The spice that gives Peking duck its distinctive red color
seems to lower blood cholesterol, two research teams reported
today at the American Heart Association's epidemiology and
prevention meeting.
In a study conducted in China, an extract of the red yeast
fermented on rice, which is sold under the name of Cholestin,
reduced total blood cholesterol by nearly 26 percent in
elderly patients after eight weeks of treatment, says the
study's lead author, Joseph Chang, Ph.D., vice president of
clinical affairs at Pharmanex, Inc. The Simi Valley, Calif.,
company imports the dietary supplement to the United
States.
"Cholestin also reduced 'bad' cholesterol or low-density
lipoprotein cholesterol (LDL) by 32.8 percent and decreased by
19.9 percent triglycerides, a type of blood fat associated
with increased risk for heart disease," says Chang.
The average total cholesterol level of study participants
was 225 milligrams/deciliter (mg/dL); average LDL was 160
mg/dL and average triglyerides were 250 mg/dL. LDL is called
the "bad" cholesterol because it collects in the blood vessels
to form plaque that can block blood flow, triggering a heart
attack or stroke. Individuals who did not receive the
supplement had reductions of total blood cholesterol and LDL
of about 7 percent, says Chang.
James Rippe, M.D., associate professor of medicine at Tufts
University School of Medicine in Boston, reports similar
results in a second study that was conducted in 12 medical
centers and funded by Pharmanex. He reports that after eight
weeks on Cholestin, individuals had a 16.4 percent drop in
total blood cholesterol. Their LDL decreased by 21 percent,
and HDL-cholesterol, the "good" cholesterol, increased by 14.6
percent. HDL cholesterol is called the "good" cholesterol
because it helps remove the "bad" cholesterol from the blood.
The average cholesterol levels for this group were 242 mg/dL;
average LDL was 158 mg/dL and the average HDL was 50
mg/dL.
"In China, the red yeast is known to promote healthy heart
function," says Rippe.
He speculated that the differences in results between the
Chinese and Boston studies could be due to the fact the
Chinese study used a more concentrated red yeast than that
found in Cholestin.
"As a natural substance there are hundreds of potentially
active ingredients in Cholestin that could have contributed to
the cholesterol lowering. Cholestin contains a range of
HMG-CoA reductase inhibitors that probably contribute to the
effect," Rippe say. "The Chinese study participants received
approximately 13.5 milligrams of HMG-CoA reductase inhibitors
each day in the Cholestin preparation that they took, while
the participants in the Boston study received about 9.6 mg per
day," according to Rippe.
Most of the cholesterol that circulates in the blood does
not come from dietary cholesterol but is instead manufactured
by the liver. HMG CoA reductase is an enzyme found in the
liver that controls cholesterol production in the body. By
inhibiting that enzyme, red yeast reduces the body's
cholesterol output, according to Rippe.
"Although red yeast fermented on rice is used to spice
traditional Chinese food, such as Peking duck and spareribs,
this is not an efficient way to consume the substance," says
Rippe. "The capsule form of red yeast rice contains a more
consistent amount of the active ingredients than the amount
people in China obtain from these sources in their diet."
The capsule form of red yeast did not cause significant
side effects, the researchers say.
Chang's colleague, J. S. Zhu, director of clinical
pharmacology at Pharmanex in Beijing, says, of the 70 patients
in his study, one dropped out because of headaches and four
other individuals discontinued the study because of travel
demands.
Eighteen percent of the men and women in the Boston study
reported mild to moderate symptoms, mostly mild
gastrointestinal problems or headaches, and 16 of the 187
individuals left the study early, says Zhu. "To put it in
perspective, that is an extremely low number in general and
shows that Cholestin causes few side effects," he adds.
Thomas A. Pearson, M.D., Ph.D., chairman of American Heart
Association's population science committee and chairman of
community and preventive medicine at the University of
Rochester School of Medicine, Rochester, NY, says, "The
results of these two studies are promising. In the future, the
red yeast rice may provide clinicians with another tool to
lower LDL cholesterol. The substance certainly merits
additional study. However, too little is known to make
scientifically sound statements about the safety and
effectiveness of this substance to make a public health
recommendation about its use at present.
"In the meantime, the American Heart Association continues
to advise individuals to try to lower high blood cholesterol
with a diet that is low in saturated fat and rich in fruits,
vegetables and whole grains," says Pearson. If diet alone does
not bring the cholesterol levels under control, treatment with
several types of medications, including statin drugs that have
been comprehensively studied, are a second step in treatment
options."
