Let’s take some time to discuss cholesterol, the supplements that exist that claim to improve it, and what we can do as consumers to help manage it.
First, what exactly is cholesterol? Cholesterol is a sterol, a waxy substance that exists within our bodies. Cholesterol serves a number of important functions, which include generating cell membranes, hormones, digestive compounds, and vitamin D. Your body naturally makes cholesterol, but it can also be found in foods like egg yolks, meat, and cheese.
There are different types of cholesterol, and each type serves a different function. High density lipoprotein (HDL) is often referred to as the “good cholesterol.” It carries excess cholesterol out of the body. Low density lipoprotein (LDL) also carries cholesterol, but we find this type building up inside the arteries. In high amounts, LDL could lead to plaque buildup and increased risk of poor cardiac outcomes. That’s why you might hear it being referred to as the “bad cholesterol.” Very low density lipoprotein (VLDL) is another type of cholesterol that can also build up in the arteries, but it carries triglycerides, a different type of fat source in the blood.
It’s important to note we need all of these cholesterol types to survive, however we only need them in certain amounts. Unhealthy lifestyle behaviors, such as poor dietary choices, lack of exercise, smoking, stress, and too much alcohol consumption may cause unwanted buildup or disproportionate levels.
There are supplements on the market that promote having cholesterol-lowering properties. But how do they work exactly? And is it safe or will it be effective if you start taking one? Here are some of the common supplements that exist and what studies say about each:
Red yeast rice is a supplement made from a type of yeast that grows on rice. It is a dietary staple in Asian cuisine and is also used in Chinese medicine. As a supplement, it is claimed to reduce cholesterol and heart disease risk. Red yeast rice contains monacolin K which is an ingredient in lovastatin (Altoprev), a commonly prescribed cholesterol-lowering drug. Red yeast rice is generally considered safe, but should be taken with caution as it may have similar side effects to statins. There are also known interactions between red yeast rice and certain foods, medications, and supplements, so it is important to discuss this supplement with your doctor before taking it. Lastly, it is not advised to take red yeast rice if you are pregnant, trying to become pregnant, or breastfeeding.
Phytosterols are naturally occurring compounds that exist in plants. They have a similar structure to that of cholesterol, and they compete with cholesterol for absorption in the gut. When phytosterols take the place of cholesterol, excess cholesterol is excreted from the body. Eating plant-based foods is a great way to get phytosterols into your body, but phytosterol supplements have also been formulated to serve the same purpose. Phytosterol supplements may be beneficial for individuals with or with family history of heart disease, high cholesterol, or atherosclerosis. They are generally considered safe, but there is limited evidence that supports the claim that supplements are equally or more potent than the phytosterols found in food.
Fiber is loaded with health benefits, but sadly, most Americans struggle to meet their daily fiber needs. There are many fiber supplements on the market that claim to promote bowel regularity, blood sugar regulation, healthy cholesterol levels, and meeting daily fiber needs. Isolated synthetic fibers (the type added to foods and in supplements) differ from naturally-occurring fiber found in fruits, vegetables, whole grains, legumes, and nuts. Most research looks at the relationship between whole, intact dietary fiber and cardiovascular disease risk. This is why it is encouraged to get fiber from your meals and snacks whenever possible. Fiber supplements, however, have been shown to yield positive health benefits for those with elevated LDL, elevated blood sugar, and bowel irregularity.
Although the option for supplements might be quick and easy, a study was published in 2022 by the Journal of The American College of Cardiology found no significant difference in LDL, total cholesterol, or triglycerides after the use of supplements. Some even saw adverse effects, including increased LDL and decreased HDL! Although more research is needed to support these findings, the results aren’t promising. In our opinion, your best bet is to adjust your diet to include all the healthy foods that are safe and effective at lowering cholesterol. Remember these tips: (1) eat plenty of fruits, vegetables and whole grains, (2) limit red meat, full-fat dairy and alcohol consumption, and (3) increase your exercise to levels deemed safe by your doctor. Lastly, always go to your annual physical for routine labs to make sure your health is maintained and cholesterol levels stay managed!
Until next time,
Emily
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