Benefits of heart health supplements come with cautions

We’ve all heard the advice to take a fish oil with omega-3 fatty acids to improve heart health, but are you actually getting the benefits they claim to provide? One Baylor College of Medicine cardiologist says probably not, and that goes for most over-the-counter supplements.

“They may not be bad for you, but you also may not know exactly what you are getting. Supplements are not regulated by the FDA, and the benefits haven’t been fully investigated,” said Dr. Christie Ballantyne, professor of medicine and chief of the section of cardiology at Baylor. “If you are at high risk for heart attack or stroke and decide to add an over-the-counter fish oil pill to your diet and you think you are getting a benefit, there is a good chance you are not.”

Ballantyne is lead researcher on the REDUCE-IT trial that investigated the effects of icosapent ethyl, a highly purified eicosapentaenoic acid (EPA) ethyl ester, which is an omega-3 fatty acid purified from fish oil. People who were at high risk of cardiovascular events despite being on a statin treatment were given a dosage of 4000 mg daily and the results (read more about REDUCE-IT) did show a decrease in cardiovascular events; however, Ballantyne said an important distinction is the amount and the type of omega-3 fatty acid used and the amount.

“What we use in the REDUCE-IT trial is prescription grade and FDA approved. It is a highly refined form, not what you find in a dietary supplement capsule,” Ballantyne said. “Even if the amount listed on the supplement label is, for example, 1000mg, you should read the ingredients. 1000mg doesn’t mean pure fish oil; there are other elements included and the usual amount of omega 3 fatty acids – EPA and docosahexanoic acid, or DHA – is usually only a total of 300 mg. So, to get the benefits we saw in the trial, you would have to take an enormous number of capsules.”

Reading the ingredient list is important on all supplements. Not all items are listed on the front label, so make sure to check the small print. In some cases, the added items might actually hurt your health, Ballantyne said. For example, losing weight is a way to improve heart health, but there have been effective weight loss supplements that include ingredients that have been known to increase the risk of cardiovascular events. Also make sure that you purchase a reputable brand as there are some protein powders that claim to be all natural and enhance muscle strength, but include synthetic steroids.

“The ingredients might not be harmful, but if you already have some type of health issue, it could add complications. You should know what you are putting in your body, and you should talk to your doctor about any type of supplements you are taking,” he said. “And if you still want to add certain supplements to your body, the best way to start is to eat healthy and get your required vitamins and health benefits from whole foods.”

Ballantyne also is the director of the Maria and Alando J. Ballantyne Atherosclerosis Clinical Research Laboratory at Baylor, director of the Center for Cardiovascular Disease Prevention at the Methodist DeBakey Heart Center and co-director of the Lipid Metabolism and Atherosclerosis Clinic at Houston Methodist. He also holds the J. S. Abercrombie Chair in Atherosclerosis and Lipoprotein Research at Baylor.