February 23, 2005
Part 1
Part 2
Part 3
Part 4 --

Locust Bean Gum

Am J Clin Nutr  1983 Aug;38(2):285-94

The hypolipidemic effect of locust bean gum food products in familial hypercholesterolemic adults and children.

Zavoral JH, Hannan P, Fields DJ, Hanson MN, Frantz ID, Kuba K, Elmer P, Jacobs DR Jr.

Seventeen adults and 11 children, a group of 18 familial hypercholesterolemic (FHC) and 10 normal subjects, were fed products with and without locust bean gum (LBG) (8 to 30 g/day) to assess the hypolipidemic effect of LBG. Identical food products with and without LBG were consumed by two groups (A and B) of arbitrarily assigned patients using a cross-over design. Plasma cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and triglycerides were measured at 2-wk intervals and compared to control feeding periods. In group A, FHC C decreased 10% and LDL-C 11%, normal subjects decreased C 6% and LDL-C 10% (p less than 0.001). In group B, FHC C decreased 17% and LDL-C 19%, normal subjects decreased cholesterol 11%, and LDL-C 6% (p less than 0.001). Cholesterol and LDL-C were lowered in FHC children in both groups. High-density lipoprotein/LDL ratios increased in both groups. The use of food products with LBG in children and adults is a unique approach to treating FHC. LBG food acceptance was good, and there were no significant side effects. LBG in food products appears to be an effective, safe approach to controlling hyperlipidemia.

PMID: 6308996 [PubMed - indexed for MEDLINE]

Magnesium

Niacin

Niacin is prescribed by some cardiologists for cholesterol reduction.  Because of potential side effects from the doses commonly used for this purpose, anyone considering niacin for cholesterol control should be under the care of a physician who can monitor its effects.  There is considerable literature on niacin.  The first entry below is a recent reference.  The second entry is a book by niacin’s chief promoter, Dr. William B. Parsons Jr.  Readers will note that the book is in the strong style of advocacy literature.  Dr. Parsons emphasizes the importance of taking niacin only under a physician’s care.

NIACIN MORE EFFECTIVE THAN GEMFIBROZIL IN RAISING HDL CHOLESTEROL

In patients with high-density lipoprotein cholesterol (HDL-C) at or below 40 mg/dL, extended-release niacin (Niaspan) raised HDL-C by up to 26%, twice as much as the increase seen with gemfibrozil administration.

http://cardiology.medscape.com/21327.rhtml

William B. Parsons Jr., MD, Cholesterol Control Without Diet! : The Niacin Solution,

Amazon.com price: $13.97.  You Save: $5.98 (30%) Hardcover - (October 1998) 231 pages

William B. Parsons, Jr., M.D. <lilacp@cholesterolnodiet.com> , November 29, 1998

Here is the introduction to the book (abridged):

CHOLESTEROL CONTROL WITHOUT DIET!  THE NIACIN SOLUTION

INTRODUCTION

Everyone likes good news. This good news should make everyone happy: YOU DON'T HAVE TO DIET TO CONTROL CHOLESTEROL!

Right! When you hear "cholesterol," you may automatically think "diet."  That's because you have been brainwashed over the years by diet advocates and the food industry.  The media has played a major role in brainwashing the public, but they haven't known any better -- until now.  This book should serve as a wake-up call for the media and the public.

You do not have to diet to control cholesterol -- if your doctor is good at niacin.  Niacin, a drug whose use for cholesterol control I pioneered in the United States (1955) and introduced to the medical world (1956), does everything right to achieve today's goals of cholesterol control.  It does so while you eat as you please!

At best, diet is a weak and often ineffective method of altering blood cholesterol levels.  Drugs accomplish this purpose better, and niacin is unquestionably the best drug currently available.  No other drug has all of its benefits.

If niacin treatment for cholesterol goes back more than forty years, why haven't we heard more about it?  The most important reason is that niacin has never been patentable, so no company can make large profits from its exclusive sale.

Why is niacin better than the other drugs?  It reduces blood levels of "bad" cholesterol.  Because bad cholesterol is the largest fraction, this reduces total cholesterol as well.  Niacin also increases "good" cholesterol. It reduces triglycerides, if they are part of the problem.  No other drug does all of these things, which reduce heart attack risk.

