Skip to main content
Log in

LDL-cholesterol-lowering effect of a dietary supplement with plant extracts in subjects with moderate hypercholesterolemia

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

Red yeast rice (RYR), sugar cane-derived policosanols (SCdP) and artichoke leaf extracts (ALEs) are currently incorporated alone or in combination into dietary supplements for their potential low-density-lipoprotein cholesterol (LDL-cholesterol)-lowering effects. Yet, there is no information supporting the efficacy of this association on the reduction in LDL-cholesterol. The main objective of this study was to investigate the effects of a new dietary supplement (DS) with RYR, SCdP and ALEs on LDL-cholesterol.

Methods

In a double-blind, randomized, parallel controlled study, 39 subjects from 21 to 55 years with moderate hypercholesterolemia without drug treatment were assigned to 2 groups and then consumed either a DS containing RYR, SCdP and ALEs or a placebo over a 16-week period. Plasma concentrations of lipids [LDL-cholesterol, total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-cholesterol), triacylglycerols (TG)] and plasma levels of vitamins C and E, total polyphenols and malondialdehyde were determined at baseline and after 4, 8, 12 and 16 weeks.

Results

LDL-cholesterol and TC were reduced by, respectively, 21.4 % (95 % CI, −13.3 to −24.9 %, p < 0.001) and 14.1 % (95 % CI, −10.1 to −18.0 %, p < 0.001) at week 16 in the DS group compared with baseline. Similar results were obtained at weeks 4, 8 and 12. TG decreased by 12.2 % after 16 weeks in the DS group (95 % CI: −24.4 to −0.1 %, p < 0.05). For the vitamin E/TC ratio, a difference was observed between groups at week 16 (p < 0.05). Other parameters were not modified.

Conclusions

Daily consumption of this new DS decreased LDL-cholesterol and TC and is therefore an interesting, convenient aid in managing mild to moderate hypercholesterolemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Wilson PW, Castelli WP, Kannel WB (1987) Coronary risk prediction in adults (the Framingham Heart Study). Am J Cardiol 59:91G–94G

    Article  CAS  Google Scholar 

  2. Robinson JG, Smith B, Maheshwari N, Schrott H (2005) Pleiotropic effects of statins: benefit beyond cholesterol reduction? A meta-regression analysis. J Am Coll Cardiol 46:1855–1862

    Article  CAS  Google Scholar 

  3. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, Kirby A, Sourjina T, Peto R, Collins R, Simes R (2005) Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 366:1267–1278

    Article  CAS  Google Scholar 

  4. Vondrakova D, Ostadal P, Kruger A (2010) Immediate effect of intensive atorvastatin therapy on lipid parameters in patients with acute coronary syndrome. Lipids Health Dis 9:71

    Article  Google Scholar 

  5. Kelly JP, Kaufman DW, Kelley K, Rosenberg L, Anderson TE, Mitchell AA (2005) Recent trends in use of herbal and other natural products. Arch Intern Med 165:281–286

    Article  Google Scholar 

  6. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486–2497

    Article  Google Scholar 

  7. Nijjar PS, Burke FM, Bloesch A, Rader DJ (2010) Role of dietary supplements in lowering low-density lipoprotein cholesterol: a review. J Clin Lipidol 4:248–258

    Article  Google Scholar 

  8. Bogsrud MP, Ose L, Langslet G, Ottestad I, Strom EC, Hagve TA, Retterstol K (2010) HypoCol (red yeast rice) lowers plasma cholesterol: a randomized placebo controlled study. Scand Cardiovasc J 44:197–200

    Article  CAS  Google Scholar 

  9. Lin CC, Li TC, Lai MM (2005) Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia. Eur J Endocrinol 153:679–686

    Article  CAS  Google Scholar 

  10. Heber D, Yip I, Ashley JM, Elashoff DA, Elashoff RM, Go VL (1999) Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr 69:231–236

    CAS  Google Scholar 

  11. Huang CF, Li TC, Lin CC, Liu CS, Shih HC, Lai MM (2007) Efficacy of Monascus purpureus Went rice on lowering lipid ratios in hypercholesterolemic patients. Eur J Cardiovasc Prev Rehabil 14:438–440

    Article  Google Scholar 

  12. Liu J, Zhang J, Shi Y, Grimsgaard S, Alraek T, Fonnebo V (2006) Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials. Chin Med 1:4

    Article  Google Scholar 

  13. Heber D, Lembertas A, Lu QY, Bowerman S, Go VL (2001) An analysis of nine proprietary Chinese red yeast rice dietary supplements: implications of variability in chemical profile and contents. J Altern Complement Med 7:133–139

    Article  CAS  Google Scholar 

  14. Chen JT, Wesley R, Shamburek RD, Pucino F, Csako G (2005) Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol. Pharmacotherapy 25:171–183

