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High Cholesterol

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One of the most significant discoveries in preventive medicine is that elevated levels of cholesterol in the blood accelerate atherosclerosis , a condition commonly known as hardening of the arteries. Along with high blood pressure , inactivity, smoking , and diabetes , high cholesterol has proven to be one of the most important promoters of heart disease , strokes , and peripheral vascular disease (blockage of circulation to the extremities, usually the legs).

Cholesterol does not directly clog arteries like grease clogs pipes. The current theory is that elevated levels of cholesterol irritate the walls of blood vessels and cause them to undergo harmful changes. Because most cholesterol is manufactured by the body itself, dietary sources of cholesterol (such as eggs) are not usually the most important problem. The relative proportion of unsaturated fats (from plants) and saturated fats (mainly from animal products) in the diet is more significant.

When the consequences of elevated cholesterol were first being researched, total cholesterol was the only measurement considered. Today, the overall lipid profile is taken into account. LDL (“bad”) cholesterol, HDL (“good”) cholesterol, and triglycerides are the most common measurements related to cholesterol. Lipoprotein A and oxidized LDL cholesterol are drawing increasing attention as well.

This change in emphasis has thrown some long-standing recommendations into confusion. For example, reducing total fat intake generally decreases total cholesterol. On this basis, medical authorities long ago adopted a policy of recommending low-fat diets. However, when you take into account other lipid measurements, it is now clear that reducing fat intake is not the clear blessing it first appeared to be. Low-fat diets improve total and LDL cholesterol levels, but worsen HDL and triglyceride levels. Conversely, low-carb, high-fat diets tend to raise levels of LDL and total cholesterol, but reduce triglycerides and raise HDL. Some researchers use these effects as “proof” that the low-fat diet is healthier, 270 but, in fact, the current state of knowledge does not tell us whether the changes in lipids produced by low-fat diets are better or worse than the changes produced by low-carb diets. It is possible that a diet low in carbs and high in mono-unsaturated fats (eg, olive oil) offers the best of both worlds, but this has not been conclusively proven. 271-276 What is clear is that losing weight is extremely important. If you are overweight and lose weight, your cholesterol profile is almost certain to improve. 188

Increasing exercise and losing weight may produce adequate improvements in the lipid profile. If such lifestyle changes are not effective, however, there are many highly effective drugs to choose from. Medications in the statin family are most effective, and they have been shown to prevent heart attacks and reduce mortality. Other useful conventional options include ezetimibe (Zetia), fibrate drugs , and various forms of the vitamin niacin (discussed below).

Principal Proposed Natural Treatments

There are several herbs and supplements that appear to help lower cholesterol levels. For some (such as stanols/sterols, vitamin B 3 , fiber, and soy), the evidence is sufficiently strong to have produced mainstream acceptance.

Note: If your primary problem is elevated triglycerides, see the High Triglycerides article.

Stanols/Sterols

Stanols are substances that occur naturally in various plants. Their cholesterol-lowering effects were first observed in animals in the 1950s. Since then, a substantial amount of research suggests that plant stanols (usually modified into stanol esters) can help to lower cholesterol in individuals with normal or mildly to moderately elevated cholesterol levels. Stanols are available in margarine spreads, salad dressings, and dietary supplement tablets. Related substances called plant sterols appear to have equivalent effects, 173,189 and in this subsection we will refer to sterols and stanols and their esters somewhat interchangeably.

Plant stanol esters reduce serum cholesterol levels by inhibiting cholesterol absorption. 10 Because they are structurally similar to cholesterol, stanols (and sterols) can displace cholesterol from the "packages" that deliver cholesterol for absorption from the intestines to the bloodstream. 1 The displaced cholesterol is then excreted from the body. This not only interferes with the absorption of cholesterol from food, it has the additional (and probably more important) effect of removing cholesterol from substances made in the liver that are recycled through the digestive tract.

Numerous double-blind, placebo-controlled studies, ranging in length from 30 days to 12 months, have found stanol esters and their chemical relatives effective for improving cholesterol profile levels. 2-15,167-169,174,175,263,280 The combined results suggest that these substances can reduce total cholesterol and LDL ("bad") cholesterol by about 10%-15%. 16,278,279 However, stanols/sterols do not appear to have any significant effect on HDL ("good") cholesterol or triglycerides.

Fish oil has also been shown to have a favorable effect on fats in the blood, in particular triglycerides. A study investigating the possible benefit of combining sterols with fish oil found that together they significantly lowered total cholesterol, LDL-cholesterol and triglycerides, and raised HDL-cholesterol in subjects with undesirable cholesterol profiles. 286

Individuals taking statin drugs may benefit from using stanols/sterols as well. 20,21,170,241,278 According to one study, if you are on statins and start taking sterol ester margarine as well, your cholesterol will improve to the same extent as if you doubled the statin dose. 170 Stanols or sterols also appear to enhance the effects of cholesterol-lowering diets. 17,174

Stanols or sterols also appear to be safe and effective in helping to improve cholesterol profile in people with type 2 (adult-onset) diabetes. 18,19,175

For more information, including dosage and safety issues, see the full Stanols article.

Niacin (Vitamin B 3 )

The common vitamin niacin, also called vitamin B 3 , is an accepted medical treatment for elevated cholesterol with solid science behind it. Several well-designed, double-blind, placebo-controlled studies have found that niacin reduced LDL cholesterol by approximately 10% and triglycerides by 25%, and raised HDL cholesterol by 20%-30%. 22-27 Niacin also lowers levels of lipoprotein A—another risk factor for atherosclerosis—by about 35%. Furthermore, long-term use of niacin has been shown to significantly reduce death rates from cardiovascular disease. 28

Niacin appears to be a safe and effective treatment for high cholesterol in people with diabetes as well, and (contrary to previous reports) does not seem to raise blood sugar levels. 29 Unfortunately, niacin, if taken in sufficient quantities to lower cholesterol, can cause an annoying flushing reaction and occasionally liver inflammation. 30 Close medical supervision is essential when using niacin to lower cholesterol.

Combining high-dose niacin with statin drugs (the most effective medications for high cholesterol) further improves lipid profile by raising HDL (“good”) cholesterol. 149-151 Unfortunately, there are real concerns that this combination therapy could cause a potentially fatal condition called rhabdomyolysis.

A growing body of evidence, however, suggests that the risk is relatively slight in individuals with healthy kidneys. Furthermore, even much lower doses of niacin than the usual dose given to improve cholesterol levels (100 mg versus 1,000 mg or more) may provide a similar benefit. 152 At this dose, the risk of rhabdomyolysis should be decreased.

Nonetheless, it is not safe to try this combination except under close physician supervision. Rhabdomyolysis can be fatal.

For more information, including dosage and safety issues, see the full Vitamin B 3 article.

Soluble Fiber

Water-soluble fiber supplements (such as psyllium, hydroxymethylcellulose and its relatives, and beta glucan from oats) are thought to lower cholesterol, 253,263,291 and the FDA has permitted products containing this form of fiber to carry a "heart-healthy" label. 31 It must be kept in mind, however, that the bulk of the supporting evidence for this theory comes from studies of oats conducted by manufacturers of oat products. 255 A typical dose of oat bran is 5 to 10 g with each meal and at bedtime; psyllium is taken at 10 g with each meal.

Soy Protein

Soy protein appears capable of modestly lowering total cholesterol, LDL ("bad") cholesterol, and triglycerides by approximately 5%-15%. 32,238,287 The FDA has allowed foods containing soy protein to make the "heart-healthy" claim on the label. One study suggests that substituting as little as 20 g daily of soy protein for animal protein can significantly improve cholesterol levels. 33 Higher doses appear to cause increased benefit. 238

Although it was once thought that isoflavones are the active ingredients in soy responsible for improving cholesterol profile, evidence suggests otherwise. 34-41,153,158-161,190-194,256,277,288,290 Other substances, such as certain soy proteins, may be more important. However, it has been additionally suggested that soy protein must be kept in its original state to be effective. Ordinary soy protein extracts are somewhat damaged (“denatured”). In a double-blind study of 120 people, a special “preserved” soy protein extract proved more effective for improving cholesterol profile than standard denatured soy protein extracts. 260

For more information, including dosage and safety issues, see the full Soy article.

Artichoke Leaf

Although primarily used to stimulate gallbladder function, artichoke leaf may be helpful for high cholesterol as well.

In a double-blind, placebo-controlled study of 143 individuals with elevated cholesterol, artichoke leaf extract significantly improved cholesterol readings. 81 Total cholesterol fell by 18.5% as compared to 8.6% in the placebo group; LDL cholesterol fell by 23% versus 6%; and the LDL to HDL ratio decreased by 20% versus 7%. In a subsequent study of 75 otherwise healthy people with high cholesterol, artichoke leaf extract significantly reduced total cholesterol compared to placebo, but it did not affect LDL, HDL, or triglycerides levels. 283

Artichoke leaf may work by interfering with cholesterol synthesis. 82 A compound in artichoke called luteolin may play a role in reducing cholesterol. 83

Red Yeast Rice

Red yeast rice is a traditional Chinese medicinal substance. It is made by fermenting a type of yeast called Monascus purpureus over rice. It contains cholesterol-lowering chemicals in the statin family , including one identical to the drug lovastatin. Like statin drugs, red yeast rice appears to be effective for improving various aspects of the lipid profile, including total cholesterol, LDL cholesterol, and the LDL/HDL ratio. 205-206,259 Presumably it also presents the same safety risks as statins, compounded by the uncertainty regarding how much active drug any particular batch of red yeast rice contains.

