IN American Heart Association Scientific Sessions 2022researchers discuss their findings that six widely used nutritional supplements often touted to promote heart health are actually ineffective in lowering cholesterol levels compared to the effects produced by statins.
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What is cholesterol?
There are two types of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL, which is often considered the “good” type of cholesterol, can protect people from atherosclerotic heart disease by preventing plaque build-up in the arteries.
Conversely, an excessive amount of LDL, also known as the “bad” type of cholesterol, can build up in vessel walls, ultimately contributing to plaque formation. A buildup of these plaques in the arteries can reduce blood flow to various organs, including the heart, leg muscles, or brain. Thus, high LDL levels exceeding 130 milligrams (mg)/deciliter (dL) may indicate an increased risk of heart disease and stroke.
Globally, there were 4.51 million deaths attributable to high LDL cholesterol in 2020, a 19% increase from 2010.
About the research
Many dietary supplements are touted as “heart healthy” because of their ability to lower cholesterol levels. Despite the lack of sufficient data to support these claims, many people will take these supplements and believe that they are as effective, if not more effective, than the cholesterol management drugs that are approved for use by the Food and Drug Administration of the United States (FDA).
In an effort to better understand the true efficacy of these supplements compared to a low-dose statin, the researchers of the present study conducted a randomized, single-blind clinical trial that included rosuvastatin and placebo as positive and negative controls, respectively, as well as fish oil, cinnamon, garlic, turmeric, plant sterols and red yeast rice supplements.
For 28 days, study participants were randomly assigned to receive placebo, 5 mg of rosuvastatin, 2400 mg of fish oil, 2400 mg of cinnamon, 5000 µg of garlic, 4500 mg of turmeric, 1600 mg of plant sterols, or 2400 mg of red yeast.
In the present study, titled Supplements placebo or rosuvastatin study (SPORT), researchers analyzed data from 199 otherwise healthy adults between the ages of 40 and 75 with no prior history of cardiovascular disease. At baseline, participants’ LDL levels ranged between 70-189 mg/dL and were associated with a 5-20% risk of developing atherosclerotic cardiovascular disease over the next ten years.
At the end of the study period, the researchers noted that statin recipients had an average reduction of 37.9% in their LDL levels. In contrast, all dietary supplement recipients showed LDL levels comparable to those of placebo recipients. Of note, HDL cholesterol levels increased in garlic supplement recipients compared to the placebo group.
Additionally, rosuvastatin recipients showed a 19% reduction in blood triglyceride levels, while placebo and all dietary supplement recipients showed no difference in triglyceride levels by day 28.
HDL cholesterol levels neither increase nor decrease after statin treatment. However, plant sterols were found to reduce HDL cholesterol levels compared to placebo recipients.
Statins, placebo, and all dietary supplements had no significant effect on blood levels of inflammatory markers throughout the study period.
Despite the marketed heart-protective benefits of many nutritional supplements, these supplements are unlikely to significantly affect cholesterol levels.
Nevertheless, it remains extremely important that people consume a nutrient-dense diet that promotes a heart-healthy lifestyle to reduce the risk of cardiovascular disease. In addition to eating a variety of foods in moderation, the American Heart Association also emphasizes the importance of light to moderate physical activity, especially for those with high blood pressure and cholesterol levels.
The researchers note that some supplements may require longer consumption to have a significant impact on cholesterol levels. Therefore, future studies are needed to determine the potential short- and long-term effects of these and other dietary supplements on cholesterol levels.