Red Yeast Rice Research on Cholesterol

In another 8-week trial involving 446 people with high cholesterol levels, those who received red yeast rice experienced a significant drop in cholesterol levels compared to those who received placebo. Total cholesterol fell by 22.7%, LDL by 31%, and triglycerides by 34% in the red yeast rice group. HDL cholesterol increased by 20% in the red yeast rice group as well. (Bonovich, K, Colfer H, Davidson M, Dujovne C, Greenspan M, Karlberg R, et al. A Multi-Center, Self-Controlled Study of Cholestin In Subjects With Elevated Cholesterol. American Heart Association. 39^th Annual Conference on Cardiovascular Disease Epidemiology and Prevention, Orlando, Fl. March 1999).

Along with its evaluation in animal trials, red yeast rice has been clinically investigated as a therapy for reducing cholesterol in two human trials. In one trial, both men and women taking 1.2 grams (approximately 13.5 mg total monacolins) of a concentrated red yeast rice extract per day for two months had significant decreases in serum cholesterol levels. In addition, people taking red yeast rice had a significant increase in HDL (“good”) cholesterol and a decrease in LDL (“bad”) cholesterol. Elevated triglycerides were also found to be lowered.

(Li C, Zhu Y, Wang Y, et al. Monascus purpureus-fermented rice (red yeast rice): a natural food product that lowers blood cholesterol in animal models of hypercholesterolemia. Nutr Res 1998;18:71–81).

(Wang J, Lu Z, Chi J, et al. Multicenter clinical trial of the serum lipid-lowering effects of a Monascus purpureus (red yeast) rice preparation from traditional Chinese medicine. Curr Ther Res 1997;58:964–77).

A double-blind trial at the UCLA School of Medicine determined that red yeast rice in the amount of 2.4 grams per day (approximately 10 mg total monacolins) in capsules significantly decreased total- and LDL-cholesterol levels in a sample of people with elevated cholesterol after 12 weeks of therapy. Triglycerides were also reduced in those taking red yeast rice. However, unlike the original study, HDL values did not increase substantially.

(Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr 1999;69:231–6).

Clinical Research Abstracts:

Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials.

Chin Med. 2006 Nov 23;1:4

Liu J, Zhang J, Shi Y, Grimsgaard S, Alraek T, Fonnebo V.

National Research Centre in Complementary and Alternative Medicine (NAFKAM), University of Tromso, Tromso N-9037, Norway. Jianping.liu@fagmed.uit.no.

ABSTRACT: Extracts of Chinese red yeast rice (RYR, a traditional dietary seasoning of Monascus purpureus) contains several active ingredients including lovastatin, and several trials of its possible lipid-lowering effects have been conducted. This meta-analysis assesses the effectiveness and safety of RYR preparations on lipid modification in primary hyperlipidemia. We included randomized controlled trials testing RYR preparation, compared with placebo, no treatment, statins, or other active lipid-lowering agents in people with hyperlipidemia through searching PubMed, CBMdisk, TCMLARS, the Cochrane Library, and AMED up to December 2004. Ninety-three randomized trials (9625 participants) were included and three RYR preparations (Cholestin, Xuezhikang and Zhibituo) were tested. The methodological quality of trial reports was generally low in terms of generation of the allocation sequence, allocation concealment, blinding, and intention-to-treat. The combined results showed significant reduction of serum total cholesterol levels (weighted mean difference -0.91 mmol/L, 95% confidence interval -1.12 to -0.71), triglycerides levels (-0.41 mmol/L, -0.6 to -0.22), and LDL-cholesterol levels (-0.73 mmol/L, -1.02 to -0.043), and increase of HDL-cholesterol levels (0.15 mmol/L, 0.09 to 0.22) by RYR treatment compared with placebo. The lipid modification effects appeared to be similar to pravastatin, simvastatin, lovastatin, atorvastatin, or fluvastatin. Compared with non-statin lipid lowering agents, RYR preparations appeared superior to nicotinate and fish oils, but equal to or less effective than fenofibrate and gemfibrozil. No significant difference in lipid profile was found between Xuezhikang and Zhibituo. RYR preparations were associated with non-serious adverse effects such as dizziness and gastrointestinal discomfort. Current evidence shows short-term beneficial effects of RYR preparations on lipid modification. More rigorous trials are needed, and long-term effects and safety should be investigated if RYR preparations are to be recommended as one of the alternative treatments for primary hyperlipidemia.