In a 2011 review of 22 trials, researchers concluded that an alcohol extract of red yeast rice (called xuezhikang) was no more or less effective than statins in lowering levels of cholesterol and triglycerides in people with high cholesterol and/or high triglycerides. 292 They also found that the supplement may be more effective than inositol nicotinate (another cholesterol-lowering medication) in reducing cholesterol levels.

For more information, including complete dosage and safety issues, see the full Red Yeast Rice article.

Other Proposed Natural Treatments

There are several other promising alternative treatments for high cholesterol. Approaches that specifically lower triglycerides (such as fish oil ) are discussed in the High Triglycerides article.

Numerous studies enrolling a total of many thousands of individuals purported to show that the substance policosanol , made from sugarcane, can markedly improve cholesterol profile. However, the single Cuban research group behind these studies has a financial connection to the product. It was not until 2006 that independent research groups began to report their results on the use of policosanol for hyperlipidemia. Currently, 9 such independent studies have been reported, enrolling more than 500 people, and in not one of these studies has policosanol proved to be more effective than placebo. See the full Policosanol article for detailed information.

In a 12-month study of 223 postmenopausal women, calcium supplements (calcium citrate at a dose of 1 g daily) significantly improved the ratio of HDL ("good") cholesterol to LDL ("bad") cholesterol. 155 This appears to have been primarily due to a meaningful rise in HDL levels.

Krill are tiny shrimp-like crustaceans that flourish in the Antarctic Ocean and provide food for numerous aquatic animals. Krill oil , similar but not identical to fish oil , may improve cholesterol profile. 204 Fish oil may enhance the effectiveness of drugs in the statin family. 252,264 EPA, another constituent of fish oil, may help prevent severe heart complications in people with high cholesterol already taking statins. 254

One double-blind study found evidence that cinnamon , taken at a dose of 1-6 grams daily, improved triglyceride, LDL cholesterol, and total cholesterol, without worsening HDL cholesterol in people with type 2 diabetes. 198

A review of 10 randomized trials consisting of 542 patients found that cinnamon may help decrease total cholesterol, LDL cholesterol, and triglyceride levels in patients with type 2 diabetes. Doses of cinnamon ranging from 0.12 g to 6 g showed significant decreases compared to placebo or no treatment. There were also beneficial increases in HDL cholesterol as well. Unfortunately, there were several flaws in the trials, including the amount of the preferred dose and length of treatment.295 At present, it would be premature to consider cinnamon an evidence-based treatment for high cholesterol, but it has definitely shown some promise.

Inconsistent evidence hints that flaxseed might reduce LDL cholesterol and, overall, slow down atherosclerosis . 95,96,98-100,157,208,284Flaxseed oil may be helpful as well, although evidence is again inconsistent. 209,242 It may be the generic fiber and not the other specific ingredients in flaxseed that benefit cholesterol levels. 97,184 Studies of purified lignans (found in flaxseed) have yielded mixed results. 210,269

A growing body of evidence suggests that increased consumption of nuts such as almonds, walnuts, pecans, and macadamia nuts may improve lipid profile and reduce heart disease risk, presumably because of their high monounsaturated fat content. 101-109,163,211-212,281

Olive oil is known to improve cholesterol profile. Up until recently, it has been thought that the monounsaturated fats in olive oil are its primary active ingredients. However, some evidence hints that polyphenols in olive oil (particularly, virgin olive oil) may play a positive role as well. 239

Some but not all studies suggest that "friendly" bacteria ( probiotics ) might be able to improve cholesterol profile. 123-128,213, 250 So-called " prebiotics ," substances that enhance the growth of friendly bacteria, have shown inconsistent benefit in studies as well. 214-221 One study found that any improvement, if it does occur, is short-lived. 262

Both black tea200 and green teas enriched with either theaflavin 201 or catechins 261 have shown promise for lowering cholesterol. 201,293 There is some suggestion that without such enhancement, both green tea 222 and black tea 266 may be ineffective.

Dark chocolate contains substances related to those in black and green tea, and it too has shown some promise for improving cholesterol profile. 243-244, 251,262

Other preliminary double-blind trials suggest potential benefit with the Iranian herb Achillea wilhelmsii , 93 the Peruvian herb caigua ( Cyclanterha pedata ), carob fiber , 94,223 the Chinese caterpillar/fungus cordyceps , 224Ipomoea batatus (sweet potato), 162 and a drink containing broccoli and cabbage. 199

Chitosan , a type of insoluble fiber derived from crustacean shells, has been proposed for reducing cholesterol levels. But, current evidence suggests that if it does offer any benefits, they are minimal at best. 84-92,147,148,187,197,225-226,285

A comprehensive review combining the results of 14 studies found that glucomannan , a dietary fiber derived from the tubers of Amorphophallus konjac , significantly reduced total and LDL cholesterol levels. 289

Weaker, and in some cases inconsistent, evidence suggests potential benefit with alfalfa ; 132-146 berberine (found in goldenseal , honey , Oregon grape , and barberry ); 227,282beta-hydroxy-beta-methylbutyrate (HMB) ; 164blue-green algae ; 129-131,233conjugated linoleic acid (CLA) ; 165L-carnitine ; 185,230-232Ayurvedic herb Eclipta alba (also know as Bhringraja or Keshraja); 257 grape polyphenols; 228-229mesoglycan ; 110-112 and nopal cactus . 268

Studies on whether the mineral chromium can improve cholesterol levels have returned mixed results. 113-121 However, this mineral may offer benefit for people taking drugs in the beta-blocker family. These medications, used for high blood pressure and other conditions, sometimes reduce HDL cholesterol levels. Chromium supplements may offset this side effect. 122

One study provides preliminary evidence that the herb black cohosh may improve lipid profiles in postmenopausal women. 156

Rice bran oil, like other vegetables oils, appears to favorably change lipid profile as well as reduce heart disease risk in other ways. 166, 234 Weaker evidence suggests that gamma oryzanol , a substance found in rice bran oil, can also improve lipid profiles.

Substances related to vitamin E called tocotrienols are sometimes promoted as improving cholesterol levels. However, while benefit has been reported in test-tube studies, animal studies, and nonblinded human trials, properly designed studies have failed to find it effective. 177, 246-249

Other herbs and supplements sometimes recommended for high cholesterol include ashwagandha , fenugreek , He shou wu , maitake , and royal jelly , but there is as yet no real evidence that they work.

A number of studies published in the 1980s and 1990s reported that various garlic preparations, including raw garlic, stabilized garlic powder, and aged garlic, can lower cholesterol. 68,69 However, several more recent and generally better-designed studies have found that if any benefits exist, they are so small as to be of little help in real life. 70-76,202,235,245

Although lecithin is commonly believed to reduce cholesterol levels, evidence indicates that it does not work. 178-182

Similarly, guggul , the sticky gum resin from the mukul myrrh tree, has been widely marketed as a cholesterol-reducing herb. However, while preliminary studies found evidence of benefit, 77-80 they all suffered from significant design flaws; a well-designed study did not find guggul effective. 186

Vitamin C , 203cranberry , 236curcumin (turmeric), 267 and elderberry204 have failed to prove effective in studies thus far.

One study failed to find special fats called medium-chain triacylglycerols (MCTs) more effective for reducing cholesterol than ordinary unsaturated fats. 183

A small randomized trial involving 67 people with high cholesterol found evidence to support the use of sage leaf extract (500 mg every 8 hours) for modestly lowering total and LDL cholesterol levels. 294

Herbs and Supplements to Use Only With Caution

According to one study, zinc taken at a dose of more than 50 mg daily might reduce levels of HDL cholesterol. 240

Unexpected results in a single trial hint that the sports supplement pyruvate might negate some of the beneficial effects of exercise on HDL levels. 237

In addition, various herbs and supplements may interact adversely with drugs used to treat high cholesterol. For more information on this potential risk, see the individual drug article in the Drug Interactions section of this database.

Revision Information

  • 1

    Law M. Plant sterol and stanol margarines and health. BMJ. 2000;320:861-864.

  • 2

    Gylling H, Miettinen TA. Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment. Diabetologia. 1994;37:773-780.

  • 3

    Gylling H, Miettinen TA. Cholesterol reduction by different plant stanol mixtures and with variable fat intake. Metabolism. 1999;48:575-580.

  • 4

    Vanhanen HT, Blomqvist S, Ehnholm C, et al. Serum cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic subjects with different apoE phenotypes during dietary sitostanol ester treatment. J Lipid Res. 1993;34:1535-1544.

