Atherosclerosis

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Atherosclerosis

Need to Know

Atherosclerosis
Get your blood flowing freely and protect your arteries from hardening with a few healthy habits. According to research or other evidence, the following self-care steps may be helpful.
  • Trim the unhealthy fat

    Protect your arteries by cutting meat, dairy fats, and foods containing trans fats out of your diet

  • Get to know tocotrienols

    Take 200 mg a day of these potent antioxidants to slow down the build-up of plaque in your arteries

  • Take extra garlic

    900 mg a day of standardized garlic powder can help slow down the process of hardening of the arteries

  • Lower your homocysteine levels

    Reduce the blood levels of this potentially toxic substance by taking a daily B-vitamin combo containing folic acid (400 to 1,000 mcg), vitamin B12 (50 to 300 mcg), and vitamin B6 (10 to 50 mg)

About

About This Condition

Atherosclerosis is hardening of the arteries, a common disease of the major blood vessels characterized by fatty streaks along the vessel walls and by deposits of cholesterol and calcium. 

Atherosclerosis of arteries supplying the heart is called coronary artery disease. It can restrict the flow of blood to the heart, which often triggers heart attacks—the leading cause of death in Americans and Europeans. Atherosclerosis of arteries supplying the legs causes a condition called intermittent claudication, which is characterized by pain in the legs after walking short distances.

People with elevated cholesterol levels are much more likely to have atherosclerosis than people with low cholesterol levels. Many important nutritional approaches to protecting against atherosclerosis are aimed at lowering serum cholesterol levels.

People with diabetes are also at very high risk for atherosclerosis, as are people with elevated triglycerides and high homocysteine.

Symptoms

Atherosclerosis is typically a silent disease until one of the many late-stage vascular manifestations intervenes. Some people with atherosclerosis may experience angina (chest pain) or intermittent claudication (leg cramps and pain) on exertion. Symptoms such as these develop gradually as the disease progresses.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why Get started
Choose omega-6-rich foods

Eating omega-6 fatty acids, found in corn, safflower, grapeseed, and sunflower oils, and in foods such as nuts and seeds, appears to protect against atherosclerosis and is associated with reduced heart disease risk.


Choose omega-6-rich foods

A diet high in omega-6 fatty acids, found in certain vegetable oils such as corn, safflower, grapeseed, and sunflower oil, and in other foods such as nuts and seeds, appears to protect against atherosclerosis. Higher dietary intake or high body levels of omega-6 fatty acids has been associated with reduced coronary heart disease risk in numerous preliminary studies,1 and an analysis of several controlled trials found that replacing saturated fats in the diet with omega-6 fats reduces the risk of coronary heart disease by an average of 24%.2
Eat a high-fiber diet Eating foods high in fiber, especially oats, psyllium seeds, fruit, and beans, may lower cholesterol and reduce the risk of coronary heart disease.

Eat a high-fiber diet

A systematic review of 20 years of research evaluated the association between dietary fiber and coronary heart disease.3 The meta-analysis portion of this review showed that whole grain foods are associated with a coronary heart disease risk reduction of about 26%. In general, the fibers most linked to the reduction of cholesterol levels are found in oats, psyllium seeds, fruit (pectin) and beans (guar gum).4 An analysis of many soluble fiber trials proves that a cholesterol-lowering effect exists, but the amount the cholesterol falls is quite modest.5 For unknown reasons, however, diets higher in insoluble fiber (found in whole grains and vegetables and mostly unrelated to cholesterol levels) have been reported to correlate better with protection against heart disease in both men and women.6 , 7 Some trials have used 20 grams of additional fiber per day for several months to successfully lower cholesterol.8
Eat more complex carbs Choose whole grains whenever possible as a diet high in refined carbs, such as white flour, white rice, and simple sugars, appears to increase the risk of coronary heart disease, especially in overweight women.

