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Nutrient supplementation no substitute for healthy diets

The VITAL trial showed that neither vitamin D nor fish oil supplementation significantly reduced the incidence of cardiovascular disease (CVD). Conversely, current evidence supports the benefits of multiple dietary patterns, especially the Mediterranean diet, in primary prevention of CVD. Health effects of low-carbohydrate diets depend on the food sources of macronutrients.

Key advances

  • The VITAL trial demonstrated that fish oil or vitamin D3 supplements are unlikely to have a significant benefit on primary prevention of cardiovascular disease (CVD) or cancer1,2.

  • The re-analysis of the PREDIMED trial reaffirmed the benefits of the Mediterranean diet in primary prevention of CVD3.

  • A meta-analysis of observational cohort studies suggests that both low carbohydrate consumption (<40% of calories) and high carbohydrate consumption (>70% of calories) are associated with increased mortality compared with moderate carbohydrate consumption9.

  • The debate on the efficacy and effectiveness of low-fat or low-carbohydrate diets in cardiovascular disease prevention is largely moot unless the food sources of fats or carbohydrates are clearly defined8,9.

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F.B.H. is supported by grants HL60712, HL118264 and DK112940 from the NIH.

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Correspondence to Frank B. Hu.

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Competing interests

F.B.H. declares receiving research support from the California Walnut Commission and honoraria for lectures from Metagenics and Standard Process and honoraria from Diet Quality Photo Navigation, unrelated to this article.

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Hu, F.B. Nutrient supplementation no substitute for healthy diets. Nat Rev Cardiol 16, 77–79 (2019).

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