  • 5

    Blair SN, Capuzzi DM, Gottlieb SO, et al. Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am J Cardiol. 2000;86:46-52.

  • 6

    Nguyen TT, Dale LV, von Bergmann K, et al. Cholesterol-lowering effect of stanol ester in a US population of mildly hypercholesterolemic men and women: a randomized controlled trial. Mayo Clin Proc. 1999;74:1198-2206.

  • 7

    Miettinen TA, Puska P, Gylling H, et al. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med. 1995;333:1308-1312.

  • 8

    Hallikainen MA, Sarkkinen ES, Uusitupa MI. Effects of low-fat stanol ester enriched margarines on concentrations of serum carotenoids in subjects with elevated serum cholesterol concentrations. Eur J Clin Nutr. 1999;53:966-969.

  • 9

    Gylling H, Siimes MA, Miettinen TA. Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia. J Lipid Res. 1995;36:1807-1812.

  • 10

    Tammi A, Ronnemaa T, Gylling H, et al. Plant stanol ester margarine lowers serum total and low-density lipoprotein cholesterol concentrations of healthy children: the STRIP project. Special Turku Coronary Risk Factors Intervention Project. J Pediatr. 2000;136:503-510.

  • 11

    Hallikainen MA, Uusitupa MI. Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects. Am J Clin Nutr. 1999;69:403-410.

  • 12

    Gylling H, Radhakrishnan R, Miettinen TA. Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine: women and dietary sitostanol. Circulation. 1997;96:4226-4231.

  • 13

    Jones PJ, Ntanios FY, Raeini-Sarjaz M, et al. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men. Am J Clin Nutr. 1999;69:1144-1150.

  • 14

    Vanhanen HT, Kajander J, Lehtovirta H, et al. Serum levels, absorption efficiency, faecal elimination and synthesis of cholesterol during increasing doses of dietary sitostanol esters in hypercholesterolaemic subjects. Clin Sci. 1994;87:61-67.

  • 15

    Neil HA, Meijer GW, Roe LS. Randomised controlled trial of use by hypercholesterolaemic patients of a vegetable oil sterol-enriched fat spread. Atherosclerosis. 2001;156:329-337.

  • 16

    Nguyen TT. The cholesterol-lowering action of plant stanol esters. J Nutr. 1999;129:2109-2112.

  • 17

    Maki KC, Davidson MH, Umporowicz DM, et al. Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet. Am J Clin Nutr. 2001;74:33-43.

  • 18

    Gylling H, Miettinen TA. Effects of inhibiting cholesterol absorption and synthesis on cholesterol and lipoprotein metabolism in hypercholesterolemic non-insulin-dependent diabetic men. J Lipid Res. 1996;37:1776-1785.

  • 19

    Gylling H, Miettinen TA. Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment. Diabetologia. 1994;37:773-780.

  • 20

    Gylling H, Miettinen TA. Effects of inhibiting cholesterol absorption and synthesis on cholesterol and lipoprotein metabolism in hypercholesterolemic non-insulin-dependent diabetic men. J Lipid Res. 1996;37:1776-1785.

  • 21

    Blair SN, Capuzzi DM, Gottlieb SO, et al. Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am J Cardiol. 2000;86:46-52.

  • 22

    Illingworth DR, Stein EA, Mitchel YB, et al. Comparative effects of lovastatin and niacin in primary hypercholesterolemia. A prospective trial. Arch Intern Med. 1994;154:1586-1595.

  • 23

    Guyton JR, Goldberg AC, Kreisberg RA, et al. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol. 1998;82:737-743.

  • 24

    Vega GL, Grundy SM. Lipoprotein responses to treatment with lovastatin, gemfibrozil, and nicotinic acid in normolipidemic patients with hypoalphalipoproteinemia. Arch Intern Med. 1994;154:73-82.

  • 25

    Lal SM, Hewett JE, Petroski GF, et al. Effects of nicotinic acid and lovastatin in renal transplant patients: a prospective, randomized, open-label crossover trial. Am J Kidney Dis. 1995;25:616-622.

  • 26

    Elam MB, Hunninghake DB, Davis KB, et al. Effect of niacin on lipid and lipoprotein levels and glycemic control in patients With diabetes and peripheral arterial disease. The ADMIT Study: a randomized trial. JAMA. 2000;284:1263-1270.

  • 27

    Morgan JM, Capuzzi DM, Guyton JR, et al. Treatment effect of Niaspan, a controlled-release niacin, in patients with hypercholesterolemia: a placebo-controlled trial. J Cardiovasc Pharmacol Ther. 1996;1:195-202.

  • 28

    Canner PL, Berge KG, Wenger NK, et al. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol. 1986;8:1245-1255.

  • 29

    Elam MB, Hunninghake DB, Davis KB, et al. Effect of niacin on lipid and lipoprotein levels and glycemic control in patients with diabetes and peripheral arterial disease. The ADMIT Study: a randomized trial. JAMA. 2000;284:1263-1270.

  • 30

    Crouse JR III. New developments in the use of niacin for treatment of hyperlipidemia: new considerations in the use of an old drug. Coron Artery Dis. 1996;7:321-326.

  • 31

    Glore SR, Van Treeck D, Knehans AW, et al. Soluble fiber and serum lipids: a literature review. J Am Diet Assoc. 1994;94:425-436.

  • 32

    Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids. N Engl J Med. 1995;333:276-281.

  • 33

    Teixeira SR, Potter SM, Weigel R, et al. Effects of feeding 4 levels of soy protein for 3 and 6 wk on blood lipids and apolipoproteins in moderately hypercholesterolemic men. Am J Clin Nutr. 2000;71:1077-1084.

  • 34

    Crouse JR III, Morgan T, Terry JG, et al. A randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins. Arch Intern Med. 1999;159:2070-2076.

  • 35

    Wangen KE, Duncan AM, Xu X, et al. Soy isoflavones improve plasma lipids in normocholesterolemic and mildly hypercholesterolemic postmenopausal women. Am J Clin Nutr. 2001;73:225-231.

  • 36

    Anthony MS, Clarkson TB, Hughes CL Jr, et al. Soybean isoflavones improve cardiovascular risk factors without affecting the reproductive system of peripubertal rhesus monkeys. J Nutr. 1996;126:43-50.

  • 37

    Greaves KA, Parks JS, Williams JK, et al. Intact dietary soy protein, but not adding an isoflavone-rich soy extract to casein, improves plasma lipids in ovariectomized cynomolgus monkeys. J Nutr. 1999;129:1585-1592.

  • 38

    Simons LA, von Konigsmark M, Simons J, et al. Phytoestrogens do not influence lipoprotein levels or endothelial function in healthy, postmenopausal women. Am J Cardiol. 2000;85:1297-1301.

  • 39

    Mackey R, Ekangaki A, Eden JA. The effects of soy protein in women and men with elevated plasma lipids. Biofactors. 2000;12:251-257.

  • 40

    Sirtori CR, Gianazza E, Manzoni C, et al. Role of isoflavones in the cholesterol reduction by soy proteins in the clinic [letter]. Am J Clin Nutr. 1997;65:166-167.

  • 41

    Howes JB, Sullivan D, Lai N, et al. The effects of dietary supplementation with isoflavones from red clover on the lipoprotein profiles of post menopausal women with mild to moderate hypercholesterolaemia. Atherosclerosis. 2000;152:143-147.

  • 42

    Mirkin A., et al. Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women. Int. J Clin Pharm Res. 2001;21:31-34.

  • 43

    Menendez R, Arruzazabala L, Mas R, et al. Cholesterol-lowering effect of policosanol on rabbits with hypercholesterolaemia induced by a wheat starch-casein diet. Br J Nutr. 1997;77:923-932.

  • 44

    Torres O, Agramonte AJ, Illnait J, et al. Treatment of hypercholesterolemia in NIDDM with policosanol. Diabetes Care. 1995;18:393-397.

  • 45

    Crespo N, Alvarez R, Mas R, et al. Effect of policosanol on patients with non-insulin-dependent diabetes mellitus and hypercholesterolemia: a pilot study. Curr Ther Res. 1997;58:44-51.

  • 46

    Castano G, Mas R, Fernandez L, et al. Effects of policosanol on postmenopausal women with type II hypercholesterolemia. Gynecol Endocrinol. 2000;14:187-195.

  • 47

    Mas R, Castano G, Illnait J, et al. Effects of policosanol in patients with type II hypercholesterolemia and additional coronary risk factors. Clin Pharmacol Ther. 1999;65:439-447.

  • 48

    Aneiros E, Mas R, Calderon B, et al. Effect of policosanol in lowering cholesterol levels in patients with type II hypercholesterolemia. Curr Ther Res. 1995;56:176-182.

  • 49

    Castano G, Canetti M, Moreira M, et al. Efficacy and tolerability of policosanol in elderly patients with type II hypercholesterolemia: a 12-month study. Curr Ther Res. 1995;56:819-828.

