February is National Heart Month. Although heart disease is the leading cause of death for men and women worldwide, it’s largely preventable. That makes heart-health supplements a big business, which means a lot of hype and marketing fluff by various supplement companies.
So we’ve taken it upon ourselves to analyze five supplements that have actual evidence behind their benefits. As always, remember to always consult with your physician before taking anything — some supplements have medication interactions.
Nitrates are one of the reasons why vegetables are so good for you. Nitrates break down into nitrites, which circulate in the body and are turned into nitric oxide (NO). Nitrates, found abundantly in beetroot and a variety of leafy greens (arugula, collards, etc.), are a reliable and effective way to increase nitric oxide synthesis in the body. Elevated NO levels are associated with better circulation and lower blood pressure.
Eating a diet with a good amount of nitrate-containing vegetables decreases your risk for hypertension and can improve endothelial cell function (the cells that line the inside of your blood vessels). As an added bonus, increasing your overall vegetable (and fruit!) intake can reduce the risk of cardiovascular disease, cancer, and premature death.
Although you can find nitrates in processed meats, it’s not quite the same as getting them through vegetables. It is thought that various compounds in the meat interact with the nitrates during cooking and processing to form potentially pro-carcinogenic elements like nitrosamines. You can read up on this process and how it may affect your health here: Scientists found that red meat causes cancer ... or did they?
While garlic can also enhance NO signaling in the body, its blood pressure lowering effects are mostly due to another compound: hydrogen sulfide (H2S). Whether part of your diet or supplemented, garlic is a cheap and potent way to increase hydrogen sulfide signaling in the body — which in turn relaxes blood vessels and lowers blood pressure.
In those with elevated cholesterol (>200 mg/dL, >5.5 mmol/L), consistently consuming garlic for two months or more can moderately reduce total as well as low-density lipoprotein (LDL) cholesterol and can slightly bump up high-density lipoprotein (HDL). Because it can improve several cardiovascular parameters, garlic makes a good heart-health supplement.
A healthy artery is a flexible one. During arterial calcification, calcium adheres to the artery wall, increasing its stiffness. Arterial stiffness and flexibility are very reliable biomarkers of mortality from cardiovascular diseases. Vitamin K2, found in egg yolks and some fermented foods, is one of the few dietary supplements that may be able to reduce arterial calcification and stiffness.
Vitamin K can roughly be broken up into 3 groups: K1, K2, and K3. K1 plays a large role in blood clotting, while K2 is responsible for calcium regulation. K3 is a synthetic provitamin not used in human food fortification or supplementation, as it can harm your health.
While most can get adequate K1 from eating green leafy vegetables, K2 supplementation may be necessary to reap some of K2 cardiovascular benefits.
With blood sugar reduction comparable to the diabetes drug Metformin, berberine is a very potent blood glucose-lowering agent that can be beneficial for people with impaired glucose regulation. When paired with lifestyle interventions, berberine can greatly improve glucose levels (HbA1c) and help bring down high cholesterol in those with type 2 diabetes.
Taurine (L-taurine) is a conditionally essential amino acid found abundantly in the body — particularly in heart tissues where it helps maintain a regular heartbeat. Under healthy conditions, our bodies can produce taurine from the amino acids methionine and cysteine and from vitamin B6.
In patients with heart failure, short-term taurine supplementation (~2 weeks) yielded improvements in cardiovascular function surrounding a bout of exercise. Studies have also suggested that taurine may have some beneficial effects on blood pressure in those with pre-hypertension or hypertension.
Adding more garlic, leafy greens, and beets to your diet is an easy first step to protect your heart and February is the perfect time to get started!
Remember — supplementation is complimentary to good nutrition, not a replacement for it (and make sure you’re getting high-quality sleep and a fair amount of exercise). It’s not sexy and it’s not a magic pill, but that’s what the evidence points towards.
If you want more specific details on when to take these supplements, how much to take, and step-by-step directions, check out our Heart & Circulation Supplement Guide, a thorough guide on the latest evidence for heart health supplements.
- The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis. Adv Nutr. (2017) Bahadoran Z, et al.
- Effects of inorganic nitrate and beetroot supplementation on endothelial function: a systematic review and meta-analysis. Eur J Nutr. (2016) Lara J, et al.
- Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. (2017) Aune D, et al.
- Garlic Lowers Blood Pressure in Hypertensive Individuals, Regulates Serum Cholesterol, and Stimulates Immunity: An Updated Meta-analysis and Review. J Nutr. (2016) Ried K.
- Effect of garlic on serum lipids: an updated meta-analysis. Nutr Rev. (2013) Ried K, Toben C, Fakler P.
- Vitamin k dependent proteins and the role of vitamin k2 in the modulation of vascular calcification: a review. Oman Med J. (2014) El Asmar MS, Naoum JJ, Arbid EJ.
- Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women. A double-blind randomised clinical trial. Thromb Haemost. (2015) Knapen MH, et al.
- Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. .
- Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. (2006) Cockayne S, et al.
- Fasting and post-challenge glucose as quantitative cardiovascular risk factors: a meta-analysis. J Atheroscler Thromb. (2012) Kodama S, et al.
- Is glucose control important for prevention of cardiovascular disease in diabetes?. Diabetes Care. (2013) Mannucci E, et al.
- Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. (2015) Lan J, et al.
- Physiological roles of taurine in heart and muscle. J Biomed Sci. (2010) Schaffer SW, et al.
- Taurine Supplementation Improves Functional Capacity, Myocardial Oxygen Consumption, and Electrical Activity in Heart Failure. J Diet Suppl. (2017) Ahmadian M, Dabidi Roshan V, Ashourpore E.
- Taurine supplementation has anti-atherogenic and anti-inflammatory effects before and after incremental exercise in heart failure. Ther Adv Cardiovasc Dis. (2017) Ahmadian M, et al.
- Effect of taurine supplementation on exercise capacity of patients with heart failure. J Cardiol. (2011) Beyranvand MR, et al.
- Taurine Supplementation Lowers Blood Pressure and Improves Vascular Function in Prehypertension: Randomized, Double-Blind, Placebo-Controlled Study. Hypertension. (2016) Sun Q, et al.
- Treatment of hypertension with oral taurine: experimental and clinical studies. Amino Acids. (2002) Militante JD, Lombardini JB.