Despite a major negative study publicized last summer, the heart health category is teeming with effective, science-backed supplements. Here’s how to win over skittish customers.
“Most dietary supplements are useless for preventing heart attacks!” This statement or a facsimile thereof caused the dietary supplement industry and natural health practitioners to have tachycardia (rapid heartbeat often induced by anxiety). It stemmed from a prestigious source—Johns Hopkins Medicine—where a research team’s meta-analysis of approximately 277 clinical trials found that “the vast majority of multivitamins, minerals and different types of diets had no measurable effect on survival or cardiovascular disease risk reduction.”
Steve Mister, president and CEO of leading trade organization, Council for Responsible Nutrition (CRN), was quick to respond in a no-holds-barred statement: “This study is a coordinated, all-out assault on nutrition, and the critical role it plays in maintaining health and reducing the risk of chronic disease. Along with a companion editorial and video, this attack recklessly disregards decades of comprehensive carefully developed and well-conducted nutrition research on the benefits of both supplemental nutrients and healthy dietary patterns. The study maligns not only dietary supplements, but also well-established dietary patterns … ”
Each year, more than 6 million Americans are hospitalized due to cardiovascular disease (CVD), which is the leading cause of death for men and women over the age of 45, cited Howard Payne, senior advisor, strategic marketing and business development, Texas-based Quantum Nutrition Labs. “With this on everyone’s mind as they age, there is a high percentage that your next customer walking through your door is going to have questions about this heart health category.”
That said, Bryan Bradford, chief nutrition officer, CHC, Sunflower Shoppe Vitamins & Natural Foods (Texas), related that they didn’t see much consumer “blow-back from this article nor was there any damage control to do. The health industry has seen articles like this for many years, yet, the industry continues to grow. The value these negative articles bring helps to drive the increase of standards within our industry and the need for more science to validate its claims. In our 50 years of serving our community, we have seen countless lives that have been changed through proper nutrition and supplementation.”
But you may indeed have had some customers express utter confusion since the media touted the publication of the study. And unfortunately, a little research will cough up this study and its mass media remoras. This means that at any day, at any time, a customer will ask if cardio support supplements “really do work.”
And there are more than enough arrows in your quiver of conviction.
Neil E. Levin, CCN, DANLA, senior nutrition education manager, NOW, Illinois, explained that despite all the known factors affecting heart function and health status, more than half of all sudden deaths from heart attack and stroke cannot be predicted. “The medical establishment largely overlooks—or simply dismisses—nutritional influences on heart health,” he commented. “Unfortunately, medical researchers often choose to look at supplementation in isolation without regard for diet or blood levels. This assumes—incorrectly—that supplemental nutrients are as novel to the body as synthetic drugs and can be measured in the same ways. This bias of ignorance often leads to misleading results and conclusions (which don’t always match), with supplements often getting a raw deal.”
Levin added that researchers also often make what he called inappropriate assumptions, for example, that people commonly take multivitamins to prevent heart disease or cancer, rather than to bridge potential nutrients gaps in their diets, the reason shown in many surveys “so they can justify looking at results of supplementation on those disease rates. But these sensational reports often are irrelevant to the actual reasons why people do take supplements and tend to ignore body levels that are usually more indicative and associative with potential risks of nutrient deficiencies and potential benefits of supplementation.”
In lockstep with Levin’s assessment is Cheryl Myers, chief of scientific affairs and education at EuroPharma, Inc./Terry Naturally, Wisconsin who also said that it is “unfortunate” that the researchers made such strong, sweeping statements in a category in which they do not have the expertise. To compare, she offered, a psychiatrist would not lead a study delving into surgical procedures, nor would an orthopedic surgeon be asked to helm a trial about menopause.
“Experts in the intelligent use of supplements for heart disease and prevention know that natural products of the same name may differ widely, that delivery systems can be a deal breaker, and they know all the ins and outs of the research that validates their effectiveness,” she commented. “These insights were visibly lacking in the Johns Hopkins trial, which only examined a few vitamins and supplements and concluded that all supplements are worthless—and this while also stating that folic acid reduced the risk of stroke by 20 percent.”
Myers pointed out that the researchers emphasized in their conclusion that diet and lifestyle were priorities for anyone with heart health concerns, which is true for everyone— no supplementation regimen will provide label claim benefits for a consumer whose diet and lifestyle are working against it.
