Cholesterol Lowering Supplements: How Do I Know Which One Is Best?

You may be aware of heart health claims made by commercial food packagers offering "sterol fortified foods", or of those marketing so-called cholesterol lowering supplements, stating that their particular products, when included along with a diet low in saturated fats, will aid your vascular health. Corporations that produce these products must protect themselves from potential litigation, so their claims must accompany the FDA required "non-cure" statement as well. Are the health promoting claims concerning natural or naturally derived products valid? What does research by independent studies show about these substances that you may be spending extra money on in the hopes of seeing your HDL (that's the good kind of cholesterol) rise, and/or your LDL (that's the bad kind) drop? Below is a brief overview of what the research data has presented on a few of the more popular products that have been marketed to consumers looking for naturally based or non-drug approaches to addressing this health concern.

Red Yeast Rice

This is by far one of the more popular supplements in this category. It's a rice derived fungus that contains statins, the substance in those drugs prescribed by physicians to lower LDL. These products were shown to lower LDL by about 20% in studies, but the potency seemed to vary from one product to another that were tested. Some study participants suffered from muscle pain: a common side effect with the use of statins. There may also be the possibility of liver damage with long-term use. Until there is a qualified regulating body to assure purity and potency of off-the-shelf supplements, which is not likely to happen anytime soon, you can't really tell what you're getting.

Niacin

It's one of the B vitamins (B-3), such as you find in the B-complex. It has a positive reputation for helping to lower serum triglycerides, (blood plasma lipids), which are another heart disease risk factor. It's somewhat impressive as an HDL raising agent, but you would likely need to consume 3 to 4 grams over a 24 hour period to make a measurable dent upon your LDL. This level of consumption would result in the so-called "niacin flush" which feels as if someone is popping your skin with rubber bands. Long term high dose ingestion (above about 6 grams) is associated with liver damage. Don't attempt to consume high doses for therapeutic purposes without having a physician monitor your liver function.

Guggul

This resin exudate comes from the stalk of a plant native to India. It has achieved recognition in part due to the increased popularity of Ayurvedic medicine. It is similar in structure to steroidal compounds. In 2003, the Journal of The American Medical Association (JAMA) published the results of a controlled trial that indicated guggul having little positive effect on HDL, but causing a small increase in LDL. There is some evidence that this substance may also contribute to liver damage. It may be wise to stay away until future trials yield more encouraging results.

Oat Bran

You've likely seen the claims on the side of cereal boxes and on TV advertisements. Does oat bran have an effect on lowering LDL? Yes. But to keep your LDL in check with oats alone, you would need to consume about 10-15 bowls of oatmeal daily or at least 2 cups of the bran portion. That's probably not going to happen. You're likely better off consuming reasonable amounts for blood sugar stabilization, colon health and regularity, and because it makes for tasty cookies.

Policosanol

A plant wax derivative of sugarcane and/or beeswax, it is supposedly similar in mode to statins in blocking cholesterol production by the liver. The latest research has shown it to not have any appreciable effect by itself on lowering LDL or raising HDL.

Plant Sterols

These wax like components are found throughout the vegetable kingdom. They both mimic and block LDL in the digestive tract carrying the harmful fats out of your system. They are in almonds, olive oil, sesame seeds, legumes, and wheat germ to name a few. They are also added to foods such as butter/margarine spreads and fruit juice beverages as a sterol complex, since it may be difficult to get enough of them from food intake alone to do you noticeable good. However, this is one additive that may be beneficial. An FDA claim says that "foods containing at least 0.65g per serving of vegetable oil plant sterol esters, eaten twice a day with meals for a total fat intake of at least 1.3g as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease." One drawback is that many of these packaged fats contain polyunsaturated fats that are hydrogenated or partially hydrogenated. These are known to be artery clogging, so consumption of these products may negate the positive benefits.

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