Natural Approaches to HDL, LDL and Total Cholesterol #4

Continued from 01.11.11

From heat to sweet, policosanol is a cholesterol-lowering natural product derived from sugar-cane wax with a therapeutic range from 5 to 20 mg/d. Policosanol from honeybee’s wax or rice bran is also available on the market. Policosanol is a combination of long-chain fatty alcohols, including octacosanol, triacontanol, dotriacontanol, tetratriacontanol, hexacosanol, heptacosanol and nonacosanol. Several research studies showed policosanol from sugar cane is effective at reducing cholesterol levels. A 2002 study published in the American Heart Journal reviewed the literature on placebo-controlled lipid-lowering studies using policosanol, and found doses of 10 to 20 mg/d lowered cholesterol by 17 percent to 21 percent and LDL by 21 percent to 29 percent, and raised HDL by 8 percent to 15 percent.12 A year later, a clinical study compared policosanol to the statin drug lovastatin on 28 patients with intermittent claudication.13 Patients who took 10 mg/d of policosanol for 20 weeks experienced a 17.5-percent drop in total cholesterol, a 31-percent drop in LDL cholesterol, and a 31.5-percent rise in HDL cholesterol, while those who took 20 mg/d lovastatin reduced total cholesterol by 18 percent and LDL cholesterol by 22.6 percent. Five lovastatin patients, but none from the policosanol group, experienced adverse events.

Also from the plant cholesterol-lowering area, phytosterols (plant sterols) have attracted a great deal of interest for their effects on cardiovascular health, especially after FDA authorized a claim that allows phytosterol-enriched foods to assert they may reduce the risk of coronary heart disease (CHD) when combined with a diet low in cholesterol and saturated fats. Phytosterols are structurally similar to cholesterol, which makes them compete with cholesterol during absorption in the digestive tract, thereby lowering plasma cholesterol levels.14 According to one review, many clinical trials have proven plant sterols can effectively decrease high serum total and LDL cholesterol by reducing intestinal absorption of cholesterol.15 And an earlier review of 16 published human studies that used phytosterols to reduce plasma cholesterol levels in 590 subjects found phytosterol therapy was accompanied by an average 10-percent reduction in total cholesterol and 13-percent reduction in LDL cholesterol levels.16 Most recently, a 2010 study found daily consumption of plant stanols up to 9 g reduced serum LDL cholesterol concentrations up to 17.4 percent.17

References:

12. Gouni-Berthold I, Berthold HK. “Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent.” Am Heart J. 2002 Feb;143(2):356-65.
13. Castaño G, et al. “Effects of policosanol and lovastatin in patients with intermittent claudication: a double-blind comparative pilot study.” Angiology. 2003 Jan;54(1):25-38.
14. Heinemann T, Axtmann G, von Bergmann K. “Comparison of intestinal absorption of cholesterol with different plant sterols in man.” Eur J Clin Invest. 1993 Dec;23(12):827-31.
15. Reiner Z, Tedeschi-Reiner E. “[The effects of plant sterols on hypercholesterolemia] [Article in Croatian]” Lijec Vjesn. 2007 Aug-Sep;129(8-9):276-81.
16. Ling WH, Jones PJ. “Dietary phytosterols: a review of metabolism, benefits and side effects.” Life Sci. 1995;57(3):195-206.
17. Mensink RP, et al. “Plant stanols dose-dependently decrease LDL-cholesterol concentrations, but not cholesterol-standardized fat-soluble antioxidant concentrations, at intakes up to 9 g/d.” Am J Clin Nutr. 2010 Jul;92(1):24-33.

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