Value of dietary changes for heart health – questioned

This month an astounding report was published in the Annals of Internal Medicine claiming little if any reduction in heart disease outcomes is obtained through Nutritional Supplements and Dietary Interventions. Unfortunately for me, I know too much to let this claim stand without a rebuttal.

The study published July 9, 2019

This study[1] was aimed at finding the true effects of nutritional supplements or dietary interventions on all causes of death or heart disease outcomes such as heart attack death, heart attack, stroke, and heart artery disease. These study authors looked only at randomized controlled trials (RCTs) and their meta-analyses—which indeed are the most powerful data to draw from, but misses a lot of data that should still be considered. While there are 14 investigators named in the study title, only two independent investigators abstracted data, assessed the quality of evidence, and rated the certainty of evidence. In all, 992,129 participants were included. The problem is that who knows what bias they had while selecting data and analyzing its quality?

The authors begin by stating, “The role of nutritional supplements and dietary interventions in preventing mortality (death) and cardiovascular disease outcomes is unclear.” Really? OK, then now they are going to build upon that false premise.

Their findings were that “Reduced salt intake (in people without high blood pressure), omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) use, and folate supplementation could reduce risk for some cardiovascular outcomes in adults” and that “Combined calcium plus vitamin D might increase risk for stroke.” Then they accurately state, “Oth