Note: To take the exam associated with this course, you
will need to go to the nutrilearn.com store, place this course in your shopping
cart and complete the checkout process. Although the course is
free, we need for you to create an account so that we can keep track of
your course history. To add this item to you shopping cart, click here
Course Title
Nutraceutical ingredients enhance cardiovascular health
Course Description
This course presents
information found in the March 2005 cover story of Health Supplement Retailer
(HSR) magazine.
Overview
Cardiovascular disease (CVD) is a host of interrelated conditions affecting
the heart, blood vessels and blood cells. Degenerative conditions include
atherosclerosis (hardening of the arteries), congestive heart failure (CHF),
coronary heart disease (CHD) and hypertension (high blood pressure). These
conditions contribute to other acute events including stroke and myocardial
infarction (heart attack). More than 20 percent of Americans have one or more
types of CVD, including 50 million Americans with hypertension and 13.2 million
with CHD.
Basic Terminology
Atherosclerosis: Hardening of the arterial walls caused by buildup
of fatty deposits; it decreases the flexibility of the arteries and the
deposits hinder blood flow, forcing the heart to work harder to pump
blood.
Cholesterol: Naturally produced by the body, and ingested through
the diet, cholesterol is critical for formation of cell membranes and
hormones. The two major kinds are low-density lipoprotein (LDL),
considered the "bad" cholesterol that carries cholesterol throughout the
body and raises the risk of heart disease, and high-density lipoprotein (HDL),
the "good" cholesterol that increases the clearance rate of cholesterol from
the body.
CRP: C-reactive protein is a marker for inflammation in the
body.
Endothelium: The thin layer of cells lining the vascular walls,
which produces nitric oxide to increase or decrease inflammation.
Homocysteine: An amino acid in the blood, high levels of which have
been linked to increased risk of heart disease.
Hypertension: Elevated blood pressure, broken into systolic, which
measures the rate at which the heart pushes the blood through the arteries,
and diastolic, the venous pressure when the heart muscle relaxes.
The continued prevalence of CVD remains a concern for Americans. "Thirty
years of supposed preventive measures have failed," said Al Sears, M.D.,
director of the Wellness Research Foundation and author of The Doctor's Heart
Cure (Dragon Door Publications, 2004). "Dietary changes have caused the
modern epidemic of heart disease. However, research and experience prove
nutritional strategies can both prevent and reverse existing heart disease."
A combination of factors appears to be driving the continued epidemic of CVD.
Of particular note are the facts that seniors are living longer, medicine is
more adept at helping people live with heart disease and survive incidents such
as heart attack, and the baby boomers are reaching the prime time for diagnosis
of CVD. The number of people treating heart conditions continues to increase,
according to the Natural Marketing Institute. Data from its Health &
Wellness Trends Database-six years of trended data from more than 2,000 consumer
household respondents-found almost 46 percent of consumer households are
managing or treating cholesterol, 31 percent are treating hypertension and 15
percent are treating heart disease.
Fortunately, there are more nutritional products available for preventing and
treating cardiovascular dysfunction. "Recent years have brought well-researched,
pioneering products to the heart health market, particularly in the area of
homocysteine reduction and cholesterol lowering," said Traci L. Kirksey,
director of sales and marketing with Gematria Products Inc. "These formulas are
much-desired alternatives to typical drugs, such as statins, and their
potentially undesirable side effects."
The range of supplements available should provide retailers many options for
serving their customers, said Doug Bibus, Ph.D., a member of the scientific
advisory board for Coromega. "Many products are targeted at lowering blood
cholesterol and blood pressure, but many supplement companies are now targeting
causes of heart disease that go well beyond cholesterol," he said. "New emphasis
is being placed on the key biochemical factors, inflammation and oxidative
status, that are viewed as root causes of atherosclerosis. There is more to
heart disease than just cholesterol."