Eat more complex carbs

Eating a diet high in refined carbohydrates (e.g., white flour, white rice, simple sugars) appears to increase the risk of coronary heart disease, and thus of heart attacks, especially in overweight women.9 However, controlled trials of reducing refined carbohydrate intake to prevent heart disease have not been attempted to confirm these preliminary findings.
Go vegetarian A pure vegetarian diet (no meat, poultry, dairy or eggs), combined with exercise and stress reduction, has been shown to decrease atherosclerosis.

Go vegetarian

Independent of their action on serum cholesterol, foods that contain high amounts of cholesterol—mostly egg yolks—can induce atherosclerosis.10 It makes sense to reduce the intake of egg yolks. However, eating eggs does not increase serum cholesterol as much as eating saturated fat, and eggs may not increase serum cholesterol at all if the overall diet is low in fat. A decrease in atherosclerosis resulting from a pure vegetarian diet (no meat, poultry, dairy or eggs), combined with exercise and stress reduction, has been proven by controlled medical research.11
Skip the salt Eating low or moderate amounts of salt may help reduce your risk of heart disease.

Skip the salt

Preliminary evidence has suggested that excessive salt consumption is a risk factor for heart disease and death from heart disease in overweight people.12 Controlled trials are needed to confirm these observations.
Try a low-fat diet The most important dietary changes in protecting arteries from atherosclerosis include choosing alternatives to meat and dairy, and eating foods without trans fats.

Try a low-fat diet

The most important dietary changes in protecting arteries from atherosclerosis include avoiding meat and dairy fat and avoiding foods that contain trans fatty acids (many margarines, some vegetable oils, and many processed foods containing vegetable oils). Increasingly, the importance of avoiding trans fatty acids is being accepted by the scientific community.13 Leading researchers have recently begun to view the evidence linking trans fatty acids to markers for heart disease as “unequivocal.”14
Try ALA People who eat diets high in alpha-linolenic acid—found in canola oil and flaxseed products—have high blood levels of omega-3 fatty acids, which may protect against atherosclerosis.

Try ALA

People who eat diets high in alpha-linolenic acid (ALA), which is found in canola oil and flaxseed products, have higher blood levels of omega-3 fatty acids than those consuming lower amounts,15 , 16 which may confer some protection against atherosclerosis. In 1994, researchers conducted a study in people with a history of heart disease, using what they called the “Mediterranean” diet.17 The diet differed significantly from what people from Mediterranean countries actually eat, in that it contained little olive oil. Instead, the diet included a special margarine high in ALA. Those people assigned to the Mediterranean diet had a remarkable 70% reduced risk of dying from heart disease compared with the control group during the first 27 months. Similar results were also confirmed after almost four years.18 The diet was high in beans and peas, fish, fruit, vegetables, bread, and cereals, and low in meat, dairy fat, and eggs. Although the authors believe that the high ALA content of the diet was partly responsible for the surprising outcome, other aspects of the diet may have been partly or even totally responsible for decreased death rates. Therefore, the success of the Mediterranean diet does not prove that ALA protects against heart disease.19

Supplements

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.


Supplement Amount Why
Garlic
 900 mg daily of a powder standardized for 0.6% allicin 3 stars   Garlic has been shown to slow down the process of the arteries hardening. Aged garlic extract has been shown to prevent oxidation of LDL ("bad") cholesterol, a significant factor in atherosclerosis development.


3 stars  Garlic

900 mg daily of a powder standardized for 0.6% allicin

Garlic has been shown to prevent atherosclerosis in a four-year double-blind trial.20 The preparation used, standardized for 0.6% allicin content, provided 900 mg of garlic powder per day. The people in this trial were 50 to 80 years old, and the benefits were most notable in women. This trial points to the long-term benefits of garlic to both prevent and possibly slow the progression of atherosclerosis in people at risk.

