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Heart on the Line


As cardiovascular disease remains the leading cause of death in the U.S., suppliers and manufacturers seek heart health ingredients that address prevention and even damage reversal.

Non-GMO Project

According to the Centers for Disease Control and Prevention (CDC), cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States and approximately 600,000 Americans die of heart disease each year. Further, The Heart Foundation noted that not only do more people die of heart disease than of AIDS and all cancers combined, but by the year 2020, heart disease will be the leading cause of death throughout the world.

These figures can startle just about anyone into paying attention to the health of their heart. Couple that with the fact that Americans are now taking the time to educate themselves on healthy lifestyles, and that many are also becoming increasingly unhappy with the side effects that prescription drugs have—the heart health segment of the natural health category is expanding. “The life extension category, in general, is growing every day, as awareness of utilizing supplements instead of drugs become a more popular choice among the educated consumer,” said Pete Maletto, president and senior scientist of PTM Food Consulting, Inc. in New Jersey. “New ingredients, such as citrus bergamot, not only perform better to change cholesterol levels than statin drugs, they often do so with no side effects. While support nutrients are helpful, the response to this relatively new dietary supplement is nothing short of amazing.”

Inflammation Nation

According to the American Heart Association, inflammation is common for heart disease and stroke patients, and is said to be a sign on atherogenic response. George Tardik, ND, key research contributor for Pennsylvania-based Pharmax added that inflammation is involved with atherosclerosis from inception to development of thrombotic complications. “There are multiple mechanisms. On a macroscopic level, poor diet high in certain fats, smoking, obesity, insulin resistance and hypertension are at the core of the process,” he explained. “One well-established effect of inflammation is on endothelial cells that form the innermost surface of the artery wall. Normally the artery wall resists adhesion by leukocytes. However, consuming a high-saturated-fat diet, smoking, hypertension, hyperglycemia, obesity, or insulin resistance, can initiate the expression of adhesion molecules by endothelial cells facilitates the attachment of leukocytes to the arterial wall.”

In addition, chronic inflammation is a large contributor to developing chronic diseases, which have become the health challenge of the 21st century. Chronic disease can lead to health issues such as diabetes and cardiovascular disease. Further, The National Heart, Lung and Blood Institute and American Heart Association have identified metabolic syndrome as “a multiplex risk factor for cardiovascular disease that is deserving of more clinical attention.”1

“The link between inflammation and heart health has a name; it is called the metabolic syndrome (MetS). MetS is a cluster of cardiometabolic risk factors that are most often found together in one individual,” explained Pierre Lemieux, COO of Acasti Pharma, a subsidiary of Neptune Technologies & Bioressources (Laval, QC, Canada). “Based on the NCEP-ATPIII (U.S.) set of criteria, people can be diagnosed for the MetS when at least three out of the five following criteria are met: high triglycerides, abdominal obesity, low HDL-C, high blood pressure and abnormal fasting glucose. The MetS is recognized, beyond traditional factors, such as bad cholesterol, as a metabolic condition that put people at increased risk for heart disease and type 2 diabetes. It is estimated that more than 50 million Americans (around one out of three) suffer from the MetS.”

Heart Healthy Ingredients

Some of the long-standing natural ingredients for heart health include omega-3 fatty acids, CoQ10, vitamin K2, among others. Research has also found that ingredients such as astaxanthin, olive oil and citrus bergamot also benefit the heart. Further, there are a number of aspects of cardiovascular health, in which different ingredients may be beneficial. PTM Food Consulting’s Maletto noted that depending on the issue of focus, each individual requires careful consideration and what supplementation strategy could be used for the specific area of cardiovascular concern. “Each ingredient has its own strengths and weaknesses related to the condition that affects the other,” he said. “For instance, if a blood pressure related issue is a concern, then using nitric oxide inducing amino acids, such as agmatine, citrulline and arginine, with high dose potassium and magnesium tend to work wonders for reducing blood pressure. If the area of concern is circulation, than high dose omega-3 fatty acids, nattokinase, turmeric, bromelain and garlic work well to keep blood platelets from sticking together and thereby increasing healthy circulation. And if the issue is cholesterol related then the combination of citrus bergamot, panthehine and slow release niacin yields results nothing but short of incredible.”