PMID: 17302963 [PubMed - in process]

Red yeast rice: a new hypolipidemic drug.

Life Sci. 2004 Apr 16;74(22):2675-83

Journoud M, Jones PJ.

School of Human Nutrition, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Canada.

Red yeast rice is a source of fermented pigment with possible bioactive effect. Evidence shows that fermented red yeast rice lowers cholesterol levels moderately compared to other statin drugs, but with the added advantage of underscores its potential as a new alternative to lipid level control. It is concluded from the present evidence that other types of pigmented rice possess opportunities for development as new functional foods.

PMID: 15069955 [PubMed - indexed for MEDLINE]

Hypolipidemic and anti-atherogenic effects of long-term Cholestin (Monascus purpureus-fermented rice, red yeast rice) in cholesterol fed rabbits.

J Nutr Biochem. 2003 Jun;14(6):314-8

Wei W, Li C, Wang Y, Su H, Zhu J, Kritchevsky D.

Department of Biochemical Pharmacology, School of Pharmaceutical Science, Peking University Health Science Center, Beijing 100083, China.

Long-term effects of Cholestin (Monascus purpureus rice; red yeast rice) on serum lipids and severity of atherosclerosis were examined in rabbits fed for 200 days on a semi-purified diet containing 0.25% cholesterol. Serum total cholesterol was 25 and 40% lower, respectively, in rabbits fed 0.4 or 1.35 g/kg/day of Cholestin (Monascus purpureus rice; red yeast rice) compared to controls. This treatment also lowered serum LDL cholesterol. This 200-day treatment significantly reduced serum triglycerides and atherosclerotic index (ratio of non-HDL-cholesterol to HDL-cholesterol). Although similar reductions of total, LDL-cholesterol and triglycerides were observed, a parallel group of rabbits fed lovastatin (0.0024 g/kg/day) failed to reduce the index significantly. Apolipoprotein A(1) was increased and apolipoprotein B was reduced in all treatment groups. Severity of atherosclerosis was reduced significantly in all treatment groups. The sudanophilic area of involvement was 80.6% in controls, and reduced significantly; to 30.1% on the low dose of Cholestin (Monascus purpureus rice; red yeast rice), and 17.2% on the high dose. Lovastatin reduced severity of lesions by 89% (sudanophilia) and 84% (visual). Visual grading of lesion severity showed reduction by 38% and 68%.

PMID: 12873712 [PubMed - indexed for MEDLINE]

Cholestin inhibits cholesterol synthesis and secretion in hepatic cells (HepG2).

Mol Cell Biochem. 2002 Apr;233(1-2):153-8

Man RY, Lynn EG, Cheung F, Tsang PS, O K.

Department of Pharmacology, Faculty of Medicine, University of Hong Kong, China.

Hyperlipidemia is a well-known risk factor for atherosclerosis and statins are widely used to treat patients with elevated levels of lipids in their plasma. Notwithstanding the proven benefits of statin drugs on both primary and secondary prevention of heart disease, the high cost of statin treatment, in addition to possible side effects such as liver function abnormalities, may limit their widespread use. We conducted a study on a natural product as an alternative to statin treatment. Cholestin, a dietary supplement, is prepared from rice fermented with red yeast (Monascus purpureus), which has been shown to significantly decrease total cholesterol levels in hyperlipidemic subjects. Our objective was to determine the cellular effect of Cholestin on cholesterol synthesis in human hepatic cells (HepG2) and the mechanism by which it caused a change in lipid metabolism. Cholestin had a direct inhibitory effect on HMG-CoA reductase activity (78-69% of control). Cholesterol levels in HepG2 cells treated with Cholestin (25-100 microg/mL) were significantly reduced in a dose-dependent manner (81-45% of control, respectively). This reduction was associated with decreased synthesis and secretion of both unesterified cholesterol (54-31 and 33-14% of control, respectively) and cholesteryl ester (18-6 and 37-19% of control, respectively). These results indicate that one of the anti-hyperlipidemic actions of Cholestin is a consequence of an inhibitory effect on cholesterol biosynthesis in hepatic cells and provide the first documentation of a biomolecular action of red yeast rice.

PMID: 12083370 [PubMed - indexed for MEDLINE]