Statins are in the news today with questions about over-prescribing in healthy people. They are used to reduce blood cholesterol due to an inhibitory effect on the enzyme HMG-CoA reductase which controls the rate of production of cholesterol. Cholesterol can be naturally raised for many reasons including an increased requirement in chronic illness and stress or associated with increased blood insulin levels in diabetic and pre-diabetic states.
Herbalists use many herbs which have a beneficial effect on cholesterol levels, although clinical trials are limited, as is the case for most herbs (see Hasani-Ranjbar et al., 2010 for examples). A recent trial involving artichoke leaf (Cynara scolymus) suggested a moderate benefit (Bundy et al., 2008) and other commonly used herbs include cinnamon, fenugreek, olive leaf and milk thistle.
Of course, herbs and food are very closely linked and diet is of fundamental importance in managing cholesterol levels. Important considerations include:
- Reducing saturated fats and increasing beneficial omega-3 oils (e.g. from fish oils and flax). Interestingly flaxseeds were shown recently to lower cholesterol in men but not women (American Society for Nutrition); nut consumption has also been linked to lower cholesterol levels(Sabate et al., 2010)
- Eating a diet high in plant ‘phytosterols’ which have been shown to reduce cholesterol and recent evidence suggests that beneficial amounts can be obtained from a healthy diet, high in fruits, vegetables, whole grains, nuts and seeds withoug supplementation (Racette et al., 2010)
- Eating a diet high in fibre including soluble fibre (e.g. oats) which prevents re-absorption of cholesterol-containing bile salts in the intestine
- Including garlic in the diet or as supplements (see a recent trial Budoff et al., 2009)
American Society for Nutrition Annual Meeting, Satellite Session at Experimental Biology (2010) Anaheim, CA.
Budoff MJ et al (2009) Prev Med 49(2-3):101-107
Bundy R, Walker AF, Middleton RW, Wallis C, Simpson HC. (2008) ‘Artichoke leaf extract (Cynara scolymus) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: a randomized, double blind placebo controlled trial’. Phytomedicine. 15(9):668-75.
Hasani-Ranjbar S, Nayebi N, Moradi L, Mehri A, Larijani B, Abdollahi M. (2010) ‘The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review.‘ Curr Pharm Des. 16(26):2935-47.
Racette SB et al (2010) Am J Clin Nutr 91:32-38Sabate J et al (2010) Arch Intern Med 170(9):821-827