Philip Ades, M.D., cardiologist, professor of medicine at the University of Vermont and an EatingWell nutrition advisor, answers your burning questions about a heart-healthy diet to prevent heart disease.
I've heard that B-vitamin supplements can help prevent heart disease. Do you recommend them?
No. I do not know of any benefit of taking B vitamins to prevent heart disease. Folic acid had a lot of promise but studies so far have not shown a benefit. [Dr. Ades notes that niacin, a B vitamin, can help some individuals lower blood cholesterol but it should only be taken under a doctor’s guidance, as it can have side effects.
Should I include soy in my diet?
Yes, particularly if you have heart disease or high cholesterol levels. I view soy protein as part of a cholesterol-lowering diet. Studies show that people can lower blood levels of cholesterol by eating a diet rich in soy protein, fiber, plant sterols and nuts, such as almonds.
I've heard that products fortified with plant sterols help lower my cholesterol. True?
The stanol/sterol spreads Take Control and Benecol have been best studied. Eating three pats a day has been found to lower LDL cholesterol by about 8%—but it also adds calories. Other products [e.g., granola bars and cookies] seem more like candy to me, so I generally don’t recommend them.
Should I take fish-oil supplements?
Maybe. Talk with your doctor, particularly if you already have heart disease or you have high triglycerides. That said, in terms of preventing heart disease, eating fish has been proven to be more beneficial than taking an isolated "active ingredient" in the form of a supplement.
One day, I hear that taking vitamin E is heart-healthy; the next, I hear it's not. Should I stop taking it?
Yes, especially if you are taking a statin. Vitamin E clearly has no benefits vis-à-vis heart disease and may be detrimental. One study found that heart patients taking vitamin E had more strokes. Another study (conducted at the University of Washington) found that vitamin E blocked statins’ ability to raise “good” HDL cholesterol. My general feeling about supplements is only to take something if it is proven to be of benefit. There are scores of stories of things that "ought to work" theoretically, but are later shown to be detrimental. Vitamin E is one such story. To say it can’t hurt is naive. It can hurt. Everyone thought that it couldn’t hurt to give women the hormones they had when they were younger. Well, turns out hormone replacement therapy increases heart disease, stroke and breast cancer rates.