    Article  CAS  Google Scholar 

  15. Gouni-Berthold I, Berthold HK (2002) Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent. Am Heart J 143:356–365

    Article  CAS  Google Scholar 

  16. Wider B, Pittler MH, Thompson-Coon J, Ernst E (2009) Artichoke leaf extract for treating hypercholesterolaemia. Cochrane Database Syst Rev CD003335

  17. Kaplan M, Aviram M (1999) Oxidized low density lipoprotein: atherogenic and proinflammatory characteristics during macrophage foam cell formation. An inhibitory role for nutritional antioxidants and serum paraoxonase. Clin Chem Lab Med 37:777–787

    Article  CAS  Google Scholar 

  18. Toshima S, Hasegawa A, Kurabayashi M, Itabe H, Takano T, Sugano J, Shimamura K, Kimura J, Michishita I, Suzuki T, Nagai R (2000) Circulating oxidized low density lipoprotein levels. A biochemical risk marker for coronary heart disease. Arterioscler Thromb Vasc Biol 20:2243–2247

    Article  CAS  Google Scholar 

  19. Bowen PE, Borthakur G (2004) Postprandial lipid oxidation and cardiovascular disease risk. Curr Atheroscler Rep 6:477–484

    Article  Google Scholar 

  20. Romero FJ, Bosch-Morell F, Romero MJ, Jareno EJ, Romero B, Marin N, Roma J (1998) Lipid peroxidation products and antioxidants in human disease. Environ Health Perspect 106(Suppl 5):1229–1234

    Article  CAS  Google Scholar 

  21. Losonczy KG, Harris TB, Havlik RJ (1996) Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Populations for Epidemiologic Studies of the Elderly. Am J Clin Nutr 64:190–196

    CAS  Google Scholar 

  22. Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC (1993) Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 328:1450–1456

    Article  CAS  Google Scholar 

  23. Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC (1993) Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 328:1444–1449

    Article  CAS  Google Scholar 

  24. Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502

    CAS  Google Scholar 

  25. Hu FB, Willett WC (2002) Optimal diets for prevention of coronary heart disease. JAMA 288:2569–2578

    Article  CAS  Google Scholar 

  26. Mente A, de Koning L, Shannon HS, Anand SS (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 169:659–669

    Article  CAS  Google Scholar 

  27. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D, Bax J, Vahanian A, Auricchio A, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Filippatos G, Funck-Brentano C, Hasdai D, Hoes A, Kearney P, Knuuti J, Kolh P, McDonagh T, Moulin C, Poldermans D, Popescu BA, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vardas P, Widimsky P, Windecker S, Berkenboom G, De Graaf J, Descamps O, Gotcheva N, Griffith K, Guida GF, Gulec S, Henkin Y, Huber K, Kesaniemi YA, Lekakis J, Manolis AJ, Marques-Vidal P, Masana L, McMurray J, Mendes M, Pagava Z, Pedersen T, Prescott E, Rato Q, Rosano G, Sans S, Stalenhoef A, Tokgozoglu L, Viigimaa M, Wittekoek ME, Zamorano JL (2011) ESC/EAS guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 32:1769–1818

    Article  Google Scholar 

  28. Sirtori CR, Galli C, Anderson JW, Arnoldi A (2009) Nutritional and nutraceutical approaches to dyslipidemia and atherosclerosis prevention: focus on dietary proteins. Atherosclerosis 203:8–17

    Article  CAS  Google Scholar 

  29. Endo A (1979) Monacolin K, a new hypocholesterolemic agent produced by a Monascus species. J Antibiot (Tokyo) 32:852–854

    Article  CAS  Google Scholar 

  30. Becker DJ, Gordon RY, Halbert SC, French B, Morris PB, Rader DJ (2009) Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Ann Intern Med 150:830–839

    Google Scholar 

  31. Journoud M, Jones PJ (2004) Red yeast rice: a new hypolipidemic drug. Life Sci 74:2675–2683

    Article  CAS  Google Scholar 

  32. Guardamagna O, Abello F, Baracco V, Stasiowska B, Martino F (2011) The treatment of hypercholesterolemic children: efficacy and safety of a combination of red yeast rice extract and policosanols. Nutr Metab Cardiovasc Dis 21:424–429

    Article  CAS  Google Scholar 

  33. Reiner Z, Tedeschi-Reiner E, Romic Z (2005) Effects of rice policosanol on serum lipoproteins, homocysteine, fibrinogen and C-reactive protein in hypercholesterolaemic patients. Clin Drug Investig 25:701–707

    Article  Google Scholar 

  34. Castano G, Mas R, Fernandez L, Illnait J, Gamez R, Alvarez E (2001) Effects of policosanol 20 versus 40 mg/day in the treatment of patients with type II hypercholesterolemia: a 6-month double-blind study. Int J Clin Pharmacol Res 21:43–57

