Monacolin K from Red Yeast Rice Improves LDL in High Cholesterol Subjects

by | Jun 26, 2019 | 2016, Blood Lipids, Cardiovascular Health

Written by Angeline A. De Leon, Staff Writer. Twelve-weeks of supplementation with a 3mg low dose of monacolin K from red yeast rice significantly reduced LDL-C, total cholesterol, and homocysteine in the participating seventy subjects with high cholesterol levels.

cardiovascularThe direct link between low-density lipoprotein cholesterol (LDL-C) and the risk of coronary heart disease is a well-known one 1. Epidemiological studies indicate that a reduction in LDL-C levels by 1 mmol/L results in almost a 25% reduction in vascular disease risk 2. Previous work suggests a promising cholesterol-lowering effect associated with red yeast rice, a staple Asian food used in traditional Chinese medicine for digestion as well as blood circulation 3. The fermentation product of yeast (Monascus purpureus) grown on white rice, red yeast rice contains monacolin K, a component chemically identical to cholesterol statin drugs like lovastatin 4. Trials involving red yeast rice supplementation with a low dose of monacolin K (3 mg), along with other cholesterol-lowering agents, have reported up to a 31% drop in LDL-C levels 5,6, although the independent lipid-lowering effect of red yeast rice at low doses of monacolin K is still unclear. Interventions using red yeast rice with monacolin K at slightly higher doses, ranging from 5 to 10 mg/d, demonstrate effective reduction of LDL-C 7. In 2016, German researchers carried out an investigation 8 looking at the impact of low-dose monacolin K (3 mg/d), combined with folic acid,  on the LDL-C and homocysteine levels of subjects with high cholesterol. Folic acid is associated  with the reduction of homocysteine concentration, which is also associated with vascular disease9.

Using a randomized, double-blind, placebo-controlled study design, researchers recruited a total of 142 non-statin-treated subjects (aged 18 to 70 years) with high cholesterol (LDLC level ≥ 4.14 mmol/L and ≤ 5.69 mmol/L). Participants were randomized to ingest a red yeast rice supplement containing 3 mg monacolin K and 200 µg folic acid (as well as 2 mg coenzyme Q10 and 0.5 mg astaxanthin) or matching placebo once daily for 12 weeks. At baseline, week 6, and at the end of week 12, anthropometric data were collected and fasting blood samples were taken and analyzed for plasma lipids (total cholesterol, TC; LDL-C, high-density lipoprotein cholesterol, HDLC; triglycerides, TG), as well as homocysteine levels, creatinine, and fasting blood glucose.

After 12 weeks of treatment, LDL-C concentration was seen to significantly diminish in the monacolin K group (mean change= -14.8%, p < 0.001), with levels dropping to 4.13 mmol/L by week 6 (p < 0.001) and remaining constant until the end of treatment. TC (mean change= -11.2%, p < 0.001), TG (mean change= -5.0%, p < 0.01), and LDL-C/HDL-C ratio (mean change= -14.1%, p < 0.001) were also significantly reduced in the treatment group at the end of 12 weeks, along with homocysteine levels (mean change= -12.5%, p < 0.001). By week 12, 51% of subjects in the monacolin K group reached the LDL-C threshold level of < 4.14 mmol/L, and 26% of subjects reached the homocysteine threshold level of <10 µmol/L.

Based on study findings, researchers confirm that low doses of monacolin K from red yeast rice can produce significant cholesterol-lowering effects in subjects with high cholesterol. The incorporation of folic acid in the formulated treatment supplement also led to significant diminishment of homocysteine levels, an effect contributing to overall protection against cardiovascular disease. The current study benefits from a large sample size and a relatively long treatment duration. However, the failure to account for the potential effects of astaxanthin and coenzyme Q10, compounds with notable antioxidant properties, on treatment outcome may be a potential limitation. It would be beneficial for future studies to determine dose-response measurements and to examine the cholesterol-lowering effects of monacolin K in subgroups with different LDL-C levels at baseline.

Source: Heinz T, Schuchart JP, Moller K, et al. Low daily dose of monacolin K from RYR reduces the concentration of LDL-C in a randomized, placebo-controlled intervention. Nutrition Research. 2016; 36: 1162-1170. DOI: 10.1016/j.nutres.2016.07.005.

© 2016 TheAuthors. Publishedby Elsevier Inc.This isanopenaccess articleunder theCCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Posted June 26, 2019.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

  1. Farzadfar F, Finucane MM, Danaei G, et al. National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3· 0 million participants. The Lancet. 2011;377(9765):578-586.
  2. Law MR, Wald NJ, Rudnicka A. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. Bmj. 2003;326(7404):1423.
  3. Ma J, Li Y, Ye Q, et al. Constituents of red yeast rice, a traditional Chinese food and medicine. Journal of agricultural and food chemistry. 2000;48(11):5220-5225.
  4. Hong MY, Seeram NP, Zhang Y, Heber D. Anticancer effects of Chinese red yeast rice versus monacolin K alone on colon cancer cells. The Journal of nutritional biochemistry. 2008;19(7):448-458.
  5. Cicero A, Benvenuti C. Efficacy of a red yeast rice based nutraceutical in large subgroups of hypercholesterolemic subjects in every day clinical practice. Mediterranean Journal of Nutrition and Metabolism. 2010;3(3):239-246.
  6. Pirro M, Lupattelli G, Del Giorno R, et al. Nutraceutical combination (red yeast rice, berberine and policosanols) improves aortic stiffness in low-moderate risk hypercholesterolemic patients. PharmaNutrition. 2013;1(2):73-77.
  7. Bogsrud MP, Ose L, Langslet G, et al. HypoCol (red yeast rice) lowers plasma cholesterol–a randomized placebo controlled study. Scandinavian Cardiovascular Journal. 2010;44(4):197-200.
  8. Heinz T, Schuchardt JP, Möller K, Hadji P, Hahn A. Low daily dose of 3 mg monacolin K from RYR reduces the concentration of LDL-C in a randomized, placebo-controlled intervention. Nutrition research. 2016;36(10):1162-1170.