What is the end result of these niacin-induced changes in blood cholesterol values?  In a landmark study, the Coronary Drug Project (CDP), performed from 1966 to 1974, niacin reduced heart attacks, strokes and related events, cardiovascular (heart and blood vessel) surgery, cardiovascular hospitalization, all hospitalization, and deaths.  Because of a1l these distinctive advantages, niacin stands alone as the drug of choice.  The term "designer drug" is appropriate for niacin.  If one lists all the desirable characteristics for a cholesterol-control drug, niacin accomplishes every goal on the "wish list."  No other drug comes close.

Could there possibly be even more good news?  Yes, there is.  The usual cost of niacin, whether plain or time-release, is about eight to ten dollars a month.  The cost of other drugs is $48 to over $200 monthly.  For a year in one patient: $96 to $120 for niacin, about $600 to $1200 for other agents.

Niacin is available over-the-counter, without prescription.  Some might conclude the proper thing to do is to buy niacin and start taking it -- right?  Absolutely not!  Here is the most important message of this book:  Niacin is not a do it-yourself drug.  It requires knowledgeable medical supervision.  You need a doctor in charge who is adept in its use -- good at niacin.

How can one be sure his doctor is good at niacin?  Give the doctor a copy of this book.  It contains not only the essentials both physician and patient need to know but also a section of medical reports and commentary, bringing the doctor more detailed information which will give him the confidence to use niacin successfully.

The book is written in the same plain words that I use in my office when talking to patients.  To doctors, I offer no apology for using nonmedical, understandable language.  They might even enjoy reading about these matters without the stilted style of medical journals.  I hope physicians will use this book as a starting point to bring their patients a better understanding of cholesterol problems.

I would like every person to live as one who has never had a heart attack rather than living as a heart attack survivor.  There is a world of difference!  For any of you who have already survived heart attacks, strokes, or blood vessel surgery, the book teaches special guidelines for you, aimed at making some cholesterol deposits regress (become smaller) while slowing the formation of new deposits.

Since I brought the use of niacin for cholesterol control to the attention of the medical world more than forty years ago, it has been used increasingly in recent years.  You can bring the message about niacin's use to your doctor and to your family and friends as well.  Doctors can bring the good news to their patients and have probably 90% or more of those with cholesterol problems taking niacin successfully.  We can all be part of a gradual but revolutionary change in cholesterol management and heart attack prevention.

I invite members of the media to read the simple truths and logic of Cholesterol Control Without Diet and report them, undismayed by the howls and screams of dietary advocates and niacin detractors.  You can do a great service to untold numbers of persons who, without your work, might not learn these lessons. For some, this could mean the difference between life and death, or between living as a person without a previous heart attack rather than as a heart attack survivor.  You yourself or some one close to you could be one of those beneficiaries.

To everyone: know what your bad and good cholesterol fractions are and realize that if they are both in the proper ranges, total cholesterol is really irrelevant.  If either or both (bad and good cholesterol fractions) should not be in desirable ranges, work out a treatment program with your doctor, as outlined in this book.  If your bad and good cholesterol fractions are now in desirable ranges without treatment, resolve to recheck them in three years.  Then go on living a normal life and enjoy every day!  As I have said in another place and time: "Perhaps we can get back to basics: eat food because it tastes good, exercise because it feels good, control weight because it looks good, and be happy, because life should be enjoyed, one day at a time."

The publisher, Victoria Hart, Marketing Associate <lilacp@cholesterolnodiet.com> , January 1, 1999

Paul Harvey liked the book!  On his radio newscasts of October 12, Paul Harvey commented: "Medical-nutritional: A new book is called CHOLESTEROL CONTROL WITHOUT DIET!  It's the story of niacin.  The author, Dr. William Parsons, pioneered 43 years ago while on the faculty of Mayo's, discovering that niacin at $9 a month was as effective as drugs costing hundreds of dollars a month."

Oat Fiber Source

Gene A. Spiller, John W. Farquhar, Joan E. Gates, and Stephen F. Nichols, “Guar gum and plasma cholesterol; effect of guar gum and an oat fiber source on plasma lipoproteins and cholesterol in hypercholesterolemic adults, Arteriosclerosis and Thrombosis 11(5) September-October 1991, 1204-1208.