Garlic has also lowered cholesterol levels in double-blind research,21 though more recently, some double-blind trials have not found garlic to be effective.22 , 23 , 24 Some of the negative trials have flaws in their design.25 Nonetheless, the relationship between garlic and cholesterol-lowering is somewhat unclear.26

Garlic has also been shown to prevent excessive platelet adhesion (stickiness) in humans.27 Allicin, often considered the main active component of garlic, is not alone in this action. The constituent known as ajoene has also shown beneficial effects on platelets.28 Aged garlic extract, but not raw garlic, has been shown, to prevent oxidation of LDL cholesterol in humans,29 an event believed to be a significant factor in the development of atherosclerosis.

Garlic and ginkgo also decrease excessive blood coagulation. Both have been shown in double-blind30 and other controlled31 trials to decrease the overactive coagulation of blood that may contribute to atherosclerosis.

Numerous medicinal plants and plant compounds have demonstrated an ability to protect LDL cholesterol from being damaged by free radicals. Garlic,32 ginkgo,33 and guggul34 are of particular note in this regard. Garlic and ginkgo have been most convincingly shown to protect LDL cholesterol in humans.

Supplement Amount Why
Omega-6 Fatty Acids
 Follow label instructions 3 stars   Though the effect has not been studied with supplements, an analysis of several controlled trials found that replacing saturated fats in the diet with omega-6 fats reduces the risk of coronary heart disease.


3 stars  Omega-6 Fatty Acids

Follow label instructions

A diet high in omega-6 fatty acids, found in certain vegetable oils such as corn, safflower, grapeseed, and sunflower oil, and in other foods such as nuts and seeds, appears to protect against atherosclerosis. Higher dietary intake or high body levels of omega-6 fatty acids has been associated with reduced coronary heart disease risk in numerous preliminary studies,35 and an analysis of several controlled trials found that replacing saturated fats in the diet with omega-6 fats reduces the risk of coronary heart disease by an average of 24%.36

Supplement Amount Why
Fish Oil
 3 to 6 grams fish oil daily, containing at least 30% omega-3 fatty acids 2 stars   Fish oil may reduce risk factors for atherosclerosis and heart disease. One trial showed that people who took fish oil had a slowing of the progression of their arterial plaque and had a decrease in cardiovascular events such as heart attack and stroke.


2 stars  Fish Oil

3 to 6 grams fish oil daily, containing at least 30% omega-3 fatty acids

Supplementation with fish oil, rich in omega-3 fatty acids, has been associated with favorable changes in various risk factors for atherosclerosis and heart disease in some,37 , 38 , 39 , 40 , 41 , 42 but not all, studies.43 , 44 , 45 A double-blind trial showed that people with atherosclerosis who took fish oil (6 grams per day for 3 months and then 3 grams a day for 21 months) had significant slowing of progression of atherosclerotic plaques and a decrease in cardiovascular events (for example, heart attack and stroke) compared with those who did not take fish oil.46 These results contradict the findings of an earlier controlled trial in which fish oil supplementation for two years (6 grams per day) did not promote major favorable changes in the diameter of atherosclerotic coronary arteries.47

Supplement Amount Why
Folic Acid
 Consult a qualified healthcare practitioner 2 stars   Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research. Taking folic acid may help lower homocysteine levels.


2 stars  Folic Acid

Consult a qualified healthcare practitioner

Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research,48 , 49 though uncertainty remains about whether elevated homocysteine actually causes heart disease.50 , 51 Although some reports have found associations between homocysteine levels and dietary factors, such as coffee and protein intakes,52 evidence linking specific foods to homocysteine remains preliminary. Higher blood levels of vitamin B6, vitamin B12, and folic acid are associated with low levels of homocysteine53 and supplementing with these vitamins lowers homocysteine levels.54 , 55

