Choose dietary supplements to reduce cholesterol: what to look for?

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Choose dietary supplements to reduce cholesterol: what to look for?

I. Cholesterol: Fundamentals and Health value

IA What is cholesterol?

Cholesterol is lipid (fat -like substance), which plays a vital role in the human body. It is a component of cell membranes, is involved in the synthesis of hormones (steroid, such as cortisol, estrogen, testosterone), vitamin D and bile acids necessary for digestion of fats. Cholesterol does not dissolve in the blood, so it is transported in the body in the form of lipoproteins.

IB types of cholesterol: LDL, HDL and triglycerides

There are several types of lipoproteins that carry cholesterol. The most important of them:

  • Lipoproteins of low density (LDL): Often called “poor” cholesterol. LDL is tolerate cholesterol from the liver to the cells of the body. The high level of LDL contributes to the formation of cholesterol plaques on the walls of arteries (atherosclerosis), which increases the risk of cardiovascular diseases.
  • High density lipoproteins (HDL): Often called “good” cholesterol. LDP is transferred to cholesterol from cells back to the liver, where it is processed and excreted from the body. A high level of HDL reduces the risk of atherosclerosis.
  • Triglycerides: This is another type of fat in the blood. A high level of triglycerides, especially in combination with a high level of LDL and a low level of HDL, also increases the risk of cardiovascular diseases.

IC normal cholesterol indicators

Recommended cholesterol levels can vary slightly depending on the age, gender, the presence of concomitant diseases and risk factors. However, the general target values ​​are as follows:

  • General cholesterol: Less than 200 mg/DL (5.2 mmol/l)
  • LDL (bad cholesterol): Less than 100 mg/DL (2.6 mmol/l). For people with a high risk of cardiovascular diseases, this indicator may be lower (for example, less than 70 mg/DL).
  • LDL (good cholesterol): More than 40 mg/DL (1.0 mmol/l) for men and more than 50 mg/DL (1.3 mmol/l) for women.
  • Triglycerides: Less than 150 mg/dl (1.7 mmol/l)

It is necessary to regularly control the level of cholesterol, especially if there are risk factors, such as heredity, overweight, smoking, improper nutrition and lack of physical activity.

ID factors affecting cholesterol levels

Many factors can affect blood cholesterol levels:

  • Diet: Saturated and trans fats increase the level of LDL. Products with a high cholesterol content can also affect blood cholesterol, although to a lesser extent than saturated and trans fats.
  • Weight: Excess weight increases the level of LDL and triglycerides, and also reduces the level of HDL.
  • Physical activity: The lack of physical activity helps to increase the level of LDL and a decrease in the level of HDL.
  • Age and Paul: Cholesterol levels usually increase with age. In women, the level of HDL is usually higher than in men, before menopause.
  • Genetics: Heredity plays an important role in determining the level of cholesterol. Some people are genetically predisposed to a high level of cholesterol, even if a healthy lifestyle is observed.
  • Smoking: Smoking reduces the level of HDL and damages the walls of the arteries, making them more susceptible to the formation of cholesterol plaques.
  • Diseases: Some diseases, such as diabetes, hypothyroidism (reduced thyroid function) and kidney disease, can affect cholesterol.
  • Medicines: Some drugs, such as corticosteroids, can increase cholesterol.

IE High -level cholesterol hazard

Chronically increased cholesterol, especially LDL, leads to atherosclerosis – the process of formation of cholesterol plaques on the walls of arteries. These plaques narrow the lumen of the arteries, limiting blood flow and increasing the risk of the following complications:

  • Corny heart (coronary heart disease): A decrease in blood flow to the heart can cause angina pectoris (chest pain) and a heart attack (myocardial infarction).
  • Stroke: If the plaque breaks away from the wall of the artery and clogs the vessel in the brain, this can lead to a stroke.
  • Diseases of the peripheral arteries: The narrowing of the arteries that supply the legs and other parts of the body can cause pain when walking (intermittent chroma) and increase the risk of amputation.
  • Transient ischemic attack (TIA): “Microinsult”, which causes temporary neurological symptoms.

