Functional medicine looks to research for support of its protocol and therapeutics. Much of this accumulated wisdom requires piecing together data and finding from multiple different studies, then applying them to real world situations. Occasionally, that work is made easier by meta-analyses which combine multiple studies, or consensus groups that attempt to systematically bring all the data on a topic together. The American College of Cardiology (ACC) has done a great service in advancing the use of supplements and nutrients in the care of cardiometabolic patients with a recent project.
Debate has raged for years whether different nutrients like omega 3 and vitamin D and others had real benefits for those with high blood pressure, heart disease, stroke risk, or diabetes. As with most medical questions like these, different studies can give different results depending on study design, which group of patients they considered, and how one analyzes the data. Some in conventional medicine chose to avoid their use altogether due to the inconclusiveness. Those of us in functional medicine did our best to apply what seemed clear to our patients with such health challenges.
Now, we can give a hearty thanks to the ACC for reviewing 884 randomized controlled studies covering almost 900 thousand patients over an average of 5 to 6 years. The effort and time required for this had to be impressive. From this voluminous research, they found a number of therapies which showed varying degrees of benefit for different cardiometabolic conditions. They listed omega 3’s, folates, and CoQ10 as the most beneficial. They also listed arginine, Vitamin D, magnesium, alpha lipoic acid, melatonin, catechin, curcumin, omega 6, quercetin, genistein, and flavanol as moderately beneficial. On the other hand, they did not find cardiovascular benefit for vitamin C, Vitamin D, and vitamin E. Beta carotene supplementation seemed to increase all-cause mortality (death rate).
While the full study requires institutional access, the link in the references does include a summary table which lists which supplements benefitted which condition. High points include:
- Omega 3’s benefited HDL and triglycerides while lowering heart disease mortality and heart attacks.
- Arginine, an amino acid, lowered blood pressure, and fasting glucose.
- Folic acid (synthetic folate) lowered systolic and diastolic blood pressure, total cholesterol and LDL, and fasting blood sugar while lowering the risk of stroke but not heart attacks.
- Magnesium lowered blood pressure and raised HDL (good cholesterol)
- Zinc lowered total cholesterol, A1c and fasting glucose levels.
- Alpha lipoic acid lowered blood pressure.
- Co Q10 lowered systolic blood pressure, triglycerides, and A1c.
- Catechins and curcumin lowered A1c and fasting glucose.
- Flavanol, genistein, quercetin, and resveratrol all lowered some aspect of blood pressure.
- Anthocyanin, catechin, curcumin, and genistein all lowered blood sugars.
The full extents of those effects are buried in the paper, but even at quick glance you can see that nutrients offer a number of benefits in the case of cardiometabolic disease. Those of us practicing functional medicine can stand on these results when challenged by conventional medicine. We can also look forward to similar work regarding other herbal therapies which we currently use based on various individual studies. Leading our patient to healthier more abundant lives requires looking to this research and finding ways to contribute our own work to the debate. If functional and conventional medicine can cooperate through research, the hope for reaching more and more patients in need can be realized.
Peng An, Sitong Wan, Yongting Luo, Junjie Luo, Xu Zhang, Shuaishuai Zhou, Teng Xu, Jingjing He, Jeffrey I. Mechanick, Wen-Chih Wu, Fazheng Ren, Simin Liu. Micronutrient Supplementation to Reduce Cardiovascular Risk. Journal of the American College of Cardiology, 2022; 80 (24): 2269 DOI: 10.1016/j.jacc.2022.09.048
Thanks to Science Daily:
American College of Cardiology. (2022, December 5). Not all micronutrients created equal: Study identifies some supplements that benefit cardiovascular health: A meta-analysis of more than 884 studies finds omega-3, folic acid and CoQ10 among the micronutrients that reduce risk. ScienceDaily. Retrieved December 6, 2022 from www.sciencedaily.com/releases/2022/12/221205153730.htm
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.