77 g/day of oat fiber source taken with water at mealtimes for three weeks reduced total plasma cholesterol 9 mg/dl from 244 mg/dl, and reduced low density lipoprotein cholesterol by 11 mg/dl.  Effects on high density lipoprotein cholesterol and very low density lipoprotein cholesterol were insignificant.  The active ingredient is probably ß-glucan, accompanied by pectin and digestible macronutrients.

SOURCE: Honeyville Grains, Rancho Cucamonga, CA.

Olive Oil —

Olive Oil and Cholesterol

OLIVE OIL

Author(s): Tom Gardiner, www.glycoscience.com

SYNONYMS: Oleum olivae, Lucca

SOURCE: oil from ripe olives, fruit of Olea europaea ; produced mainly in countries adjoining the Mediterranean Sea 1

Olive oil contains principally mixed glycerides of oleic, palmitic, linoleic, stearic, and arachidic acid. Minor constituents are squalene, phytosterol and tocopherols 1 , iron, calcium, and vitamin A.2  In addition to its use as a food, olive oil is used as an emollient for skin treatments and as a mild laxative.3  Since olive oil is high in monounsaturated fats, a type of fat many experts now consider beneficial in reducing the level of low-density lipoprotein (LDL) cholesterol, it is widely believed that olive oil consumption may be associated with reducing the risk of heart disease.  In vitro evidence suggests that olive oil may prove useful in preventing blood clots.4

1. Budavari S, O'Neil MJ, Smith A, et al, eds. The Merck Index. 12th ed. Whitehouse Station, NJ: Merck & Co., Inc.; 1996.

2. Ensminger AH, Ensminger ME, Konlande JE, Robson JRK. The Concise Encyclopedia of Foods and Nutrition. Boca Raton, Florida: CRC Press; 1995.

3. Grieve M. A Modern Herbal. NY, NY: Dover Publications, Inc.; 1971.

4. Petroni A, Blasevich M, Salami M, et al. Inhibition of platelet aggregation and eicosanoid production by phenolic components of olive oil. Thrombosis Research 1995;78:151-160.

Extra Olive Oil Beats Blood Pressure

March 29, 2000 - Italian scientists report that patients with high blood pressure reduced the amount of high blood pressure drugs they needed by switching to a diet low in saturated fat and rich in olive oil.  Some of the patients were able to stop their high blood pressure pills altogether.  "A slight reduction in saturated fat intake, along with the use of extra-virgin olive oil, greatly lowers the need for high blood pressure meds," lead author Dr. L. Ferrara says in the Archives of Internal Medicine.  Patients who increased their intake of sunflower oil did not get the same benefit.  In the study, researchers studied 23 patients with mild to moderate high blood pressure who normally ate a diet with 34% of calories from fat and 11% from saturated fat.  The patients switched to a diet with 26% of calories from fat and 6% saturated fat.  About half of them increased their monounsaturated fat by eating more extra-virgin olive oil while the other half increased their polyunsaturated fat by eating more sunflower oil.  After 6 months, patients switched to the other diet and remained on it for another 6 months.  By the end of the study, the investigators found that patients had a lower resting blood pressure on the olive oil diet compared to the sunflower oil diet.  While on the olive oil diet, patients were able to reduce their daily dose of high blood pressure medication by 48% compared with a reduction of only 4% while on the sunflower oil diet.  Furthermore, 8 patients did not require any blood pressure medication at all while on the olive oil diet.  All patients required drug therapy while on the sunflower diet.  The authors believe that olive oil reduced the need for blood pressure drugs because it contains polyphenols, which are antioxidant compounds that may help dilate arteries, reducing blood pressure.  Sunflower oil does not contain polyphenols.

Source: Archives of Internal Medicine 2000;160:837-842

Omega-3 Fatty Acids

The FDA in November, 2000 said the evidence of health benefits, particularly protection against heart disease, from omega-3 fatty acids is unclear, in response to a suit by a group of doctors, scientists and a dietary supplement company seeking approval for putting health claims on dietary supplements. 

The following claim was, however, approved: "The scientific evidence about whether omega-3 fatty acids may reduce the risk of coronary heart disease (CHD) is suggestive, but not conclusive.  Studies in the general population have looked at diets containing fish and it is not known whether diets or omega-3 fatty acids in fish may have a possible effect on a reduced risk of CHD.  It is not known what effect omega-3 fatty acids may or may not have on risk of CHD in the general population."

The FDA warned against total intake in food and supplements in excess of 3 grams could result in "excessive bleeding in some individuals."  This is because the acids appear to reduce blood clotting.

