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Most dietary supplements don't help your heart and some may be harmful, from the August 2014 Harvard Heart Letter

Every day, about half of American adults take a vitamin, mineral, herb, amino acid, or other dietary supplement. Most do this because they seek to improve or maintain their health. Others do it in hopes of staving off heart disease. Yet only a handful of supplements offer possible—though limited—help against heart disease. Some popular ones have no benefit, and others contain dangerous contaminants, reports the August 2014 Harvard Heart Letter.

"A lot of people want to add something natural and alternative to the conventional medications they're taking, and they assume that dietary supplements might help and can't hurt," says Dr. Pieter Cohen, a dietary supplement safety researcher and assistant professor of medicine at Harvard Medical School. But that's not the case.

Unlike pharmaceuticals, which undergo extensive testing to prove they're effective and safe before they can be sold, dietary supplements can be sold without proof of effectiveness or safety. Moreover, supplement makers can claim their products improve health, even when there's little or no evidence to support such claims.

Multivitamins are one of the most popular supplements taken by people trying to prevent heart disease. But large, "gold standard" trials have shown that taking a daily multivitamin does not ward off heart disease. Small studies suggest that some dietary supplements, such as red yeast rice, lowers cholesterol, a risk factor for heart disease. Yet the amount of the active ingredient in red yeast rice products varies widely, from very low to very high. And up to one-third of red rice yeasts products may be contaminated with a kidney toxin called citrinin.

Such contamination isn't rare. As Dr. Cohen noted in a perspective in The New England Journal of Medicine, the FDA has found more than 500 supplements adulterated with pharmaceuticals or closely related compounds. The offenders include stimulants, body-building steroids, antidepressants, weight-loss medications, and supplements aimed at treating erectile dysfunction. All can cause unwanted side effects and may be especially risky when taken with heart drugs or other prescription medications.

Because of the potential risks and unclear benefits of dietary supplements, most doctors advise their patients to avoid them, though they may recommend specific supplements such as calcium and vitamin D to prevent osteoporosis.

For most people, "a well-balanced diet rich in whole foods including fruits, vegetables, fish, olive oil, and nuts negates the need for any supplements," says Dr. Cohen.

Read the full-length article: "Dietary supplements: Sorting out the science

Also in this issue of the Harvard Heart Letter

  • Dietary supplements: Sorting out the science
  • Ask the doctor: Catheter ablation for afib
  • Ask the doctor: Understanding aortic valve sclerosis
  • The lesser-known fat in your blood
  • Reaching the heart through an artery in the wrist
  • Heart failure with 'preserved ejection fraction': What does it mean?
  • New guidelines for the prevention of recurrent stroke
  • E-cigs: A threat to the heart?
  • Extra-virgin olive oil may lower afib risk
  • Treating sleep apnea may decrease blood pressure
  • Obesity raises heart disease risk despite healthy metabolic profile

More Harvard Health News »

About Harvard Health Publications

Harvard Health Publications publishes four monthly newsletters--Harvard Health Letter, Harvard Women's Health Watch, Harvard Men's Health Watch, and Harvard Heart Letter--as well as more than 50 special health reports and books drawing on the expertise of the 8,000 faculty physicians at Harvard Medical School and its world-famous affiliated hospitals.