Among all the modifiable cardiovascular risk factors, the values of total cholesterol and bad cholesterol certainly play an important role. Even more so if we consider the data from the American Heart Association, which estimated that, in 2016, in the United States, only 75% of children and 47% of adults had total cholesterol values within the recommended limits. In any case, this is also observable in many Western countries characterized by a sedentary lifestyle and a diet rich in sugars and fats. But how can we act to reduce cholesterol values and thus cardiovascular risk?
Diet and lifestyle against high cholesterol
Certainly a help comes from dietary changes, trying to adopt a diet low in saturated fat and adhering as much as possible to the Mediterranean Diet. Therefore, a good choice, for heart health but also for that of the whole organism, is to take fruit, vegetables, whole grains, nuts, poultry, low-fat dairy products and fish, trying to limit red meat, sweets and sugary drinks. It is also important to ensure a moderate daily physical activity of at least 20 minutes a day, stop smoking, also avoiding passive smoking, and try to lose weight if overweight. If maintained over time, these measures can lead to a reduction of bad LDL cholesterol between 5% and 15%. This fact is noteworthy, since it is considered that each 1% reduction in LDL cholesterol values is associated with a 1% reduction in cardiovascular risk (Cicero et al, Methodist Debakey Cardiovasc J., 2019). If it is not possible to reduce cholesterol, as for example the endogenous cholesterol, that is the cholesterol produced by the body, is excessive, it may be useful to use substances capable of lowering cholesterol. The most famous cholesterol-lowering substances are certainly statins (Cicero et al, Methodist Debakey Cardiovasc J., 2019).
Natural and synthetic statins
Statins are substances taken to effectively reduce cholesterol. However, synthetic statins are often associated with problems such as myopathies, diseases that damage the muscles. In fact, it should be taken into consideration that statins not only act by reducing cholesterol but also other substances such as coenzyme Q 10, involved in the stabilization of the cell membrane and with antioxidant action, capable of protecting DNA from damage by free radicals. A reduction in coenzyme Q 10 levels can lead to myopathies (Traub et al, Natural Medicine Journal, 2014). More tolerated, but always effective, are natural statins, a category to which red yeast rice belongs.
The cholesterol-fighting properties of red yeast rice
Red yeast rice is obtained, as the term suggests, by fermenting yeast in red rice. The result is a product that provides fatty acids, sterols, isoflavones but above all monacolins, which are substances capable of lowering the levels of circulating lipids in the blood (Cicero et al, Methodist Debakey Cardiovasc J., 2019). One of these monacolins isolated in red yeast rice is monacolin K, designed to inhibit the enzyme that regulates the cholesterol synthesis process and is structurally similar to lovastatin, a statin used in the treatment of hypercholesterolemia. Studies have observed that the intake of red yeast rice has an action, after at least 2 months of treatment, similar to synthetic statins such as provastatin and lovastatin. In particular, red yeast rice is able to reduce bad LDL cholesterol by up to 25%. Not only that, red yeast rice also led to a modest increase in HDL good cholesterol and a reduction in triglycerides (Cicero et al, Methodist Debakey Cardiovasc J., 2019). In addition, red yeast rice has also been shown to improve the function of the endothelium, which is the lining of blood vessels and the heart, reducing the stiffness of the arteries (Cicero et al, Methodist Debakey Cardiovasc J., 2019). In addition to this, red yeast rice contrasts arteriosclerosis, is antitumor, hepatoprotective, antiobesity, antidiabetic, anti-inflammatory and anti-hypertensive (Zhou et al, Front Pharmacol, 2019).
Red yeast rice, risks and warnings
Red yeast rice is considered generally safe and well tolerated, even in patients who had shown intolerance to synthetic statins (Cicero et al, Methodist Debakey Cardiovasc J., 2019). However, pay attention to the combination of red yeast rice and grapefruit, cyclosperine, which is a drug that inhibits the immune system, antifungals and antidepressants, which can alter the values of monacolin K and increase the risk of myotoxicity up to rhabdomyolysis, which is a condition in which skeletal muscle is damaged, as well as causing gastrointestinal symptoms and liver problems (Cicero et al, Methodist Debakey Cardiovasc J., 2019 - Farkouh et al, Int J Gen Med, 2019). Never exceed with the administration of red yeast rice, to avoid an excess of monacolin K, and always rely on your doctor or pharmacist who will be able to recommend the best and well-balanced products as, sometimes, some companies market products containing high quantities of monacolin K that could cause side effects similar to synthetic statins. Not only that, sometimes low-quality products can contain toxins. Often red yeast rice is then combined with other substances, which can increase its anti-cholesterol action, such as coenzyme Q 10, olive tree extracts and sterols (Zhou et al, Front Pharmacol, 2019). The association with coenzyme Q 10 also helps to avoid possible reductions of this substance and myopathies. Finally, do not take red yeast rice along with other statins.
