Cholesterol: Red Yeast Rice andd Omega-3s
December 24, 2008
Red yeast rice and omega-3s found in fish are two popular natural options. In fact, FDA approved a prescription form of omega-3s for the purpose of regulating lipid levels, with therapeutic dosages being 2 to 4 g/d of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), according to researchers at Virginia Commonwealth University in Richmond.2 They added the treatment may also increase LDL levels, but the net effect is a reduction in non-HDL cholesterol.
One review examined the role of omega-3 and red yeast rice in preventing clinical cardiovascular events.3 Researchers found modest doses of omega-3 reduced cardiac deaths, and in high doses reduced nonfatal cardiovascular events, while red yeast rice reduced adverse cardiac events to a similar degree as the statins. Another study compared the lipid-lowering effects of an alternative treatment group (AG), i.e., lifestyle changes, red yeast rice and fish oil to a standard dose of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, a statin.4 Seventy-four patients with hypercholesterolemia were randomized to an AG or to receive 40 mg/d of simvastatin for 12 weeks. There was a statistically significant reduction in LDL levels in both the AG and simvastatin group. The AG also showed significant reductions in triglycerides and weight compared with the simvastatin group.
Xuezhikang (XZK), a partially purified extract of red yeast rice, was examined in a multicenter, placebo-controlled study for its effects on lipoprotein and cardiovascular end points in Chinese patients (n=5,000) who experienced a previous myocardial infarction (MI).5 The primary end point was a major coronary event that included nonfatal MI and death from coronary heart disease. After 4.5 years, 10.4 percent of subjects in the placebo group experienced a major coronary event, including nonfatal MI or death, compared to 5.7 percent in the XZK-treated group. Treatment with XZK also significantly decreased cardiovascular events and total mortality by 30 percent and 33 percent, the need for coronary revascularization by one-third, and lowered total and LDL cholesterol and triglycerides; it did raise HDL levels.
According to a study of 923 pregnant women at the Swedish Medical Center in Seattle, the long-chain polyunsaturated fatty acids (LCPUFAs) found in fish improve cholesterol profiles.6 Women who reported eating fish twice or more per week had lower triglycerides and higher HDL than women who reported eating fish only once or less per week.
A policosanol omega-3 nanodispersion (as Nanocosanol®, from Valensa) may lower all parameters of cholesterol except HDL, which may increase slightly when taken in a twice-daily 690 mg capsule (containing 10 mg of policosanol and 100 mg of omega-3s), according to a company-sponsored trial reported in 2006.7 In a three-month, non-controlled, open-label trial, the most clearly established changes among the 11 subjects were in total cholesterol, and the LDL:HDL and total:HDL ratios.
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