    CAS  Google Scholar 

  35. Castano G, Fernandez L, Mas R, Illnait J, Mesa M, Fernandez JC (2003) Comparison of the effects of policosanol and atorvastatin on lipid profile and platelet aggregation in patients with dyslipidaemia and type 2 diabetes mellitus. Clin Drug Investig 23:639–650

    Article  CAS  Google Scholar 

  36. Prat H, Roman O, Pino E (1999) Comparative effects of policosanol and two HMG-CoA reductase inhibitors on type II hypercholesterolemia. Rev Med Chil 127:286–294

    CAS  Google Scholar 

  37. Singh DK, Li L, Porter TD (2006) Policosanol inhibits cholesterol synthesis in hepatoma cells by activation of AMP-kinase. J Pharmacol Exp Ther 318:1020–1026

    Article  CAS  Google Scholar 

  38. Marazzi G, Cacciotti L, Pelliccia F, Iaia L, Volterrani M, Caminiti G, Sposato B, Massaro R, Grieco F, Rosano G (2011) Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients. Adv Ther 28:1105–1113

    Article  CAS  Google Scholar 

  39. Francini-Pesenti F, Brocadello F, Beltramolli D, Nardi M, Caregaro L (2008) Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: a double blind, controlled study. Complement Ther Med 16:61–65

    Article  CAS  Google Scholar 

  40. Cubeddu LX, Cubeddu RJ, Heimowitz T, Restrepo B, Lamas GA, Weinberg GB (2006) Comparative lipid-lowering effects of policosanol and atorvastatin: a randomized, parallel, double-blind, placebo-controlled trial. Am Heart J 152(982):e981–e985

    Google Scholar 

  41. Berthold HK, Unverdorben S, Degenhardt R, Bulitta M, Gouni-Berthold I (2006) Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial. JAMA 295:2262–2269

    Article  CAS  Google Scholar 

  42. Gebhardt R (1998) Inhibition of cholesterol biosynthesis in primary cultured rat hepatocytes by artichoke (Cynara scolymus L.) extracts. J Pharmacol Exp Ther 286:1122–1128

    CAS  Google Scholar 

  43. Bundy R, Walker AF, Middleton RW, Wallis C, Simpson HC (2008) Artichoke leaf extract (Cynara scolymus) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: a randomized, double blind placebo controlled trial. Phytomedicine 15:668–675

    Article  Google Scholar 

  44. Englisch W, Beckers C, Unkauf M, Ruepp M, Zinserling V (2000) Efficacy of Artichoke dry extract in patients with hyperlipoproteinemia. Arzneimittelforschung 50:260–265

    CAS  Google Scholar 

  45. Glass CK, Witztum JL (2001) Atherosclerosis. The road ahead. Cell 104:503–516

    Article  CAS  Google Scholar 

  46. Bazzano LA, Serdula MK, Liu S (2003) Dietary intake of fruits and vegetables and risk of cardiovascular disease. Curr Atheroscler Rep 5:492–499

    Article  Google Scholar 

  47. Hung HC, Joshipura KJ, Jiang R, Hu FB, Hunter D, Smith-Warner SA, Colditz GA, Rosner B, Spiegelman D, Willett WC (2004) Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst 96:1577–1584

    Article  Google Scholar 

  48. French Study (2009) Etude individuelle nationale des consommations alimentation: INCA2, AFSSA

  49. Nagila A, Permpongpaiboon T, Tantrarongroj S, Porapakkham P, Chinwattana K, Deakin S, Porntadavity S (2009) Effect of atorvastatin on paraoxonase 1 (PON1) and oxidative status. Pharmacol Rep 61:892–898

    CAS  Google Scholar 

  50. Meagher EA, Barry OP, Lawson JA, Rokach J, Fitzgerald GA (2001) Effects of vitamin E on lipid peroxidation in healthy persons. JAMA 285:1178–1182

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We would like to thank Marion Nowicki and Romain Bott for their expert technical assistance. This work was financed by Laboratoire Lescuyer.

Conflict of interest

Nicolas Ogier, Sébastien L. Peltier and Nicolas Cardinault are employees of the company Laboratoire Lescuyer. Jean-François Lescuyer is the general director of the company. Other authors have no conflicting interests.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sébastien L. Peltier.

Additional information

Trial registration: ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT01354327.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ogier, N., Amiot, MJ., Georgé, S. et al. LDL-cholesterol-lowering effect of a dietary supplement with plant extracts in subjects with moderate hypercholesterolemia. Eur J Nutr 52, 547–557 (2013). https://doi.org/10.1007/s00394-012-0357-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-012-0357-x

Keywords

Navigation