Magnesium. A deficiency of this mineral is linked to MVP. Magnesium is necessary for maintaining normal muscle and nerve function, as well as keeping bones strong and heart rhythm steady. One study found that, of 141 patients with heavily symptomatic MVP, 60 per cent showed lower-than-normal levels of blood magnesium. But after five weeks of supplementing their diets with magnesium, the patients experienced significant reductions in symptoms, including physical weakness, chest pain, dyspnoea (breathlessness), palpitations and anxiety (Am J Cardiol, 1997; 79: 768-72).

Magnesium is found in green vegetables such as spinach, and in nuts and seeds. Avoid refined foods such as white bread. Wheat germ and bran are rich in magnesium, but are removed during the processing of white flour. The recommended dosage of magnesium is 200-600 mg/day.

* Coenzyme Q10 (ubiquinone). CoQ10 is fundamental to the body’s energy production and for the synthesis of nucleic acids and proteins. Among its various roles, it also enhances heart function. One study treated 424 patients who had various forms of cardiovascular disease, including MVP, by adding CoQ10 to their treatment regimes. Results showed that over 87 per cent of patients showed significant improvement in their everyday heart function and performance. Also, a considerable number were able to reduce the number of different medications they were having to take (Mol Aspects Med, 1994; 15 Suppl: s165-75).

The richest natural sources of CoQ10 are sardines and mackerel, pork, spinach, soya oil, peanuts, sesame seeds and walnuts. To aid its uptake, make sure you have plenty of B vitamins and iron. Avoid stimulants such as caffeine and nicotine, as well as sugar, as they destroy CoQ10. The recommended dosage of CoQ10 is 10-90 mg/day.

* L-carnitine. A rich source of amino acid, it plays an important role in strengthening the heart. Italian researchers investigating the effect of L-carnitine in type 2 diabetic patients with essential hypertension found that 2 g twice daily for 45 weeks significantly reduced heart symptoms such as an irregular heartbeat as well as loss of strength (Minerva Med, 1989; 80: 227-31).

Good dietary sources of L-carnitine are dairy, red meat and avocado pears. The recommended dosage is 500 mg/day.

* Vitamin E. There are mixed views as to whether this vitamin really can have benefit for potential heart-disease patients. Several observational studies support vitamin E’s role in lowering the risk of cardiovascular disease (Ann NY Acad Sci, 2004; 1031: 280-91). However, the Heart Outcomes Prevention Evaluation (HOPE) study, comparing the ACE-inhibitor ramipril with vitamin E, found that the vitamin did not protect patients against heart problems and chest pain (Cleve Clin J Med, 2000; 67: 287-93). Nevertheless, other studies are ongoing to determine whether a longer period of treatment with vitamin E supplements may be required for any benefit to become evident. The recommended dosage of vitamin E is 200-800 IU/day.