The role of functional food and nutraceuticals in therapy of hypercholesterolemia
Authors:
Michaela Šnejdrlová
Authors place of work:
Centrum preventivní kardiologie, III. interní klinika 1. LF UK a VFN v Praze
Published in the journal:
AtheroRev 2017; 2(3): 175-180
Category:
Reviews
Summary
Dyslipidemia, arterial hypertension, smoking and type 2 diabetes mellitus are the most important risk factors for cardiovascular diseases (CVD). The first step in treatment of dyslipidemia is a healthy lifestyle including diet and physical activity, but according to 2016 EAS/ESC Guidelines for the management of dyslipidaemias, in addition to reduction of saturated and trans-unsaturated fatty acids consumption and increase of fiber consumption, the use of functional foods rich in phytosterols or nutraceuticals containing red yeast rice may be considered. Plant sterols/stanols, when taken at 2 g/day lower LDL cholesterol levels by between 8–10%, influence to triglycerides level is dependent on the initial level. The ArmoLIPID PLUS, containing red yeast rice extract, berberin and policosanol, has proved to be able to achieve significant reductions in LDL-cholesterol (15–31,7 %) levels and decrease glycemia, it has been able to change the size and density of LDL particles in patients with familial combined hyperlipoproteinemia. Clear data from long-term prospective trials confirming a positive impact to cardiovascular risk are still lacking, however due to the positive influence to the main risk factor of CVD, it is to be expected. The use of phytosterols and the ArmoLIPID supplement is tolerated very well and may be considered in individuals with high LDL cholesterol level at intermediate or low CV risk who do not qualify for pharmacotherapy and as adjunct to treatment in high and very high risk patients who fail to achieve LDL cholesterol targets on other available (and tolerated) lipid lowering therapy.
Key words:
functional food, hypercholesterolemia, nutraceuticals, plant sterols, red yeast rice
Zdroje
1. Wohlfahrt P, Krajčoviechová A, Bruthans J et al. Hypertenze a hypercholesterolemie v české populaci. Vnitř Lék 2016; 62(11): 863–867.
2. Dalen JE, Devries S. Diets to prevent coronary heart disease 1957–2013: what have we learned? Am J Med 2014; 127(5): 364–369.
3. 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 Association for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis 2016; 253: 281–344. Dostupné z DOI: <http://dx.doi.org/10.1016/j.atherosclerosis.2016.08.018>.
4. Gylling H, Plat J, Turley S et al. Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease. Atherosclerosis 2014; 232(2): 346–360.
5. Pollack OJ. Reduction of blood cholesterol in man. Circulation 1953; 7(5): 702–706.
6. Normén L, Dutta P, Lia A et al. Soy sterol esters and beta-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am J Clin Nutr 2000; 71(4): 908–913.
7. Altmann SW, Davis HR, Zhu LJ et al. Niemann-Pick C1 Like 1 protein is critical for intestinal cholesterol absorption. Science 2004; 303(5661): 1201–1204.
8. Lu K, Lee M-H, Patel SB. Genetic basis of sitosterolemia. Curr Opin Lipidol 2001; 12(2): 141–149.
9. Ostlund RE jr, McGill JB, Zeng C-M et al. Gastrointestinal absorption and plasma kinetics of soy 5α-phytosterols and phytostanols in humans. Am J Physiol Endocrinol Metab 2002; 282: E911-E916. Dostupné z DOI: <http://doi: 10.1152/ajpendo.00328.2001>.
10. Andersson SW, Skinner J, Ellegård L et al. Intake of plant sterols is inversely related to serum cholesterol concentration in men and women in the EPIC Norfolk population: a cross-sectional study. Eur J Clin Nutr 2004; 58(10): 1378–1385.
11. Lin X, Racette SB, Lefevre M et al. The effects of phytosterols present in natural food matrices on cholesterol metabolism and LDL-cholesterol: a controlled feeding trial. Eur J Clin Nutr 2010; 64(12): 1481–1487.
12. Racette SB, Lin X, Lefevre M, et al. Dose effects of dietary phytosterols on cholesterol metabolism: a controlled feeding study. Am J Clin Nutr 2010; 91(1): 32–38.
13. Musa-Veloso K, Poon TH, Elliot JA et al. A comparison of the LDLcholsterol efficacy of plant stanols and plant sterols over a continuous range: Results of a meta-analysis of randomized, placebo-controlled trials. Prostaglandins Leukot Essent Fatty Acids 2011; 85(1): 9–28.
