Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel
Status PubMed-not-MEDLINE Jazyk angličtina Země Polsko Médium print-electronic
Typ dokumentu časopisecké články
PubMed
28883839
PubMed Central
PMC5575230
DOI
10.5114/aoms.2017.69326
PII: 30429
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
Biotechnology Research Center Mashhad University of Medical Sciences Mashhad Iran
Cardiology Clinic School of Medicine University of Athens Greece; Hellenic Atherosclerosis Society
Department of Primary Care and Public Health Imperial College London UK
Heart Disease Prevention Program Division of Cardiology University of California Irvine USA
Zobrazit více v PubMed
Organisation WH Cardiovascular diseases (CVDs) 2015. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/. Last access Aug 28, 2016.
Perk J, De Backer G, Gohlke H, et al. European Association for Cardiovascular Prevention & Rehabilitation (EACPR); ESC Committee for Practice Guidelines (CPG) European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) Eur Heart J. 2012;33:1635–701. PubMed
Bloom DE, Cafiero ET, Jané-Llopis E, et al. The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum; 2011. Sep, Report No.: 080911.
SIGN (Scottish Intercollegiate Guidelines Network) Risk estimation and the prevention of cardiovascular disease. A national clinical guideline. 2007. Feb, Report No. 97.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421. PubMed
Australian Institute of Health and Welfare . High Blood Cholesterol. Cat. No. AUS 156. Canberra: Australian Institute of Health and Welfare; 2012-2013.
Colantonio LD, Bittner V, Reynolds K, et al. Association of serum lipids and coronary heart disease in contemporary observational studies. Circulation. 2016;133:256–64. PubMed PMC
Ford ES, Li C, Pearson WS, Zhao G, Mokdad AH. Trends in hypercholesterolemia, treatment and control among United States adults. Int J Cardiol. 2010;140:226–35. PubMed
Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, et al. American Heart Association Statistics Committee; Stroke Statistics Subcommittee Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133:e38–360. PubMed
Baigent C, Keech A, Kearney PM, et al. Cholesterol Treatment Trialists’ (CTT) Collaborators Efficacy and safety of cholesterol-lowering treatment: prospective metaanalysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–78. PubMed
NCD Risk Factor Collaboration (NCD-RisC) Lancet. 2017. Trends in total cholesterol and lipid fractions in 22 Western and Asian countries. in press.
Hobbs FD, Banach M, Mikhailidis DP, Malhotra A, Capewell S. Is statin-modified reduction in lipids the most important preventive therapy for cardiovascular disease? A pro/con debate. BMC Med. 2016;14:4. PubMed PMC
Baigent C, Blackwell L, Emberson J, et al. Cholesterol Treatment Trialists’ (CTT) Collaboration Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670–81. PubMed PMC
Heart Protection Study Collaborative Group MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002;360:7–22. PubMed
Shepherd J, Blauw GJ, Murphy MB, et al. PROSPER Study Group Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002;360:1623–30. PubMed
Jacobson TA, Ito MK, Maki KC, et al. National lipid association recommendations for patient-centered management of dyslipidemia: part 1--full report. J Clin Lipidol. 2015;9:129–69. PubMed
Law MR, Wald NJ, Thompson SG. By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ. 1994;308:367–72. PubMed PMC
Catapano AL, Graham I, De Backer G, et al. Authors/Task Force Members 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR) Atherosclerosis. 2016;253:281–344. PubMed
Reiner Ž. Hypertriglyceridemia and risk of coronary artery disease. Nat Rev Cardiol. 2017 Mar;:16. doi: 10.1038/nrcardio.2017.3. [Epub ahead of print] PubMed DOI
Booth JN, 3rd, Colantonio LD, Howard G, et al. Healthy lifestyle factors and incident heart disease and mortality in candidates for primary prevention with statin therapy. Int J Cardiol. 2016;207:196–202. PubMed PMC
Banach M, Jankowski P, Jóźwiak J, et al. PoLA/CFPiP/PCS Guidelines for the management of dyslipidaemias for family physicians 2016. Arch Med Sci. 2017;13:1–45. PubMed PMC
Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR) Eur J Prev Cardiol. 2016;23:NP1–96. PubMed
Vanhees L, Geladas N, Hansen D, et al. on behalf of the writing group Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II) Eur J Prev Cardiol. 2012;19:1005–33. PubMed
American Heart Association Nutrition Committee. Lichtenstein AH, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114:82–96. PubMed
American Heart Association Lifestyle Changes and Cholesterol. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Lifestyle-Changes-andCholesterol_UCM_305627_Article.jsp Last accessed: March 31, 2017.
Appel LJ, Sacks FM, Carey VJ, et al. OmniHeart Collaborative Research Group Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA. 2005;294:2455–64. PubMed
Brown MS, Goldstein JL. Biomedicine. Lowering LDL – not only how low, but how long? Science. 2006;311:1721–31. PubMed
Brinton EA. Management of hypertriglyceridemia for prevention of atherosclerotic cardiovascular disease. Endocrinol Metab Clin North Am. 2016;45:185–204. PubMed
Patti AM, Toth PP, Giglio RV, et al. Nutraceuticals as an important part of combination therapy in dyslipidaemia. Curr Pharm Des. 2017 Mar 17; doi: 10.2174/1381612823666170317145851. PubMed DOI
Chen ZY, Jiao R, Ma KY. Cholesterol-lowering nutraceuticals and functional foods. J Agric Food Chem. 2008;56:8761–73. PubMed
Cicero AF, Colletti A. Role of phytochemicals in the management of metabolic syndrome. Phytomedicine. 2016;23:1134–44. PubMed
Sahebkar A, Serban MC, Gluba-Brzózka A, et al. Lipid-modifying effects of nutraceuticals: an evidence-based approach. Nutrition. 2016;32:1179–92. PubMed
Houston M. The role of nutraceutical supplements in the treatment of dyslipidemia. J Clin Hypertens. 2012;14:121–32. PubMed PMC
Cicero AF, Fogacci F, Colletti A. Food and plant bioactives for reducing cardiometabolic disease risk: an evidence based approach. Food Funct. 2017;8:2076–88. PubMed
Stroes ES, Thompson PD, Corsini A, et al. European Atherosclerosis Society Consensus Panel Statin-associated muscle symptoms: impact on statin therapy – European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur Heart J. 2015;36:1012–22. PubMed PMC
Bangalore S, Fayyad R, Hovingh GK, et al. Treating to New Targets Steering Committee and Investigators Statin and the risk of renal-related serious adverse events: analysis from the IDEAL, TNT, CARDS, ASPEN, SPARCL, and other placebo-controlled trials. Am J Cardiol. 2014;113:2018–20. PubMed
Reiner Ž. Resistance and intolerance to statins. Nutr Metab Cardiovasc Dis. 2014;24:1057–66. PubMed
Banach M, Rizzo M, Toth PP, et al. Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel. Arch Med Sci. 2015;11:1–23. PubMed PMC
Patel J, Martin SS, Banach M. Expert opinion: the therapeutic challenges faced by statin intolerance. Expert Opin Pharmacother. 2016;17:1497–507. PubMed
Banach M, Serban MC. Discussion around statin discontinuation in older adults and patients with wasting diseases. J Cachexia Sarcopenia Muscle. 2016;7:396–99. PubMed PMC
Banach M, Aronow WS, Serban MC, Rysz J, Voroneanu L, Covic A. Lipids, blood pressure and kidney update 2015. Lipids Health Dis. 2015;14:167. PubMed PMC
Devaraj S, Jialal I. The role of dietary supplementation with plant sterols and stanols in the prevention of cardiovascular disease. Nutr Rev. 2006;64:348–54. PubMed
Law M. Plant sterol and stanol margarines and health. BMJ. 2000;320:861–4. PubMed PMC
Ras RT, Hiemstra H, Lin Y, Vermeer MA, Duchateau GS, Trautwein EA. Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies. Atherosclerosis. 2013;230:336–46. PubMed
Ferguson JJ, Stojanovski E, MacDonald-Wicks L, Garg ML. Fat type in phytosterol products influence their cholesterol-lowering potential: a systematic review and meta-analysis of RCTs. Prog Lipid Res. 2016;64:16–29. PubMed
Demonty I, Ras RT, van der Knaap HC, et al. The effect of plant sterols on serum triglyceride concentrations is dependent on baseline concentrations: a pooled analysis of 12 randomised controlled trials. Eur J Nutr. 2013;52:153–60. PubMed PMC
Athyros VG, Kakafika AI, Papageorgiou AA, et al. Effect of a plant stanol ester-containing spread, placebo spread, or Mediterranean diet on estimated cardiovascular risk and lipid, inflammatory and haemostatic factors. Nutr Metab Cardiovasc Dis. 2011;21:213–21. PubMed
Talati R, Sobieraj DM, Makanji SS, Phung OJ, Coleman CI. The comparative efficacy of plant sterols and stanols on serum lipids: a systematic review and meta-analysis. J Am Diet Assoc. 2010;110:719–26. PubMed
Ras RT, Fuchs D, Koppenol WP, et al. The effect of a low-fat spread with added plant sterols on vascular function markers: results of the Investigating Vascular Function Effects of Plant Sterols (INVEST) study. Am J Clin Nutr. 2015;101:733–41. PubMed PMC
Gylling H, Halonen J, Lindholm H, et al. The effects of plant stanol ester consumption on arterial stiffness and endothelial function in adults: a randomised controlled clinical trial. BMC Cardiovasc Disord. 2013;13:50. PubMed PMC
Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999;69:30–42. PubMed
Doi K. Effect of konjac fibre (glucomannan) on glucose and lipids. Eur J Clin Nutr. 1995;49(Suppl 3):S190–7. PubMed
Zhu X, Sun X, Wang M, et al. Quantitative assessment of the effects of beta-glucan consumption on serum lipid profile and glucose level in hypercholesterolemic subjects. Nutr Metab Cardiovasc Dis. 2015;25:714–23. PubMed
EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific opinion on the substantiation of a health claim related to oat beta-glucan and lowering blood cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA J. 2010;8:188.