Bernard Collett, Ph.D., chief executive officer with Designing Health, agreed
with the assessment. "What most people don't know or won't accept is both high
cholesterol and blood pressure problems generally develop over years and can be
categorized as degenerative diseases that are normalized through multiple
channels of lifestyle choice," he said.
The importance of a healthy lifestyle is critical. Researchers suggest
incorporating regular physical activity, avoiding smoking, maintaining a healthy
body weight and consuming a diet rich in whole grains, fruits and vegetables,
omega-3 essential fatty acids (EFAs) and unsaturated fats as the predominant
form of dietary fats could prevent the majority of CVD in Western
populations.1 In addition, there are
certain specialty foods that may help in lowering the risk of CVD. For example,
the American Heart Association (AHA) and National Cholesterol Education Program
suggest the use of soy protein to lower cholesterol. The Food and Drug
Administration (FDA) even approved a health claim linking the intake of 25 g/d
of soy protein with a reduced risk of CHD. Soy consumption appears to improve
plasma lipids, reduce LDL oxidation and improve vascular reactivity.2
Intervention studies have shown promising results for the use of isolated soy
protein. Researchers at the University of Illinois, Urbana-Champaign, found
providing 0.5 g/kg/d of isolated soy protein for 16 weeks to men with Type II
diabetes significantly improved their total-to-HDL ratio and HDL cholesterol
levels.3 Another study found the use of 30
g/d or 50 g/d of isolated soy protein in 130 subjects significantly reduced LDL
cholesterol concentrations.4
There is some question as to whether soy's heart healthy effects can be
attributed to its protein or other compounds such as isoflavones. Tokyo
researchers conducted a meta-analysis using eight studies comparing high- and
low-isoflavone levels with identical soy protein intake and found higher levels
of isoflavones led to greater decreases in LDL levels.5 As soy isoflavones already appear efficacious in
reducing some menopausal symptoms, their heart health benefits may be an added
bonus for women. In a Dutch study of more than 900 postmenopausal women, higher
intake of isoflavones and lignans were associated with lower triglyceride
levels, as well as a reduced cardiovascular risk factor metabolic
score.6
Supplemental dosages of isoflavones from red clover also appear
beneficial. In a 12-week, randomized study in 252 menopausal women, the use
of two different red clover dietary supplements (Promensil, 82 mg total
isoflavones, and Rimostil, 57.2 mg total isoflavones) significantly increased
HDL levels and decreased triglyceride levels compared to women taking a
placebo.7 Similarly, use of a
supplement with 43.5 mg isoflavones by perimenopausal women reduced
triglycerides, total cholesterol and LDL cholesterol.8
Ground flaxseed is another source of dietary phytoestrogens as lignans. A
review from the University of Pennsylvania, Philadelphia, noted flaxseed may
modestly reduce serum total and LDL cholesterol and decrease some markers of
inflammation.9 Researchers from Oklahoma
State University, Stillwater, examined the impact of 40 g/d of ground flaxseed
on cholesterol levels in women not on hormone therapy and found supplementation
significantly lowered serum total cholesterol and non-HDL cholesterol.10
Flaxseed is also a rich source of the omega-3 fatty acid alpha-linolenic acid
(ALA), which may beneficially impact inflammation. When fed to rats, flaxseed
increases the serum levels of both ALA and the longer-chain eicosapentaenoic
acid (EPA), which is produced through enzymatic conversion of ALA.11 Studies have found intake of a high-ALA diet may
decrease vascular inflammation and endothelial activation.12 Similarly, hypercholesterolemic men and women who
received margarine enriched with ALA showed lower levels of C-reactive protein
(CRP), a marker of inflammation.13
Flaxseed forms the basis of the new MegaFlax™ line of target-specific
formulations from Designing Health. According to Collett, the MegaFlax Heart™
product incorporates whole foods with cardio-protective effects with special
phytonutrients. "Bearing on the inflammatory aspect of heart disease, it has
properly balanced essential fatty acids incorporated from organic flaxseed,
which also delivers lignans that have renal protective antioxidant and
anti-inflammatory properties," he said. Additional ingredients include oat bran
fiber, hawthorn, garlic, lycopene and grape seed extract.
