• Home
• Healthy Heart

• Choose text size:
• A
• A
• A

November 9, 2010 | Comments: 0

Cholesterol Busters?

If you have high cholesterol, you may be tempted to try a "heart-health" supplement. Some have evidence to back their use, but others are questionable.

Sterols or stanols: These plant compounds interfere with the absorption of dietary cholesterol. The standard dose (2 grams, or 2,000 milligrams, a day) lowers LDL (“bad”) cholesterol by 9% to 20%. The government’s cholesterol guidelines and the American Heart Association recommend foods fortified with sterols/stanols. There are also sterol and stanol supplements, which vary in composition and dosage. The FDA allows labels on foods or supplements to claim they reduce the risk of heart disease if they supply at least 400 milligrams of sterols per serving or dose, for a daily total of at least 800 milligrams. Our take: Worth trying.

Soluble fiber supplements: The government’s cholesterol guidelines recommend fruit, vegetables, and grains rich in soluble fiber, including psyllium, a seed grain sold as a laxative and fiber supplement. Psyllium can lower LDL cholesterol by 5% to 15% and has other heart-healthy effects; you have to take the standard dose three times a day to get the greatest effect. Beta glucan, found in oats and barley, is another soluble fiber that lowers LDL cholesterol. Many supplements provide beta glucan or other soluble fibers, but have not been adequately studied. Our take: Psyllium is a good option, as part of a heart-healthy diet. Get other soluble fibers from foods, rather than supplements.

Red yeast rice extract: Made by fermenting red yeast on rice, the extract contains a statin compound, lovastatin, so it does improve cholesterol levels. But the effect is less predictable, since the supplements are not standardized. In fact, a new analysis of 12 red yeast rice supplements, reported in the Archives of Internal Medicine, found that the products varied widely in how much active ingredient they contained. Moreover, a potentially harmful substance was detected in three products. Keep in mind, also, that red yeast rice supplements can cause the same side effects as statin drugs. Our take: It may be effective, but it’s safer to take a prescription-quality statin under medical supervision. A generic statin may not cost much more and is covered by insurance.

Fish oil supplements: The omega-3 fats in fish have a variety of potential cardiovascular benefits, but do not lower cholesterol. In fact, they may raise both LDL and HDL cholesterol slightly. Our take: If you have heart disease or high triglycerides, talk to your doctor about omega-3 supplements, but don’t take them to lower your cholesterol.

Garlic: Studies have yielded inconsistent results. There are many types of supplements, with different amounts of garlic components. A well-designed study at Stanford University found no benefit on cholesterol from two popular supplements or raw garlic. If there is an effect, it’s probably small. Our take: Garlic supplements are not rec­om­mended; eat garlic if you like it, but not to lower cholesterol.

Guggul extract (guggulipid): Guggul is a gummy resin from a tree. Despite some positive research from India, two well-designed studies (from the U.S. and Norway) found no lowering of LDL cholesterol, but did note frequent side effects, mostly gastrointestinal. It can interfere with certain drugs. Our take: Not recommended.

Policosanol: Usually derived from sugar cane or beeswax, policosanol has been studied mostly in Cuba, where it’s been found to improve cholesterol levels. But independent studies from Germany and Italy found it ineffective. Potential side effects include gastrointestinal upset and rashes; it can affect blood-clotting medication. Our take: Not recommended.

Keep in mind: Cholesterol-lowering drugs have been well studied, have impressive results, and their side effects, mostly rare, are known. You can be sure of what’s in the drug, in contrast to dietary supplements, which are not well-regulated. But if you have high cholesterol and want to try one of these supplements, tell your doctor, so the effects can be monitored.

Read more on this topic