Reiner Z, Catapano A, De Backer G, et al. The task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2011;32:1769–818. PubMed
Cleeman J, Grundy S, Becker D, Clark L. Expert panel on Detection, Evaluation and Treatment of High blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP III) JAMA. 2001;285:2486–97. PubMed
Tabesh F, Sanei H, Jahangiri M, et al. The effects of beta-glucan rich oat bread on serum nitric oxide and vascular endothelial function in patients with hypercholesterolemia. Biomed Res Int. 2014;2014:481904. PubMed PMC
Anderson JW. Dietary fibre, complex carbohydrate and coronary artery disease. Can J Cardiol. 1995;11(Suppl G):55G–62G. PubMed
Wei ZH, Wang H, Chen XY, et al. Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials. Eur J Clin Nutr. 2009;63:821–7. PubMed
Ribas SA, Cunha DB, Sichieri R, Santana da Silva LC. Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial. Br J Nutr. 2015;113:134–41. PubMed
Anderson JW, Zettwoch N, Feldman T, Tietyen-Clark J, Oeltgen P, Bishop CW. Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic men. Arch Intern Med. 1988;148:292–6. PubMed
Gibb RD, McRorie JW, Jr, Russell DA, Hasselblad V, D’Alessio DA. Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. Am J Clin Nutr. 2015;102:1604–14. PubMed
Pal S, Khossousi A, Binns C, Dhaliwal S, Radavelli-Bagatini S. The effects of 12-week psyllium fibre supplementation or healthy diet on blood pressure and arterial stiffness in overweight and obese individuals. Br J Nutr. 2012;107:725–34. PubMed
Anderson JW, Allgood LD, Lawrence A, et al. Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. Am J Clin Nutr. 2000;71:472–9. PubMed
Behera SS, Ray RC. Konjac glucomannan, a promising polysaccharide of Amorphophallus konjac K. Koch in health care. Int J Biol Macromol. 2016;92:942–56. PubMed
Sood N, Baker WL, Coleman CI. Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis. Am J Clin Nutr. 2008;88:1167–75. PubMed
Onakpoya I, Posadzki P, Ernst E. The efficacy of glucomannan supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials. J Am Coll Nutr. 2014;33:70–8. PubMed
Guardamagna O, Abello F, Cagliero P, Visioli F. Could dyslipidemic children benefit from glucomannan intake? Nutrition. 2013;29:1060–5. PubMed
Martino F, Martino E, Morrone F, Carnevali E, Forcone R, Niglio T. Effect of dietary supplementation with glucomannan on plasma total cholesterol and low density lipoprotein cholesterol in hypercholesterolemic children. Nutr Metab Cardiovasc Dis. 2005;15:174–80. PubMed
Martino F, Puddu PE, Pannarale G, et al. Low dose chromium-polynicotinate or policosanol is effective in hypercholesterolemic children only in combination with glucomannan. Atherosclerosis. 2013;228:198–202. PubMed
Baker WL, Tercius A, Anglade M, White CM, Coleman CI. A meta-analysis evaluating the impact of chitosan on serum lipids in hypercholesterolemic patients. Ann Nutr Metab. 2008;55:368–74. PubMed
Rizzo M, Giglio RV, Nikolic D, et al. Effects of chitosan on plasma lipids and lipoproteins: a 4-month prospective pilot study. Angiology. 2014;65:538–42. PubMed
Jull AB, Ni Mhurchu C, Bennett DA, Dunshea-Mooij CA, Rodgers A. Chitosan for overweight or obesity. Cochrane Database Syst Rev. 2008;3:CD003892. PubMed
Kim HJ, Ahn HY, Kwak JH, et al. The effects of chitosan oligosaccharide (GO2KA1) supplementation on glucose control in subjects with prediabetes. Food Funct. 2014;10:2662–9. PubMed
Mhurchu CN, Poppitt S, McGill A, et al. The effect of the dietary supplement, chitosan, on body weight: a randomised controlled trial in 250 overweight and obese adults. Int J Obes. 2004;28:1149–56. PubMed
Guarner F, Schaafsma GJ. Probiotics. Int J Food Microbiol. 1998;39:237–8. PubMed
Gilliland SE, Nelson CR, Maxwell C. Assimilation of cholesterol by Lactobacillus acidophilus. Appl Environ Microbiol. 1985;49:377–81. PubMed PMC
Mistry P. Natural cholesterol-lowering products: focus on probiotics. Br J Community Nurs. 2014;19(Suppl 11):S14–8. PubMed
Kim GB, Yi SH, Lee BH. Purification and characterization of three different types of bile salt hydrolases from Bifidobacterium strains. J Dairy Sci. 2004;87:258–66. PubMed
Liong MT, Dunshea FR, Shah NP. Effects of a synbiotic containing Lactobacillus acidophilus ATCC 4962 on plasma lipid profiles and morphology of erythrocytes in hypercholesterolaemic pigs on high- and low-fat diets. Br J Nutr. 2007;98:736–44. PubMed
Cho YA, Kim J. Effect of probiotics on blood lipid concentrations: a meta-analysis of randomized controlled trials. Medicine. 2015;94:e1714. PubMed PMC
Agerholm-Larsen L, Bell ML, Grunwald GK, Astrup A. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. Eur J Clin Nutr. 2000;54:856–60. PubMed
Shimizu M, Hashiguchi M, Shiga T, Tamura HO, Mochizuki M. Meta-analysis: effects of probiotic supplementation on lipid profiles in normal to mildly hypercholesterolemic individuals. PLoS One. 2015;10:e0139795. PubMed PMC
Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis (Review) 2015;60(Suppl 2):S129–34. PubMed PMC
Ma J, Li Y, Ye Q, et al. Constituents of red yeast rice, a traditional Chinese food and medicine. J Agric Food Chem. 2000;48:5220–5. PubMed
Gordon RY, Cooperman T, Obermeyer W, Becker DJ. Marked variability of monacolin levels in commercial red yeast rice products: buyer beware! Arch Intern Med. 2010;170:1722–7. PubMed
Wang RW, Kari PH, Lu AY, Thomas PE, Guengerich FP, Vyas KP. Biotransformation of lovastatin. IV. Identification of cytochrome P450 3A proteins as the major enzymes responsible for the oxidative metabolism of lovastatin in rat and human liver microsomes. Arch Biochem Biophys. 1991;290:355–61. PubMed
Li YG, Zhang F, Wang ZT, Hu ZB. Identification and chemical profiling of monacolins in red yeast rice using high-performance liquid chromatography with photodiode array detector and mass spectrometry. J Pharm Biomed Anal. 2004;35:1101–12. PubMed
Gerards MC, Terlou RJ, Yu H, Koks CH, Gerdes VE. Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis. Atherosclerosis. 2015;240:415–23. PubMed
Mazzanti G, Moro PA, Raschi E, Da Cas R, Menniti-Ippolito F. Adverse reactions to dietary supplements containing red yeast rice: assessment of cases from the Italian surveillance system. Br J Clin Pharmacol. 2017 Jan 17; doi: 10.1111/bcp.13171. [Epub ahead of print] PubMed DOI PMC
Liu J, Zhang J, Shi Y, Grimsgaard S, Alraek T, Fønnebø V. Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials. Chin Med. 2006;1:4. PubMed PMC
Zhao SP, Liu L, Cheng YC, et al. Xuezhikang, an extract of cholestin, protects endothelial function through antiinflammatory and lipid-lowering mechanisms in patients with coronary heart disease. Circulation. 2004;110:915–20. PubMed
DFG Permanent Senate Commission on Food Safety . Toxicological evaluation of red mould rice: an update 2012.
