DIETARY SUPPLEMENTS TO LOWER CHOLESTEROL?

Many patients are turning to natural substances to lower their cholesterol levels and the risk of cardiovascular disease. But are they really effective? The point on these different products whose advertising boast so much the merits.

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According to a US study, 75% of patients who have cardiovascular disease consume dietary supplements to lower their cholesterol levels. Largely mediatized and marketed, these substances seem to be a miracle product. However, in contrast to taking statins and a balanced diet, the evidence for their effectiveness is still limited: some dietary supplements have a proven effect on cholesterol levels, but variable and limited to cardiovascular risk; others do not have any at all, according to the existing scientific data.

You should know that dietary supplements have a potential influence on three specific elements: HDL cholesterol (the “good” cholesterol, or lipoproteins that help eliminate cholesterol), LDL cholesterol (the “bad” cholesterol, or the lipoproteins that accumulate in the blood vessels) and triglycerides (fatty acids, harmful when they are in excess).

The intake of these products should therefore be followed up with the treating physician, in the same way as usual drug treatments.

Red rice yeast

Red rice yeast is the result of rice fermentation and has the same characteristics as statins, which are usually prescribed to patients with high cholesterol levels. Thanks to the monacolin K molecule it contains, red yeast rice can increase HDL cholesterol while lowering LDL and triglycerides. It is therefore indicated for primary prevention, for example in a patient who does not wish to take synthetic statins or who has difficulty changing his lifestyle. On the other hand, there is not enough evidence to prescribe it to patients who have already had a cardiovascular event.

Note that it should not be taken at the same time as synthetic statins, since it shares the same -beneficial and secondary effects. Prohibited in Switzerland, it is marketed in the rest of Europe.

Phytosterols

Lipids from plants and vegetable oils, phytosterols are very similar to the cholesterol present in our body. Ingesting (2 g per day, ideally) helps to limit the absorption of cholesterol in the intestine and reduce the “bad” LDL cholesterol. However, their effects on HDL, triglycerides and cardiovascular risk are zero.

Dietary fiber

It is widely recognized that eating dietary fiber plays an important role in reducing cholesterol and preventing cardiovascular disease. The Federal Office of Public Health recommends to this end to consume 30 g per day and to favor oat bran, fruits and vegetables.

Omega-3 fatty acids

If foods rich in omega-3 (oily fish, nuts, rapeseed oil, soy) are really effective in terms of cardiovascular prevention, it is not the same for omega-3 in the form of dietary supplements. Indeed, supplements of omega-3 fatty acids have no effect on cholesterol levels and the reduction of cardiovascular risk. It is therefore better to prefer the real foods, and eat for example two portions of fatty fish per week.

Green tea, soy, guggul and artichoke leaves

Contrary to what is widely known, these four foods are only slightly – if at all – effective on cholesterol levels. To date, there is no evidence of their ability to reduce cardiovascular risk.

While the consumption of green tea can significantly reduce total cholesterol and LDL, it remains powerless on the other hand on HDL and triglycerides. In addition, it would take a very large dose (6-7 cups per day) to achieve the desired effect!

As for soy, its effect is minimal; Ditto for guggul, a plant resin from Ayurvedic medicine, and for artichoke leaves, whose supposedly beneficial effects are still not confirmed.

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