Key result
Lipid-lowering therapy use is linked to ~5.4-fold higher heart supplement use vs untreated controls.
Why the study?
The 2026 AHA/ACC dyslipidemia guideline advises against supplements for lipid lowering, and it remained uncertain whether supplement use reflects broader engagement in cardiovascular prevention, including healthy eating.
Does self-reported heart health or cholesterol supplement use and dietary misalignment burden vary across lipid-lowering therapy treatment and eligibility groups in US adults?
Cross-Sectional (n=3,743)
Does self-reported heart health or cholesterol supplement use and dietary misalignment burden vary across lipid-lowering therapy treatment and eligibility groups in US adults?
Answers are grounded in this paper and cite their sources.
Millions of untreated US adults who are guideline-eligible for lipid-lowering therapy use non-recommended heart health or cholesterol supplements while maintaining poor dietary quality, highlighting an opportunity to redirect counseling toward evidence-based LLT and nutrition.
Background: The 2026 American Heart Association/ American College of Cardiology (AHA/ACC) dyslipidemia guideline advises against supplements for lipid lowering. Whether supplement use reflects broader engagement in cardiovascular prevention, including healthy eating, remains uncertain. We examined supplement use and selected dietary characteristics across lipid-lowering therapy (LLT) treatment and eligibility groups. Methods: We conducted a cross-sectional analysis of National Health and Nutrition Examination Survey data (2015-2020) from adults aged 30-75 years. Participants were classified as current LLT users or untreated adults. Untreated adults were further classified as recommended, reasonable/selectively consider, or not routinely recommended for LLT, using the 2026 AHA/ACC guideline. Outcomes were self-reported heart health or cholesterol supplement use and dietary misalignment burden, defined as the number of unmet benchmarks across nine selected recall-day indicators informed by 2026 AHA dietary guidance. Analyses incorporated the complex survey design and fasting subsample weights to generate national estimates and compare supplement use across burden categories. Results: We analyzed 3,743 participants, representing 147.3 million US adults; 49.0% were female, and 25.0% were receiving LLT. Overall, 11.3% [9.4-13.6] reported supplement use. Supplement use was highest among adults receiving LLT (19.5% [14.9-25.1]) and lowest among untreated adults for whom LLT was not routinely recommended (3.6% [2.6-5.1]). Among untreated adults for whom LLT was recommended, 4.2 million (12.8% [10.5-15.4]) used supplements. Dietary inadequacies were common across measured domains and LLT eligibility strata; the weighted median misalignment burden was 7 (IQR 6-8). Supplement use did not differ significantly across dietary misalignment burden categories. Conclusions: Millions of US adults recommended for LLT were untreated while using heart health or cholesterol supplements, and supplement use did not differ significantly across selected dietary misalignment burden categories. Proactive assessment of supplement use may help redirect prevention counseling toward guideline-directed LLT and heart-healthy dietary patterns.
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Mangalesh et al. (2026) conducted a cross-sectional in Eligibility and use of lipid-lowering therapy (LLT) and dyslipidemia prevention (n=3,743). Lipid-lowering therapy (LLT) use or guideline-based LLT recommendation status vs. Untreated adults for whom LLT is not routinely recommended was evaluated on Self-reported heart health or cholesterol supplement use and dietary misalignment burden (unmet benchmarks across nine selected recall-day indicators informed by 2026 AHA dietary guidance). Lipid-lowering therapy users had the highest heart health/cholesterol supplement use (19.5% vs 3.6% in untreated non-recommended adults), while 12.8% of untreated LLT-recommended adults used them.
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