II. Dietary supplement for reduction of cholesterol: review and classification

II.A. What are dietary supplements?

Biologically active food additives (dietary supplements) are concentrates of natural or identical to natural biologically active substances, designed for direct intake or introduction into food products in order to enrich the diet with individual food or biologically active substances and their complexes, as well as to maintain normal and restoration of impaired health. It is important to understand that dietary supplements are not medicines and are not intended for the treatment of diseases. They can be used as an addition to the main treatment and a healthy lifestyle.

II.B. Classification of dietary supplements to reduce cholesterol

Bades designed to reduce cholesterol level can be classified according to various criteria, including the main active substance, the mechanism of action and the form of release.

II.B.1. According to the main active substance:

  • Plant sterols (phytosterols): Competently block the absorption of cholesterol in the intestines.
  • Red yeast rice: Contains Monacoline K, which is a natural inhibitor of the GMG-CoA reductase (enzyme involved in cholesterol synthesis).
  • Omega-3 fatty acids: Reduce the level of triglycerides and can slightly increase the level of HDL.
  • Fiber (dietary fiber): Bind cholesterol in the intestines and contribute to its elimination from the body.
  • Niacin (Vitamin B3): In high doses, it can reduce the level of LDL and triglycerides, as well as increase the level of HDL.
  • Polikosanol: Reduces the level of LDL and increases the level of HDL.
  • Lecitin: Improves fat metabolism and can help reduce cholesterol.
  • Garlic: Contains allicin and other compounds that can reduce the level of cholesterol and triglycerides.
  • Artichoke: Contains zinarin, which stimulates the production of bile and helps to remove cholesterol from the body.
  • Turmeric (curcumin): It has antioxidant and anti -inflammatory properties that can help reduce cholesterol.

II.B.2. By the mechanism of action:

  • Cholesterol absorption inhibitors: Plant sterols.
  • Cholesterol synthesis inhibitors: Red yeast rice (Monacoline K).
  • Improving lipid profile: Omega-3 fatty acids, niacin, polycosanol, lecithin.
  • Binding cholesterol: Fiber.
  • With a comprehensive action: Garlic, artichoke, turmeric.

II.B.3. By the form of release:

  • Capsules: Convenient in use, contain an accurately dosed amount of active substance.
  • Tablets: Similar to capsules, but may contain additional components.
  • Powders: You can add to food or drinks.
  • Liquids (oils, extracts): Omega-3 fatty acids or plant extracts usually contain.
  • Bades enriched with dietary supplements: For example, yogurt or spreads with the addition of plant sterols.

III. The most popular dietary supplements to reduce cholesterol: detailed analysis

III.A. Plant sterols (phytosterols)

III.A.1. The mechanism of action: Plant sterols are structurally similar to cholesterol and compete with it for absorption in the intestines. As a result, less cholesterol enters the bloodstream, which leads to a decrease in the level of LDL.

III.A.2. Efficiency: Numerous studies have shown that the use of plant sterols at a dose of 2-3 grams per day can reduce the level of LDL by 8-15%.

III.A.3. Output forms: Plant sterols are available in the form of capsules, tablets and products enriched with plant sterols (for example, spreads, yogurts, juices).

III.A.4. Safety: Plant sterols are usually well tolerated. In rare cases, minor side effects can occur, such as discomfort in the abdomen or bloating. It is important to note that plant sterols can reduce the absorption of some fat -soluble vitamins (for example, vitamin A, D, E, K).

III.A.5. To whom they fit: Plant sterols are suitable for people with a moderately increased LDL level who want to reduce it without using drugs. They can also be useful in combination with other methods of reducing cholesterol, such as diet and physical activity.

III.B. Red yeast rice

III.b.1. The mechanism of action: Red yeast rice is a product of rice fermentation with Monascus Purpureus yeast. It contains Monacoline K, which is a natural inhibitor of the GMG-Koa reductase-the enzyme necessary for the synthesis of cholesterol in the liver. Monacolin is valid similarly to statins – drugs widely used to reduce cholesterol.