Beyond flax omega-3s, there has been a great deal of attention paid to the
role of fish oil as a source of preformed EPA and docosahexaenoic acid (DHA).
"Purified fish oils are becoming one of the most popular heart health
supplements on the market today," Bibus said. "The data is so compelling that
the American Heart Association now recommends consuming enough fish oil
supplements per day to supply 1 gram of EPA and DHA if you are at risk of heart
disease."
The original link between marine omega-3 fatty acids and heart health came
from observational studies of Japanese and Eskimo populations, for whom diets
rich in fatty fish protected against CHD. Since that point, population studies
have supported the association. For example, a cohort study of almost 80,000
women in the Nurses' Health Study found women in the highest quintile of intake
of fish and long-chain omega-3s had a 28-percent reduced risk of stroke and a
33-percent reduced risk of thrombotic infarction compared with the lowest
quintile.14
These have led researchers to suggest marine-source omega-3 fatty acids
protect against CHD through several mechanisms of action, including
antiarrhythmic, antithrombotic, antiatherosclerotic and anti-inflammatory
activities, lowering blood pressure, lowering triglyceride concentrations and
improving endothelial function.15 "Hundreds
of papers document the life saving effects of long chain omega-3 fats for the
reduction of heart disease and death related to heart disease," Bibus noted.
The best known intervention study that assessed the link between
marine-source omega-3 EFAs and CVD risk was the GISSI-Prevenzione trial, in
which 11,324 patients surviving recent myocardial infarction received either
marine omega-3 EFAs (1 g/d), 300 mg/d vitamin E, both or neither for 3.5
years.16 Treatment with omega-3s significantly lowered the risk of overall,
cardiovascular and sudden death, as well as incidence of non-fatal myocardial
infarction and stroke. Studies have also shown the benefit of fish oil
supplementation on reducing CRP levels17
and thrombin generation,18 and enhancing
endothelial function, even in healthy subjects.19
There has been some discussion of the quality of fish oil supplements. "To be
healthy, fish oils must be free of contaminants and must not be oxidized," Bibus
said. "A general rule of thumb is that if a fish oil product smells fishy, it
probably is. Generally, the fishy smell is a sign of oxidation and oxidized fish
oil is not heart healthy." Instead, Bibus recommended retailers ask their
manufacturers about the source of the fish oil and what type of quality control
procedures they follow to ensure the freshness of the product. Many natural
products manufacturers, including Coromega and Enzymatic Therapy (which supplies
Eskimo 3), use pharmaceutical grade, molecularly distilled fish oil that is free
of pesticides and heavy metals; however, it is critical to request documentation
of the raw materials.
Another beneficial fat is olive oil, which contains high levels of
monounsaturated fatty acids as well as a host of phytochemicals. The
antioxidants in olive oil may protect against peroxidation, reduce plasma levels
of LDL cholesterol and increase HDL cholesterol levels.20 Olive oil rich diets have also been shown to
normalize blood pressure in hypertensive patients.21 In addition, the oleic acid in olive oil appears to
interfere with the inflammatory response, decreasing the expression of
pro-inflammatory proteins associated with atherosclerosis.22 And olive polyphenols, including hydroxytyrosol,
appear to be effective free radical scavengers that can inhibit platelet
aggregation.23
Another rich source of polyphenols is grape seed extract, which has been
shown to have antioxidant activity that reduces LDL oxidation.24 In addition, phenolic-rich extracts from grape
seeds have been shown to prevent the development of aortic atherosclerosis
without impacting plasma antioxidant capacity.25 They further act in endothelial cells, increasing
nitric oxide xynthase expression, enhancing vasorelaxation.26
In a study at Creighton University, Omaha, Neb., researchers investigated the
effects of grape seed extract (as ActiVin® from San Joaquin Valley) with and
without niacin-bound chromium (as ChromeMate® from InterHealth Nutraceuticals)
on blood pressure in normotensive and hypertensive rats.27 The compounds, both individually and in
combination, significantly lowered systolic blood pressure in both types of
rats.