While several trials have consistently shown that B6, B12, and folic acid lower homocysteine, the amounts used vary from study to study. Many doctors recommend 50 mg of vitamin B6, 100–300 mcg of vitamin B12, and 500–800 mcg of folic acid. Even researchers finding only inconsistent links between homocysteine and heart disease have acknowledged that a B vitamin might offer protection against heart disease independent of the homocysteine-lowering effect.56 In one trial, people with normal homocysteine levels had demonstrable reversal of atherosclerosis when supplementing B vitamins (2.5 mg folic acid, 25 mg vitamin B6, and 250 mcg of vitamin B12 per day).57 Similar results were seen in another study.58

For the few cases in which vitamin B6, vitamin B12, and folic acid fail to normalize homocysteine, adding 6 grams per day of betaine (trimethylglycine) may be effective.59 Of these four supplements, folic acid appears to be the most important.60 Attempts to lower homocysteine by simply changing the diet rather than by using vitamin supplements have not been successful.61

Supplement Amount Why
Horny Goat Weed
 5 grams three times per day 2 stars   Horny goat weed has historically been used in people with symptoms caused by hardening of the arteries, in particular those recovering from strokes.


2 stars  Horny Goat Weed

5 grams three times per day

Horny goat weed has historically been used in people with symptoms caused by hardening of the arteries, in particular those recovering from strokes. One study of older people who had symptoms due to hardening neck arteries found that a formula in which the main ingredient was horny goat weed was superior to one not containing horny goat weed at relieving symptoms and improving the electrocardiogram findings.62

Supplement Amount Why
Niacin (Vitamin B3)

2,000 mg per day (only under a doctor's supervision)

2 stars   In a preliminary trial, doctor-supervised supplementation with extended-release niacin in combination with a cholesterol-lowering statin drug appeared to reverse atherosclerosis of the carotid arteries (the arteries that supply blood to the brain).


2 stars  Niacin (Vitamin B3)

2,000 mg per day (only under a doctor's supervision)

Niacin is known to reduce serum cholesterol levels and to increase levels of HDL ("good") cholesterol. In a preliminary trial, supplementation with extended-release niacin, when used in combination with a cholesterol-lowering statin drug, appeared to reverse atherosclerosis of the carotid arteries (the arteries that supply blood to the brain). The combination of a statin drug and niacin was significantly more effective than a statin drug combined with a second cholesterol-lowering drug (ezetimibe). In addition, the statin-niacin combination was associated with a significant reduction in the number of major cardiovascular event (such as myocardial infarction or death from coronary heart disease). Niacin was used in this study in amounts up to 2,000 mg per day.63 These large amounts of niacin have the potential to cause side effects, including liver damage, and should be taken only with the supervision of a doctor.

Supplement Amount Why
Selenium
 100 mcg daily 2 stars   Some doctors recommend that people with atherosclerosis supplement with selenium, which has been shown in one study to help reduce the risk of death from heart disease.

2 stars  Selenium

100 mcg daily

In some studies, people who consumed more selenium in their diet had a lower risk of heart disease.64 , 65 In one double-blind report, people who had already had one heart attack were given 100 mcg of selenium per day or placebo for six months.66 At the end of the trial, there were four deaths from heart disease in the placebo group but none in the selenium group; however, the number of people was too small for this difference to be statistically significant. Some doctors recommend that people with atherosclerosis supplement with 100–200 mcg of selenium per day.

Supplement Amount Why
Tocotrienols
 200 mg daily 2 stars   Tocotrienols are potent antioxidants that may help slow down the build-up of plaque in the arteries.


2 stars  Tocotrienols

200 mg daily

Tocotrienols may offer protection against atherosclerosis by preventing oxidative damage to LDL cholesterol.67 In a double-blind trial in people with severe atherosclerosis of the carotid artery—the main artery supplying blood to the head—tocotrienol administration (200 mg per day) reduced the level of lipid peroxides in the blood. Moreover, people receiving tocotrienols for 12 months had significantly more protection against atherosclerosis progression, and in some cases reductions in the size of their atherosclerotic plaques, compared with those taking a placebo.68

Supplement Amount Why
Vitamin C
 250 mg twice per day 2 stars   Supplementing with vitamin C may help reverse the progression of atherosclerosis and protect against heart disease.