III.B.2. Efficiency: Studies have shown that red yeast rice can effectively reduce the level of LDL and total cholesterol. The effect depends on the dose of Monacoline K contained in the product.

III.B.3. Output forms: Red yeast rice is available in the form of capsules and tablets.

III.B.4. Safety: Red yeast rice contains Monacoline K, which has the same mechanism of action as statins. Therefore, it can cause the same side effects as statins, including muscle pain (myalgia), weakness, an increase in the level of liver enzymes and, in rare cases, rabdomyolysis (destruction of muscle tissue). In addition, red yeast rice may contain a citrine – a toxic substance that can damage the kidneys. It is important to choose products from reliable manufacturers who control the content of citrine.

III.B.5. To whom they fit: Red yeast rice can be considered as an alternative to statins for people with a moderately elevated LDL level who cannot tolerate statins or want to try a natural remedy. However, before taking red yeast rice, it is necessary to consult a doctor in order to evaluate risks and benefits and make sure that there are no contraindications. It is important to regularly monitor the level of liver and creatinkinase enzymes (KFK) during red yeast rice.

III.C. Omega-3 fatty acids

III.C.1. The mechanism of action: Omega-3 fatty acids, especially eicopascentenic acid (EPC) and daily oxenoic acid (DGC) contained in fish and other sources, have a positive effect on the cardiovascular system. They reduce the level of triglycerides, can slightly increase the level of HDLs and have anti -inflammatory properties.

III.C.2. Efficiency: Omega-3 fatty acids are most effective for reducing triglycerides. High doses (2-4 grams per day) can reduce triglycerides by 25-50%. The impact on the level of LDL and LDP is usually insignificant.

III.C.3. Output forms: Omega-3 fatty acids are available in the form of capsules with fish oil, croil oil, linseed oil and other plant sources.

III.C.4. Safety: Omega-3 fatty acids are usually well tolerated. In high doses, side effects can cause side effects, such as stomach disorder, nausea, fish taste in the mouth and increased bleeding.

III.C.5. To whom they fit: Omega-3 fatty acids are suitable for people with a high level of triglycerides. They are also useful for maintaining the health of the heart and blood vessels in general.

III.D. Fiber (dietary fiber)

III.D.1. The mechanism of action: Fiber is undigested carbohydrates contained in plant products. Soluble fiber (for example, oat bran, pectin, guar gum) binds cholesterol in the intestines and contributes to its elimination from the body.

III.D.2. Efficiency: The use of a sufficient amount of fiber (25-35 grams per day) can reduce the level of LDL by 5-10%.

III.D.3. Output forms: Fiber is available in the form of powders, capsules and products enriched with fiber (for example, bran, whole grain products).

III.D.4. Safety: Fiber is usually well tolerated. In high doses, side effects can cause side effects, such as bloating, gases and constipation. It is important to use fiber with enough liquid.

III.D.5. To whom they fit: Fiber is suitable for everyone who wants to improve their lipid profile and general health. It is especially useful for people with a high level of LDL and for those who want to control their weight.

III.E. Niacin (withitatment B3)

III.E.1. The mechanism of action: Niacin (nicotinic acid) in high doses affects lipid metabolism. It reduces the production of LDL and triglycerides in the liver and increases the level of HDL.

III.E.2. Efficiency: Niacin can significantly reduce the level of LDL (by 10-25%) and triglycerides (by 20-50%) and increase the level of HDL (by 15-35%).

III.E.3. Output forms: Niacin is available in the form of tablets with immediate and prolonged release.

III.E.4. Safety: Niacin in high doses can cause side effects, such as redness of the skin (especially the face and neck), itching, headache, nausea, vomiting, diarrhea, increasing the level of liver enzymes and increasing blood glucose. It is important to start taking niacin with low doses and gradually increase them under the supervision of a doctor. Niacin is contraindicated in people with liver diseases, peptic ulcer and diabetes.

III.E.5. To whom they fit: Niacin can be prescribed by a doctor with a high risk of cardiovascular diseases, in which the level of LDL and triglycerides is increased, and the level of HDL levels is low. Due to the high risk of side effects, niacin is not recommended for self-medication.