Jennifer Weinhardt, BS MS, senior R&D specialist, Texas-based Bluebonnet Nutrition, advises that the most effective plan of action when combating dubious stories related by confused customers is to read the research and understand the science, “not just buzz stories made popular by the media,” so you may present an authoritative stance. Also know your stats, she cited:
• The American Heart Association estimates nearly 83.6 million Americans (>1 in 3 adults) have one or more types of cardiovascular disease including: high blood pressure, coronary heart disease, heart failure, stroke and congenital cardiovascular defects.
• Treating CVD accounts for 17 percent of the overall U.S. health expenditures. From 2010 to 2030, the cost to treat heart disease will increase from $273 billion to $818 billion!
• CVDs, especially atherosclerotic coronary heart disease and stroke, are now the leading causes of death globally.
• According to WHO (World Health Organization) between 2009 and 2030, 24 million will die from CVD.
• These numbers will continue to grow, especially in the developed world, as a consequence of the increased rates of type 2 diabetes, obesity and other lifestyle related health issues.
“While supplements may not be the answer for everyone, it’s important for retailers to know the above statistics to help customers for whom supplements can help,” she offered.
A similar sentiment is provided by Jay Levy, director of sales, California-based Wakunaga of America Co., Ltd., who asserted that sharing credible science can help dispel any doubts a customer may have about efficacy of cardio-support supplements. Brands retailers carry, he said, can provide links to credible studies on their products.
For example, he provided a randomized double-blind study (published in the International Wound Journal) that looked at Kyolic AGE’s impact on microcirculation. Researchers selected 122 patients with a Framingham Risk Score of <10. The Framingham Risk Score is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. The participants were then randomized to receive either 2,400 mg of AGE or a placebo for 12 months. Cutaneous microcirculation—the circulation that takes place in the dermis just below the surface of the skin—was taken to measure the speed of blood flow at a specific site. The results showed that after 12 months of supplementation, microcirculation improved by 31 percent in the AGE group, especially in those with an increased risk of a cardiovascular event, Levy reported.
A new clinical trial in the European Journal of Nutrition found that a daily dose of phytosterols significantly lowered cholesterol levels, he added as a second example. By the end of this three-week study, involving 159 participants, the researchers found that 2 g of phytosterols per day reduced LDL (low-density lipoprotein) cholesterol by nearly 6 percent. Those participants taking a placebo saw no reductions. “While cholesterol is no longer considered the most important risk factor for atherosclerosis, it still matters and is a risk factor that is widely recognized by consumers,” he said.
In the herbal category, which for some consumers are still somewhat of an exotic mystery, clinical herbalist David Winston RH(AHG), founder and formulator, Herbalist & Alchemist, New Jersey, pointed out that numerous studies support how herbs can improve cardiovascular function. These include hawthorn, dan shen (Salvia miltiorrhiza), astragalus, olive leaf and hong hua/safflower. “In addition, research, while important and useful, is not the only available information we have,” he noted.
Many herbs have been successfully used for hundreds or thousands of years in TCM (traditional Chinese medicine), ayurveda, eclectic medicine, siddha, Tibetan medicine, physio-medicalism and Unani-Tibb “to relieve angina pain, reduce blood pressure, enhance circulation, control palpitations and aid in recovery from mild heart attacks or TIA (transient ischemic attack),” he said. These include herbs such as arjuna, dang gui, tienqi ginseng, linden flower, motherwort, corydalis, night blooming cereus, prickly ash, butchers broom and ginger.
Levin agreed, noting that overall, a bevy of nutrients have repeatedly and significantly been shown to play a role in cardiovascular health. For example, mineral imbalances have been implicated in the development of cardiovascular risk factors and acknowledged as such by official Health Canada. In the Nurses’ Health Study that followed 88,375 women for 26 years, he pointed out, the incidence of sudden cardiac death was 77 percent lower in those with the highest serum magnesium levels versus the lowest quartile.
More facts you can confidently provide, according to Levin:
• The FDA (U.S. Food and Drug Administration) has allowed a qualified health claim linking consumption of omega-3 fatty acids to lower risk of coronary heart disease, and another claim related to phytosterols lowering cholesterol.
• The WHO’s Monitoring Trends in Cardiovascular Disease Study (MONICA) reported that low levels of vitamin E predicted a heart attack 62 percent of the time, while high serum cholesterol predicted only 29 percent of the time and high blood pressure only 25 percent of the time.