2 stars  Vitamin C

250 mg twice per day

Experimentally increasing homocysteine levels in humans has led to temporary dysfunction of the cells lining blood vessels. Researchers are concerned this dysfunction may be linked to atherosclerosis and heart disease. Vitamin C has been reported in one controlled study to reverse the dysfunction caused by increases in homocysteine.69 Vitamin C also protects LDL.70

Despite the protective mechanisms attributed to vitamin C, some research has been unable to link vitamin C intake to protection against heart disease. These negative trials have mostly been conducted using people who consume 90 mg of vitamin C per day or more—a level beyond which further protection of LDL may not occur. Studies of people who eat foods containing lower amounts of vitamin C have been able to show a link between dietary vitamin C and protection from heart disease. Therefore, leading vitamin C researchers have begun to suggest that vitamin C may be important in preventing heart disease, but only up to 100–200 mg of intake per day.71 In a double-blind trial,72 supplementation with 250 mg of timed-release vitamin C twice daily for three years resulted in a 15% reduction in the progression of atherosclerosis, compared with placebo. Many doctors suggest that people take vitamin C—often 1 gram per day—despite the fact that research does not yet support levels higher than 500 mg per day.

Supplement Amount Why
Vitamin K
(Vitamin K1, for coronary calcification )
 500 mcg per day of vitamin K1 2 stars  

In a double-blind trial, supplementing with vitamin K1 for three years appeared to slow the rate of progression of coronary artery calcification in seniors.



2 stars  Vitamin K

500 mcg per day of vitamin K1

In a double-blind trial, supplementing with vitamin K1 for three years appeared to slow the rate of progression of coronary artery calcification in elderly people who had preexisting coronary artery calcification. Participants in that study were randomly assigned to receive a multivitamin that contained 500 mcg per day of vitamin K1 or the same multivitamin without vitamin K1.73 


Supplement Amount Why
Betaine (Trimethylglycine)
 Refer to label instructions 1 star   For the few cases in which vitamin B6, vitamin B12, and folic acid fail to normalize homocysteine, adding betaine (trimethylglycine) may be effective.

1 star  Betaine (Trimethylglycine)

Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research,74 , 75 though uncertainty remains about whether elevated homocysteine actually causes heart disease.76 , 77 Although some reports have found associations between homocysteine levels and dietary factors, such as coffee and protein intakes,78 evidence linking specific foods to homocysteine remains preliminary. Higher blood levels of vitamin B6, vitamin B12, and folic acid are associated with low levels of homocysteine79 and supplementing with these vitamins lowers homocysteine levels.80 , 81

For the few cases in which vitamin B6, vitamin B12, and folic acid fail to normalize homocysteine, adding 6 grams per day of betaine (trimethylglycine) may be effective.82 Of these four supplements, folic acid appears to be the most important.83 Attempts to lower homocysteine by simply changing the diet rather than by using vitamin supplements have not been successful.84

Supplement Amount Why
Bilberry
 Refer to label instructions 1 star   Bilberry has been shown to prevent platelet aggregation.

1 star  Bilberry

Turmeric ’s active compound curcumin has shown potent anti-platelet activity in animal studies.85 It has also demonstrated this effect in preliminary human studies.86 In a similar vein, bilberry has been shown to prevent platelet aggregation87 as has peony.88 However, none of these three herbs has been documented to help atherosclerosis in human trials.

Supplement Amount Why
Butcher’s Broom
 Refer to label instructions 1 star   Butcher’s broom exerts effects that protect arteries.