Kantola T, Kivistö KT, Neuvonen PJ. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther. 1998;63:397–402. PubMed
Prasad GV, Wong T, Meliton G, Bhaloo S. Transplantation. Rhabdomyolysis due to red yeast rice (Monascus purpureus) in a renal transplant recipient. Transplantation. 2002;74:1200–1. PubMed
Rasheva TV, Nedeva TS, Hallet JN, Kujumdzieva AV. Characterization of a non-pigment producing Monascus purpureus mutant strain. Antonie Van Leeuwenhoek. 2003;83:333–40. PubMed
Arai M, Hibino T. Tumorigenicity of citrinin in male F344 rats. Cancer Lett. 1983;17:281–7. PubMed
Chan WH, Shiao NH. Effect of citrinin on mouse embryonic development in vitro and in vivo. Reprod Toxicol. 2007;24:120–5. PubMed
Singh ND, Sharma AK, Dwivedi P, Patil RD, Kumar M. Experimentally induced citrinin and endosulfan toxicity in pregnant Wistar rats: histopathological alterations in liver and kidneys of fetuses. J Appl Toxicol. 2008;28:901–7. PubMed
EFSA, Scientific Opinion on the risks for public and animal health related to the presence of citrinin in food and feed. EFSA Panel on Contaminants in the Food Chain (CONTAM). European Food Safety Authority (EFSA), Parma, Italy. EFSA J. 2012;10:2605.
EFSA, Scientific Opinion on the substantiation of health claims related to monacolin K from red yeast rice and maintenance of normal blood LDL-cholesterol concentrations (ID 1648, 1700) pursuant to Article 13(1) of Regulation (EC) No 1924/20061; EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA), European Food Safety Authority (EFSA), Parma, Italy. EFSA J. 2011;9:2304.
Borlinghaus J, Albrecht F, Grunhlke MCH, Nwachukwu ID, Slusarenko A. Allicin: chemistry and biological properties. Molecules. 2014;19:12591–618. PubMed PMC
Ried K, Toben C, Fakler P. Effect on garlic on serum lipids: an updated meta-analysis. Nutr Rev. 2013;71:282–99. PubMed
Ackermann RT, Mulrow CD, Ramirez G, Gardner CD, Morbidoni L, Lawrence VA. Garlic shows promise for improving some cardiovascular risk factors. Arch Intern Med. 2001;161:813–24. PubMed
Ried K. Garlic lowers blood pressure in hypertensive individuals, regulates serum cholesterol, and stimulates immunity: an updated meta-analysis and review. J Nutr. 2016;146:389S–396S. PubMed
Jung ES, Park SH, Choi EK, et al. Reduction of blood lipid parameters by a 12-wk supplementation of aged black garlic: a randomized controlled trila. Nutrition. 2014;30:1034–9. PubMed
Sahebkar A, Serban C, Ursoniu S, Banach M. Effect of garlic on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of randomized controlled clinical trials. Nutrition. 2016;32:33–40. PubMed
Morihara N, Hino A. Aged garlic extract suppresses platelet aggregation by changing the functional property of platelets. J Nat Med. 2017;71:249–256. PubMed
Cighetti G, Del Puppo M, Paroni R, Galli Kienle M. Modulation of HMG-CoA reductase activity by pantetheine/pantethine. Biochim Biophys Acta. 1988;963:389–93. PubMed
Cighetti G, Del Puppo M, Paroni R, Fiorica E, Galli Kienle M. Pantethine inhibits cholesterol and fatty acid syntheses and stimulates carbon dioxide formation in isolated rat hepatocytes. J Lipid Res. 1987;28:152–61. PubMed
Eto M, Watanabe K, Chonan N, Ishii K. Lowering effect of pantethine on plasma beta-thromboglobulin and lipids in diabetes mellitus. Artery. 1987;15:1–12. PubMed
Binaghi P, Cellina G, Lo Cicero G, Bruschi F, Porcaro E, Penotti M. Evaluation of the cholesterol-lowering effectiveness of pantethine in women in perimenopausal age. Minerva Med. 1990;81:475–9. PubMed
Rumberger JA, Napolitano J, Azumano I, Kamiya T, Evans M. Pantethine, a derivative of vitamin B(5) used as a nutritional supplement, favorably alters low-density lipoprotein cholesterol metabolism in low- to moderate-cardiovascular risk North American subjects: a triple-blinded placebo and diet-controlled investigation. Nutr Res. 2011;31:608–15. PubMed
Bertolini S, Donati C, Elicio N, et al. Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children. Int J Clin Pharmacol Ther Toxicol. 1986;24:630–7. PubMed
Evans M, Rumberger JA, Azumano I, Napolitano JJ, Citrolo D, Kamiya T. Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol in low to moderate cardiovascular risk subjects eligible for statin therapy: a triple-blinded placebo and diet-controlled investigation. Vasc Health Risk Manag. 2014;10:89–100. PubMed PMC
Donati C, Barbi G, Cairo G, Prati GF, Degli Esposti E. Pantethine improves the lipid abnormalities of chronic hemodialysis patients: results of a multicenter clinical trial. Clin Nephrol. 1986;25:70–4. PubMed
Giglio RV, Patti AM, Nikolic D, et al. The effect of bergamot on dyslipidemia. Phytomedicine. 2016;23:1175–81. PubMed
Di Donna L, De Luca G, Mazzotti F, Napoli A, Salerno R, Taverna D, Sindona G. Statin-like principles of bergamot fruit (Citrus bergamia): isolation of 3-hydroxymethylglutaryl flavonoid glycosides. J Nat Prod. 2009;72:1352–4. PubMed
Miceli N, Mondello MR, Monforte MT, et al. Hypolipidemic effects of Citrus bergamia Risso et Poiteau juice in rats fed a hypercholesterolemic diet. J Agric Food Chem. 2007;55:10671–7. PubMed
Gliozzi M, Walker R, Muscoli S, et al. Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia. Int J Cardiol. 2013;170:140–5. PubMed
Gliozzi M, Carresi C, Musolino V, et al. The effect of Bergamot-derived polyphenolic fraction on LDL small dense particles and non alcoholic fatty liver disease in patients with metabolic syndrome. Adv Biol Chem. 2014;4:129–37.