There are several other sources of antioxidant flavonoids. The flavonoids in
tea, for example, appear to work as direct and indirect antioxidants, improving
the resistance of lipoproteins to oxidation and inhibiting atherogenesis.28
Cocoa flavonoids may improve endothelial function, lower blood pressure,
decrease platelet activation and serve as general antioxidants.29 And a review of studies on French maritime pine
bark extract (as Pycnogenol®) noted the extract protects against oxidative
stress, prevents platelet aggregation and reduces LDL cholesterol
levels.30,31
Some newer research is exploring the role of citrus on cardiovascular
function. Citrus contains an array of bioactive compounds, including flavonoids
and limonoids.32 Animal studies have found
supplementation with the bioflavonoid naringin from grapefruit increases
plasma antioxidant capacity and reduces aortic fatty streak areas in animals fed
a high cholesterol diet.33 The citrus flavonoid hesperidin was found in studies
using hypertensive rats to decrease blood pressure and heart rate.34 And tangeretin, a polymethoxylated flavone (PMF)
from tangerine peel, was found in a study from KGK Synergize to modulate
apoB-containing lipoprotein metabolism.35 A
review of research on formulations containing citrus flavonoids including
tangeritin, hesperedin and naringin noted supplementation in the diet appears to
significantly reduce total and LDL cholesterol, with a tendency to further
reduce serum triacylglycerols.36 Citrus
PMFs are the primary ingredient in Sytrinol™, a branded ingredient distributed
by SourceOne Global. The PMFs and tocotrienols work synergistically to improve
cholesterol levels, according to Richard Staack, Ph.D., SourceOne's vice
president of business development. "Sytrinol is a natural solution to the
cholesterol problem that has been clinically proven to help maintain a healthy
heart and encourage normal blood flow in arterial walls," he said.
"Additionally, Sytrinol possesses antioxidant activity that helps inhibit lipid
peroxide production and protects cells from damaging effects of free
radicals."
Another hot source of polyphenols is pomegranate; its flavonoids appear to
protect LDL against oxidation both through direct interaction with lipoprotein
and through accumulation in arterial macrophages.37 Studies further suggest pomegranate juice
supplementation can reduce the size of established atherosclerotic lesions and
decrease the number of foam cells.38 A three-year study conducted in Israel
involving 10 patients taking pomegranate juice daily found administration
resulted in significant reductions in carotid intima-media thickness (IMT) and
serum lipid peroxidation.39
Beyond the water-soluble polyphenols are the fat-soluble carotenoids, another
powerful class of antioxidants. Carotenoids appear particularly adept at
scavenging singlet oxygen and peroxyl radicals generated in the process of lipid
peroxidation.40 The majority of the
attention in the carotenoid area has centered on lycopene, which may work not
only as an antioxidant, but also impact LDL degradation and particle size, as
well as altering endothelial function.41
Data from 725 men participating in the Kuopio Ischaemic Heart Disease Risk
Factor Study found men in the lowest quarter of serum lycopene levels had a
3.3-fold risk of acute coronary events or stroke compared with others,
42 as well as significantly higher IMT of
the carotid artery.43
While there are several dietary sources of antioxidants, there has been some
dispute regarding the benefits of antioxidant supplementation on cardiovascular
risk factors. A systematic review of the effects of antioxidant vitamins in
prevention of CVD found while observational studies showed a link between intake
of antioxidant vitamins in the diet and reduced risk of CVD, randomized
controlled trials have shown no beneficial effects in primary prevention of
myocardial infarction and stroke.44 Another
meta-analysis reviewed seven randomized trials of vitamin E (50 IU/d to 800
IU/d) and found vitamin E did not benefit mortality nor significantly decrease
risk of cardiovascular death.45 However,
recent clinical studies have shown some benefits of vitamin E supplementation.