According to the American Heart Association, omega-3s, especially EPA and DHA are heart healthy nutrients that help the heart function optimally. Further, research has shown that omega-3 can help lower blood pressure and triglycerides, as well as reduce the risk for both coronary heart disease and sudden cardiac death.

In fact, according to a study that was published in 2013 in The FASEB Journal showed that naturally derived compounds from polyunsaturated fatty acids (omega-3s) may reduce the inflammation associated with these procedures to help arteries more fully and completely heal from procedures like angioplasty, stenting and bypass surgery. And according to a 2014 study published in the journal Advances in Nutrition, researchers found that increasing the amount of omega-3s in a person’s diet will likely decrease the risk of getting heart disease.

Neptune introduced Neptune Krill Oil (NKO) in 2003, and according to Lemieux, the company published one of its first studies on cardiovascular health in 2004, comparing NKO to fish oil and a placebo. NKO was proven significantly better than fish oil to support normal cholesterol levels at a low daily dose of 1-1.5 g per day. And in 2014, Neptune launched condition-specific formulations, including NKO Beat for heart and circulation health, which offers a wider management of cardiovascular health. “NKO Beat features all the proven heart health benefits of NKO, plus coenzyme Q10 (CoQ10),” Lemieux said. “When combined with NKO, a clinical trial showed the antioxidant CoQ10 levels are greatly increased—demonstrating up to 25 times better absorption as compared to a generic USP CoQ10.”

Aker BioMarine Antartic US offers Superba Krill, which is a pure, natural source of phospholipids, the omega-3 fatty acids EPA and DHA and the naturally occurring antioxidant astaxanthin, according to the company. “Superba Krill is backed by a growing evidence base. In fact, the majority of clinical trials conducted on krill during the last several years have featured Superba Krill,” said Becky Wright, marketing director for the Washington-based company. “A study published in the February edition of Nutrition Research, researchers investigated Superba Krill’s ability to lower triglycerides without raising LDL, the ‘bad’ cholesterol (which has been the case in some fish oil trials) in those who have borderline high or high triglyceride levels. Three hundred subjects participated in this randomized, double-blind, placebo-controlled, multi-center U.S. study. The five treatment groups included a placebo group (olive oil), as well as four groups taking 0.5, 1, 2 and 4 grams of krill oil daily.”

Vitamin K2

Vitamin K2 is not only beneficial for bone health, but greatly benefits cardiovascular health as well. In fact, a number of studies have found the benefit of vitamin K2 for cardiac health, including decreasing calcification and reducing the risk of death from heart disease. For instance, according to 2006 study in which 16,000 people were followed for 10 years, researchers found that found that each additional 10 mcg of K2 in the diet results in 9 percent fewer cardiac events.

New Jersey-based NattoPharma USA, Inc. offers MenaQ7 Vitamin K2 as MK-7 (menaquinone-7), which not only offers bone health benefits, but vitamin K2 offers cardiovascular benefits as well, particularly as vitamin K2 activates the matrix gla protein (MGP), the most potent inhibitor of vascular calcification.

“Our newest innovation is MenaQ7 PURE, an all-trans, nature-identical synthetic vitamin K2 menaquinone 7 (MK-7) that contains no cis-isomers,” said Eric Anderson, NattoPharma’s global vice president of marketing. “A patent-pending synthesis process produces an unprecedentedly pure vitamin K2 molecule that provides a much more desirable outcome for stability, efficacy, and safety, resulting in a greater than 98 percent purity of active product. It is produced exclusively by NattoPharma in a pharma cGMP (current good manufacturing practice) facility on a dedicated line. PURE may be used directly in dietary supplements, premixes and in food, and is also naturally stable in omega-3 EFA products. “What is important to understand is that MenaQ7 PURE is not a racemic form of vitamin K2 as MK-7, he continued. “’Racemic’ means a product contains a mixture of both cis- and trans-isomers. Research has established the efficacy of the trans-form of menaquinione-7 isomers, while the cis-isomers benefit and activity in the body is unknown. And MenaQ7 PURE is the only nature-identical MK-7.”