III.F. Polikosanol

III.F.1. The mechanism of action: Polikosanol is a mixture of higher aliphatic alcohols obtained from sugarcane, rice or bee wax. It is believed that polycsanol reduces the level of LDL and increases the level of HDL, affecting the metabolism of cholesterol in the liver. The exact mechanism of action of the polycsanol has not been fully studied.

III.F.2. Efficiency: Some studies have shown that polycosanol can be effective for reducing the level of LDL and increasing the level of HDL. However, the results of the studies are contradictory, and additional studies are needed to confirm the effectiveness of the polycosanol.

III.F.3. Output forms: Polycosanol is available in the form of tablets and capsules.

III.F.4. Safety: Polycosanol is usually well tolerated. In rare cases, side effects can occur, such as headache, dizziness, insomnia and stomach disorder.

III.F.5. To whom they fit: Polycosanol can be considered as an alternative to other dietary supplements for reducing cholesterol. However, due to the insufficient evidence base, before the reception of the polycsanol, it is necessary to consult a doctor.

III.G. Lecitin

III.G.1. The mechanism of action: Lecithin is a complex of phospholipids, which is an important component of cell membranes. It is believed that lecithin improves fat metabolism and promotes cholesterol emulsification, which can facilitate its excretion from the body.

III.G.2. Efficiency: Studies on assessing the effect of lecithin on the level of cholesterol gave conflicting results. Some studies have shown that lecithin can slightly reduce LDL level and increase the level of HDL, while other studies have not revealed significant influence.

III.G.3. Output forms: Lecithin is available in the form of capsules, powders and granules. It is also contained in soy products, egg yolks and other foods.

III.G.4. Safety: Lecithin is usually well tolerated. In high doses, side effects can cause side effects, such as stomach disorder, nausea and diarrhea.

III.G.5. To whom they fit: Lecithin can be used as an addition to a healthy lifestyle to maintain general health. However, its effectiveness is not proven to reduce cholesterol.

III.H. Garlic

III.H.1. The mechanism of action: Garlic contains allicin and other sulfur -containing compounds that have antioxidant, anti -inflammatory and antibacterial properties. It is believed that garlic can reduce the level of cholesterol, triglycerides and blood pressure.

III.H.2. Efficiency: Some studies have shown that garlic can slightly reduce the level of total cholesterol and LDL. However, the results of the studies are contradictory, and additional studies are needed to confirm the effectiveness of garlic.

III.H.3. Output forms: Garlic is available fresh, in the form of powder, extract and capsules.

III.H.4. Safety: Garlic is usually well tolerated. In high doses, side effects can cause side effects, such as heartburn, belching, unpleasant odor from the mouth and increased bleeding.

III.H.5. To whom they fit: Garlic can be used as an addition to a healthy lifestyle to maintain general health. However, its effectiveness is not proven to reduce cholesterol.

III.I. Artishok

III.I.1. The mechanism of action: The artichoke contains zinarin and other compounds that stimulate the production of bile and help to remove cholesterol from the body.

III.I.2. Efficiency: Some studies have shown that artichoke extract can reduce the level of total cholesterol and LDL. However, the results of the studies are contradictory, and additional studies are needed to confirm the effectiveness of the artichoke.

III.I.3. Output forms: The artichoke is available fresh, in the form of extract and capsules.

III.I.4. Safety: The artichoke is usually well tolerated. In rare cases, side effects can occur, such as stomach disorder and allergic reactions.

III.I.5. To whom they fit: The artichoke can be used as an addition to a healthy lifestyle to maintain the health of the liver and gall bladder. However, its effectiveness is not proven to reduce cholesterol.

III.J. Kurkuma (turcumin)

III.j.1. The mechanism of action: Turmeric contains curcumin, which has antioxidant and anti -inflammatory properties. It is believed that Kurkumin can reduce the level of cholesterol, triglycerides and blood pressure.