Athyros VG, Tziomalos K, Katsiki N, Doumas M, Karagiannis A, Mikhailidis DP. Cardiovascular risk across the histological spectrum and the clinical manifestations of non-alcoholic fatty liver disease: an update. World J Gastroenterol. 2015;21:6820–34. PubMed PMC
Mollace V, Sacco I, Janda E, et al. Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies. Fitoterapia. 2011;82:309–16. PubMed
Chen JT, Wesley R, Shamburek RD, Pucino F, Csako G. Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol. Pharmacotherapy. 2005;25:171–83. PubMed
Singh DK, Li L, Porter TD. Policosanol inhibits cholesterol synthesis in hepatoma cells by activation of AMP-kinase. J Pharmacol Exp Ther. 2006;318:1020–6. PubMed
Berthold HK, Unverdorben S, Degenhardt R, Bulitta M, Gouni-Berthold I. Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial. JAMA. 2006;295:2262–9. PubMed
Backes JM, Gibson CA, Ruisinger JF, Moriarty PM. Modified-policosanol does not reduce plasma lipoproteins in hyperlipidemic patients when used alone or in combination with statin therapy. Lipids. 2011;46:923–9. PubMed
Reiner Ž, Tedeschi-Reiner E, Romić Ž. Effects of rice policosanol on serum lipoproteins, homocysteine, fibrinogen and C-reactive protein in hypercholesterolaemic patients. Clin Drug Invest. 2005;25:701–7. PubMed
Reiner Ž, Tedeschi-Reiner E. Rice policosanol does not have any effects on blood coagulation factors in hypercholesterolemic patients. Coll Antropol. 2007;31:315–9. PubMed
Liu CS, Zheng YR, Zhang YF, Long XY. Research progress on berberine with a special focus on its oral bioavailability. Fitoterapia. 2016;109:274–82. PubMed
Abidi P, Zhou Y, Jiang JD, Liu J. Extracellular signal-regulated kinase-dependent stabilization of hepatic low-density lipoprotein receptor mRNA by herbal medicine berberine. Arterioscler Thromb Vasc Biol. 2005;25:2170–6. PubMed
Li H, Dong B, Park SW, Lee HS, Chen W, Liu J. Hepatocyte nuclear factor 1alpha plays a critical role in PCSK9 gene transcription and regulation by the natural hypocholesterolemic compound berberine. J Biol Chem. 2009;284:28885–95. PubMed PMC
Li XY, Zhao ZX, Huang M, et al. Effect of Berberine on promoting the excretion of cholesterol in high-fat diet-induced hyperlipidemic hamsters. J Transl Med. 2015;13:278. PubMed PMC
Qiang X, Xu L, Zhang M, et al. Demethyleneberberine attenuates non-alcoholic fatty liver disease with activation of AMPK and inhibition of oxidative stress. Biochem Biophys Res Commun. 2016;472:603–9. PubMed
Kim WS, Lee YS, Cha SH, et al. Berberine improves lipid dysregulation in obesity by controlling central and peripheral AMPK activity. Am J Physiol Endocrinol Metab. 2009;296:E812–9. PubMed
Zarei A, Changizi-Ashtiyani S, Taheri S, Ramezani M. A quick overview on some aspects of endocrinological and therapeutic effects of Berberis vulgaris L. Avicenna J Phytomed. 2015;5:485–97. PubMed PMC
Meng S, Wang LS, Huang ZQ, et al. Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention. Clin Exp Pharmacol Physiol. 2012;39:406–11. PubMed
Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69–81. PubMed
Derosa G, Maffioli P, Cicero AF. Berberine on metabolic and cardiovascular risk factors: an analysis from preclinical evidences to clinical trials. Expert Opin Biol Ther. 2012;12:1113–24. PubMed
Sosnowska B, Penson P, Banach M. The role of nutraceuticals in the prevention of cardiovascular disease. Cardiovasc Diagn Ther. 2017;7(Suppl 1):S21–31. PubMed PMC
Way TD, Lin HY, Kuo DH, et al. Pu-erh tea attenuates hyperlipogenesis and induces hepatoma cells growth arrest through activating AMP-activated protein kinase (AMPK) in human HepG2 cells. J Agric Food Chem. 2009;57:5257–64. PubMed
Shishikura Y, Khokhar S, Murray BS. Effects of tea polyphenols on emulsification of olive oil in a small intestine model system. J Agric Food Chem. 2006;54:1906–13. PubMed
Onakpoya I, Spencer E, Heneghan C, Thompson M. The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis. 2014;24:823–36. PubMed
Park CS, Kim W, Woo JS, et al. Green tea consumption improves endothelial function but not circulating endothelial progenitor cells in patients with chronic renal failure. Int J Cardiol. 2010;145:261–2. PubMed
Lin QF, Qiu CS, Wang SL, et al. A cross-sectional study of the relationship between habitual tea consumption and arterial stiffness. J Am Coll Nutr. 2016;35:354–61. PubMed
Serban C, Sahebkar A, Antal D, Ursoniu S, Banach M. Effects of supplementation with green tea catechins on plasma C-reactive protein concentrations: a systematic review and meta-analysis of randomized controlled trials. Nutrition. 2015;31:1061–71. PubMed
Zhang C, Qin YY, Wei X, Yu FF, Zhou YH, He J. Tea consumption and risk of cardiovascular outcomes and total mortality: a systematic review and meta-analysis of prospective observational studies. Eur J Epidemiol. 2015;30:103–13. PubMed
Cicero AF, Fogacci F, Colletti A. Potential role of bioactive peptides in prevention and treatment of chronic diseases: a narrative review. Br J Pharmacol. 2017;174:1378–94. PubMed PMC
Weggemans RM, Trautwein EA. Relation between soy-associated isoflavones and LDL and HDL cholesterol concentrations in humans: a meta-analysis. Eur J Clin Nutr. 2003;57:940–6. PubMed
Cho SJ, Juillerat MA, Lee CH. Cholesterol lowering mechanism of soybean protein hydrolysate. J Agric Food Chem. 2007;55:10599–604. PubMed
Grieco A, Miele L, Pompili M, et al. Acute hepatitis caused by a natural lipid-lowering product: when “alternative” medicine is no “alternative” at all. J Hepatol. 2009;50:1273–7. PubMed
Potter SM. Overview of proposed mechanisms for the hypocholesterolemic effect of soy. J Nutr. 1995;125(3 Suppl):606S–11S. PubMed
Lammi C, Zanoni C, Scigliuolo GM, D’Amato A, Arnoldi A. Lupin peptides lower low-density lipoprotein (LDL) cholesterol through an up-regulation of the LDL receptor/sterol regulatory element binding protein 2 (SREBP2) pathway at HepG2 cell line. J Agric Food Chem. 2014;62:7151–9. PubMed
Tokede OA, Onabanjo TA, Yansane A, Gaziano JM, Djoussé L. Soya products and serum lipids: a meta-analysis of randomised controlled trials. Br J Nutr. 2015;114:831–43. PubMed
Beavers DP, Beavers KM, Miller M, Stamey J, Messina MJ. Exposure to isoflavone-containing soy products and endothelial function: a Bayesian meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2012;22:182–91. PubMed
Hazim S, Curtis PJ, Schär MY, et al. Acute benefits of the microbial-derived isoflavone metabolite equol on arterial stiffness in men prospectively recruited according to equol producer phenotype: a double-blind randomized controlled trial. Am J Clin Nutr. 2016;103:694–702. PubMed PMC
Arnoldi A, Greco S. Nutraceutical characteristics of lupin protein. Nutrafoods. 2011;10:23–9.
Bähr M, Fechner A, Krämer J, Kiehntopf M, Jahreis G. Lupin protein positively affects plasma LDL cholesterol and LDL:HDL cholesterol ratio in hypercholesterolemic adults after four weeks of supplementation: a randomized, controlled crossover study. Nutr J. 2013;12:107. PubMed PMC
Bähr M, Fechner A, Kiehntopf M, Jahreis G. Consuming a mixed diet enriched with lupin protein beneficially affects plasma lipids in hypercholesterolemic subjects: a randomized controlled trial. Clin Nutr. 2015;34:7–14. PubMed
Fechner A, Kiehntopf M, Jahreis G. The formation of short-chain fatty acids is positively associated with the blood lipid-lowering effect of lupin kernel fiber in moderately hypercholesterolemic adults. J Nutr. 2014;144:599–607. PubMed
EFSA Panel on Dietetic Products NaAN Scientific Opinion on the substantiation of health claims related to EPA, DHA, DPA and maintenance of normal blood pressure (ID 502), maintenance of normal HDL-cholesterol concentrations (ID 515), maintenance of normal (fasting) blood concentrations of triglycerides (ID 517), maintenance of normal LDL-cholesterol concentrations (ID 528, 698) and maintenance of joints (ID 503, 505, 507, 511, 518, 524, 526, 535, 537) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA J. 2009;7:1263–89.