The situation is confusing in that in October, 2000 the American Heart Association recommended that all individuals increase their intake of omega-3 fatty acids.  The AHA recommended consumption of at least two servings of fish (a significant source of the acids) a week, in its updated dietary guidelines.

Research suggests that omega-3 fatty acids may lower of blood levels of triglycerides, thereby reducing the risk of heart disease, and decreasing the risk of developing an irregular heartbeat.  However, the acids can also raise LDL ("bad") cholesterol, a major risk factor for heart disease.

Pectin

Rich in galactose.  A blood thinner.

Tom Gardiner, “Citrus Pectin Biological Activities: A Review,” GlycoScience & Nutrition 1(34) December 1, 2000 (http://www.glycoscience.com)

Pectins are a soluble fiber composed primarily of chains of 1,4 linked partially methylated polygalacturonic acid residues. They are found in the cell walls of common dietary plants, such as apples, citrus fruits, sugar beets, soy, oat fiber, and peas. Pectins can constitute as much as 1/3 of the dry weight of a plant and are also found in some plant juices.

One of the most important biological activities of citrus pectin is its ability to lower blood cholesterol by regulating cholesterol homeostasis and lipoprotein metabolism when given as a dietary supplement to test animals and humans. For example, in guinea pigs fed a high-cholesterol diet supplemented with 7.5-12.5% citrus pectin, LDL cholesterol was reduced by 29-67%, compared to animals fed the same diet without citrus pectin supplementation.10 Citrus pectin was also hypocholesterolemic in guinea pigs fed a diet comprised of 5% citrus pectin plus ascorbic acid.11 In chickens fed a diet of 2-6% citrus pectin, there was a reduction in blood cholesterol, total lipids, and triglycerides,12 as well as liver fat and body weight.13 In fact, there was actually reduced atherosclerosis in aortas and coronary arteries of pigs fed a diet containing 3% grapefruit pectin.14

When an amount of citrus pectin equivalent to that present in a high-fiber diet of fruits and vegetables was added to a low-fiber diet in human subjects, a small but significant reduction in blood cholesterol was observed.15 ,16 In another human study with nine subjects, dietary supplementation with 15 grams citrus pectin per day for 3 weeks resulted in a 13% decrease in blood cholesterol and increased fecal excretion of fat (44%), neutral steroids (17%), and bile acids (33%), with no change in plasma triglyceride levels.17 In a six week study of 21 adults with mild hypercholesterolemia, subjects consuming a diet supplemented with 15 grams of pectin and 450 mg ascorbic acid experienced a 8.6% decrease in total blood cholesterol levels; HDL cholesterol levels remained unchanged.11

10. Fernandez ML, Sun DM, Tosca MA. Citrus pectin and cholesterol interact to regulate hepatic cholesterol homeostasis and lipoprotein metabolism: a dose- response study in guinea pigs. Am J Clin Nutr. 1994;59(4):869-878.

11. Ginter E, Kubec FJ, Vozár J, Bobek P. Natural hypocholesterolemic agent: pectin plus ascorbic acid.Int J Vitam Nutr Res. 1979;49(4):406-412.

12. Drochner W, Cerci IH, Stadermann B, Lüders H. [The effect of increasing additions of low-esterified pectins in the diet on the metabolism of laying hens--tested by pair-feeding studies]. Arch Tierernahr. 1990;40(5-6):431-442.

13. Patel MB, McGinnis J, Pubols MH. Effect of dietary cereal grain, citrus pectin, and guar gum on liver fat in laying hens and young chicks. Poult Sci. 1981;60(3):631-636.

14. Cerda JJ, Normann SJ, Sullivan MP. Inhibition of atherosclerosis by dietary pectin in microswine with sustained hypercholesterolemia. Circulation. 1994;89(3):1247-1253.

15. Stasse-Wolthuis M., Katan MB, Hermus RJ, Hautvast JG. Increase of serum cholesterol in man fed a bran diet. Atherosclerosis. 1979;34(1):87-91.

16. Stasse-Wolthuis M., Albers HF, van Jeveren JG, et al. Influence of dietary fiber from vegetables and fruits, bran or citrus pectin on serum lipids, fecal lipids, and colonic function. Am J Clin Nutr. 1980;33(8):1745-1756.

