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NOVEMBER 17, 2022 | Join the conversation on LinkedIn and Twitter
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By Luke Huber, N.D., MBA, Vice President, Scientific & Regulatory Affairs, CRN
Earlier in my career, I had a clinical practice as a naturopathic doctor (ND). Years of seeing patients informs my view of the role dietary supplements can play in supporting wellness beyond just filling nutrient gaps.
As an ND, I worked with patients to diagnose, prevent, and treat illness, using integrative approaches to optimize health. The Association of Accredited Naturopathic Medical Colleges outlines key requirements for licensed naturopathic physicians including more than 4,100 hours of instruction, graduation from a four-year, in-residence doctoral degree program accredited by the Council on Naturopathic Medical Education, and 1,200 hours of supervised, hands-on clinical training.
Naturopathic principles are formally codified and accepted by the American Association of Naturopathic Physicians (AANP) and the Canadian Association of Naturopathic Doctors (CAND). These include:
1. First, do no harm
2. The healing power of nature
3. Identify and treat the causes
4. Doctor as teacher
5. Treat the whole person
6. Prevention
To “do no harm,” NDs employ methods and medicinal substances that minimize the risk of harmful effects. NDs apply the least force necessary when treating patients and avoid suppressing symptoms, as appropriate. NDs acknowledge that health and disease result from combined physical, mental, emotional, genetic, environmental, and social factors. They have an individualized approach for health and disease management, developing personalized health plans for patients.
In my practice, providing patients with treatment plans and actionable medical advice to address their health concerns would sometimes involve discussions about cardiovascular health. Naturopathic doctors often work with patients on integrative approaches for cardiovascular disease (CVD) as it is the leading cause of death in the U.S., according to the U.S. Centers for Disease Control.
Hypertension, hyperlipidemia, and smoking are all risk factors for CVD. Diet, lifestyle, and underlying medical conditions can all increase risk.
As an ND, in the “doctor as teacher” role, I would provide guidance to patients on diet, lifestyle, and dietary supplements to reduce CVD risk and optimize health. Patients often had questions about prescription medications such as statins which are used for lowering cholesterol levels. So it was with great interest that I read the results of the Supplements, Placebo, or Rosuvastatin (SPORT) study presented at the American Heart Association Scientific Sessions earlier this month and published in the Journal of the American College of Cardiology, to which CRN responded.
SPORT compared the effects of a statin medication with a placebo and six dietary supplements—fish oil, cinnamon, garlic, turmeric, plant sterols, and red yeast rice during a four-week period. Upon reading the findings, a couple of concerns immediately came to mind. First, some of the supplements chosen by the researchers are not indicated for cholesterol reduction (e.g., cinnamon). Other supplements that would be obvious choices for cholesterol management were not included (e.g., fiber supplements). Also, the four-week intervention period was more appropriate for a fast-acting statin drug than dietary supplements, which generally take longer for their effects to be seen and are also used for prevention.
The authors took the opportunity to inappropriately dismiss supplements for heart health in general. This does a disservice to patients who should have more choices to improve their cardiovascular health, not fewer.
I’m pained to think how some patients with an earnest desire for integrative approaches to heart health would be shut down by a health care practitioner who took this latest news blip on supplements for heart health as the final word—especially when there are so many meaningful options.
For patients who were seeking an integrative approach to cardiovascular health, I would consider a range of dietary supplements, diet and lifestyle choices dialed into their personal profile including underlying health conditions and activity level.
Several dietary supplements may be recommended for heart health and are supported by science. For example, since 2000, FDA has allowed heart disease health claims for plant sterols based on scientific evidence.
In 2022, FDA announced a qualified health claim for products containing magnesium for the reduction of blood pressure. In addition, FDA permits the use of claims for omega-3 fatty acids and reduced risk of coronary heart disease and hypertension.
The National Center for Complementary and Integrative Health (NCCIH) in a clinical digest for health professionals discusses what the science says about high cholesterol and natural products. Stanols and sterols, soy, flaxseed, garlic, green tea, red yeast rice, oats and oat bran are noted for having supportive research and safety for most populations.
As a healthcare practitioner, I understand that both prescription drugs and dietary supplements have beneficial roles to play in achieving better health. However, supplements to support cardiovascular health should not be dismissed simply based on the SPORT trial, a four-week study with notable limitations.
Dr. Huber focuses on CRN’s scientific affairs and nutrition policy activities that support the appropriate role for dietary supplements and functional food in health promotion and disease prevention. He has over 20 years of experience in the dietary supplement industry leading product development, scientific and technical affairs, clinical research, and regulatory affairs. In his prior roles, he has been a leader in product innovation and scientific initiatives. Most recently, Dr. Huber held the position of global R&D director, VMS with Reckitt. Prior to Reckitt, he held senior scientific & technical leadership roles at prominent companies within the dietary supplement industry. Learn more about Dr. Huber.