1 star  Butcher’s Broom

Butcher’s broom and rosemary are not well studied as being circulatory stimulants but are traditionally reputed to have such an action that might impact atherosclerosis. While butcher’s broom is useful for various diseases of veins, it also exerts effects that are protective for arteries.89

Supplement Amount Why
Chondroitin Sulfate
Refer to label instructions 1 star   Preliminary research shows that chondroitin sulfate may prevent atherosclerosis and may also prevent heart attacks in people who already have atherosclerosis.

1 star  Chondroitin Sulfate

Preliminary research shows that chondroitin sulfate may prevent atherosclerosis in animals and humans and may also prevent heart attacks in people who already have atherosclerosis.90 , 91 However, further research is needed to determine the value of chondroitin sulfate supplements for preventing or treating atherosclerosis.

Supplement Amount Why
Evening Primrose Oil
 Refer to label instructions 1 star   Taking evening primrose oil has been shown to lower cholesterol in double-blind research. Lowering cholesterol levels should in turn reduce the risk of atherosclerosis.

1 star  Evening Primrose Oil

Though low levels (2 grams per day) of evening primrose oil appear to be without action,92 3–4 grams per day have lowered cholesterol in double-blind research.93 Lowering cholesterol levels should in turn reduce the risk of atherosclerosis.

Preliminary research shows that chondroitin sulfate may prevent atherosclerosis in animals and humans and may also prevent heart attacks in people who already have atherosclerosis.94 , 95 However, further research is needed to determine the value of chondroitin sulfate supplements for preventing or treating atherosclerosis.

Supplement Amount Why
Ginger
 Refer to label instructions 1 star   Supplementing with ginger may reduce platelet stickiness.

1 star  Ginger

The research on ginger’s ability to reduce platelet stickiness indicates that 10 grams (approximately 1 heaping teaspoon) per day is the minimum necessary amount to be effective.96 Lower amounts of dry ginger,97 as well as various levels of fresh ginger,98 have not been shown to affect platelets.

Supplement Amount Why
Ginkgo
 Refer to label instructions 1 star   The herb Ginkgo biloba may reduce atherosclerosis risk by stopping platelets from sticking together too much. It also increases blood circulation to the brain, arms, and legs.


1 star  Ginkgo

Ginkgo may reduce the risk of atherosclerosis by interfering with a chemical the body sometimes makes in excess, called platelet activating factor (PAF).99 PAF stimulates platelets to stick together too much; ginkgo stops this from happening. Ginkgo also increases blood circulation to the brain, arms, and legs.100

Garlic and ginkgo also decrease excessive blood coagulation. Both have been shown in double-blind101 and other controlled102 trials to decrease the overactive coagulation of blood that may contribute to atherosclerosis.

Numerous medicinal plants and plant compounds have demonstrated an ability to protect LDL cholesterol from being damaged by free radicals. Garlic,103 ginkgo,104 and guggul105 are of particular note in this regard. Garlic and ginkgo have been most convincingly shown to protect LDL cholesterol in humans.

Supplement Amount Why
Lycopene
 Refer to label instructions 1 star   The carotenoid lycopene, present in high amounts in tomatoes, may help prevent atherosclerosis.

1 star  Lycopene

The carotenoid, lycopene, has been found to be low in the blood of people with atherosclerosis, particularly if they are smokers.106 Although no association between atherosclerosis and blood level of any other carotenoid (e.g., beta-carotene) was found, the results of this study suggested a protective role for lycopene. Lycopene is present in high amounts in tomatoes.

Supplement Amount Why
Peony
 Refer to label instructions 1 star   Peony has been shown to prevent platelet aggregation.

1 star  Peony

Turmeric ’s active compound curcumin has shown potent anti-platelet activity in animal studies.107 It has also demonstrated this effect in preliminary human studies.108 In a similar vein, bilberry has been shown to prevent platelet aggregation109 as has peony.110 However, none of these three herbs has been documented to help atherosclerosis in human trials.

Supplement Amount Why
Quercetin
 Refer to label instructions 1 star   Quercetin, a flavonoid, protects LDL cholesterol from damage.