III.j.2. Efficiency: Some studies have shown that Kurkumin can slightly reduce the level of total cholesterol and LDL. However, the results of the studies are contradictory, and additional studies are needed to confirm the effectiveness of turmeric.

III.j.3. Output forms: Turmeric is available in the form of powder, capsules and extract.

III.j.4. Safety: Turmeric is usually well tolerated. In high doses, side effects can cause side effects, such as stomach disorder, nausea and diarrhea.

III.j.5. To whom they fit: Turmeric can be used as an addition to a healthy lifestyle to maintain general health. However, its effectiveness is not proven to reduce cholesterol.

IV. How to choose dietary supplement for reduction cholesterol: practical recommendations

IV.A. Consultation with a doctor:

Before you start taking any dietary supplement to reduce cholesterol, you need to consult a doctor. The doctor will evaluate your lipid profile, risk factors for cardiovascular diseases and general health and will help choose the most suitable and safe dietary supplement. Self -medication can be dangerous, especially if you have concomitant diseases or you take other drugs.

IV.B. Study of composition and dosage:

Carefully study the composition of the dietary supplement. Make sure that it contains the declared active substance in a sufficient dose. Pay attention to the presence of additional ingredients, such as dyes, preservatives and flavors. Choose dietary supplements with a minimum number of additives.

IV.C. The choice of a reliable manufacturer:

Choose dietary supplements from famous and reliable manufacturers who have a good reputation and conduct quality control of their products. Check the availability of quality certificates (for example, GMP) and customer reviews.

IV.D. Accounting for contraindications and side effects:

Learn about possible contraindications and side effects of the selected dietary supplement. If you have concomitant diseases or you take other medicines, be sure to consult a doctor to exclude the possibility of interaction between dietary supplements and medicines.

IV.E. Compliance with the reception and dosage mode:

Strictly observe the recommended reception and dosage of the dietary supplement indicated on the packaging or recommended by the doctor. Do not exceed the dose, as this can lead to side effects.

IV.F. Efficiency and safety monitoring:

During the intake of Bad, regularly control the cholesterol level and other blood indicators (for example, liver enzymes, creatinkinase) as a doctor’s prescription. Pay attention to any side effects and inform the doctor about them.

IV.G. A combination with other methods of reduction of cholesterol:

Bades should be used as an addition to other methods of reducing cholesterol, such as diet, physical activity and rejection of smoking. Do not rely only on dietary supplements and neglect a healthy lifestyle.

IV.H. Assessment of the ratio “price-quality”:

Compare the prices of various dietary supplements with a similar composition and dosage. Do not choose the cheapest product, as this can indicate low quality. Evaluate the ratio of “price-quality” and choose a product that meets your needs and capabilities.

V. The role of a diet and lifestyle in a decrease in cholesterol

VA diet reducing cholesterol

Diet plays a key role in reducing cholesterol levels. The basic principles of a diet that reduces cholesterol include:

  • Restriction of saturated and trans fats: Saturated fats are found in red meat, fatty dairy products (cheese, butter, cream) and some vegetable oils (palm, coconut). Transfiders are contained in fried foods, baking and Margarine. Replace saturated and trans fats with unsaturated fats, such as olive oil, avocados, nuts and seeds.
  • The use of products rich in soluble fiber: Soluble fiber is contained in oat bran, apples, pears, citrus, legumes and other plant products.
  • The use of products enriched with plant sterols: Plant sterols are found in small quantities in vegetable oils, nuts and seeds. They are also added to some products, such as spreads, yogurts and juices.
  • The use of fish, rich omega-3 fatty acids: Fat fish (salmon, tuna, mackerel, herring) contains omega-3 fatty acids that are useful for the health of the heart and blood vessels. It is recommended to consume fatty fish 2-3 times a week.
  • High cholesterol products restriction: Products with a high cholesterol content (egg yolks, offal, shrimp) can affect blood cholesterol, especially in people sensitive to cholesterol. However, moderate use of eggs (up to 1 egg per day) usually does not have a significant effect on cholesterol.
  • Reducing sugar and simple carbohydrates: Excess sugar and simple carbohydrates can lead to an increase in the level of triglycerides.

