Red Yeast Rice

The role of red yeast rice for the physician.
Gordon RY, Becker DJ.
Curr Atheroscler Rep. 2011 Feb;13(1):73-80.

  Red yeast rice is an ancient Chinese dietary staple and medication used by millions of patients as an alternative therapy for hypercholesterolemia. In recent years, the use of red yeast rice has grown exponentially due to increased public interest in complementary and alternative medications and the publication of several randomized, controlled trials demonstrating its efficacy and safety in different populations. The most promising role for red yeast rice is as an alternative lipid-lowering therapy for patients who refuse to take statins because of philosophical reasons or patients who are unable to tolerate statin therapy due to statin-associated myalgias. However, there is limited government oversight of red yeast rice products, wide variability of active ingredients in available formulations, and the potential of toxic byproducts. Therefore, until red yeast rice products are regulated and standardized, physicians and patients should be cautious in recommending this promising alternative therapy for hyperlipidemia. PMID: 21061097

   Lowered lipids efficiency of compound red yeast rice extract in rats with hyperlipidemia
Chen Y, Zhang G, Ye Z.
Zhongguo Zhong Yao Za Zhi. 2010 Feb;35(4):504-7.

  To observe the effects of compound red yeast rice extract (CRYRE) on blood lipids, hemorheology and blood coagulant system in rats with hyperlipidemia. SD rats were randomly divided into six groups: normal control group, model group, Xuezhikang group (0. 24 g x kg(-1)), CRYRE high dose group (2.4 g x kg(-1)), middle dose group (1.2 g x kg(-1)) and low dose group (0.6 g x kg(-1)). The normal control rats were given pure water, and rats of other five groups were given 10 mL kg lipid emulsion and subjected to daily intragastric administration simultaneously in two days, continuously for 3 weeks. After the last medication, all the rats were sacrificed for measurement of blood lipids, hemorheology and coagulation factors. CRYRE 2.4 g x kg(-1) could significantly reduce the serum TG, TC levels and increase the HDL-C level (P < 0.01, P < 0.05). CRYRE 0.6-2.4 g x kg(-1) could significantly increase the ratios of HDL-C/TG,HDL-C/TC and HDL-C/LDL-C (P < 0.01). CRYRE 2.4 g x kg(-1) also reduced whole blood viscosity and plasma viscosity (P < 0.01, P < 0.05), prolonged active partial thromboplastin time, and lowered fibrinogen content (P < 0.01, P < 0.05). CRYRE 2.4 g x kg(-1) could reduce blood lipids, blood viscosity and fibrinogen content, improve blood circulation, and depress the alteration of blood coagulant system resulted from lipid metabolic disorder in rats with hyperlipidemia. PMID: 20450054

   Diet and exercise in the management of hyperlipidemia.
Kelly RB.
Am Fam Physician. 2010 May 1;81(9):1097-102.

 Dietary factors that influence lipid levels include modification of nutritional components, consumption of specific foods, use of food additives and supplements, and major dietary approaches. The most beneficial changes result from reducing intake of saturated and trans fats; increasing intake of polyunsaturated and monounsaturated fats; fortifying foods with plant stanols or sterols; isocalorically adding tree nuts to the diet; consuming one or two alcoholic drinks per day; and adopting a Portfolio, Mediterranean, low-carbohydrate, or low-fat diet. Smaller but still beneficial effects result from reducing intake of dietary cholesterol, increasing intake of soluble fiber and soy protein, and eating fatty marine fish or taking marine-derived omega-3 fatty acid supplements. Red yeast rice supplements have effects similar to those of statin medications and are better tolerated in some patients. Regular aerobic exercise has beneficial effects on lipid levels, particularly if performed for at least 120 minutes per week. Brief physician counseling will have relatively small effects on unselected patients, so efforts should be concentrated on patients who are motivated and ready to make lifestyle changes. PMID: 20433126

   Herbs and atherosclerosis.
Heber D.
Curr Atheroscler Rep. 2001 Jan;3(1):93-6.

  It is now widely accepted that atherosclerosis is a complex multicellular process involving oxidation of cholesterol and the intracellular accumulation of oxidized cholesterol. This accumulation causes a cascade of inflammatory processes, resulting in an unstable atherosclerotic plaque that ultimately bursts, causing myocardial infarction. Botanical dietary supplements (herbs) can ameliorate this process and prevent cardiovascular disease at many steps in the process. Many herbs have antioxidant activity and can reduce low-density lipoprotein oxidation. Some phytosterols found in botanicals can inhibit cholesterol absorption. After a brief review of herbs being promoted for achieving and maintaining healthy cholesterol levels, the evidence and future prospects for Chinese red yeast rice, the main component of dietary supplements with HMG-CoA reductase inhibiting activity, are discussed in detail. Initial phase II clinical trials are highly encouraging. This herb is likely to be able to directly impact the process of atherosclerosis, but large-scale clinical trials are needed to assess the public health potential of this herbal supplement. PMID: 11123854

   Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement.
Heber D, Yip I, Ashley JM, Elashoff DA, Elashoff RM, Go VL.
Am J Clin Nutr. 1999 Feb;69(2):231-6.

  We examined the cholesterol-lowering effects of a proprietary Chinese red-yeast-rice supplement in an American population consuming a diet similar to the American Heart Association Step I diet using a double-blind, placebo-controlled, prospectively randomized 12-wk controlled trial at a university research center. We evaluated the lipid-lowering effects of this red-yeast-rice dietary supplement in US adults separate from effects of diet alone. Eighty-three healthy subjects (46 men and 37 women aged 34-78 y) with hyperlipidemia [total cholesterol, 5.28-8.74 mmol/L (204-338 mg/dL); LDL cholesterol, 3.31-7.16 mmol/L (128-277 mg/dL); triacylglycerol, 0.62-2.78 mmol/L (55-246 mg/dL); and HDL cholesterol 0.78-2.46 mmol/L (30-95 mg/dL)] who were not being treated with lipid-lowering drugs participated. Subjects were treated with red yeast rice (2.4 g/d) or placebo and instructed to consume a diet providing 30% of energy from fat, <10% from saturated fat, and <300 mg cholesterol daily. Main outcome measures were total cholesterol, total triacylglycerol, and HDL and LDL cholesterol measured at weeks 8, 9, 11, and 12. Total cholesterol concentrations decreased significantly between baseline and 8 wk in the red-yeast-rice-treated group compared with the placebo-treated group [(x+/-SD) 6.57+/-0.93 mmol/L (254+/-36 mg/dL) to 5.38+/-0.80 mmol/L (208+/-31 mg/dL); P < 0.001]. LDL cholesterol and total triacylglycerol were also reduced with the supplement. HDL cholesterol did not change significantly. Red yeast rice significantly reduces total cholesterol, LDL cholesterol, and total triacylglycerol concentrations compared with placebo and provides a new, novel, food-based approach to lowering cholesterol in the general population. PMID: 9989685