1 star  Quercetin

Quercetin , a flavonoid, protects LDL cholesterol from damage.111 While several preliminary studies have found that eating foods high in quercetin lowers the risk of heart disease,112 , 113 , 114 the research on this subject is not always consistent,115 and some research finds no protective link.116 Quercetin is found in apples, onions, black tea, and as a supplement. In some studies, dietary amounts linked to protection from heart disease are as low as 35 mg per day.

Supplement Amount Why
Resveratrol
 Refer to label instructions 1 star   Studies have found that red wine, which contains resveratrol, lowers risk of death from heart disease. Its antioxidant activity and effect on platelets leads some researchers believe that it is the protective agent in red wine.


1 star  Resveratrol

Preliminary studies have found that people who drink red wine, which contains resveratrol, are at lower risk of death from heart disease. Because of its antioxidant activity and its effect on platelets, some researchers believe that resveratrol is the protective agent in red wine.117 , 118 , 119 Resveratrol research remains very preliminary, however, and as yet there is no evidence that the amounts found in supplements help prevent atherosclerosis in humans.

Supplement Amount Why
Rice Protein
 Refer to label instructions 1 star   Though not yet proven in clinical research, animal studies suggest that rice protein–based diets result in less buildup of atherosclerotic plaque compared with animal protein–based diets.


1 star  Rice Protein

Animal studies suggest that rice protein–based diets result in less buildup of atherosclerotic plaque compared with animal protein–based diets.120 This effect may be due to mechanisms involving antioxidant function,121 cholesterol metabolism,122 or insulin function.123 Controlled human studies are needed to determine whether consuming rice protein can prevent or treat atherosclerotic disease.

Supplement Amount Why
Rosemary
 Refer to label instructions 1 star   Rosemary is traditionally reputed to have a positive effect on atherosclerosis.


1 star  Rosemary

Butcher’s broom and rosemary are not well studied as being circulatory stimulants but are traditionally reputed to have such an action that might impact atherosclerosis. While butcher’s broom is useful for various diseases of veins, it also exerts effects that are protective for arteries.124

Supplement Amount Why
Shelled Hemp Seed
 Refer to label instructions 1 star   Shelled hemp seed or its oil may theoretically be useful for people with atherosclerosis due to its essential fatty acid content.

1 star  Shelled Hemp Seed

Though it has not been studied, shelled hemp seed or its oil may theoretically be useful for people with atherosclerosis due to its content of essential fatty acids.125

Supplement Amount Why
Turmeric
 Refer to label instructions 1 star   Turmeric’s active compound curcumin has shown potent anti-platelet activity in preliminary studies.

1 star  Turmeric

Turmeric ’s active compound curcumin has shown potent anti-platelet activity in animal studies.126 It has also demonstrated this effect in preliminary human studies.127 In a similar vein, bilberry has been shown to prevent platelet aggregation128 as has peony.129 However, none of these three herbs has been documented to help atherosclerosis in human trials.

Supplement Amount Why
Vitamin B12
 Refer to label instructions 1 star   Blood levels of the amino acid homocysteine have been linked to atherosclerosis and heart disease in most research. Taking vitamin B12 may help lower homocysteine levels.

1 star  Vitamin B12

Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research,130 , 131 though uncertainty remains about whether elevated homocysteine actually causes heart disease.132 , 133 Although some reports have found associations between homocysteine levels and dietary factors, such as coffee and protein intakes,134 evidence linking specific foods to homocysteine remains preliminary. Higher blood levels of vitamin B6, vitamin B12, and folic acid are associated with low levels of homocysteine135 and supplementing with these vitamins lowers homocysteine levels.136 , 137

