Should doctors discourage nutritional supplementation? A cardiovascular perspective

Cardiovascular disease is the major cause of death in most western countries, and current preventive treatment is relatively ineffective. There are theoretical reasons why nutritional therapy-antioxidant vitamins, minerals and omega 3 oils-should be beneficial. Because of some negative trials, there is the risk of tossing the baby out with the bath water. This paper reviews how nutritional therapy could assist in a comprehensive preventive approach to reduce heart disease-especially primary prevention. It stresses the need to separate primary prevention-initiated by oxidation of LDL in the vessel wall, and secondary prevention-the consequences of plaque rupture. Because a therapy is ineffective in the secondary preventive role, does not mean that it could not have a primary preventive action. There are many positive studies utilizing nutritional therapies, these are detailed in this paper, and a comprehensive preventive programme including these is suggested.