  • 50

    Castano G, Tula L, Canetti M, et al. Effects of policosanol in hypertensive patients with type II hypercholesterolemia. Curr Ther Res. 1996;57:691-699.

  • 51

    Torres O, Agramonte AJ, Illnait J, et al. Treatment of hypercholesterolemia in NIDDM with policosanol. Diabetes Care. 1995;18:393-397.

  • 52

    Aneiros E, Calderon B, Mas R, et al. Effect of successive dose increases of policosanol on the lipid profile and tolerability of treatment. Curr Ther Res. 1993;54:304-312.

  • 53

    Castano G, Mas R, Nodarse M, et al. One-year study of the efficacy and safety of policosanol (5 mg twice daily) in the treatment of type II hypercholesterolemia. Curr Ther Res. 1995;56:296-304.

  • 54

    Batista J, Stusser R, Penichet M, et al. Doppler-ultrasound pilot study of the effects of long-term policosanol therapy on carotid-vertebral atherosclerosis. Curr Ther Res. 1995;56:906-914.

  • 55

    Pons P, Rodriguez M, Mas R, et al. One-year efficacy and safety of policosanol in patients with type II hypercholesterolemia. Curr Ther Res. 1994;55:1084-1092.

  • 56

    Pons P, Rodriguez M, Robaina C, et al. Effects of successive dose increases of policosanol on the lipid profile of patients with type II hypercholesterolaemia and tolerability to treatment. Int J Clin Pharm Res. 1994;14:27-33.

  • 57

    Pons P, Mas R, Illnait J, et al. Efficacy and safety of policosanol in patients with primary hypercholesterolemia. Curr Ther Res. 1992;52:507-513.

  • 58

    Zardoya R, Tula L, Castano G, et al. Effects of policosanol on hypercholesterolemic patients with abnormal serum biochemical indicators of hepatic function. Curr Ther Res. 1996;57:568-577.

  • 59

    Castano G, Mas R, Arruzazabala ML, et al. Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older hypercholesterolemic patients. Int J Clin Pharmacol Res. 1999;19:105-116.

  • 60

    Crespo N, Illnait J, Mas R, et al. Comparative study of the efficacy and tolerability of policosanol and lovastatin in patients with hypercholesterolemia and noninsulin dependent diabetes mellitus. Int J Clin Pharmacol Res. 1999;19:117-127.

  • 61

    Benitez M, Romero C, Mas R, et al. A comparative study of policosanol versus pravastatin in patients with type II hypercholesterolemia. Curr Ther Res. 1997;58:859-867.

  • 62

    Ortensi G, Gladstein J, Valli H, et al. A comparative study of policosanol versus simvastatin in elderly patients with hypercholesterolemia. Curr Ther Res. 1997;58:390-401.

  • 63

    Alcocer L, Fernandez L, Campos E, et al. A comparative study of policosanol versus acipimox in patients with type II hypercholesterolemia. Int J Tissue React. 1999;21:85-92.

  • 64

    Fernandez JC, Mas R, Castano G, et al. Comparison of the efficacy, safety and tolerability of policosanol versus fluvastatin in elderly hypercholesterolaemic women. Clin Drug Invest. 2001;21:103-113.

  • 65

    Castano G, Mas R, Fernandez JC, et al. Efficacy and tolerability of policosanol compared with lovastatin in patients with type II hypercholesterolemia and concomitant coronary risk factors. Curr Ther Res. 2000;61:137-146.

  • 66

    Torres O, Agramonte AJ, Illnait J, et al. Treatment of hypercholesterolemia in NIDDM with policosanol. Diabetes Care. 1995;18:393-397.

  • 67

    Crespo N, Alvarez R, Mas R, et al. Effect of policosanol on patients with non-insulin-dependent diabetes mellitus and hypercholesterolemia: a pilot study. Curr Ther Res. 1997;58:44-51.

  • 68

    Warshafsky S, Kamer RS, Sivak SL. Effect of garlic on total serum cholesterol. A meta-analysis. Ann Intern Med. 1993;119:599-605.

  • 69

    Neil HA, Silagy CA, Lancaster T, et al. Garlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis. J R Coll Physicians Lond. 1996;30:329-334.

  • 70

    Simons LA, Balasubramaniam S, von Konigsmark M, et al. On the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolaemia. Atherosclerosis. 1995;113:219-225.

  • 71

    Superko HR, Krauss RM. Garlic powder, effect on plasma lipids, postprandial lipemia, low-density lipoprotein particle size, high-density lipoprotein subclass distribution and lipoprotein (a). J Am Coll Cardiol. 2000;35:321-326.

  • 72

    Isaacsohn JL, Moser M, Stein EA, et al. Garlic powder and plasma lipids and lipoproteins: a multicenter, randomized, placebo-controlled trial. Arch Intern Med. 1998;158:1189-1194.

  • 73

    Gardner CD, Chatterjee LM, Carlson JJ. The effect of a garlic preparation on plasma lipid levels in moderately hypercholesterolemic adults. Atherosclerosis. 2001;154:213-220.

  • 74

    Stevinson C, Pittler MH, Ernst E. Garlic for treating hypercholesterolemia. A meta-analysis of randomized clinical trials. Ann Intern Med. 2000;133:420-429.

  • 75

    Kannar D, Wattanapenpaiboon N, Savige GS, et al. Hypocholesterolemic effect of an enteric-coated garlic supplement. J Am Coll Nutr. 2001;20:225-231.

  • 76

    Kannar D, Wattanapenpaiboon N, Savige GS, et al. Hypocholesterolemic effect of an enteric-coated garlic supplement. J Am Coll Nutr. 2001;20:225-231.

  • 77

    Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid. A new hypolipidaemic agent. J Assoc Physicians India. 1989;37:323-328.

  • 78

    Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid—a new hyperlipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res. 1986;84:626-634.

  • 79

    Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther. 1994;8:659-664.

  • 80

    Verma SK, Bordia A. Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Indian J Med Res. 1988;87:356-360.

  • 81

    Englisch W, Beckers C, Unkauf M, et al. Efficacy of artichoke dry extract in patients with hyperlipoproteinemia. Arzneimittelforschung. 2000;50:260-265.

  • 82

    Petrowicz O, Gebhardt R, Donner M, et al. Effects of artichoke leaf extract (ALE) on lipoprotein metabolism in vitro and in vivo [abstract]. Atherosclerosis. 1997;129:147.

  • 83

    Kraft K. Artichoke leaf extract—recent findings reflecting effects on lipid metabolism, liver and gastrointestinal tracts. Phytomedicine. 1997;4:369-378.

  • 84

    Maezaki Y, Tsuji K, Nakagawa Y, et al. Hypocholesterolemic effect of chitosan in adult males. Biosci Biotechnol Biochem. 1993;57:1439-1444.

  • 85

    Jing SB, Li L, Ji D, et al. Effect of chitosan on renal function in patients with chronic renal failure. J Pharm Pharmacol. 1997;49:721-723.

  • 86

    Ormrod D, Holmes CC, Miller TE. Dietary chitosan inhibits hypercholesterolaemia and atherogenesis in the apolipoprotein E-deficient mouse model of atherosclerosis. Atherosclerosis. 1998;138:329-334.

  • 87

    Deuchi K, Kanauchi O, Imasato Y, et al. Decreasing effect of chitosan on the apparent fat digestibility by rats fed on a high-fat diet. Biosci Biotechnol Biochem. 1994;58:1613-1616.

  • 88

    Deuchi K, Kanauchi O, Imasato Y, et al. Effect of the viscosity or deacetylation degree of chitosan on fecal fat excreted from rats fed on a high-fat diet. Biosci Biotechnol Biochem. 1995;59:781-785.

  • 89

    Deuchi K, Kanauchi O, Shizukuishi M, et al. Continuous and massive intake of chitosan affects mineral and fat-soluble vitamin status in rats fed on a high-fat diet. Biosci Biotechnol Biochem. 1995;59:1211-1216.

  • 90

    Kanauchi O, Deuchi K, Imasato Y, et al. Increasing effect of a chitosan and ascorbic acid mixture on fecal dietary fat excretion. Biosci Biotechnol Biochem. 1994;58:1617-1620.

  • 91

    Kobayashi T, Otsuka S, Yugari Y. Effect of chitosan on serum and liver cholesterol levels in cholesterol-fed rats. Nutr Rep Int. 1979;19:327-334.

  • 92

    Ho SC, Tai ES, Eng PH, et al. In the absence of dietary surveillance, chitosan does not reduce plasma lipids or obesity in hypercholesterolaemic obese Asian subjects. Singapore Med J. 2001;42:6-10.

  • 93

    Asgary S, Naderi GH, Sarrafzadegan N, et al. Antihypertensive and antihyperlipidemic effects of Achillea wilhelmsii.Drugs Exp Clin Res. 2000;26:89-93.

  • 94

    Gonzales GF, Gonez C, Villena A. Serum lipid and lipoprotein levels in postmenopausal women: short-course effect of caigua. Menopause. 1995;2:225-234.

