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A healthy, balanced diet is the only way to get all the vitamins that may lower cholesterol. Such a diet -- low in saturated fat, trans fat, and cholesterol -- plus a lifestyle that includes regular physical activity and losing excess weight, form the basis for fighting heart disease.

Yet, the battle being waged against the high-cholesterol plaques in the walls of your blood vessels is a complex one.

Vitamins and minerals -- and their role in helping to stave off heart disease -- are continually under scientific investigation; sometimes they show promise, and other times they stir up controversy. The form that vitamins and minerals take -- in food or in supplements -- seems to be an especially important factor in determining their effectiveness in promoting heart health.

The role vitamins play in lowering cholesterol is unclear, but they do seem to be less effective as supplements than in their natural form.

There's no question that your food choices can influence your risk of disease, but it's possible that a variety of other compounds in foods -- such as fiber or phytonutrients -- may act in harmony with vitamins or minerals to enhance their health effects. Moreover, the antioxidants in food may be beneficial.

In fact, studies show that eating antioxidant-rich foods, such as fruits and vegetables, lowers the risk of heart disease; however, evidence suggests that antioxidant supplements do not lower risk. This may be because lifelong exposure to an antioxidant-rich diet -- before atherosclerosis or signs of heart disease develop -- may offer better protection.

The only way you can be assured of getting the full complement of health benefits vitamins, minerals, and antioxidants offer is to make food your primary source of nutrients, and consider supplements only to reach any higher dosages that may be needed. This approach also means that any possible toxicity that accompanies very high intakes of some supplements will be avoided.

What exactly are antioxidants? Antioxidants include some vitamins and minerals, but to appreciate the value of antioxidants, you first need to understand the potential dangers of free radicals, a form of oxygen that has been chemically modified into a highly unstable substance.

Free radicals are unstable because they are missing electrons, which must be replaced. So they seek out other compounds in the body and steal electrons to restore stability. If the compound giving up its electrons is the fat and protein in an LDL-cholesterol molecule, the result is the formation of fatty lesions in the walls of the blood vessels -- the hallmark of atherosclerosis.

Although the body has a means of handling a normal burden of free radicals, many of the forces that cause free radicals to form cannot be stopped. For instance, they form in the normal course of the day, just by our breathing in oxygen. (Obviously, it's impossible to avoid this type of free radical because we have to breathe.)

Yet the production of free radicals is not always a bad thing. They are part of the immune system and help fight off infection. (During cancer treatment, the free radicals produced help to destroy cancer cells.) Antioxidants are the armament the body uses for protection against damage from free radicals. It is when the production of free radicals overwhelms the body's protective system of antioxidants that disease-producing damage results.

The heart and the blood vessels, like the lungs, are especially vulnerable to the effects of oxygen because their exposure to this element is so great. The blood is the route of transport for oxygen throughout the body. The blood is also the route of transport for many of the substances that can act on oxygen to produce free radicals.

Cholesterol is carried through the blood, packaged in LDL particles; LDL is responsible for depositing cholesterol in the walls of the arteries. These deposits form the fatty plaques that eventually narrow the arteries, possibly leading to a heart attack. Scientists now know that before LDL cholesterol can have this effect, it first has to be modified by a free radical to form an oxidized LDL.

In other words, the free radical substances produced in the blood from oxygen by any one of a number of causes -- like chemicals from cigarette smoke or environmental pollution -- can set off a chain of events that generates oxidized LDL cholesterol and ultimately can lead to heart disease.

The body benefits from a variety of different antioxidants. Vitamin C, vitamin E, and beta-carotene (a compound related to vitamin A) are the vitamin antioxidants. Oranges, grapefruit, strawberries, green peppers, broccoli, and tomatoes are rich in vitamin C. Carrots, apricots, squash, spinach, and other green leafy or yellow-orange fruits and vegetables are rich sources of beta-carotene. Vitamin E is found in dark-green leafy vegetables, nuts, and vegetable oils.

The mineral selenium is a component of antioxidant enzymes, so it acts as an antioxidant when combined with these special proteins. A number of natural compounds found in plant sources also have antioxidant activity, but these are neither vitamins nor minerals. Flavonoids, which are found in apples, tea, and onions, are an example. Red wine is also believed to contain a flavonoid antioxidant that may partly explain the protection from high rates of heart disease attributed to people in some Mediterranean countries.

Antioxidants protect against damage from free radicals either by preventing them from forming altogether or by destroying them once they have formed. Generally, vitamin antioxidants act as scavengers that intercept free radicals before they can interact with LDL cholesterol or other important cell compounds.

Additionally, there is growing evidence that inflammation in the arteries can cause plaque to rupture, triggering the formation of clots. It is a clot that may eventually plug an artery that has been narrowed by fatty plaques, thereby cutting off the supply of oxygen to a portion of the heart -- which may bring on a heart attack. Since free radicals can trigger an inflammatory response, it is possible that antioxidants may help control inflammation.

One particular concern with taking antioxidant supplements is their effect on cancer. Large clinical trials in the 1990s, mostly on beta-carotene, have shown inconsistent results. In 1994, a well-publicized study on Finnish male smokers found a higher incidence of lung cancer in men who took beta-carotene supplements, but in 1996, another large study of mostly nonsmoking doctors found no change in cancer rates among those who took beta-carotene supplements. A study on the effect of antioxidant supplements on the risk of prostate cancer is currently underway. Overall, it appears that the role of antioxidant supplements in cancer prevention is still unclear.

The rest of this article will give you the latest scientifically based information on the roles that certain vitamins, minerals, and antioxidants may play in modifying blood cholesterol and lowering the risk of heart disease