EFSA Panel on Dietetic Products NaAN Scientific Opinion on the substantiation of health claims related to eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and maintenance of normal cardiac function (ID 504, 506, 516, 527, 538, 703, 1128, 1317, 1324, 1325), maintenance of normal blood glucose concentrations (ID 566), maintenance of normal blood pressure (ID 506, 516, 703, 1317, 1324), maintenance of normal blood HDL-cholesterol concentrations (ID 506), maintenance of normal (fasting) blood concentrations of triglycerides (ID 506, 527, 538, 1317, 1324, 1325), maintenance of normal blood LDL-cholesterol concentrations (ID 527, 538, 1317, 1325, 4689), protection of the skin from photo-oxidative (UV-induced) damage (ID 530), improved absorption of EPA and DHA (ID 522, 523), contribution to the normal function of the immune system by decreasing the levels of eicosanoids, arachidonic acid-derived mediators and pro-inflammatory cytokines (ID 520, 2914), and “immunomodulating agent” (4690) pursuant to Article 13(1) of Regulation (EC) No 1924/20061. EFSA J. 2010;8:1796–828.
Howe P, Mori T, Buckley J. Long chain omega-3 fatty acids and cardiovascular disease – FSANZ consideration of a commissioned review. FSANZ; 2013. PDF: http://www.foodstandards.gov.au/consumer/labelling/nutrition/documents/FSANZ%20consideration%20of%20omega-3%20review1.pdf. Last accessed: 31 March, 2017.
Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292–333. PubMed
Harris WS, Bulchandani D. Why do omega-3 fatty acids lower serum triglycerides? Curr Opin Lipidol. 2006;17:387–93. PubMed
Eslick GD, Howe PR, Smith C, Priest R, Bensoussan A. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009;136:4–16. PubMed
Leslie MA, Cohen DJ, Liddle DM, Robinson LE, Ma DW. A review of the effect of omega-3 polyunsaturated fatty acids on blood triacylglycerol levels in normolipidemic and borderline hyperlipidemic individuals. Lipids Health Dis. 2015;14:53. PubMed PMC
Di Stasi D, Bernasconi R, Marchioli R, et al. Early modifications of fatty acid composition in plasma phospholipids, platelets and mononucleates of healthy volunteers after low doses of n-3 polyunsaturated fatty acids. Eur J Clin Pharmacol. 2004;60:183–90. PubMed
Trumbo P, Schlicker S, Yates AA, Poos M. Food and Nutrition Board of the Institute of Medicine, The National Academies Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc. 2002;102:1621–30. PubMed
Wei MY, Jacobson TA. Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysis. Curr Atheroscler Rep. 2011;13:474–83. PubMed
Cicero AF, Reggi A, Parini A, Borghi C. Application of polyunsaturated fatty acids in internal medicine: beyond the established cardiovascular effects. Arch Med Sci. 2012;8:784–93. PubMed PMC
Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico (GISSI) Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet. 1999;354:447–55. PubMed
Cicero AF, Colletti A. Krill oil: evidence of a new source of polyunsaturated fatty acids with high bioavailability. Clin Lipidol. 2015;10:1–4.
Ulven SM, Kirkhus B, Lamglait A, et al. Metabolic effects of krill oil are essentially similar to those of fish oil but at lower dose of EPA and DHA, in healthy volunteers. Lipids. 2011;46:37–46. PubMed PMC
Cicero AF, Rosticci M, Morbini M, et al. Lipid-lowering and anti-inflammatory effects of omega 3 ethyl esters and krill oil: a randomized, cross-over, clinical trial. Arch Med Sci. 2016;12:507–12. PubMed PMC
Ursoniu S, Sahebkar A, Serban MC, et al. Lipid and Blood Pressure Meta-analysis Collaboration Group Lipid-modifying effects of krill oil in humans: systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2017;75:361–73. PubMed
Pan A, Yu D, Demark-Wahnefried W, Franco OH, Lin X. Meta-analysis of the effects of flexseed interventions on blood lipids. Am J Clin Nutr. 2009;90:288–97. PubMed PMC
Ursoniu S, Sahebkar A, Andrica F, Serban C, Banach M. Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Effects of flaxseed supplements on blood pressure: a systematic review and meta-analysis of controlled clinical trial. Clin Nutr. 2016;35:615–25. PubMed
Khalesi S, Paukste E, Nikbakht E, Khosravi-Boroujeni H. Sesame fractions and lipid profiles: a systematic review and meta-analysis of controlled trials. Br J Nutr. 2016;115:764–73. PubMed
Kromhout D, Giltay EJ, Geleijnse JM, Alpha Omega Trial Group n-3 fatty acids and cardiovascular events after myocardial infarction. N Engl J Med. 2010;363:2015–26. PubMed
Kotwal S, Jun M, Sullivan D, Perkovic V, Neal B. Omega 3 fatty acids and cardiovascular outcomes: systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2012;5:808–18. PubMed
Cicero AF, Gaddi A. Rice bran oil and gamma-oryzanol in the treatment of hyperlipoproteinaemias and other conditions. Phytother Res. 2001;15:277–89. PubMed
Mäkynen K, Chitchumroonchokchai C, Adisakwattana S, Failla M, Ariyapitipun T. Effect of gamma-oryzanol on the bioaccessibility and synthesis of cholesterol. Eur Rev Med Pharmacol Sci. 2012;16:49–56. PubMed
Kim HW, Kim JB, Cho SM, et al. Characterization and quantification of gamma-oryzanol in grains of 16 Korean rice varieties. Int J Food Sci Nutr. 2015;66:166–74. PubMed
Jolfaie NR, Rouhani MH, Surkan PJ, Siassi F, Azadbakht L. Rice bran oil decreases total and LDL cholesterol in humans: a systematic review and meta-analysis of randomized controlled clinical trials. Horm Metab Res. 2016;48:417–26. PubMed
Nagaoka S, Shimizu K, Kaneko H, et al. A novel protein C-phycocyanin plays a crucial role in the hypocholesterolemic action of Spirulina platensis concentrate in rats. J Nutr. 2005;135:2425–30. PubMed
Serban MC, Sahebkar A, Dragan S, et al. A systematic review and meta-analysis of the impact of Spirulina supplementation on plasma lipid concentrations. Clin Nutr. 2016;35:842–51. PubMed
Pulido-Moran M, Moreno-Fernandez J, Ramirez-Tortosa C, Ramirez-Tortosa M. Curcumin and health. Molecules. 2016;21:264. PubMed PMC
Panahi Y, Hosseini MS, Khalili N, et al. Effects of supplementation with curcumin on serum adipokine concentrations: A randomized controlled trial. Nutrition. 2016;32:1116–22. PubMed
Sahebkar A, Cicero AF, Simental-Mendía LE, Aggarwal BB, Gupta SC. Curcumin downregulates human tumor necrosis factor-alpha levels: a systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2016;107:234–42. PubMed
Kumar P, Malhotra P, Ma K, et al. SREBP2 mediates the modulation of intestinal NPC1L1 expression by curcumin. Am J Physiol Gastrointest Liver Physiol. 2011;301:G148–55. PubMed PMC
Liu XL, Liu MH, Hu HJ, et al. Curcumin enhanced choelsterol efflux by upregulating ABCA1 expression through AMPK-SIRT1-LXRalpha signaling in THP-1 macrophage-derived foam cells. DNA Cell Biol. 2015;34:561–72. PubMed
Tai MH, Chen PK, Chen PY, Wu MJ, Ho CT, Yen JH. Curcumin enhances cell-surface LDLR level and promotes LDL uptake through downregulation of PCSK9 gene expression in HepG2 cells. Mol Nutr Food Res. 2014;58:2133–45. PubMed
Momtazi AA, Derosa G, Maffioli P, Banach M, Sahebkar A. Role of microRNAs in the therapeutic effects of curcumin in non-cancer diseases. Mol Diagn Ther. 2016;20:335–45. PubMed
Sahebkar A. A systematic review and meta-analysis of randomized controlled trials investigating the effects of curcumin on blood lipid levels. Clin Nutr. 2014;33:406–14. PubMed
Yang YS, Su YF, Yang HW, Lee YH, Chou JI, Ueng KC. Lipid-lowering effects of curcumin in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled trial. Phytother Res. 2014;28:1770–7. PubMed
Panahi Y, Khalili N, Hosseini MS, Abbasinazari M, Sahebkar A. Lipid-modifying effects of adjunctive therapy with curcuminoids-piperine combination in patients with metabolic syndrome: results of a randomized controlled trial. Complement Ther Med. 2014;22:851–7. PubMed