  • 95

    Prasad K. Dietary flax seed in prevention of hypercholesterolemic atherosclerosis. Atherosclerosis. 1997;132:69-76.

  • 96

    Arjmandi BH, Khan DA, Juma S, et al. Whole flaxseed consumption lowers serum LDL-cholesterol and lipoprotein(a) concentrations in postmenopausal women. Nutr Res. 1998;18:1203-1214.

  • 97

    Singer P, Jaeger W, Berger I, et al. Effects of dietary oleic, linoleic, and alpha-linolenic acids on blood pressure, serum lipids, lipoproteins and the formation of eicosanoid precursors in patients with mild essential hypertension. J Hum Hypertens. 1990;4:227-233.

  • 98

    Prasad K. Reduction of serum cholesterol and hypercholesterolemic atherosclerosis in rabbits by secoisolariciresinol diglucoside isolated from flaxseed. Circulation. 1999;99:1355-1362.

  • 99

    Jenkins DJ, Kendall CW, Vidgen E, et al. Health aspects of partially defatted flaxseed, including effects on serum lipids, oxidative measures, and ex vivo androgen and progestin activity: a controlled crossover trial. Am J Clin Nutr. 1999;69:395-402.

  • 100

    Tarpila S, Kivinen A. Ground flaxseed is an effective hypolipidemic bulk laxative [abstract]. Gastroenterology. 1997;112:A836.

  • 101

    Hu FB, Stampfer MJ, Manson JE, et al. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ. 1998;317:1341-1345.

  • 102

    Fraser GE, Sabate J, Beeson WL, et al. A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med. 1992;152:1416-1424.

  • 103

    Abbey M, Noakes M, Belling GB, et al. Partial replacement of saturated fatty acids with almonds or walnuts lowers total plasma cholesterol and low-density-lipoprotein cholesterol. Am J Clin Nutr. 1994;59:995-999.

  • 104

    Spiller GA, Jenkins DA, Bosello O, et al. Nuts and plasma lipids: an almond-based diet lowers LDL-C while preserving HDL-C. J Am Coll Nutr. 1998;17:285-290.

  • 105

    Spiller GA, Jenkins DJ, Cragen LN, et al. Effect of a diet high in monounsaturated fat from almonds on plasma cholesterol and lipoproteins. J Am Coll Nutr. 1992;11:126-130.

  • 106

    Curb JD, Wergowske G, Dobbs JC, et al. Serum lipid effects of a high-monounsaturated fat diet based on macadamia nuts. Arch Intern Med. 2000;160:1154-1158.

  • 107

    Zambon D, Sabate J, Munoz S, et al. Substituting walnuts for monounsaturated fat improves the serum lipid profile of hypercholesterolemic men and women. A randomized crossover trial. Ann Intern Med. 2000;132:538-546.

  • 108

    Morgan WA, Clayshulte BJ. Pecans lower low-density lipoprotein cholesterol in people with normal lipid levels. J Am Diet Assoc. 2000;100:312-318.

  • 109

    Hu FB, Stampfer MJ. Nut consumption and risk of coronary heart disease: a review of epidemiologic evidence. Curr Atheroscler Rep. 1999;1:204-209.

  • 110

    Vecchio F, Zanchin G, Maggioni F, et al. Mesoglycan in treatment of patients with cerebral ischemia: effects on hemorheologic and hematochemical parameters. Acta Neurol (Napoli). 1993;15:449-456.

  • 111

    Saba P, Galeone F, Giuntoli F, et al. Hypolipidemic effect of mesoglycan in hyperlipidemic patients. Curr Ther Res. 1986;40:761-768.

  • 112

    Postiglione A, De Simone B, Rubba P, et al. Effect of oral mesoglycan on plasma lipoprotein concentration and on lipoprotein lipase activity in primary hyperlipidemia. Pharmacol Res Commun. 1984;16:1-8.

  • 113

    Mertz W. Chromium in human nutrition: a review. J Nutr. 1993;123:626-633.

  • 114

    Press RI, Geller J, Evans GW. The effect of chromium picolinate on serum cholesterol and apolipoprotein fractions in human subjects. West J Med. 1990;152:41-45.

  • 115

    Abraham AS, Brooks BA, Eylath U. The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes. Metabolism. 1992;41:768-771.

  • 116

    Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care. 1994;17:1449-1452.

  • 117

    Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes. 1997;46:1786-1791.

  • 118

    Roeback JR Jr, Hla KM, Chambless LE, et al. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med. 1991;115:917-924.

  • 119

    Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin, and lipid variables. Metabolism. 1983;32:894-899.

  • 120

    Offenbacher EG, Rinko CJ, Pi-Sunyer FX. The effects of inorganic chromium and brewer's yeast on glucose tolerance, plasma lipids, and plasma chromium in elderly subjects. Am J Clin Nutr. 1985;42:454-461.

  • 121

    Preuss HG, Wallerstedt D, Talpur N, et al. Effects of niacin-bound chromium and grape seed proanthocyanidin extract on the lipid profile of hypercholesterolemic subjects: a pilot study. J Med. 2000;31:227-246.

  • 122

    Roeback JR, Hla KM, Chambless LE, et al. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med. 1991;115:917-924.

  • 123

    Agerholm-Larsen L, Raben A, Haulrik N, et al. Effect of 8 week intake of probiotic milk products on risk factors for cardiovascular diseases. Eur J Clin Nutr. 2000;54:288-297.

  • 124

    Agerbaek M, Gerdes LU, Richelsen B. Hypocholesterolaemic effect of a new fermented milk product in healthy middle-aged men. Eur J Clin Nutr. 1995;49:346-352.

  • 125

    Bertolami MC, Faludi AA, Batlouni M. Evaluation of the effects of a new fermented milk product (Gaio) on primary hypercholesterolemia. Eur J Clin Nutr. 1999;53:97-101.

  • 126

    Richelsen B, Kristensen K, Pedersen SB. Long-term (6 months) effect of a new fermented milk product on the level of plasma lipoproteins—a placebo-controlled and double blind study. Eur J Clin Nutr. 1996;50:811-815.

  • 127

    Anderson JW, Gilliland SE. Effect of fermented milk (yogurt) containing Lactobacillus acidophilus L1 on serum cholesterol in hypercholesterolemic humans. J Am Coll Nutr. 1999;18:43-50.

  • 128

    Agerholm-Larsen L, Bell ML, Grunwald GK, et al. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. Eur J Clin Nutr. 2000;54:856-860.

  • 129

    Iwata K, Inayama T, Kato T. Effects of Spirulina platensis on plasma lipoprotein lipase activity in fructose-induced hyperlipidemic rats. J Nutr Sci Vitaminol. 1990;36:165-171.

  • 130

    Gonzalez de Rivera C, Miranda-Zamora R, Diaz-Zagoya JC, et al . Preventive effect of Spirulina maxima on the fatty liver induced by a fructose-rich diet in the rat, a preliminary report. Life Sci. 1993;53:57-61.

  • 131

    Nakaya N, Homma Y, Goto Y. Cholesterol lowering effect of spirulina. Nutr Rep Int. 1988;37:1329-1337.

  • 132

    Story JA, LePage SL, Petro MS, et al. Interactions of alfalfa plant and sprout saponins with cholesterol in vitro and in cholesterol-fed rats. Am J Clin Nutr. 1984;39:917-929.

  • 133

    Malinow MR, McLaughlin P, Naito HK, et al. Effect of alfalfa meal on shrinkage (regression) of atherosclerotic plaques during cholesterol feeding in monkeys. Atherosclerosis. 1978;30:27-43.

  • 134

    Malinow MR, Connor WE, McLaughlin P, et al. Cholesterol and bile acid balance in Macaca fascicularis. Effects of alfalfa saponins. J Clin Invest. 1981;67:156-162.

  • 135

    Esper E, Barichello AW, Chan EK, et al. Synergistic lipid-lowering effects of alfalfa meal as an adjuvant to the partial ileal bypass operation. Surgery. 1987;102:39-51.

  • 136

    Dixit VP, Joshi SC. Antiatherosclerotic effects of alfalfa meal ingestion in chicks: a biochemical evaluation [abstract]. Indian J Physiol Pharmacol. 1985;29:47-50.

  • 137

    Malinow MR, McLachlin P, Papworth L, et al. Effect of alfalfa saponins on intestinal cholesterol absorption in rats. Am J Clin Nutr. 1977;30:2061-2067.

  • 138

    Malinow MR, McLaughlin P, Stafford C, et al. Comparative effects of alfalfa saponins and alfalfa fiber on cholesterol absorption in rats [abstract]. Am J Clin Nutr. 1979;32:1810-1812.

  • 139

    Malinow MR, McLaughlin P, Stafford C, et al. Alfalfa saponins and alfalfa seeds. Dietary effects in cholesterol-fed rabbits. Atherosclerosis. 1980;37:433-438.

