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Publix GreenWise Market Magazine - Summer 2009
Red Yeast Rice Advice
 WHAT IT IS
Red yeast rice, made by fermenting rice with yeast, has been used as a medicine in China for more than a thousand years. It contains compounds that naturally inhibit the production of cholesterol, most notably monacolin K (aka lovastatin). At higher doses lovastatin is sold as a widely prescribed statin drug, which lowers cholesterol.
WHERE TO GET IT
Red yeast rice extract is available in pill and capsule form as a dietary supplement. A typical dose of red yeast rice extract is 1,200 to 2,400 mg daily, divided into two doses. For most products, that would translate into 2 to 20 mg of monacolin K. By comparison, the usual dose for people taking lovastatin as a prescription drug is 20 to 80 mg a day. But unlike prescription lovastatin, red yeast rice supplements also contain other monacolins and plant sterols that may contribute to their overall effect on cholesterol.
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THE EVIDENCE SO FAR
Earlier research had found that red yeast rice supplements could lower LDL “bad” cholesterol (The American Journal of Clinical Nutrition, February 1999). And in a more recent study, when combined with fish oil and healthy lifestyle changes, the supplements worked as well as a statin drug (Mayo Clinic Proceedings, July 2008). This latest study included 74 people with high cholesterol who were randomly assigned to either take a statin or participate in a program that included daily red yeast rice and fish oil supplements as well as weekly classes on diet, exercise and relaxation. After three months LDL was down by about 40 percent in both groups, according to lead researcher David Becker, M.D., a cardiologist at the University of Pennsylvania Health System. It’s impossible to isolate how much of that effect was due to the red yeast rice, though.
Another study, conducted in China, included nearly 5,000 people who had previously suffered a heart attack (The American Journal of Cardiology, June 2008). Among those who took a particular red yeast rice supplement every day for an average of 4.5 years, the risk of a repeat heart attack was slashed by 45 percent and the chance of dying from cardiovascular disease was cut by one-third.
The supplement used in that study is not sold in the U.S., and it’s not known if the results would be as good in American patients, who are a more heterogeneous group. “It would be a big leap to say that we would see the same degree of risk reduction,” says Mary McGowan, M.D., medical director of the Cholesterol Treatment Center at Concord Hospital in New Hampshire.
THE JURY’S STILL OUT
It’s unclear if such promising results would apply to red yeast rice supplements sold in the United States. The FDA does not strictly regulate dietary supplements, so the amount of active ingredient in each pill can vary widely. An independent analysis of 10 red yeast rice supplements found that some brands contained over 100 times more monacolin K than others.
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BOTTOM LINE
“Don’t just stop taking your statin to go on red yeast rice,” cautions Becker. If you already have heart disease, you need a treatment with proven effectiveness. For others who are interested in trying red yeast rice supplements, Becker recommends discussing it first with your doctor.
Possible side effects include upset stomach, abdominal pain, gas, cramps, constipation and, in rare cases, serious muscle and liver or kidney problems. If you’re already taking a statin, don’t add a red yeast rice supplement. “When you add a second product with a similar mechanism of action, you may increase your risk,” says McGowan.
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