Rahmani S, Asgary S, Askari G, et al. Treatment of non-alcoholic fatty liver disease with curcumin: a randomized placebo-controlled trial. Phytother Res. 2016 Jun 8; doi: 10.1002/ptr.5659. [Epub ahead of print] PubMed DOI
Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendía LE, Sahebkar A. Curcumin lowers serum lipids and uric acid in subjects with non-alcoholic fatty liver disease: a randomized controlled trial. J Cardiovasc Pharmacol. 2016;68:223–9. PubMed
Derosa G, Limas CP, Macías PC, Estrella A, Maffioli P. Dietary and nutraceutical approach to type 2 diabetes. Arch Med Sci. 2014;10:336–44. PubMed PMC
Nakayama H, Tsuge N, Sawada H, et al. A single consumption of curry improved postprandial endothelial function in healthy male subjects: a randomized, controlled crossover trial. Nutr J. 2014;13:67. PubMed PMC
Chuengsamarn S, Rattanamongkolgul S, Phonrat B, Tungtrongchitr R, Jirawatnotai S. Reduction of atherogenic risk in patients with type 2 diabetes by curcuminoid extract: a randomized controlled trial. J Nutr Biochem. 2014;25:144–50. PubMed
Rahimi HR, Nedaeinia R, Sepehri Shamloo A, Nikdoust S, Kazemi Oskuee R. Novel delivery system for natural products: nano-curcumin formulations. Avicenna J Phytomed. 2016;6:383–98. PubMed PMC
El-Hattab AW, Scaglia F. Disorders of carnitine biosynthesis and transport. Mol Genet Metab. 2015;116:107–12. PubMed
Serban MC, Sahebkar A, Mikhailidis DP, et al. Impact of L-carnitine on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2016;6:19188. PubMed PMC
Pooyandjoo M, Nouhi M, Shab-Bidar S, Djafarian K, Olyaeemanesh A. The effect of (L-) carnitine on weight loss in adults: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2016;17:970–6. PubMed
Mazidi M, Rezaie P, Banach M. Impact of L-carnitine on C-reactive proteIn: a systematic review and meta-analysis of 10 randomized control trials with 925 patients. Presentation at 2nd CPPEI Congress in Vienna; 2017. Jul, (data unpublished)
Capasso F, Gaginella TS, Grandolini G, Izzo AA. Phytotherapy: a Quick Reference to Herbal Medicine. Berlin: Springer; 2003.
Safaa M, Hanaa A, Abdel F, Nahila A, Abdelaaty S. Cynara scolymus for relieving on nonalcoholic steatohepatitis induced in rat. Int J Pharm Pharmac Sci. 2013;5:57–66.
Rangboo V, Noroozi M, Zavoshy R, Rezadoost SA, Mohammadpoorasl A. The effect of artichoke leaf extract on alanine aminotransferase and aspartate aminotransferase in the patients with nonalcoholic steatohepatitis. Int J Hepatol. 2016;2016:4030476. PubMed PMC
Bundy R, Walker AF, Middleton RW, Wallis C, Simpson HC. Artichoke leaf extract (Cynara scolymus) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: a randomized, double blind placebo controlled trial. Phytomedicine. 2008;15:668–75. PubMed
Englisch W, Beckers C, Unkauf M, Ruepp M, Zinserling V. Efficacy of Artichoke dry extract in patients with hyperlipoproteinemia. Arzneimittelforschung. 2000;50:260–5. PubMed
Petrowicz O, Gebhardt R, Donner M, Schwandt M, Kraft K. Effects of artichoke leaf extract (ALE) on lipoprotein metabolism in vitro and in vivo. Atherosclerosis. 1997;129:147.
Sahebkar A, Pirro M, Banach M, Mikhailidis DP, Atkin SL, Cicero AFG. Lipid-lowering activity of artichoke extracts: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2017 Jun 13; doi: 10.1080/10408398.2017.1332572. PubMed DOI
Li F, Tan W, Kang Z, Wong CW. Tocotrienol enriched palm oil prevents atherosclerosis through modulating the activities of peroxisome proliferators-activated receptors. Atherosclerosis. 2010;211:278–82. PubMed
Ajuluchukwu JN, Okubadejo NU, Mabayoje M, et al. Comparative study of the effect of tocotrienols and -tocopherol on fasting serum lipid profiles in patients with mild hypercholesterolaemia: a preliminary report. Niger Postgrad Med J. 2007;14:30–3. PubMed
Rasool AH, Rahman AR, Yuen KH, Wong AR. Arterial compliance and vitamin E blood levels with a self emulsifying preparation of tocotrienol rich vitamin E. Arch Pharm Res. 2008;31:1212–7. PubMed
Prasad K. Tocotrienols and cardiovascular health. Curr Pharm Des. 2011;17:2147–54. PubMed
Loffredo L, Perri L, Di Castelnuovo A, Iacoviello L, De Gaetano G, Violi F. Supplementation with vitamin E alone is associated with reduced myocardial infarction: a meta-analysis. Nutr Metab Cardiovasc Dis. 2015;25:354–63. PubMed
Sen CK, Khanna S, Rink C, Roy S. Tocotrienols: the emerging face of natural vitamin E. Vitam Horm. 2007;76:203–61. PubMed PMC
Wallace TC, Slavin M, Frankenfeld CL. Systematic review of anthocyanins and markers of cardiovascular disease. Nutrients. 2016;8 doi: 10.3390/nu8010032. pii: E32. PubMed DOI PMC
Li D, Zhang Y, Liu Y, Sun R, Xia M. Purified anthocyanin supplementation reduces dyslipidemia, enhances antioxidant capacity, and prevents insulin resistance in diabetic patients. J Nutr. 2015;145:742–8. PubMed
Davinelli S, Bertoglio JC, Zarrelli A, Pina R, Scapagnini G. A randomized clinical trial evaluating the efficacy of an anthocyanin-Maqui Berry Extract (Delphinol®)on oxidative stress biomarkers. J Am Coll Nutr. 2015;34(Suppl 1):28–33. PubMed
Jennings A, Welch AA, Fairweather-Tait SJ, et al. Higher anthocyanin intake is associated with lower arterial stiffness and central blood pressure in women. Am J Clin Nutr. 2012;96:781–8. PubMed
Marques C, Fernandes I, Norberto S, et al. Pharmacokinetics of blackberry anthocyanins consumed with or without ethanol: a randomized and crossover trial. Nutr Food Res. 2016;60:2319–30. PubMed
Skottová N, Krecman V. Silymarin as a potential hypocholesterolaemic drug. Physiol Res. 1998;47:1–7. PubMed
Voroneanu L, Nistor I, Dumea R, Apetrii M, Covic A. Silymarin in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. J Diabetes Res. 2016;2016:5147468. PubMed PMC
Mitchell PL, McLeod RS. Conjugated linoleic acid and atherosclerosis: studies in animal models. Biochem Cell Biol. 2008;86:293–301. PubMed
Farvid MS, Ding M, Pan A, et al. Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies. Circulation. 2014;130:1568–78. PubMed PMC
Derakhshande-Rishehri SM, Mansourian M, Kelishadi R, Heidari-Beni M. Association of foods enriched in conjugated linoleic acid (CLA) and CLA supplements with lipid profile in human studies: a systematic review and meta-analysis. Public Health Nutr. 2015;18:2041–54. PubMed PMC
Taylor JS, Williams SR, Rhys R, James P, Frenneaux MP. Conjugated linoleic acid impairs endothelial function. Arterioscler Thromb Vasc Biol. 2006;26:307–12. PubMed
Sahebkar A, Serban C, Ursoniu S, et al. Lipid and Blood Pressure Meta-analysis Collaboration Group Lack of efficacy of resveratrol on C-reactive protein and selected cardiovascular risk factors: results from a systematic review and meta-analysis of randomized controlled trials. Int J Cardiol. 2015;189:47–55. PubMed
Aziz Z, Wong SY, Chong NJ. Effects of Hibuscus sabdariffa L. on serum lipids: a systematic review and meta-analysis and meta-analysis. J Ethnopharmacol. 2013;150:442–50. PubMed
Serban C, Sahebkar A, Ursoniu S, Andrica F, Banach M. Effect of sour tea (Hibiscus sabdariffa L) on arterial hypertension: a systematic review and meta-analysis of randomized controlled trials. J Hypertens. 2015;33:1119–27. PubMed
Ursoniu S, Sahebkar A, Serban MC, Banach M. Lipid profile and glucose changes after supplementation with astaxanthin: a systematic review and meta-analysis of randomized controlled trials. Arch Med Sci. 2015;11:253–66. PubMed PMC
Cicero AF, Colletti A. Combinations of phytomedicines with different lipid lowering activity for dyslipidemia management: the available clinical data. Phytomedicine. 2016;23:1113–8. PubMed
Cicero AF, Ferroni A, Ertek S. Tolerability and safety of commonly used dietary supplements and nutraceuticals with lipid-lowering effects. Expert Opin Drug Saf. 2012;11:753–66. PubMed
Cicero AF, Parini A, Rosticci M. Nutraceuticals and cholesterol-lowering action. Int J Cardiol Med Endocr. 2015;6:1–4.