  • 140

    Yanaura S, Sakamoto M. Effect of alfalfa meal on experimental hyperlipidemia [in Japanese; English abstract]. Nippon Yakurigaku Zasshi. 1975;71:387-393.

  • 141

    Srinivasan SR, Patton D, Radhakrishnamurthy B, et al. Lipid changes in athersclerotic aortas of Macaca fascicularis after various regression regimens. Atherosclerosis. 1980;37:591-601.

  • 142

    Malinow MR. Experimental models of atherosclerosis regression. Atherosclerosis. 1983;48:105-118.

  • 143

    Malinow MR, Connor WE, McLaughlin P, et al. Cholesterol and bile acid balance in Macaca fasicularis. Effects of alfalfa saponins. J Clin Invest. 1981;67:156-162.

  • 144

    Molgaard J, von Schenck H, Olsson AG. Alfalfa seeds lower low density lipoprotein cholesterol and apolipoprotein B concentrations in patients with type II hyperlipoproteinemia. Atherosclerosis. 1987;65:173-179.

  • 145

    Malinow MR, McLaughlin P, Stafford C. Alfalfa seeds: effects on cholesterol metabolism. Experientia. 1980;36:562-564.

  • 146

    Colodny LR, Montgomery A, Houston M. The role of esterin processed alfalfa saponins in reducing cholesterol. J Am Nutraceutical Assoc. 2001;3:6-15.

  • 147

    Tai TS, Sheu WH, Lee WJ, et al. Effect of chitosan on plasma lipoprotein concentrations in type 2 diabetic subjects with hypercholesterolemia [letter]. Diabetes Care. 2000;23:1703-1704.

  • 148

    Wuolijoki E, Hirvela T, Ylitalo P. Decrease in serum LDL cholesterol with microcrystalline chitosan. Methods Find Exp Clin Pharmacol. 1999;21:357-361.

  • 149

    Jacobson TA, Amorosa LF. Combination therapy with fluvastatin and niacin in hypercholesterolemia: a preliminary report on safety. Am J Cardiol. 1994;73:25D-29D.

  • 150

    Kashyap ML, Evans R, Simmons PD, et al. New combination niacin/statin formulation shows pronounced effects on major lipoproteins and is well tolerated. J Am Coll Cardiol. 2000;35(suppl A):326.

  • 151

    Wolfe ML, Vartanian SF, Ross JL, et al. Safety and effectiveness of Niaspan when added sequentially to a statin for treatment of dyslipidemia. Am J Cardiol. 2001;87:476-479.

  • 152

    Wink J, Giacoppe G, King J. Effect of very-low-dose niacin on high-density lipoprotein in patients undergoing long-term statin therapy. Am Heart J. 2002;143:514-518.

  • 153

    Dewell A, Hollenbeck CB, Bruce B. The effects of soy-derived phytoestrogens on serum lipids and lipoproteins in moderately hypercholesterolemic postmenopausal women. J Clin Endocrinol Metab. 2002;87:118-121.

  • 154

    Gouni-Berthold I, Berthold HK. Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent. Am Heart J. 2002;143:356-365.

  • 155

    Reid IR, Mason B, Horne A, et al. Effects of calcium supplementation on serum lipid concentrations in normal older women: A randomized controlled trial. Am J Med. 2002;112:343-347.

  • 156

    Wuttke W. P3-333, P3-317 [abstract]. 84th Annual Meeting of The Endocrine Society. June 21, 2002.

  • 157

    Lucas EA, Wild RD, Hammond LJ, et al. Flaxseed improves lipid profile without altering biomarkers of bone metabolism in postmenopausal women. J Clin Endocrinol Metab. 2002;87:1527-1532.

  • 158

    Messina M, Gardner C, Barnes S. Gaining insight into the health effects of soy but a long way still to go: commentary on the fourth International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. J Nutr. 2002;132:547S-551S.

  • 159

    Sanders TA, Dean TS, Grainger D, et al. Moderate intakes of intact soy protein rich in isoflavones compared with ethanol-extracted soy protein increase HDL but do not influence transforming growth factor beta(1) concentrations and hemostatic risk factors for coronary heart disease in healthy subjects. Am J Clin Nutr. 2002;76:373-377.

  • 160

    Nestel PJ, Yamashita T, Sasahara T, et al. Soy isoflavones improve systemic arterial compliance but not plasma lipids in menopausal and perimenopausal women. Arterioscler Thromb Vasc Biol. 1997;17:3392-3398.

  • 161

    Jenkins DJ, Kendall CW, Jackson CJ, et al. Effects of high- and low-isoflavone soyfoods on blood lipids, oxidized LDL, homocysteine, and blood pressure in hyperlipidemic men and women. Am J Clin Nutr. 2002;76:365-372.

  • 162

    Ludvik BH, Mahdjoobian K, Waldhaeusl W, et al. The effect of Ipomoea batatus (Caiapo) on glucose metabolism and serum cholesterol in patients with type 2 diabetes: a randomized study. Diabetes Care. 2002;25:239-240.

  • 163

    Jenkins DJ, Kendall CW, Marchie A, et al. Dose response of almonds on coronary heart disease risk factors: blood lipids, oxidized low-density lipoproteins, lipoprotein(a), homocysteine, and pulmonary nitric oxide: a randomized, controlled, crossover trial. Circulation. 2002;106:1327-1332.

  • 164

    Nissen S, Sharp RL, Panton L, et al. ß-hydroxy-ß-methylbutyrate (HMB) supplementation in humans is safe and may decrease cardiovascular risk factors. J Nutr. 2000;130:1937-1945.

  • 165

    Noone EJ, Noone EJ, Roche HM, et al. The effect of dietary supplementation using isomeric blends of conjugated linoleic acid on lipid metabolism in healthy human subjects. Br J Nutr. 2002;88:243-251.

  • 166

    Cicero AF, Gaddi A. Rice bran oil and gamma-oryzanol in the treatment of hyperlipoproteinaemias and other conditions. Phytother Res. 2001;15:277-289.

  • 167

    Ostlund RE Jr, Racette SB, Okeke A, et al. Phytosterols that are naturally present in commercial corn oil significantly reduce cholesterol absorption in humans. Am J Clin Nutr. 2002;75:1000-1004.

  • 168

    Temme EH, Van Hoydonck PG, Schouten EG, et al. Effects of a plant sterol-enriched spread on serum lipids and lipoproteins in mildly hypercholesterolaemic subjects. Acta Cardiol. 2002;57:111-115.

  • 169

    Amundsen AL, Ose L, Nenseter MS, et al. Plant sterol ester-enriched spread lowers plasma total and LDL cholesterol in children with familial hypercholesterolemia. Am J Clin Nutr. 2002;76:338-344.

  • 170

    Simons L. Additive effect of plant sterol-ester margarine and cerivastatin in lowering low-density lipoprotein cholesterol in primary hypercholesterolemia. Am J Cardiol. 2002;90:737.

  • 171

    Castano G, Mas R, Fernandez JC, et al. Effects of policosanol on older patients with hypertension and type II hypercholesterolaemia. Drugs R D. 2002;3:159-172.

  • 172

    Gouni-Berthold I, Berthold HK. Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent. Am Heart J. 2002;143:356-365.

  • 173

    Vanstone CA, Raeini-Sarjaz M, Parsons WE, et al. Unesterified plant sterols and stanols lower LDL-cholesterol concentrations equivalently in hypercholesterolemic persons. Am J Clin Nutr. 2002;76:1272-1278

  • 174

    Cleghorn CL, Skeaff CM, Mann J, et al. Plant sterol-enriched spread enhances the cholesterol-lowering potential of a fat-reduced diet. Eur J Clin Nutr. 2003;57:170-176.

  • 175

    Lee YM, Haastert B, Scherbaum W, et al. A phytosterol-enriched spread improves the lipid profile of subjects with type 2 diabetes mellitus A randomized controlled trial under free-living conditions. Eur J Nutr. 2003;42:111-117.

  • 176

    Castano G, Fernandez L, Mas R, et al. Comparison of the efficacy, safety and tolerability of original policosanol versus other mixtures of higher aliphatic primary alcohols in patients with type II hypercholesterolemia. Int J Clin Pharmacol Res. 2002;22:55-66.

  • 177

    Mustad VA, Smith CA, Ruey PP, et al. Supplementation with 3 compositionally different tocotrienol supplements does not improve cardiovascular disease risk factors in men and women with hypercholesterolemia. Am J Clin Nutr. 2002;76:1237-1243.

  • 178

    Oosthuizen W, Vorster HH, Vermaak, WJ, et al. Lecithin has no effect on serum lipoprotein, plasma fibrinogen and macro molecular protein complex levels in hyperlipidaemic men in a double-blind controlled study. Eur J Clin Nutr. 1998;52:419-424.

  • 179

    Knuiman JT, Beynen AC, Katan MB. Lecithin intake and serum cholesterol. Am J Clin Nutr. 1989;49:266-268.

  • 180

    Greten H, et al. The effect of polyunsaturated phosphatidylcholine on plasma lipids and fecal sterol excretion. Atherosclerosis. 1980;36:81-88.