In two separate human studies, supplemental alpha-tocopherol (one of the eight
isomers of vitamin E) decreased the susceptibility of LDL cholesterol to
oxidation.46,47
Coenzyme Q10 (CoQ10) is another antioxidant compound with multiple roles to
play in the heart health area. In fact, Sears called it "the single most
important supplement to improve heart capacity and reduce the risks of heart
disease." Among the activities he noted were CoQ10's role in improving muscular
energy output, destruction of free radicals, reducing accumulation of oxidized
fat in blood vessels, reducing hypertension and hypercholesterolemia, and
regulating heart rate. Studies have shown CoQ10 has favorable activity on
patients with CHF, including increasing cardiac output and reducing stroke
volume,48 as well as reducing
hypertension.49 Studies have found cosupplementation of CoQ10 with vitamin E
reduces atherosclerosis progression and increases the plasma's resistance to
lipid peroxidation.50
One of CoQ10's most promising applications in the heart health area is
prevention of cardiomyopathy induced by the use of statin drugs. These
pharmaceuticals, widely prescribed to lower cholesterol levels, work by blocking
the same uptake channel used by CoQ10; studies have shown use of statins for as
little as 30 days significantly decreases blood concentrations of
CoQ10.51 Two citizen's petitions to FDA, in
fact, request the agency require statins to carry a recommendation for CoQ10
supplementation to prevent statin-induced cardiomyopathy; as yet, there has been
no response to the most recent request.
Often used concurrently with CoQ10 is L-carnitine, an amino acid that boosts
mitochondrial activity by shuttling fuel into the cells. Carnitine has a
relaxation effect on aortic rings in hypertensive animals, apparently by
mediating endothelial production of nitric oxide,52 and, when used prior to induction of heart attack,
protects heart function and improves recovery.53 Further, L-carnitine administration was found in an
animal study to prevent the progression of atherosclerosis.54 Additional amino acids of interest to cardiac
function are L-arginine, which is critical to nitric oxide production,55 and taurine, which inhibits inflammation.56
A newer product combination uses CoQ10 and enzymes, including proteolytic
proteins and fibrinolytic enzymes. Arthur Andrew Medical offers the product,
Neprinol™, which combines CoQ10 with Serratiopeptidase, which emulsifies
deposits of cholesterol, and Nattokinase, which functions as a blood thinner and
works to dissolve blood clots and arterial plaque. A recent study from Japan
found that nattokinase administration prior to induction of endothelial injury
prevented intimal thickening and development of thrombotic clots.57
"Systemic enzymes have an anti-inflammatory effect by directly consuming the
pro-inflammatory cytokines, which directly addresses the primary cause of heart
disease," said William Wong, Ph.D., N.D. "In addition, the enzymes lyse away at
fibrin, the second cause of heart disease, which causes blood cells to glom
together. The enzymes also eat away at adhesion molecules and reduce platelet
aggregation. Systemic enzymes really open up the blood vessels and have been
used for years in Europe for their ability to treat vascular diseases."
Another type of protein-casein protein hydrolysate (C12 Peptide from DMV
International)-has also been investigated in the CVD arena, specifically for its
ability to reduce hypertension. Researchers from the University of Pennsylvania,
Philadelphia, conducted a placebo-controlled study in 10 hypertensive subjects
to determine whether a single dose of C12 Peptide could reduce daytime blood
pressure.58 Administration of C12 Peptide
resulted in a significant reduction of systolic and diastolic blood pressure at
six hours, suggesting the dairy peptides could reduce hypertension.
Many of the processes associated with hypertension, including arterial wall
thickening and endothelial dysfunction, are influenced by magnesium levels,
which impact vascular tone and cardiac function.59 Deficiencies in magnesium are also associated with
CHF, arrhythmia and myocardial infarction,60 and experimentally induced low
plasma levels of magnesium increase LDL concentrations and changes to more
atherogenic forms.61
"Deficiency of magnesium may reduce relaxation of the heart and predispose
individuals to hypertension," said Kirksey, whose company offers the product
MagCardio, using chelated magnesium from Albion Advanced Nutrition.
