American Heart Association Recommendation
We recommend that healthy people get adequate nutrients by eating a variety of foods in moderation, rather than by taking supplements. An exception for omega-3 fatty acid supplements is explained below.
The Recommended Dietary Allowances (RDAs) published by the National Research Council are the best available estimates of safe and adequate dietary intakes. Almost any nutrient can be potentially toxic if eaten in large quantities over a long time. Interactions between dietary supplements and prescription drugs and among several dietary supplements taken at the same time may occur. Too much iron can increase the risk of chronic disease, and too much vitamin A can cause birth defects.
There aren’t sufficient data to suggest that healthy people benefit by taking certain vitamin or mineral supplements in excess of the RDAs. While some observational studies have suggested that lower rates of cardiovascular disease and/or lower risk factor levels result in populations who use vitamin or mineral supplements, it isn’t clear if this is due to the supplements. For example, supplement users may be less overweight and more physically active.
Moreover, vitamin or mineral supplements aren’t a substitute for a balanced, nutritious diet that limits excess calories, saturated fat, trans fat and dietary cholesterol. This dietary approach has been shown to reduce coronary heart disease risk in both healthy people and those with coronary disease.
What about antioxidant vitamins?
Many people are interested in antioxidant vitamins (A, C and E). This is due to suggestions from large observational studies comparing healthy adults consuming large amounts of these vitamins with those who didn’t. However, these observations are subject to bias and don’t prove a cause-and-effect relationship. Scientific evidence does not suggest that consuming antioxidant vitamins can eliminate the need to reduce blood pressure, lower blood cholesterol or stop smoking cigarettes. Clinical trials are under way to find out whether increased vitamin antioxidant intake may have an overall benefit. However, a recent large, placebo-controlled, randomized study failed to show any benefit from vitamin E on heart disease.
What about omega-3 fatty acid supplements?
Epidemiologic and clinical trials have shown that omega-3 fatty acids reduce the risk of cardiovascular disease. Healthy people, people at high risk of CVD and patients with preexisting CVD all benefit. We recommend including omega-3 fatty acids in the diet mainly from fish and plant sources.
However, some people with high triglycerides (blood fats) and patients with CVD may benefit from more omega-3 fatty acids than they can easily get from diet alone. These people should talk to their doctor about taking supplements to reduce heart disease risk. (See the “Fish Oil and Omega-3 Fatty Acids” entry in this guide for more details.)
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