The current trend and challenges of developing red yeast rice-based food supplements for hypercholesterolemia

Chen, Gong; Chen, Wanbo; Xu, Jinhong; Ma, Guodong; Hu, Xiaoyan; Chen, Guoxun

doi:10.1016/j.jfutfo.2023.03.003

Cited by 4 publications

(2 citation statements)

References 113 publications

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“…In the future, further studies will help to define the place of RYR in the management of dyslipidemia. For example, the role of components of RYR other than monacolins in lipid-lowering effects and their interactions with monacolin K, require further investigation, and a trial comparing an RYR preparation with a pharmaceutical containing the same dose of lovastatin could be informative [ 103 ]. Combinations of other nutraceuticals with RYR also require further clinical trials to establish the risk–benefit ratios and cost-effectiveness of these options.…”

Section: Discussionmentioning

confidence: 99%

Red Yeast Rice for the Improvement of Lipid Profiles in Mild-to-Moderate Hypercholesterolemia: A Narrative Review

et al. 2023

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Reducing low-density lipoprotein cholesterol (LDL-C) levels is a key target for lowering cardiovascular risk and preventing atherosclerotic cardiovascular disease (ASCVD). Red yeast rice (RYR) is a nutraceutical widely used as a lipid-lowering dietary supplement. The main cholesterol-lowering components of RYR are monacolins, particularly monacolin K, which is structurally identical to lovastatin and targets the same key enzyme of cholesterol biosynthesis. RYR supplementation reduces LDL-C levels by approximately 15–34% versus placebo, with a similar effect to low-dose, first-generation statins in subjects with mild-to-moderate dyslipidemia. RYR has also demonstrated beneficial reductions of up to 45% versus placebo in the risk of ASCVD events in secondary prevention studies. RYR at a dose that provides about 3 mg/d of monacolin K is well tolerated, with an adverse event profile similar to that of low-dose statins. RYR is therefore a treatment option for lowering LDL-C levels and ASCVD risk for people with mild-to-moderate hypercholesterolemia who are ineligible for statin therapy, particularly those who are unable to implement lifestyle modifications, and also for people who are eligible for statin therapy but who are unwilling to take a pharmacologic therapy.

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Section: Discussionmentioning

confidence: 99%

Red Yeast Rice for the Improvement of Lipid Profiles in Mild-to-Moderate Hypercholesterolemia: A Narrative Review

et al. 2023

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“…Several compounds are produced during the fermentation process [3]. RYR contains naturally occurring compounds known as monacolins, which are chemically identical to statins, a class of prescription drugs used to lower cholesterol levels.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Red Yeast Rice Extract Use on the Occurrence of Muscle Symptoms and Liver Dysfunction: An Update from the Adverse Event Reporting Systems and Available Meta-Analyses

Norata,

Banach

2024

Nutrients

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Red yeast rice (RYR) has a cholesterol-lowering effect due to the presence of bioactive components (monacolins, mainly monacolin K) that act by inhibiting the activity of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. The European Food Safety Authority (EFSA) assessed the use of RYR and, while pointing out several uncertainties regarding the available data, raised a warning related to the safety of RYR when used as a food supplement at a dose of monacolin as low as 3 mg/day. In their decision in June 2023, EFSA approved the use of monacolins from RYR at doses less than 3 mg/day. We therefore decided to interrogate the different adverse event reporting systems (FAERS and CAERS) and analyse the characteristics of the cases reported to be associated with RYR supplements, and we reviewed the most recent meta-analyses with a focus on the occurrence of muscle symptoms and liver dysfunction. In terms of all musculoskeletal disorders from September 2013 (when the first case related to RYR consumption was recorded) to 30 September 2023, 363,879 cases were reported in the FAERS, with the number of cases related to RYR consumption being very small and accounting for 0.008% of cases. In the same time frame, 27,032 cases of hepatobiliary disorders were reported, and the cases attributable to RYR ingestion accounted for 0.01% of all cases. A low rate of muscle symptoms and liver dysfunction attributed to RYR ingestion was also observed in the CAERS database, where only 34 cases of adverse muscle events and 10 cases of adverse liver events reported RYR as the suspect product, while 19 cases of both muscle events and 10 cases of adverse liver events reported it as a concomitant product. This profile mirrors that of meta-analyses of randomised clinical trials of RYR, in which RYR use was not associated with either liver dysfunction or muscular adverse symptoms.

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Physicochemical properties and HMG-CoA reductase inhibitor activity of red yeast extruded rice

Chen,

Wang

et al. 2024

Journal of Cereal Science

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The current trend and challenges of developing red yeast rice-based food supplements for hypercholesterolemia

Cited by 4 publications

References 113 publications

Red Yeast Rice for the Improvement of Lipid Profiles in Mild-to-Moderate Hypercholesterolemia: A Narrative Review

Red Yeast Rice for the Improvement of Lipid Profiles in Mild-to-Moderate Hypercholesterolemia: A Narrative Review

The Impact of Red Yeast Rice Extract Use on the Occurrence of Muscle Symptoms and Liver Dysfunction: An Update from the Adverse Event Reporting Systems and Available Meta-Analyses

Physicochemical properties and HMG-CoA reductase inhibitor activity of red yeast extruded rice

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