• Another study followed 74,272 women and 44,592 men free of CVD and cancer at baseline and followed up to 12 years, reporting that men who had an intake of at least 600 IU per day of vitamin D had a CVD risk 16 percent lower than men who had an intake of less than 100 IU per day.
• Two study cohorts have shown significant reductions in coronary heart disease (CHD) risk related to vitamin K intake, with a dose-dependent reduction in CHD risk in one study.
Cardio Support Products
Besides qualitative and quantitative factual information that can support the practice of taking dietary supplements that work to promote and protect heart health, there are numerous products that have compelling science supporting these claims.
Wakunaga’s primary cardiovascular support product is Kyolic Aged Garlic Extract (AGE), according to Levy. In studies, he noted, AGE has shown to exert wide-ranging benefits for heart health. Randomized double-blind clinical trials show that AGE lowers systolic blood pressure 7 to 16 mmHg and diastolic pressure 5 to 9 mmHg compared to placebo. Other human studies have found that total cholesterol has been reduced 7 to 29 mg/dL in those taking a daily AGE supplement. In men with coronary artery disease, AGE improved flow mediated dilation (a marker of blood flow in arteries) by 44 percent. This suggests that AGE may improve endothelial function in men already under treatment for cardiovascular disease.
Herbalist & Alchemist’s Cardio Compound, formulated to support healthy blood pressure, contains hawthorn berry flower and leaf, linden flower, motherwort, olive leaf and European mistletoe. Hawthorn is a cardiovascular trophorestorative, he explained, which strengthens heart and vascular function. Human clinical trials have shown it to mildly reduce blood pressure and enhance vascular endothelial function. Linden flower and motherwort are nervines that reduce stress-induced hypertension, while olive leaf and mistletoe have been shown in clinical trials to promote healthy blood pressure.
Another hawthorn-containing product from Herbalist & Alchemist is Healthy Heart Compound that also has dan shen, nightblooming cereus, astragalus, corydalis and dong quai to promote healthy heart function and to enhance cardiovascular circulation, according to Winston. “In TCM dan shen, astragalus, dong quai and corydalis are the major cardiovascular herbs used to relieve blood stagnation, promote circulation and to enhance cardiovascular activity, Winston explained. “Night-blooming cereus was introduced into medical practice by the Eclectic Physicians who used it for heart weakness in the elderly, it is a slow acting restorative remedy.”
According to Myers, all three of Terry Naturally’s best-selling heart health supplements—Clinical OPC, Clinical OPC Extra Strength, and Clinical OPC Heart—feature the company’s French Grape Seed VX1 extract, containing only tannin-free OPCs that are small enough to guarantee absorption. “Grape seed extract addresses many of the concerns that lead to heart disease: reducing high blood pressure, protecting the blood vessel walls from free radical damage, and preventing the dangerous oxidation of LDL cholesterol,” she explained.
In a clinical study, participants with pre- or mild hypertension were divided into three groups, two with grape seed extract, at lower (150 mg daily) and higher (300 mg) dosages, and the control group with a diet and exercise intervention only. At the end of the four-month trial, Myers reported, both grape seed extract groups saw an improvement in blood pressure, although those at the higher dosage noticed more dramatic effects; blood pressure numbers normalized in 93 percent of those in the higher dosage group.
Another clinical study compared the results of individuals with mildly high cholesterol taking a grape seed extract versus a placebo for eight weeks. Lipid profiles and oxidized LDL (bad) cholesterol were improved in those taking grape seed extract. The researchers concluded that grape seed extract decreased the risk of blood clotting and other cardiovascular disorders. Also, she cited, a Yale review of grape seed extract studies concluded from the existing research that this powerful botanical lowers systolic blood pressure and helps improve heart rate, so a broad spectrum of medical experts have definitely taken notice.
The additional nutrients in Clinical OPC Heart—magnesium, benfotiamine, vitamin B6 as pyridoxal-5-phosphate (P-5-P), and pomegranate—all have beneficial effects for the heart and arteries, Myers added.
Terry Naturally’s Healthy Cholesterol with Amla, featuring a clinically studied amla (gooseberry), Myers noted. A clinical study showed that participants taking amla increased high-density lipoprotein (HDL) by 14 percent and decreased LDL cholesterol by 21 percent. Their total serum cholesterol was reduced by 17 percent and triglyceride levels dropped by 24 percent within three months.