Cicero AF, Brancaleoni M, Laghi L, Donati F, Mino M. Antihyperlipidaemic effect of a Monascus purpureus brand dietary supplement on a large sample of subjects at low risk for cardiovascular disease: a pilot study. Complement Ther Med. 2005;13:273–8. PubMed
Stefanutti C, Mazza F, Vivenzio A, et al. Combined treatment with Dif1stat and diet reduce plasma lipid indicators of moderate hypercholesterolemia more effectively than diet alone: a randomized trial in parallel groups. Lipids. 2009;44:1141–8. PubMed
Cicero AF, Benvenuti C, ARMoweb study Group Efficacy of a red yeast rice based nutraceutical in large subgroups of hypercholesterolemic subjects in every day clinical practice. Med J Nutr Metab. 2010;3:239–46.
Guardamagna O, Abello F, Baracco V, Stasiowska B, Martino F. The treatment of hypercholesterolemic children: efficacy and safety of a combination of red yeast rice extract and policosanols. Nutr Metab Cardiovasc Dis. 2011;21:424–9. PubMed
Pirro M, Mannarino MR, Bianconi V, et al. The effects of a nutraceutical combination on plasma lipids and glucose: a systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2016;110:76–88. PubMed
Pirro M, Mannarino MR, Ministrini S, et al. Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial. Sci Rep. 2016;6:23587. PubMed PMC
Marazzi G, Cacciotti L, Pelliccia F, et al. Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients. Adv Ther. 2011;28:1105–13. PubMed
Cicero AF, Derosa G, Borghi C. Red yeast rice and statin-intolerant patients. Am J Cardiol. 2010;105:1504. PubMed
De Castro-Orós I, Solà R, Valls RM, et al. Genetic variants of LDLR and PCSK9 associated with variations in response to antihypercholesterolemic effects of armolipid plus with berberine. PLoS One. 2016;11:e0150785. PubMed PMC
Affuso F, Ruvolo A, Micillo F, Saccà L, Fazio S. Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study. Nutr Metab Cardiovasc Dis. 2010;20:656–61. PubMed
Cicero AF, Parini A, Rosticci M, et al. Effect of a lipid-lowering nutraceutical on pulse-wave-velocity in hypercholesterolemic patients with or without chronic kidney disease. Open Hypertens J (TOJH) 2013;5:18–22.
Kamal-Eldin A, Moazzami A. Plant sterols and stanols as cholesterol-lowering ingredients in functional foods. Recent Pat Food Nutr Agric. 2009;1:1–14. PubMed
Feuerstein JS, Bjerke WS. Powdered red yeast rice and plant stanols and sterols to lower cholesterol. J Diet Suppl. 2012;9:110–5. PubMed
Cicero AF, Fogacci F, Rosticci M, et al. Effect of a short-term dietary supplementation with phytosterols, red yeast rice or both on lipid pattern in moderately hypercholesterolemic subjects: a three-arm, double-blind, randomized clinical trial. Nutr Metab. 2017 In press. PubMed PMC
Ogier N, Amiot MJ, Georgé S, et al. LDL-cholesterol-lowering effect of a dietary supplement with plant extracts in subjects with moderate hypercholesterolemia. Eur J Nutr. 2013;52:547–57. PubMed
Barrat E, Zaïr Y, Ogier N, et al. A combined natural supplement lowers LDL cholesterol in subjects with moderate untreated hypercholesterolemia: a randomized placebo-controlled trial. Int J Food Sci Nutr. 2013;64:882–9. PubMed
Barrat E, Zaïr Y, Sirvent P, et al. Effect on LDL-cholesterol of a large dose of a dietary supplement with plant extracts in subjects with untreated moderate hypercholesterolaemia: a randomised, double-blind, placebo-controlled study. Eur J Nutr. 2013;52:1843–52. PubMed
Cicero AF, Colletti A, Fogacci F, Bove M, Rosticci M, Borghi C. Effects of a combined nutraceutical on lipid pattern, glucose metabolism and inflammatory parameters in moderately hypercholesterolemic subjects: a double-blind, cross-over, randomized clinical trial. High Blood Press Cardiovasc Prev. 2016;24:13–8. PubMed PMC
Derosa G, Bonaventura A, Bianchi L, et al. A randomized, placebo-controlled study on the effects of a nutraceutical combination of red yeast rice, silybum marianum and octasonol on lipid profile, endothelial and inflammatory parameters. J Biol Regul Homeost Agents. 2014;28:317–24. PubMed
Cicero AF, Colletti A, Rosticci M, Grandi E, Borghi C. Efficacy and tolerability of a combined lipid-lowering nutraceutical on cholesterolemia, hs-CRP level and endothelial function in moderately hypercholesterolemic subjects. J Biol Regul Homeost Agents. 2016;30:593–8. PubMed
Cicero AF, Derosa G, Parini A, et al. Red yeast rice improves lipid pattern, high-sensitivity C-reactive protein, and vascular remodeling parameters in moderately hypercholesterolemic Italian subjects. Nutr Res. 2013;33:622–8. PubMed
Cicero AF, Morbini M, Rosticci M, D’Addato S, Grandi E, Borghi C. Middle-term dietary supplementation with red yeast rice plus coenzyme Q10 improves lipid pattern, endothelial reactivity and arterial stiffness in moderately hypercholesterolemic subjects. Ann Nutr Metab. 2016;68:213–9. PubMed
Cicero AF, Morbini M, Parini A, et al. Effect of red yeast rice combined with antioxidants on lipid pattern, hs-CRP level, and endothelial function in moderately hypercholesterolemic subjects. Ther Clin Risk Manag. 2016;12:281–6. PubMed PMC
Cicero AF, Rosticci M, Parini A, et al. Short-term effects of a combined nutraceutical of insulin-sensitivity, lipid level and indexes of liver steatosis: a double-blind, randomized, cross-over clinical trial. Nutr J. 2015;14:30. PubMed PMC
Derosa G, Bonaventura A, Bianchi L, et al. Berberis aristata/Silybum marianum fixed combination on lipid profile and insulin secretion in dyslipidemic patients. Expert Opin Biol Ther. 2013;13:1495–506. PubMed
Cicero AF, Fiorito A, Panourgia MP, Sangiorgi Z, Gaddi A. Effects of a new soy/beta-sitosterol supplement on plasma lipids in moderately hypercholesterolemic subjects. J Am Diet Assoc. 2002;102:1807–11. PubMed
Lerman RH, Minich DM, Darland G, et al. Subjects with elevated LDL cholesterol and metabolic syndrome benefit from supplementation with soy protein, phytosterols, hops rho iso-alpha acids, and Acacia nilotica proanthocyanidins. J Clin Lipidol. 2010;4:59–68. PubMed
Jenkins DJ, Kendall CW, Marchie A, et al. The effect of combining plant sterols, soy protein, viscous fibers, and almonds in treating hypercholesterolemia. Metabolism. 2003;52:1478–83. PubMed