17. Kay RM, Truswell AS. Effect of citrus pectin on blood lipids and fecal steroid excretion in man. Am J Clin Nutr. 1977;30(2):171-175.

Pantethine

RX Meds Deplete Nutrients

March 22, 2000 - Many prescription and over-the-counter medications can cause nutritional losses affecting your health.  A new book, "The Nutritional Cost of Prescription Drugs," by two pharmacists describes the health problems that can come from such nutritional losses.  More than 1,000 brand name medications are listed.  "Our main purpose was to alert people to the tremendous amount of scientific research showing that drugs deplete nutrients," said Pelton.  "People should know about this so they can supplement on their own or get some advice on how to supplement."  All claims in the book are documented by studies from peer-reviewed medical journals.  For example, oral contraceptives deplete folic acid, vitamins B6, B12, B1, B2, B3, C and the minerals magnesium, selenium and zinc. Folic acid is involved in cellular division.  "So if a woman is low in folic acid, she's going to have trouble making new cells correctly, and that affects bone marrow, which replenishes the blood supply. Women who are deficient in folic acid can become anemic, and end up with cervical dysplasia" or develop abnormal cells in the uterus, Pelton explained.  Folic acid deficiency can also cause birth defects and increase the risk of breast cancer.  In addition, Pelton explained, folic acid is necessary to metabolize homocysteine. High homocysteine levels indicate risk for heart disease.  In another example, Pelton said that many drugs deplete levels of coenzyme Q10, which is critical for heart function. CoQ10 lowering drugs include cholesterol-control drugs, antidiabetic drugs, blood pressure lowering drugs, beta-blockers and some antidepressants.  Pelton suggested that chronic depletion of CoQ10 may be partly responsible for the rising rate of congestive heart failure.  What to do?  People should take nutritional supplements to compensate.  They may also want to have their levels of some nutrients checked by a doctor.  The depletions caused by drugs may be made even worse by stress, environmental pollution, poor diets and other factors.  By knowing that some drugs can trigger deficiencies and by taking action, drug side effects may be reduced, suggested Pelton.  The book is published by Morton Publishing Company, Englewood, Colorado, (303) 761-4805.

Source: Medical PressCorps News Service

Red Yeast Rice

http://www.wholehealthmd.com/refshelf/substances_view/1,1525,10054,00.html
“red yeast rice, an Asian dietary staple made by fermenting red yeast (Monascus purpureus) on rice … . … careful fermentation process yielded specific amounts of statins … chemically too similar to the prescription statin medication Mevacor … . And the original product, Cholestin [from NuSkin International], has been reformulated without red yeast rice. … It seems to help reduce total cholesterol levels, lower levels of LDL ("bad") cholesterol, increase levels of HDL ("good") cholesterol, and lower levels of unhealthy fats called triglycerides. It appears to accomplish this by restricting the liver's production of cholesterol. The compound responsible for this effect--mevinolin--is chemically identical to the cholesterol-lowering compound lovastatin, which is sold as the prescription drug Mevacor. Hence the action by the FDA. Mevinolin is also similar to the active ingredients in other cholesterol medications such as Zocor (simvastatin) and Lipitor (atorvastatin). Unsaturated fatty acids in red yeast rice extract are also believed to be beneficial, possibly by lowering triglycerides. … There are no known drug or nutrient interactions associated with red yeast rice. However, there are interactions associated with lovastatin. Prescription statin drugs such as lovastatin can reduce levels of coenzyme Q10, an antioxidant produced by the heart and other tissues to protect cells from damage. Some experts recommend supplementing a regimen of red yeast extract (or other statin drugs) with this nutrient.”