  • 181

    Childs MT, et al. The contrasting effects of a dietary soya lecithin product and corn oil on lipoprotein lipids in normolipidemic and familial hypercholesterolemic subjects. Atherosclerosis. 198;38:217-228.

  • 182

    Kesaniemi YA, et al. Effects of dietary polyenylphosphatidylcholine on metabolism of cholesterol and triglycerides in hypertriglyceridemic patients. Am J Clin Nutr. 1986;43:98-107.

  • 183

    Nosaka N, Kasai M, Nakamura M, et al. Effects of dietary on serum lipoproteins and biochemical parameters in healthy men. Biosci Biotechnol Biochem. 2002;66:1713-1718.

  • 184

    Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(suppl):1645S-1654S.

  • 185

    Davini P, Bigalli A, Lamanna F, et al. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res. 1992;18:355-365.

  • 186

    Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial. JAMA. 2003;290:765-72.

  • 187

    Bokura H, Kobayashi S. Chitosan decreases total cholesterol in women: a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr. 2003;57:721-725.

  • 188

    Michael L, Dansinger, MD. One year effectiveness of the Atkins, Ornish, Weight Watchers, and Zone diets in decreasing body weight and heart disease risk. Paper presented at: American Heart Association 2003 Scientific Sessions; November 12, 2003.

  • 189

    Katan MB, Grundy SM, Jones P, et al. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc. 2003;78:965-980.

  • 190

    Nikander E, Tiitinen A, Laitinen K, et al. Effects of isolated isoflavonoids on lipids, lipoproteins, insulin sensitivity, and ghrelin in postmenopausal women. J Clin Endocrinol Metab. 2004;89:3567-3572.

  • 191

    Atkinson C, Oosthuizen W, Scollen S, et al. Modest protective effects of isoflavones from a red clover-derived dietary supplement on cardiovascular disease risk factors in perimenopausal women, and evidence of an interaction with ApoE genotype in 49-65 year-old women. J Nutr. 2004;134:1759-1764.

  • 192

    Kreijkamp-Kaspers S, Kok L, Grobbee DE, et al. Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women. JAMA. 2004;292:65-74.

  • 193

    Dalais FS, Ebeling PR, Kotsopoulos D, et al. The effects of soy protein containing isoflavones on lipids and indices of bone resorption in postmenopausal women. Clin Endocrinol (Oxf). 2003;58:704-709.

  • 194

    Yeung J, Yu TF. Effects of isoflavones (soy phyto-estrogens) on serum lipids: a meta-analysis of randomized controlled trials. Nutr J. 2003. [Epub ahead of print]

  • 195

    Mas R, Castano G, Fernandez J, et al. Long-term effects of policosanol on obese patients with Type II hypercholesterolemia. Asia Pac J Clin Nutr. 2004;13(suppl):S102.

  • 196

    Mas R, Castano G, Fernandez J, et al. Long-term effects of policosanol on older patients with Type 2 diabetes. Asia Pac J Clin Nutr. 2004;13(suppl):S101.

  • 197

    Metso S, Ylitalo R, Nikkila M, et al. The effect of long-term microcrystalline chitosan therapy on plasma lipids and glucose concentrations in subjects with increased plasma total cholesterol: a randomised placebo-controlled double-blind crossover trial in healthy men and women. Eur J Clin Pharmacol. 2003 Nov 7. [Epub ahead of print]

  • 198

    Khan A, Safdar M, Ali Khan MM, et al. Cinnamon improves glucose and lipids of people with Type 2 diabetes. Diabetes Care. 2003;26:3215-3218.

  • 199

    Takai M, Suido H, Tanaka T, et al. [LDL-cholesterol-lowering effect of a mixed green vegetable and fruit beverage containing broccoli and cabbage in hypercholesterolemic subjects]. Rinsho Byori. 2003;51:1073-1083.

  • 200

    Davies MJ, Judd JT, Baer DJ, et al. Black tea consumption reduces total and LDL cholesterol in mildly hypercholesterolemic adults. J Nutr. 2003;133:3298S-3302S.

  • 201

    Maron DJ, Lu GP, Cai NS, et al. Cholesterol-lowering effect of a theaflavin-enriched green tea extract: a randomized controlled trial. Arch Intern Med. 2003;163:1448-1453.

  • 202

    Satitvipawee P, Rawdaree P, Indrabhakti S, et al. No effect of garlic extract supplement on serum lipid levels in hypercholesterolemic subjects. J Med Assoc Thai. 2003;86:750-757.

  • 203

    Kim MK, Sasaki S, Sasazuki S, et al. Long-term vitamin C supplementation has no markedly favourable effect on serum lipids in middle-aged Japanese subjects. Br J Nutr. 2004;91:81-90.

  • 204

    Murkovic M, Abuja PM, Bergmann AR, et al. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr. 2004;58:244-249.

  • 205

    Lin CC, Li TC, Lai MM, et al. Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia. Eur J Endocrinol. 2005;153:679-86.

  • 206

    Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr. 1999;69:231-236.

  • 207

    Bunea R, El Farrah K, Deutsch L, et al. Evaluation of the effects of Neptune Krill oil on the clinical course of hyperlipidemia. Altern Med Rev. 2005;9:420-428.

  • 208

    Stuglin C, Prasad K. Effect of flaxseed consumption on blood pressure, serum lipids, hemopoietic system and liver and kidney enzymes in healthy humans. J Cardiovasc Pharmacol Ther. 2005;10:23-27.

  • 209

    Wendland E, Farmer AJ, Paul G, et al. Effect of alpha-linolenic acid on cardiovascular risks markers: a systematic review. Heart. 2005 May 12. [Epub ahead of print]

  • 210

    Hallund J, Ravn-Haren G, Bugel S, et al. A lignan complex isolated from flaxseed does not affect plasma lipid concentrations or antioxidant capacity in healthy postmenopausal women. J Nutr. 2005;136:112-116.

  • 211

    Jambazian PR, Haddad E, Rajaram S, et al. Almonds in the diet simultaneously improve plasma alpha-tocopherol concentrations and reduce plasma lipids. J Am Diet Assoc. 2005;105:449-454.

  • 212

    Tapsell LC, Gillen LJ, Patch CS, et al. Including Walnuts in a Low-Fat/Modified-Fat Diet Improves HDL Cholesterol-to-Total Cholesterol Ratios in Patients With Type 2 Diabetes. Diabetes Care. 2004;27:2777-2783.

  • 213

    Hlivak P, Odraska J, Ferencik M, et al. One-year application of probiotic strain Enterococcus faecium M-74 decreases serum cholesterol levels. Bratisl Lek Listy. 2005;106:67-72.

  • 214

    Williams CM, Jackson KG. Inulin and oligofructose: effects on lipid metabolism from human studies. Br J Nutr. 2002;87(suppl 2):S261-S264.

  • 215

    van Dokkum W, Wezendonk B, Srikumar TS, van den Heuvel EG. Effect of nondigestible oligosaccharides on large-bowel functions, blood lipid concentrations and glucose absorption in young healthy male subjects. Eur J Clin Nutr. 1999;53:1-7.

  • 216

    Giacco R, Clemente G, Luongo D, et al. Effects of short-chain fructo-oligosaccharides on glucose and lipid metabolism in mild hypercholesterolaemic individuals. Clin Nutr. 2004;23:331-340.

  • 217

    Davidson MH, Synecki C, Maki KC, Drennen KB. Effects of dietary inulin in serum lipids in men and women with hypercholesterolaemia. Nutr Res. 1998;3:503-517.

  • 218

    Schaafsma G, Meuling WJ, van Dokkum W, Bouley C. Effects of a milk product, fermented by Lactobacillus acidophilus and with fructo-oligosaccharides added, on blood lipids in male volunteers. Eur J Clin Nutr. 1998;52:436-40.

  • 219

    Jackson KG, Taylor GRJ, Clohessy AM, Wlliams CM. The effect of the daily intake of inulin on fasting lipid, insulin and glucose concentrations in middle-aged men and women. Br J Nutr. 1999;82:23-30.

  • 220

    Pedersen A, Sandstrom B, van Amelsvoort JMM. The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healthy females. Br J Nutr. 1997;78:215-222.

  • 221

    Lewis SJ, Burmeister S. A double-blind placebo-controlled study of the effects of Lactobacillus acidophilus on plasma lipids. Eur J Clin Nutr. 2005 Apr 20. [Epub ahead of print]

  • 222

    Diepvens K, Kovacs EM, Vogels N, et al. Metabolic effects of green tea and of phases of weight loss. Physiol Behav. 2005 Nov 4. [Epub ahead of print]

  • 223

    Zunft HJ, Luder W, Harde A, et al. Carob pulp preparation rich in insoluble fibre lowers total and LDL cholesterol in hypercholesterolemic patients. Eur J Nutr. 2003;42:235-242.