VB physical activity

Regular physical activity helps to reduce the level of LDL and triglycerides, as well as increase the level of HDL. It is recommended to engage in moderate physical activity (for example, walking, swimming, cycling) for at least 30 minutes a day of the week of the week.

VC Refusal of smoking

Smoking reduces the level of HDL and damages the walls of arteries, which contributes to the formation of cholesterol plaques. Refusal of smoking is one of the most important steps to improve the health of the heart and blood vessels.

VD weight control

Excess weight increases the level of LDL and triglycerides, and also reduces the level of HDL. Maintaining a healthy weight helps to improve a lipid profile and reduce the risk of cardiovascular diseases.

Ve control of stress

Chronic stress can affect cholesterol and other risk factors for cardiovascular diseases. Learn to manage stress using relaxation techniques, meditation, yoga or other methods.

VI. Interaction of dietary supplements with drugs

It is important to remember that dietary supplements can interact with drugs, enhancing or weakening their effect, as well as causing undesirable side effects. Therefore, before taking any dietary supplement, it is necessary to inform the doctor about all the drugs that you take, including prescription and over -the -counter drugs, vitamins and other dietary supplements.

VI.A. Examples of interactions:

  • Red yeast rice and statins: Red yeast rice contains Monacoline K, which is a natural inhibitor of the GMG-KoA reductase, like statins. Simultaneous intake of red yeast rice and statins can increase the risk of side effects, such as muscle pain (myalgia) and liver damage.
  • Omega-3 fatty acids and anticoagulants: High doses of omega-3 fatty acids can increase the risk of bleeding. Simultaneous intake of omega-3 fatty acids and anticoagulants (for example, warfarin, clopidogrel) may require adjustments to the dose of anticoagulant.
  • Niacin and drugs to reduce blood pressure: Niacin can enhance the effect of drugs to reduce blood pressure, which can lead to hypotension (low arterial pressure).
  • Plant sterols and drugs to reduce cholesterol levels: Plant sterols can reduce the absorption of some drugs used to reduce cholesterol, such as ezetimib.

Vi.b. General recommendations:

  • Tell the doctor about all medicines and dietary supplements that you take.
  • Do not take dietary supplements simultaneously with medicines. Observe the interval between receptions for at least 2-3 hours.
  • Carefully read the instructions for drugs and dietary supplements.
  • When any side effects appear, consult a doctor immediately.

VII. Research and evidence base: What do scientific data say?

It is important to critically evaluate information about dietary supplements and rely on scientific data. Not all statements of dietary supplement manufacturers are confirmed by scientific research. When assessing the effectiveness of dietary supplements, attention should be paid to the following factors:

  • Type of research: The most reliable are randomized controlled studies (RCTs), in which participants are randomly distributed into groups receiving dietary supplements or placebo (dummy).
  • Research size: The more participants in the study, the more reliable the results.
  • Research quality: It is important that the study is carried out in compliance with all scientific standards in order to exclude the possibility of errors and distortions.
  • Publication in the reviewed journal: The publication in the reviewed scientific journal means that the study was verified by other experts in this field.

VII.A. Meta-analyzes and systematic reviews:

Met-analyzes and systematic reviews combine the results of several studies on one topic, which allows you to get a more reliable assessment of the effectiveness and safety of Bad.

VII.B. Sources of information:

Reliable information about dietary supplements can be found in the following sources:

  • National Health Institutes of the USA (NIH): NIH conduct research on various aspects of health, including dietary supplements.
  • Office for Sanitary Supervision of the quality of food and US medicines (FDA): FDA regulates the dietary supplement market in the USA.
  • Medical organizations (for example, American Cardiological Association, European Cardiology Society): These organizations develop recommendations for the prevention and treatment of cardiovascular diseases.
  • Reviewed scientific journals: These magazines publish the results of scientific research.

VII.C. Research restrictions:

It is important to consider that many dietary supplements have restrictions, such as a small sample size, short duration and lack of blinding (when participants and researchers know who gets dietary supplement and who is a placebo).

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