Plant sterols, turmeric, red yeast rice etc pretty much useless for cholesterol lowering, compared to statins

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Eddy Edson

Eddy Edson

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New study just published. Comparing commonly-touted supplements to low-dose rosuvastatin.

newsroom.heart.org

6 common “heart-health” supplements ineffective at lowering cholesterol compared to statins

Research Highlights: Six widely used dietary supplements promoted for improving heart health – including brands of fish oil, cinnamon, garlic and turmeric – were not effective at lowering “bad” cholesterol more than placebo after 28 days of use. ...
newsroom.heart.org newsroom.heart.org

“According to a 2020 market research analysis, Americans spend an estimated $50 billion on dietary supplements annually, and many are marketed for ‘heart protection’ or ‘cholesterol management’. Yet there is minimal-to-no research demonstrating these benefits,” said study author Luke J. Laffin, M.D., co-director of the Center for Blood Pressure Disorders at the Cleveland Clinic in Cleveland, Ohio. “Some people also believe supplements are as effective or more effective than cholesterol-lowering statin medications.”

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Study funded by AstraZeneca, the original patent holder for rosuvastatin/Crestor (now generic), so I guess you can just play the Big-Pharma-lies card if you don't want to engage with the science.
 
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More than 80 independent clinical studies prove that plant stanol ester – the active ingredient in Benecol – can reduce cholesterol. 67 of these studies are randomised placebo -controlled trials (RCTs)

Does Benecol work? - Benecol - UK

Absolutely! More than 80 independent clinical studies prove that plant stanol ester – the active ingredient in Benecol – can reduce cholesterol. 67 of these studies are randomised placebo -controlled trials (RCTs), which are regarded as the ‘gold standard’ of scientific evidence, and for good...
benecol.co.uk benecol.co.uk
 
Benecol does work. Whether it's as effective as statins I don't know but it does work and can be an alternative way of lowering cholesterol if no statins are viable for someone.
 
ColinUK said:
Benecol does work. Whether it's as effective as statins I don't know but it does work and can be an alternative way of lowering cholesterol if no statins are viable for someone.
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Your link claims a lowering of 7-10% in cholesterol for Benecol.
Not too far from the 4.4% change in LDL in the chart above.
But a lot less then the 37.9% change from statins.
 
travellor said:
Your link claims a lowering of 7-10% in cholesterol for Benecol.
Not too far from the 4.4% change in LDL in the chart above.
But a lot less then the 37.9% change from statins.
Click to expand...
Absolutely it's a nudge thing rather with plant sterols but equally that may well be enough sometimes.
 
ColinUK said:
Absolutely it's a nudge thing rather with plant sterols but equally that may well be enough sometimes.
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Sure.

A big issue highlighted in the paper is that the actual contents of supplements are highly variable and may have little connection to the manufacturer's claims. You smply don't get the benefit of the tight regulation drugs are subject to. How much that applies to Benecol in particular - no idea!

One thing to be aware of is the wide range of individual responses to any of these things, hidden in the averages. From the presentation for this study:

1667836283909.png

Each bar on those charts is one individual. In this study, some people in the sterol leg got 20%+ LDL-C reduction, some people saw it actually increase. Ditto for the placebo leg.

Somebody may well get good LDL reduction from any of these things, but the same is true for placebo. Anecdotes <<<< science!
 
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Red yeast rice? I can’t even picture what that looks like.
 
Bloden said:
Red yeast rice? I can’t even picture what that looks like.
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Here's an irony.
"Monacolin K, which is the same as the drug lovastatin, is the most abundant in red yeast rice"
But it seems to have a different result to a manufactured statin?
Probably due to the variation in fermentations.
 
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travellor said:
Here's an irony.
"Monacolin K, which is the same as the drug lovastatin, is the most abundant in red yeast rice"
But it seems to have a different result to a manufactured statin?
Probably due to the variation in fermentations.
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Possibly also dose actually present when used as a supplement, or another component of the rice?
 
Some researchers discussing this study on twitter reference a detailed 2017 scientific statement on lipid lowering nutraceuticals from a big group of international experts: https://www.archivesofmedicalscience.com/pdf-130942-58027?filename=Lipid lowering.pdf

Quoting just the conclusion:

8. Conclusions

A large number of nutraceuticals have been tested in available trials, demonstrating their lipid-lowering effects.

It is, however, important to once again emphasize that nutraceuticals cannot replace lipid-lowering therapy but might essentially help to optimize it (reducing CV residual risk). Taking into account the influence of some of the presented nutraceuticals on different lipid parameters, it seems that this therapy might be especially important to consider for patients with mixed dyslipidemia, especially atherogenic dyslipidemia in patients with diabetes and MetS, in patients with low-to-moderate hypercholesterolemia not on target, as well as in all patients with statin-associated side effects, who cannot be treated with statins/suitable doses of statins and are at higher risk of CV events [298].

However, the main concern is still which lipid-lowering effects of nutraceuticals are clinically relevant, which are maintained in the long term and which might also be associated with an improvement in CVD risk. Combinations of lipid-lowering nutraceuticals could improve their safety (reducing the dosages of the single components), but their efficacy has been rarely tested in more than one study/RCT, while some of the tested nutraceutical combinations contained underdosed components.

On the other hand, both single components and some combinations (in particular red yeast rice, berberine, policosanol combination) have proved to maintain their efficacy in the long term (years), to have a positive impact on CVD risk factors other than LDL-C, and to improve some markers of vascular aging (endothelial function, pulse wave velocity).

Finally, some nutraceuticals have been shown to significantly improve the efficacy of standard pharmacological treatments. In this context, an evidence-based approach to the use of lipid-lowering nutraceuticals could improve the quality of the treatment, including therapy adherence, and achievement of the LDL-C goal in clinical practice. However, it has to be clearly stressed that there are still no outcome studies proving that nutraceuticals can prevent CVD morbidity or mortality.
 
So I should keep taking the statin, and not rely solely on the rather nice flavoured Madagascan dark chocolate bar I just bought from Waitrose, even though it's got ginger and turmeric.
 
Bruce Stephens said:
So I should keep taking the statin, and not rely solely on the rather nice flavoured Madagascan dark chocolate bar I just bought from Waitrose, even though it's got ginger and turmeric.
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Yes. The world is a cold heartless place & we deserve better.
 
Bruce Stephens said:
At least it has flavonoids so will be good for me in that respect. (At least according to the stories that'll be printed in a few weeks.)
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Is it chocolate’s week to kill you or cure you of everything this week? I lose track.
 
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