“An even more recent clinical study demonstrated that amla reduced the atherogenic index (AIP), a measure of the ratio of triglycerides to HDL, by an incredible 39 percent in 12 weeks,” she reported. “This is significant, because high AIP measures are a sign of higher risk for coronary heart disease and is a marker of atherosclerosis. This study also saw slight reductions in fasting blood sugar levels and did not reduce levels of CoQ10—unlike statin drugs.”
Bluebonnet’s Targeted Choice Blood Pressure Support, Weinhardt described, “is a blend of complementary vitamins, minerals and sustainably harvested or wildcrafted herbal extracts, as well as pharmaceutical-grade amino acids plus CoQ10 to help maintain blood pressure levels already within the normal range.”
Its constituents act to promote heart health in the following ways, she explained:
• Hawthorn, taurine, vitamin B6, magnesium and CoQ10 have been shown to help increase excretion of bodily fluids thereby inhibiting sodium and water retention that elevate blood pressure.
• Magnesium and hawthorn leaf/flower extract have demonstrated the ability to reduce vasoconstriction by affecting the movement of calcium, causing blood vessels to relax.
• Magnesium, arginine and grape seed extract have been shown to help enhance circulation and blood flow by sending out a signal for vasodilation.
• Hawthorn, hibiscus, olive leaf and grape seed, as well as onion and pumpkin have been shown to decrease hypertensive hormones in the adrenal and pituitary glands by interfering with the conversion of angiotensin II from angiotensin I and inhibiting the degradation of bradykinin, a potent endothelium-dependent vasodilator.
• Grape seed extract, taurine and CoQ10 exhibit potent antioxidant properties, which is important for heart health.
Quantum Nutrition Labs, said Payne, offers several supplements targeted to support healthy inflammatory response while promoting desirable cardiovascular blood flow, and promoting cellular ATP to optimize mitochondrial function.
Quantum Plant DHA, Quantum EPA/DHA are offered in liquid and soft gels. DHA, he explained is important for heart health as it contributes to the maintenance of normal blood triglyceride levels. EPA and DHA contribute to the normal function of the heart and maintenance of normal blood pressure. Quantum Delta Tocotrienol from annatto contain delta and gamma tocotrienols that Payne said provide significant properties for cardiovascular and circulatory health. They also support regulation of healthy metabolic functioning‚ and support the epithelial lining of blood vessels. Research also shows that tocotrienols promote healthy levels of CoQ10 in the blood.
But mitochondrial functioning is often overlooked when considering cardio support supplements. “Although many factors can play a direct role in heart health, the extreme vulnerability of the heart can be seen when cellular energy, adenosine triphosphate (ATP), is low,” Payne explained. “Mitochondrial stress and its revival are essential to support the health of the heart. Mitochondria can be supported by Quantum CoQ10, which Payne described is “a potent antioxidant that utilizes the electrons from food to produce ATP. CoQ10 also acts as a potent antioxidant during ATP production, supporting cell membrane and arterial health from the oxidative stress and inflammatory damage during this process.”
NOW offers numerous supplements for heart health. For example, Levin described, NOW Beta-Sitosterol Plant Sterols, features CardioAid-S Plant Sterol Esters, a combination of the ester forms of beta-sitosterol, campesterol and stigmasterol. An FDA-qualified health claim is “Foods containing at least 0.65 grams per serving of plant sterol esters, eaten twice a day with meals for a daily total intake of at least 1.3 grams, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.” One serving of this supplement provides 1 gram (1,000 mg) of plant sterol esters in a base of fish oil.
A more “boutique” blend is “NOW Cholesterol Pro, a combination of two ingredients that Levin stated have clinically shown ability to support serum lipid levels already within the healthy range: Bergamonte, a standardized citrus polyphenolic extract that can help to support cardiovascular health, as well as proper blood sugar management; and CardioAid, a plant sterol combination, which has also demonstrated its use for the support of healthy cholesterol levels already within healthy range.
You can select any of these plus many more—when you work with brands that can show you the science, and any other proof you need to convey to customers seeking cardiovascular support, you will encourage those customers to take heart in the category.
Said retailer Bradford, “In spite of a negative article we see each and every year, we can show you thousands of people who believe supplements have changed their life. Science is needed in our industry and we are seeing more of it every day.” VR
For More Information:
Bluebonnet Nutrition, www.bluebonnetnutrition.com
EuroPharma, Inc./Terry Naturally, www.europharmausa.com
Herbalist & Alchemist, www.herbalist-alchemist.com
NOW, www.nowfoods.com
Quantum Nutrition Labs, www.qnlabs.com
