have the outcomes of heart attack and stroke risk addressed in order to determine if statins vs. supplements improve clinical outcomes.
As a cardiologist, Dr. Yang notes that he often tries to explain that just because a supplement claims to be “heart healthy,” doesn’t mean that it is—or that there is research to back it up. “Even if I try my best to explain to them that we don’t really have a lot of scientific evidence that these things actually help,” he says, “now we’re armed with at least one study that randomized people to all these different over-the-counter, commonly used supplements and now we can say that at least based on this small study, that there is no evidence that these have any beneficial effect on lowering your cholesterol.”
Should I try a statin?
Statins are generally prescribed for people who have consistently high LDL cholesterol levels, says Prest. “Diet, exercise, and lifestyle factors can help to reduce LDL cholesterol before a statin is needed. If the LDL cholesterol levels remain elevated, statins are then prescribed,” Prest explains.
Folks who should be taking statins for prevention are people who have already had a heart attack or stroke, and people who are at higher risk of these, which is determined by LDL numbers as well as age, hypertension, as well as “good” cholesterol numbers, says Jennifer Wong, M.D., cardiologist and medical director of non-invasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center.
What are some natural ways to improve heart health?
The best way to improve your heart health, according to Dr. Yang, is to “focus on the optimization of lifestyle behaviors: don’t smoke, exercise regularly, eat healthier. You don’t need to take a pill or a supplement, because they clearly have no benefit.”
The easiest way for people to improve their heart health is to make dietary changes like incorporating fish two to three times per week, reducing the amount of saturated fat in the diet, and increasing fiber-rich grains and fruits and vegetables, says Prest. Eating these foods will help lower cholesterol levels.
Exercise is also important to strengthen the heart muscle and keep blood pressure in check. If you are more sedentary now, find ways to add more movement into your day like taking a movement break every 60 minutes, Prest suggests.
You should also look at ways to limit stress and get a consistent seven to nine hours of sleep each night, Prest adds. “If you need more help with diet and lifestyle goals, reach out to a registered dietitian nutritionist to help you create a plan for success.”
The bottom line
Don’t rely on supplements alone to reduce LDL cholesterol, says Prest. They are supplementary to an overall heart-healthy diet, exercise, and lifestyle plan, she says. “Many people see positive improvements in LDL cholesterol when they make changes to their overall diet and lifestyle, which is the first line of treatment for reducing LDL cholesterol before a statin is added.”
So before you go looking for a magic pill, consult a healthcare professional and start with a few lifestyle tweaks to get the ball rolling.
Dietary supplements are products intended to supplement the diet. They are not medicines and are not intended to treat, diagnose, mitigate, prevent, or cure diseases. Be cautious about taking dietary supplements if you are pregnant or nursing. Also, be careful about giving supplements to a child, unless recommended by their healthcare provider.
Madeleine, Prevention’s assistant editor, has a history with health writing from her experience as an editorial assistant at WebMD, and from her personal research at university. She graduated from the University of Michigan with a degree in biopsychology, cognition, and neuroscience—and she helps strategize for success across Prevention’s social media platforms.