Rice Bran Oil

Rice bran oil, not fiber, lowers cholesterol in humans.
Most MM, Tulley R, Morales S, Lefevre M.
Am J Clin Nutr. 2005 Jan;81(1):64-8.
Division of Functional Foods Research, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA.
BACKGROUND: The cholesterol-lowering abilities of rice bran's fiber and oil apart from its fatty acid composition remain unclear. OBJECTIVE: The objective of the study was to assess the effects of defatted rice bran and rice bran oil in an average American diet on blood lipids in moderately hypercholesterolemic persons. DESIGN: Study 1 used a parallel-arm design. Twenty-six healthy volunteers consumed a diet with 13-22 g dietary fiber/d for 3 wk, and then 13 of the volunteers were switched to a diet with defatted rice bran to double the fiber intake for 5 wk. Study 2 was a randomized, crossover, 10-wk feeding study performed in 14 volunteers who consumed a diet with rice bran oil (1/3 of the total dietary fat) substituted for an oil blend that had a fatty acid composition similar to that of the rice bran oil. Serum lipids and factor VII were measured in both studies. RESULTS: Defatted rice bran did not lower lipid concentrations. In study 2, total cholesterol was significantly lower with consumption of the diet containing rice bran oil than with consumption of the control diet. Moreover, with consumption of the rice bran oil diet, LDL cholesterol decreased by 7% (P < 0.0004), whereas HDL cholesterol was unchanged. CONCLUSIONS: Rice bran oil, not fiber, lowers cholesterol in healthy, moderately hypercholesterolemic adults. There were no substantial differences in the fatty acid composition of the diets; therefore, the reduction of cholesterol was due to other components present in the rice bran oil, such as unsaponifiable compounds.

Soy

www.alternativemedicine.com/products/soybiotics/frames.html

Kathleen Kelly, a Juno Beach, FL, nutritionist and president of the Florida Dietetic Association, says there are about 40 studies that show adding soy protein to one's diet can lower blood cholesterol.

Statins Reduce CoQ10 Level

1994 - The biosynthetic pathway of the CoQ chain is the same as that of cholesterol.  We performed this study to see whether cholesterol-lowering drugs like Zocor change blood levels of CoQ10.  Thirty-four patients with high cholesterol were treated with 20mg of Zocor for 6 months (no-CoQ10 group) or with 20mg of Zocor plus 100mg CoQ10 (CoQ10 group).  Total cholesterol, HDL, LDL, triglycerides, CoQ10 blood level and more were checked at 0, 45, 90, 135 and 180 days.  In the no-CoQ10 group, total cholesterol and LDL went down and so did plasma CoQ10 levels.  In contrast, in the CoQ10 group, CoQ10 plasma levels increased while cholesterol reduction was similar to the S group.  Platelet CoQ10 also decreased in the no CoQ10 group and increased in the CoQ10 group.  This study shows that Zocor lowers LDL plasma levels, plasma and platelet levels of CoQ10.  CoQ10 therapy prevents both plasma and platelet CoQ10 decrease, without affecting the cholesterol lowering effect of Zocor.  If you take a "statin" cholesterol lowering drug like Zocor, you should take extra CoQ10.  It won't affect the action of the cholesterol drug.  The cholesterol drug is reducing the amount of CoQ10 in your blood and this extra CoQ10 will make up for it.

Title: Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors

Authors: Bargossi AM; Grossi G; Fiorella PL; Gaddi A; Di Giulio R; Battino M
Source: Mol Aspects Med, 1994, 15 Suppl:, s187-93.  ID number: 95272323

Triglycerides

“Hypertriglyceridemia and Coronary Heart Disease”
Robert A. Kreisberg, MD, MACP, Mobile, Ala
[Clin Rev Spring:29-32, 2000]

Introduction

The relationship between hypertriglyceridemia (HTG) and coronary heart disease (CHD) has been controversial to say the least.  An inverse relationship exists between the triglyceride and high-density lipoprotein cholesterol (HDL-C) levels; the exceptions are in patients taking estrogen therapy and those with alcoholism, in which cases HDL-C levels are increased.  Multivariate analyses have indicated no significant influence of triglycerides on CHD risk when adjusted for the HDL-C level.  As a result, most interpretations of the data conclude that any risk associated with HTG is due to reduced levels of HDL-C.  Because triglyceride and HDL-C levels are covariates, these interpretations are open to criticism.  It is likely that HTG rather than low HDL-C level is the risk factor, or, more likely, both are important.

Vitamin E

About 25 years ago in Toronto, Canada the Shute brothers, a medical research team focusing on cardiac patients, publicized the beneficial effects of vitamin E supplements for reducing the incidence of heart attacks and reducing the rate of cardiac arterial blockages.  Already at that time there was extensive research literature from around the world on the effects of vitamin E. 

The benefits of vitamin E are now recognized in the United States.

Vitamin E is an anti-oxidant (it scavenges free radicals that would otherwise contribute to molecular dissociations and thereby result in tissue damage).  It is widely used as a healing agent in burns and other skin wounds.