14. 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(1): 153–160.
15. Sialvera TE, Pounis GD, Koutelidakis AE et al. Phytosterols supplementation decreases plasma small and dense LDL levels in metabolic syndrome patients on a westernized type diet. Nutr Metab Cardiovasc Dis 2012; 22(10): 843–848.
16. Noakes M, Clifton PM, Doornbos AM et al. Plant sterol ester-enriched milk and yoghurt effectively reduce serum cholesterol in modestly hypercholesterolemic subjects Eur J Nutr 2005; 44(4): 214–222.
17. Tuomilehto J, Tikkanen MJ, Högström P et al. Safety assessment of common foods enriched with natural nonesterified plant sterols. Eur J Clin Nutr 2009; 63(5): 684–691.
18. Windler E, Zyriax BC, Kuipers F et al. Association of plasma phytosterol concentrations with incident coronary heart disease Data from the CORA study, a case-control study of coronary artery disease in women. Atherosclerosis 2009; 203(1): 284–290.
19. Assmann G, Cullen P, Erbey J et al. Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study. Nutr Metab Cardiovasc Dis 2006; 16(1): 13–21.
20. Genser B, Silbernagel G, De Backer G et al. Plant sterols and cardiovascular disease: a systematic review and meta-analysis. Eur Heart J 2012; 33(4): 444–451.
21. Robinson JG, Wang S, Smith BJ et al. Meta-analysis of the relationship between non-high-density lipoprotein cholesterol reduction and coronary heart disease risk. J Am Coll Cardiol 2009; 53(4): 316–322.
22. Thompson GR. Additive effect of plant sterols and stanol esters to statin therapy. Am J cardiol 2005; 96(1 Suppl ): 37–39.
23. Jakulj L, Trip MD, Sudhop T et al. Inhibition of sterol absorption by the combination of dietary plant sterols and ezetimkbe: effect on plasma lipid levels. J Lipid Res 2005; 46(12): 2692–2698.
24. Affuso F, Ruvolo A, Micillo F et al. 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(9): 656–661.
25. Ruscica M, Gomaraschi M, Mombelli G et al. Nutraceutical approach to moderate cardiometabolic risk: results of a randomized, double-blind and crossover study with Armolipid Plus. J Clin Lipidol 2014; 8(1): 61–68.
26. Gonnelli S, Caffarelli C, Stolakis K et al. Efficacy and Tolerability of a Nutraceutical Combination (Red Yeast Rice, Policosanols, and Berberine) in Patients with Low-Moderate Risk Hypercholesterolemia: A Double-Blind, Placebo-Controlled Study. Curr Ther Res Clin Exp 2014; 77: 1–6.
27. 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. Dostupné z DOI: <http://doi: 10.1186/1476–511X-11–123>.
28. Pirro M, Mannarino MR, Bianconi V et al. The effects of nutraceutical combination on plasma lipids and glucose: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2016; 110: 76–88.
29. Gentile M, Calcaterra I, Strazzullo A et al. Effects of Armolipid Plus on small dense LDL particles in a sample of patients affected by familial combined hyperlipidemia. Clin Lipidol 2015; 10(6): 475–480.
30. AbuMweis SS, Jew S, Ames NP. β-glucan from barley and its lipid-lowering capacity: a meta-analysis of randomized, controlled trials. Eur J Clin Nutr. 2010; 64(12): 1472–1480.
31. Wolever TM, Tosh SM, Gibbs AL et.al. Physicochemical properties of oat beta-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial. Am J Clin Nutr. 2010; 92(4): 723–732.
32. Yoshida M, Vanstone CA, Parsons WD et al. Effect of plant sterols and glucomann on lipid in indiviaduals with and without type II diabetes. Eur J Clin Nutr 2006; 60(4): 529–537.
33. Rosolová H. Mají doplňky stravy (nutraceuticals) svoje místo v ovlivnění dyslipidemií? Přípravek Armolipid Plus. AtheroRev 2017; 2(2): 143–146.
Štítky
Angiology Diabetology Internal medicine Cardiology General practitioner for adultsČlánok vyšiel v časopise
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- Opinion of the Committee of the Czech Society for Atherosclerosis on the ESC/ EAS Recommendations for Dyslipidemia Diagnostics and Treatment 2016
- The role of functional food and nutraceuticals in therapy of hypercholesterolemia