"Sufficient delivery of a good, bioavailable magnesium for persons with cardiac
conditions may be lifesaving."
While several nutrients impact endothelial function, increased levels of the
amino acid homocysteine have been connected to venous dysfunction and an
increased risk of CVD. The B vitamin folic acid is seen as one of the best
compounds for lowering levels of homocysteine. Population studies have shown
patients with lower folate intakes have a higher risk of CVD; for example, a
Spanish study in 171 patients with myocardial infarction and 171 control
patients found participants in the lowest quartile of folate intake had twice
the risk of heart attack.62 Additional
studies have shown a higher intake of folate significantly reduced the risk of
peripheral arterial disease63 and the risk
of ischemic stroke.64
Folate may also affect blood pressure. A recent study published in the
Journal of the American Medical Association found younger women who
consumed at least 1,000 mcg/d of total folate (through food and
supplements)-two and a half times the recommended daily intake-had a
46-percent decreased risk of hypertension compared to younger women consuming
less than 200 mcg/d; in older women, higher folate intake reduced the risk
of hypertension by 18 percent.65
Another critical B vitamin is niacin, which is primarily used for its ability
to increase levels of beneficial HDL cholesterol. It was used for treatment of
dyslipidemia as early as the 1950s for its favorable impact on HDL levels, and
studies have shown it raises HDL levels while increasing LDL size to less
atherogenic large LDL subclasses.66 Its
ability to increase HDL has led researchers to investigate concomitant use of
niacin with statin drugs, prescribed for hypercholesterolemia. A double blind,
placebo-controlled trial at the Walter Reed Army Medical Center in Washington,
D.C., found the addition of 1,000 mg/d of extended-release niacin significantly
reduced the rate of IMT progression in CHD patients taking statins.67 Another U.S. study found the combination of 40 mg/d
lovastatin and 2,000 mg/d extended-release niacin significantly reduced LDL and
triglyceride levels while significantly increasing HDL.68
On the botanical side, the herb garlic (Allium sativum) has a storied
history of therapeutic use in heart health, possibly through antioxidant
activity.69 In vitro work has focused on
garlic's sulfur compounds, including diallyl sulfide, S-ethylcysteine and
N-acetylcysteine, for their ability to inhibit superoxide production and protect
LDL from oxidation.70 Enteric coated fresh
garlic, such as Enzymatic Therapy's Garlinase 4000, is designed to keep the
different allicin precursors separate until they reach the intestines. "In
cooking, this is what happens when garlic is crushed," explained Cheryl Myers,
director of health sciences with Enzymatic Therapy. "In our product, it happens
when the internal wall melts away and the substances mix."
Instead of keeping the components separate, aged garlic extract instead is
produced to stabilize sensitive organosulfur compounds such as
allicin.71 A placebo controlled study at
Harbor-UCLA Medical Center Research and Education Institute in Torrance, Calif.,
investigated whether aged garlic extract could slow the rate of atherosclerosis
progression in 23 subjects, and found supplementation improved the total
cholesterol-to-HDL ratio and lowered homocysteine levels.72
The botanical hawthorn (Crataegus oxyacantha L.) has been found
beneficial for decreasing the pressure-heart rate and improving exercise
tolerance, particularly in patients with CHF.73 Short-term studies have also shown hawthorn may
reduce systolic and diastolic blood pressure,74 and lower total cholesterol in animals fed a high
cholesterol diet.75
The Western world is not the only source for beneficial compounds. "Plants
containing nutrients for the heart and arteries were discovered thousands of
years ago and practiced in ancient Chinese and Ayurvedic medicine," said Grace
Ormstein, M.D., medical director with Himalaya USA. "Today, this information is
used to manufacture pure herbs and herbal formulations for the treatment and
prevention of many health care concerns."