Astaxanthin is a powerful antioxidant, and research has shown that it benefits the heart—specifically cholesterol levels. In a study published in 2010 in the journal Atherosclerosis, researchers found that 12 and 18 mg per day of astaxanthin reduced triglyceride levels, while 6 and 12 mg doses increased HDL-cholesterol (good cholesterol). According to Janice Brown, technical sales/support for New Jersey-based AstaReal, Inc., astaxanthin is superior to many other antioxidants because of the unique role it may play in protecting the cell membrane due to its unique chemical structure and corresponding orientation within the living cell. “Its unique chemical structure is comprised of polar ends which are held together by lipid soluble double bonds,” she said. “This allows astaxanthin to span the cellular membrane protecting both the inside and the outside of the cell, giving overall better antioxidant protection.”

Brown noted that AstaReal natural astaxanthin has been the company’s most successful heart health ingredient. “In the near future we expect to see astaxanthin positioned as one of the ‘go to’ heart health ingredients that consumers reach for without hesitation,” she said. “AstaREAL astaxanthin is the most researched natural astaxanthin on the market today and one of our major areas of focus is improving cardiovascular health.”

Olive Oil

According to a 2013 study published in the New England Journal of Medicine, consuming more than four tablespoons a day can significantly lower your risk of having a heart attack, suffering from a stroke or dying of heart disease. “One of the most dramatic developments that has occurred in the area of heart health in recent years was the 2013 PREDIMED Study that was published in the New England Journal of Medicine on the heart healthy benefits of what has come to be known as the Mediterranean Diet,” said Barbara Davis, PhD, RD, director of medical and scientific affairs for New Jersey-based PLT Health Solutions, Inc. “This study showed a relative risk reduction of approximately 30 percent among high-risk persons who were initially free of cardiovascular disease. As a result, interest in The Mediterranean Diet—and some of its primary elements—exploded into consumer consciousness. This has been particularly true of olive oil.”

PLT Health Solutions offers Hytolive Olive Fruit Polyphenol into the heart health space. Hytolive is a 100 percent natural, patented ingredient. It is a solvent-free extraction of olive polyphenols from the by-product water of olive oil production—the primary constituent of which is hydroxytyrosol. The recommended addition rate of Hytolive of 100 milligrams to foods, beverages and supplements contains hydroxytyrosol equivalent to 10 olives or a half liter of extra virgin olive oil, the company stated.

According to Davis, one of the most interesting compounds in olive oil for researchers is hydroxytyrosol. “Hydroxytyrosol is a polar, phenolic phytochemical found in olive fruit, olive leaf and olive oil, as well as by-products of olive processing,” she explained. “Along with tyrosol and their conjugates, it represents the main phenolic compounds in olive oil (50 percent). Hydroxytyrosol has a simple structure, the highest bioavailability and ORAC of the olive oil.

Further, Davis noted that in 2012, the European Food Safety Authority (EFSA) approved a heart health claim for olive oil based on its content of hydroxytyrosol, concluding that “a cause and effect relationship has been established between the consumption of olive oil polyphenols (standardized by the content of hydroxytyrosol and its derivatives) and protection of LDL particles from oxidative damage.”

Standing Out

In a sea of ingredients and heart health products, ingredient suppliers and manufacturers are looking for ways to set themselves apart from the rest of the pack. According to NattoPharma’s Anderson, specificity and brevity are key for successful marketing communications. “Your supplier(s) should be partners in your efforts to concisely communicate the benefits your product delivers due to their ingredient’s inclusion,” he said. “Consumers interested in advanced information should be directed to the supplier’s web presence to learn more. And if your supplier has significant educational materials available, it is recommended to tie into them and keep the key messaging intact; straying from this may cause confusion.

“In the case of formulas with several ingredients blended together—again, keep the supplier’s key claims intact in your labeling and promotional campaigns,” Anderson concluded. “When working with quality suppliers that have invested in research, there is no reason to re-invent the wheel.” NIE


1 Circulation. 2004; 109:433-438.

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