Cicero AF, Derosa G, Pisciotta L, Barbagallo C, SISA-PUFACOL Study Group Testing the short-term efficacy of a lipid-lowering nutraceutical in the setting of clinical practice: a multicenter study. J Med Food. 2015;18:1270–3. PubMed PMC
Lee IT, Lee WJ, Tsai CM, Su IJ, Yen HT, Sheu WH. Combined extractives of red yeast rice, bitter gourd, chlorella, soy protein, and licorice improve total cholesterol, low-density lipoprotein cholesterol, and triglyceride in subjects with metabolic syndrome. Nutr Res. 2012;32:85–92. PubMed
Shrestha S, Volek JS, Udani J, et al. A combination therapy including psyllium and plant sterols lowers LDL cholesterol by modifying lipoprotein metabolism in hypercholesterolemic individuals. J Nutr. 2006;136:2492–7. PubMed
Micallef MA, Garg ML. The lipid-lowering effects of phytosterols and (n-3) polyunsaturated fatty acids are synergistic and complementary in hyperlipidemic men and women. J Nutr. 2008;138:1085–90. PubMed
Jeyaraj S, Shivaji G, Jeyaraj SD, Vengatesan A. Effect of combined supplementation of fish oil with garlic pearls on the serum lipid profile in hypercholesterolemic subjects. Indian Heart J. 2005;57:327–31. PubMed
Accinni R, Rosina M, Bamonti F, et al. Effects of combined dietary supplementation on oxidative and inflammatory status in dyslipidemic subjects. Nutr Metab Cardiovasc Dis. 2006;16:121–7. PubMed
Sirtori CR, Triolo M, Bosisio R, et al. Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals. Br J Nutr. 2012;107:1176–83. PubMed
Yoshida M, Vanstone CA, Parsons WD, Zawistowski J, Jones PJ. Effect of plant sterols and glucomannan on lipids in individuals with and without type II diabetes. Eur J Clin Nutr. 2006;60:529–37. PubMed
Houston M, Sparks W. Effect of combination pantethine, plant sterols, green tea extract, delta-tocotrienol and phytolens on lipid profiles in patients with hyperlipidemia. JANA. 2010;13:15–20.
Sabatine MS. Advances in the treatment of dyslipidemia. Cleve Clin J Med. 2016;83:181–6. PubMed
Šimić I, Reiner Ž. Adverse effects of statins – myths and reality. Curr Pharm Des. 2015;21:1220–6. PubMed
Banach M, Stulc T, Dent R, Toth PP. Statin non-adherence and residual cardiovascular risk: there is need for substantial improvement. Int J Cardiol. 2016;225:184–96. PubMed
Reiner Ž. Combined therapy in the treatment of dyslipidemia. Fundam Clin Pharmacol. 2010;24:19–28. PubMed
Cicero AF, Morbini M, Bove M, et al. Additional therapy for cholesterol lowering in ezetimibe-treated, statin-intolerant patients in clinical practice: results from an internal audit of a university lipid clinic. Curr Med Res Opin. 2016 Jun;8:1–6. [Epub ahead of print] PubMed
Cicero AF, Colletti A. Statins and nutraceuticals/functional food: could they be combined? In: Banach M, editor. Combination Therapy In Dyslipidemia. 2016. pp. 127–42.
Maki KC, Orloff DG, Nicholls SJ, et al. A highly bioavailable omega-3 free fatty acid formulation improves the cardiovascular risk profile in high-risk, statin-treated patients with residual hypertriglyceridemia (the ESPRIT trial) Clin Ther. 2013;35:1400-11.e1–-3. PubMed
Kim SH, Kim MK, Lee HY, Kang HJ, Kim YJ, Kim HS. Prospective randomized comparison between omega-3 fatty acid supplements plus simvastatin versus simvastatin alone in Korean patients with mixed dyslipidemia: lipoprotein profiles and heart rate variability. Eur J Clin Nutr. 2011;65:110–6. PubMed
Yokoyama M, Origasa H, Matsuzaki M, et al. Japan EPA lipid intervention study (JELIS) investigators. Lancet. 2007;369:1090–8. PubMed
Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Lancet. 1999;354:447–55. PubMed
Agrawal AR, Tandon M, Sharma PL. Effect of combining viscous fibre with lovastatin on serum lipids in normal human subjects. Int J Clin Pract. 2007;61:1812–8. PubMed
Moreyra AE, Wilson AC, Koraym A. Effect of combining psyllium fiber with simvastatin in lowering cholesterol. Arch Intern Med. 2005;165:1161–6. PubMed
Ramos SC, Fonseca FA, Kasmas SH, et al. The role of soluble fiber intake in patients under highly effective lipid-lowering therapy. Nutr J. 2011;10:80. PubMed PMC
Marazzi G, Pelliccia F, Campolongo G, et al. Usefulness of nutraceuticals (Armolipid Plus) versus ezetimibe and combination in statin-intolerant patients with dyslipidemia with coronary heart disease. Am J Cardiol. 2015;116:1798–801. PubMed
Pisciotta L, Bellocchio A, Bertolini S. Nutraceutical pill containing berberine versus ezetimibe on plasma lipid pattern in hypercholesterolemic subjects and its additive effect in patients with familial hypercholesterolemia on stable cholesterol-lowering treatment. Lipids Health Dis. 2012;11:123. PubMed PMC
Di Pierro F, Bellone I, Rapacioli G, Putignano P. Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins. Diabetes Metab Syndr Obes. 2015;8:89–96. PubMed PMC
Malina DM, Fonseca FA, Barbosa SA, et al. Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens. J Clin Lipidol. 2015;9:542–52. PubMed
Gylling H, Miettinen TA. LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects. Nutr Metab Cardiovasc Dis. 2002;12:19–23. PubMed
Qureshi AA, Sami SA, Salser WA, Khan FA. Synergistic effect of tocotrienol-rich fraction (TRF 25) of rice bran and lovastatin on lipid parameters in hypercholesterolemic humans. J Nutr Biochem. 2001;12:318–29. PubMed
Ahmad Alobaidi AH. Effect of Nigella sativa and Allium sativum coadminstered with simvastatin in dyslipidemia patients: a prospective, randomized, double-blind trial. Antiinflamm Antiallergy Agents Med Chem. 2014;13:68–74. PubMed
Qin XF, Zhao LS, Chen WR, Yin da W, Wang H. Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial. Clin Nutr. 2015;34:201–6. PubMed
Michalska-Kasiczak M, Sahebkar A, Mikhailidis DP, et al. Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Analysis of vitamin D levels in patients with and without statin-associated myalgia – a systematic review and meta-analysis of 7 studies with 2420 patients. Int J Cardiol. 2015;178:111–6. PubMed
Serban MC, Colantonio LD, Manthripragada AD, et al. Statin intolerance and risk of coronary heart events and all-cause mortality following myocardial infarction. J Am Coll Cardiol. 2017;69:1386–95. PubMed
Latest Updates on Lipid Management