One such Ayurvedic offering is guggul, made from the resin of the
Commiphora mukul tree, which has been used for more than 2,000 years and
appears to decrease cholesterol levels. Based on clinical studies, the Indian
Pharmacopeia included a standardized preparation of guggul for treatment of
dyslipidemia type IIb and IV. The preparation has since been investigated in the
United States by Sabinsa Corp. (which supplies the preparation as Gugulipid®).
Data submitted to the FDA on a short-term safety and efficacy study showed 150
mg/d of guggulsterones may have an effect on dyslipidemia as well as other
systemic effects.
Nature's Formulary is a supplier of Ayurvedic dietary supplements, including
guggul, which company President P.K. Dave suggests has broader heart function
than currently known. "Some studies have shown that guggul interferes with the
mechanism that produces cholesterol by being an antagonist to the receptor
chemicals that are needed by the body to synthesize cholesterol," he said.
"Guggul is also believed to stimulate the thyroid, an organ that plays an
important role in metabolizing fat."
Arjuna (Terminalia arjuna), another Indian botanical, appears to
benefit heart function. A study in rats found administration of arjuna extract
prior to induction of heart damage increased levels of antioxidant defense
systems and improved recovery.76 In a human
trial, 500 mg of arjuna extract every eight hours significantly improved
flow-mediated dilation in smokers, possibly improving endothelial
function.77
Ormstein noted together with arjuna and guggul, Ayurvedic medicine offers
other beneficial products. "Billilotan is a known heart tonic and supports
healthy blood pressure," she added. "While Ashwagandha, an adaptogenic, has
anti-stress properties that help the body maintain physical effort." Himalaya
combines these ingredients in its HeartCare® product, which has been studied for
its benefits to cardiovascular health. An eight-week study in 50 patients who
took a placebo or two capsules of HeartCare twice daily found those taking
HeartCare showed reductions in cholesterol, triglycerides, LDL and
VLDL.78
Keeping Consumers' Interests at Heart
The increasing number of Americans hoping to avoid cardiovascular
complications or help treat existing conditions creates an opportunity for
retailers of dietary supplements. However, with so many new ingredients and
formulas, the claims and purported benefits can be overwhelming. Most
manufacturers advise retailers to carefully review the research and ask
questions to stock efficacious products for interested shoppers.
"Retailers should recognize that many of the heart health supplements being
sold today have failed to consistently deliver on claims," Staack said. "It is
vitally important that independent science continue to distinguish those
compounds that work from those that do not consistently deliver the results they
claim to provide."
Ormstein also encouraged retailers to ask questions about the scientific
substantiation behind product claims, as well as manufacturing quality.
"Retailers should know how long a manufacturer has been in business and the
history of its product lines," she said. "Does the company have control over all
aspects of production? Does it follow GMPs, conduct primary research on its
products and employ quality control techniques to ensure consistency? The more
knowledgeable retailers become, the more comfortable they will be with making
better choices regarding supplements and contributing to their customers'
health."
Most manufacturers also suggested offering a range of well-researched
products, including combination formulas to address overall cardiac function, as
well as specific options for cholesterol control, hypertension and homocysteine
reduction. "Retailers should have a variety of products to improve heart health
available in inventory with supportive educational materials on these natural
treatments," Sears said. "Sales associates should be well trained and well
informed about supplements but should resist the urge to prescribe solutions.
They should inform, but be respectful and respond to customers' requests."
Therefore, it falls to retailers to get educated and pass on the relevant
information. "Informing and educating the customer is the big hurdle, not the
lack of product offerings," Collett said. "Retailers need to inform their
customers and encourage young men and women to make healthy choices a consistent
and ongoing part of their lifestyles so that their risk of cardiovascular
disease is minimized."
To take the exam for this course, please make sure you have the course in
your nutrilearn.com profile. If you need to add the course to your profile
click
here and complete the checkout process.
If you already have the course in your profile and are ready to take the
test, click here or visit your profile once you are logged in to the nutrilearn
system. Note: To access
the available courses in your profile, click on the "courses" link at the top of
the page once you are logged in.