While several trials have consistently shown that B6, B12, and folic acid lower homocysteine, the amounts used vary from study to study. Many doctors recommend 50 mg of vitamin B6, 100–300 mcg of vitamin B12, and 500–800 mcg of folic acid. Even researchers finding only inconsistent links between homocysteine and heart disease have acknowledged that a B vitamin might offer protection against heart disease independent of the homocysteine-lowering effect.138 In one trial, people with normal homocysteine levels had demonstrable reversal of atherosclerosis when supplementing B vitamins (2.5 mg folic acid, 25 mg vitamin B6, and 250 mcg of vitamin B12 per day).139 Similar results were seen in another study.140

For the few cases in which vitamin B6, vitamin B12, and folic acid fail to normalize homocysteine, adding 6 grams per day of betaine (trimethylglycine) may be effective.141 Of these four supplements, folic acid appears to be the most important.142 Attempts to lower homocysteine by simply changing the diet rather than by using vitamin supplements have not been successful.143

Supplement Amount Why
Vitamin B6
 Refer to label instructions 1 star   Blood levels of the amino acid homocysteine have been linked to atherosclerosis and heart disease in most research. Taking vitamin B6 may help lower homocysteine levels.

1 star  Vitamin B6

Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research,144 , 145 though uncertainty remains about whether elevated homocysteine actually causes heart disease.146 , 147 Although some reports have found associations between homocysteine levels and dietary factors, such as coffee and protein intakes,148 evidence linking specific foods to homocysteine remains preliminary. Higher blood levels of vitamin B6, vitamin B12, and folic acid are associated with low levels of homocysteine149 and supplementing with these vitamins lowers homocysteine levels.150 , 151

While several trials have consistently shown that B6, B12, and folic acid lower homocysteine, the amounts used vary from study to study. Many doctors recommend 50 mg of vitamin B6, 100–300 mcg of vitamin B12, and 500–800 mcg of folic acid. Even researchers finding only inconsistent links between homocysteine and heart disease have acknowledged that a B vitamin might offer protection against heart disease independent of the homocysteine-lowering effect.152 In one trial, people with normal homocysteine levels had demonstrable reversal of atherosclerosis when supplementing B vitamins (2.5 mg folic acid, 25 mg vitamin B6, and 250 mcg of vitamin B12 per day).153 Similar results were seen in another study.154

For the few cases in which vitamin B6, vitamin B12, and folic acid fail to normalize homocysteine, adding 6 grams per day of betaine (trimethylglycine) may be effective.155 Of these four supplements, folic acid appears to be the most important.156 Attempts to lower homocysteine by simply changing the diet rather than by using vitamin supplements have not been successful.157

Supplement Amount Why
Vitamin E
 100 to 200 IU daily 1 star   Vitamin E is an antioxidant that protects LDL cholesterol from oxidative damage and has been linked to heart disease prevention. Many doctors recommend supplementing with vitamin E to lower the risk of atherosclerosis and heart attacks.


1 star  Vitamin E

100 to 200 IU daily

Vitamin E is an antioxidant that serves to protect LDL from oxidative damage158 and has been linked to prevention of heart disease in double-blind research.159 Many doctors recommend 400–800 IU of vitamin E per day to lower the risk of atherosclerosis and heart attacks. However, some leading researchers suggest taking only 100–200 IU per day, as studies that have explored the long-term effects of different supplemental levels suggest no further benefit beyond that amount, and research reporting positive effects with 400–800 IU per day have not investigated the effects of lower intakes.160 In a double-blind trial, people with high cholesterol who took 136 IU of natural vitamin E per day for three years had 10% less progression of atherosclerosis compared with those taking placebo.161

References

1. Harris WS, Mozaffarian D, Rimm E, et al. Omega-6 fatty acids and risk for cardiovascular disease: a science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 2009;119:902-7 [review].

2. Gordon DJ. Lowering cholesterol and total mortality. In: Rifkin BM, ed. Lowering cholesterol in high-risk individuals and populations. New York, NY: Marcel Dekker, Inc; 1995:33– 48.

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