[Atherosclerosis and micronutrients]

Large epidemiological studies have shown a reduced incidence of cardiovascular diseases in relation to dietary intake of micronutrients such as n-3 fatty acids (FA), folic acid, and vitamin E. The meaning of such results has been extended to promote the consumption of several vitamin supplements. Such supplementation, which represents a huge market, is generally taken as self-medication, with no medical prescription or control. Recent prospective trials confirm the efficacy of n-3 fatty acids in the secondary prevention of cardiovascular diseases. N-3 FA markedly affect cell metabolism by interacting at different levels. Increased intake of folic acid, either through changes in dietary habits or via supplements, also appears to positively affect cardiovascular prevention. Folic acid acts, both as an antioxidant and by reducing serum homocysteine concentration. While increased dietary intakes of vitamin E are associated with a reduced cardiovascular risk, the clinical results of recent studies evaluating the effect of vitamin E supplementation have generally been disappointing and contrast with the demonstration of potent antioxidant properties, as well as protective effects on endothelial and immune functions.