By Kim Schoenhals

If the Boston Red Sox can beat the curse that's followed them since 1918 to win the 2004 World Series, can Americans beat the No. 1 cause of death that has reigned since the same year? It looks like it's going to take us a little longer than it took the Sox, but the trend is encouraging.

In 2002, heart disease claimed nearly 700,000 lives in the United States, according to the Centers for Disease Control and Prevention (CDC). The good news is that this number was 2.8 percent lower than the previous year's number. In fact, the CDC reported there has been a steady decline in the number of deaths from heart disease since 1980.

Perhaps Americans really have become more aware of heart-healthful habits and products. After all, as of November 2004, the US Food and Drug Administration (FDA) had approved heart-health claims for several foods, including soy, fiber and olive oil. And there are also many dietary supplements that promote cardiovascular wellness. The following list (in alphabetical order) comprises 20 such ingredients, which are likely to appear on the labels of heart-focused supplements and functional foods.

Alpha-Lipoic Acid
Alpha-lipoic acid (ALA) has been identified as a powerful antioxidant found naturally in our diets, but it appears to have increased functional capacity when given as a supplement in the form of a natural or synthetic isolate," state Canadian researchers in the November 2003 issue of The Journal of Nutrition. They also noted that ALA prevents cardiovascular risk factors such as LDL oxidation and high blood pressure.

Chlorella
Chlorella, a green superfood, may reduce the risk of heart disease by lowering blood pressure, according to a fall 2002 report in the Journal of Medicinal Food. Researchers at Virginia Commonwealth University in Richmond found that chlorella helped one-quarter of their study group participants reach their blood pressure goals.

Coenzyme Q10 (CoQ10
CoQ10 was the focus of a new clinical trial, Q-SYMBIO, which was announced in a 2003 issue of BioFactors. Danish researchers are suggesting that CoQ10 may reverse the "energy starvation" in heart tissue that is a large underlying factor for heart attack. (More on CoQ10.)

Fiber
As evidenced by the FDA's July 2003 approval of a qualified health claim, fiber is a good way to protect against coronary heart disease (CHD). Dietary fiber also seems to prevent peripheral arterial disease (PAD) in men, according to a November 2003 study of more than 46,000 men.

Fish Oil
Fish oil was the No. 2 seller in heart-health segments in the 52-week period that ended September 9, 2004, according to SPINS/AC Nielsen. And compared to the previous year, fish oil sales increased by 37 percent. Consumers must be reading the research: Fish oil supplements lower cholesterol, have anti-inflammatory properties and reduce the risk of death from heart attack, according to a report in the August 2004 issue of Molecular and Cellular Biochemistry.

Folic Acid
Similar to fiber, folic acid is known to decrease PAD risk in men, as noted in the September 2003 issue of The Journal of Nutrition. The B vitamin -- at 800 micrograms (mcg) per day -- also appears to reduce young women's risk of developing high blood pressure, as reported by Harvard researchers at an October 2004 meeting of the American Heart Association.

Garlic
Aged garlic extract (AGE) has a history of reducing several cardiovascular risk factors, including blood pressure, cholesterol and platelet aggregation, according to the November 2004 issue of Preventive Medicine. The 1-year pilot trial described in that issue showed that AGE supplementation also slows coronary calcification, a marker of arterial plaque formation.

Ginseng
There is evidence that ginseng can help manage high blood pressure and improve cardiovascular function, as explained in the August 2004 Medical Science Monitor. Some of the herb's protective effects include its antioxidant properties, its ability to improve lipid levels and its effects on glucose control.

Green Tea
Drinking green tea reduces the risk of coronary artery disease (CAD), according to a Japanese study of 203 subjects published in July 2004 in Circulation Journal. Researchers concluded that the more green tea the participants consumed, the less likely they were to develop CAD.

L-Arginine
L-arginine can improve endothelial function, which tends to be reduced in congestive heart failure (CHF), as described in the January 2004 issue of Current Vascular Pharmacology. Subsequent research -- published in April 2004 in a Polish medical journalÑshowed that by improving endothelial function, L-arginine also improves exercise tolerance in patients with CHF.

L-Carnitine
A compound formed from two amino acids (lysine and methionine), L-carnitine may be a viable option for lowering cholesterol, according to research in the November 2004 issue of Diabetes Research and Clinical Practice. In an animal model of diabetes-induced high cholesterol, 10 days of L-carnitine supplementation lowered cholesterol and triglycerides.

Lycopene
In addition to receiving media attention for reducing the risk of prostate and breast cancers, lycopene is an antioxidant known for diminishing the risk of heart disease. Higher serum lycopene levels reduce the risk of CVD by half, according to a study of more than 39,500 women reported in the January 2004 issue of The American Journal of Clinical Nutrition.

Magnesium
Endogenous magnesium levels play an important role in several aspects of heart health -- including blood pressure regulation -- according to a 2003 research review in Molecular Aspects of Medicine. Despite the fact that clinical trials have had less than convincing results, the reviewers recommended a magnesium-rich diet to prevent hypertension, and suggested that patients with high blood pressure take magnesium supplements.

Olive Oil
Previously recognized as an integral part of the heart-healthy Mediterranean diet, olive oil gained added acclaim in November 2004 when the FDA announced approval of a qualified health claim stating that an intake of 23 grams per day of olive oil may lower the risk of CHD.

Omega-3 Fatty Acids
Known as healthful fats, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) were both included in the FDA's approval of a qualified health claim for the prevention of CHD. Recent research in the July 2004 Clinical Science shows that a higher intake of omega-3s slows the development of atherosclerotic plaques and lowers the risk of death from heart disease.

Resveratrol
One up-and-comer in the world of heart health is resveratrol, an antioxidant compound found in grape skins, red wine and peanuts. The in vitro and in vivo data support this compound for bolstering heart health, as noted in the fall 2004 issue of Cardiovascular Drug Reviews. Specifically, resveratrol affects vascular cell function and prevents LDL oxidation and platelet aggregation.

Soy
Like fiber and omega-3s, soy has received FDA approval for a heart-health claim, although the legume has been qualified since October 1999. One study, which was published in September 2003 in The Journal of Nutrition, showed that of 65,000 women, those who had the highest soy food intakes were at a reduced risk of heart disease.

Sterols and Stanols
Plant sterols and stanols are functional food ingredients used to improve cholesterol levels. A June 2003 study of Polish men demonstrates this effect, with those consuming sterol-enriched margarine exhibiting 7 percent reductions in total cholesterol and 11 percent reductions in LDL levels.

Vitamin C
Vitamin C possesses antioxidant properties, which may be partly responsible for its ability to stave off heart disease. Researchers at Children's Hospital Boston reviewed 16 years of data from more than 85,000 women and noted vitamin supplements were specifically seen to reduce the risk of heart disease.

Vitamin E
While vitamin E sales were down 10 percent for the 52-week period that ended September 4, 2004, it still was the No. 1 seller in heart-health segments, according to SPINS/AC Nielsen. Recently, vitamin E has been somewhat controversial in clinical settings; however, proponents say a recent study showing vitamin E does not benefit the heart are incorrect.