  • 224

    Shao G, You ZH, Cu XC, et al. (1990). Treatment of hyperlipidemia with Cordyceps sinensis. A double blind placebo control trial. Inter J Oriental Med. 15:77-80.

  • 225

    Guha S, Pal SK, Chatterjee N, et al. Effect of chitosan on lipid levels when administered concurrently with atorvastatin—a placebo controlled study. J Indian Med Assoc. 2005;103:418,420.

  • 226

    Lehtimaki T, Metso S, Ylitalo R, et al. Microcrystalline chitosan is ineffective to decrease plasma lipids in both apolipoprotein E epsilon4 Carriers and non-carriers: a long-term placebo-controlled trial in hypercholesterolaemic volunteers. Basic Clin Pharmacol Toxicol. 2005;97:98-103.

  • 227

    Kong W, Wei J, Abidi P, et al. Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins. Nat Med. 2004 Nov 07. [Epub ahead of print]

  • 228

    Zern TL, Wood RJ, Greene C, et al. Grape polyphenols exert a cardioprotective effect in pre- and postmenopausal women by lowering plasma lipids and reducing oxidative stress. J Nutr. 2005;135:1911-1917.

  • 229

    Hansen AS, Marckmann P, Dragsted LO, et al. Effect of red wine and red grape extract on blood lipids, haemostatic factors, and other risk factors for cardiovascular disease. Eur J Clin Nutr. 2005 Jan 26. [Epub ahead of print]

  • 230

    Davini P, Bigalli A, Lamanna F, et al. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res. 1992;18:355-365.

  • 231

    Pistone G, Marino A, Leotta C, et al. Levocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue. Drugs Aging. 2003;20:761-767.

  • 232

    Rahbar AR, Shakerhosseini R, Saadat N, et al. Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus. Eur J Clin Nutr. 2005 Mar 2. [Epub ahead of print]

  • 233

    Shaish A, Harari A, Hananshvili L, et al. 9-cis beta-carotene-rich powder of the alga Dunaliella bardawil increases plasma HDL-cholesterol in fibrate-treated patients. Atherosclerosis. 2006 Jan 12. [Epub ahead of print]

  • 234

    Most MM, Tulley R, Morales S, et al. Rice bran oil, not fiber, lowers cholesterol in humans. Am J Clin Nutr. 2005;81:64-68.

  • 235

    Tanamai J, Veeramanomai S, Indrakosas N, et al. The efficacy of cholesterol-lowering action and side effects of garlic enteric coated tablets in man. J Med Assoc Thai. 2004;87:1156-1161.

  • 236

    Duthie SJ, Jenkinson AM, Crozier A, et al. The effects of cranberry juice consumption on antioxidant status and biomarkers relating to heart disease and cancer in healthy human volunteers. Eur J Nutr. 2005 Jul 20. [Epub ahead of print]

  • 237

    Koh-Banerjee PK, Ferreira MP, Greenwood M, et al. Effects of calcium pyruvate supplementation during training on body composition, exercise capacity, and metabolic responses to exercise. Nutrition. 2005;21:312-319.

  • 238

    Reynolds K, Chin A, Lees KA, et al. A meta-analysis of the effect of soy protein supplementation on serum lipids. Am J Cardiol. 2006;98:633-640.

  • 239

    Covas MI, Nyyssonen K, Poulsen HE, et al. The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial. Ann Intern Med. 2006;145:333-341.

  • 240

    Hughes S, Samman S. The effect of zinc supplementation in humans on plasma lipids, antioxidant status and thrombogenesis. J Am Coll Nutr. 2006;25:285-291.

  • 241

    Castro Cabezas M, de Vries JH, Van Oostrom AJ, et al. Effects of a stanol-enriched diet on plasma cholesterol and triglycerides in patients treated with statins. J Am Diet Assoc. 2006;106:1564-1569.

  • 242

    Harper CR, Edwards MC, Jacobson TA. Flaxseed oil supplementation does not affect plasma lipoprotein concentration or particle size in human subjects. J Nutr. 2006;136:2844-2848.

  • 243

    Polagruto JA, Wang-Polagruto JF, Braun MM, et al. Cocoa flavanol-enriched snack bars containing phytosterols effectively lower total and low-density lipoprotein cholesterol levels. J Am Diet Assoc. 2006;106:1804-1813.

  • 244

    Ding EL, Hutfless SM, Ding X, et al. Chocolate and prevention of cardiovascular disease: a systematic review. Nutr Metab (Lond). 2006 Jan 3. [Epub ahead of print]

  • 245

    Gardner CD, Lawson LD, Block E, et al. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med. 2007;167:346-353.

  • 246

    Ajuluchukwu JN, Okubadejo NU, Mabayoje M, et al. Comparative study of the effect of tocotrienols and -tocopherol on fasting serum lipid profiles in patients with mild hypercholesterolaemia: a preliminary report. Niger Postgrad Med J. 2007;14:30-33.

  • 247

    Kerckhoffs DA, Brouns F, Hornstra G, Mensink RP. Effects on the human serum lipoprotein profile of beta-glucan, soy protein and isoflavones, plant sterols and stanols, garlic and tocotrienols. J Nutr. 2002;132:2494-2505.

  • 248

    Mensink RP, van Houwelingen AC, Kromhout D, et al. A vitamin E concentrate rich in tocotrienols had no effect on serum lipids, lipoproteins, or platelet function in men with mildly elevated serum lipid concentrations. Am J Clin Nutr. 1999;69:213-219.

  • 249

    Szapary PO, Cirigliano MD. Tocotrienols in the management of hypercholesterolemia and atherosclerosis. AlternMed Alert. 2000;3:101-105.

  • 250

    Greany KA, Bonorden MJ, Hamilton-Reeves JM, et al. Probiotic capsules do not lower plasma lipids in young women and men. Eur J Clin Nutr. 2007 Mar 14. [Epub ahead of print]

  • 251

    Baba S, Osakabe N, KatoY, et al. Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans. Am J Clin Nutr. 2007;85:709-717.

  • 252

    Meyer BJ, Hammervold T, Rustan AC, et al. Dose-dependent effects of docosahexaenoic acid supplementation on blood lipids in statin-treated hyperlipidaemic subjects. Lipids. 2007;42:109-115.

  • 253

    Queenan KM, Stewart ML, Smith KN, et al. Concentrated oat beta-glucan, a fermentable fiber, lowers serum cholesterol in hypercholesterolemic adults in a randomized controlled trial. Nutr J. 2007 Mar 26. [Epub ahead of print].

  • 254

    Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet. 2007;369:1090-1098.

  • 255

    Kelly S, Summerbell C, Brynes A, et al. Wholegrain cereals for coronary heart disease. Cochrane Database Syst Rev. 2007 Apr 18;CD005051.

  • 256

    Ho SC, Chen YM, Ho SS, et al. Soy isoflavone supplementation and fasting serum glucose and lipid profile among postmenopausal Chinese women: A double-blind, randomized, placebo-controlled trial. Menopause. 2007 Mar 19. [Epub ahead of print]

  • 257

    Rangineni V, Sharada D, Saxena S. Diuretic, hypotensive, and hypocholesterolemic effects of eclipta alba in mild hypertensive subjects: a pilot study. J Med Food. 2007;10:143-148.

  • 258

    Reiner Z, Tedeschi-Reiner E, Romic Z. Effects of rice policosanol on serum lipoproteins, homocysteine, fibrinogen, and C-reactive protein in hypercholesterolaemic patients. Clin Drug Investig. 2005;25:701-707.

  • 259

    Huang CF, Li TC, Lin CC, et al. Efficacy of Monascus purpureus Went rice on lowering lipid ratios in hypercholesterolemic patients. Eur J Cardiovasc Prev Rehabil. 2007;14:438-440.

  • 260

    Hoie LH, Guldstrand M, Sjoholm A, et al. Cholesterol-lowering effects of a new isolated soy protein with high levels of nondenaturated protein in hypercholesterolemic patients. Adv Ther. 2007;24:439-447.

  • 261

    Nagao T, Hase T, Tokimitsu I. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity (Silver Spring). 2007;15:1473-1483.

  • 262

    Forcheron F, Beylot M. Long-term administration of inulin-type fructans has no significant lipid-lowering effect in normolipidemic humans. Metabolism. 2007;56:1093-1098.

  • 263

    Woodgate D, Chan CH, Conquer JA. Cholesterol-lowering ability of a phytostanol softgel supplement in adults with mild to moderate hypercholesterolemia. Lipids. 2006;41:127-132.

  • 264

    Davidson MH, Stein EA, Bays HE, et al. Efficacy and tolerability of adding prescription omega-3 fatty acids 4 g/d to simvastatin 40 mg/d in hypertriglyceridemic patients: an 8-week, randomized, double-blind, placebo-controlled study. Clin Ther. 2007;29:1354-1367.

  • 265

    Reppas C, Swidan SZ, Tobey SW, et al. Hydroxypropylmethylcellulose significantly lowers blood cholesterol in mildly hypercholesterolemic human subjects. Eur J Clin Nutr. 2007 Sep 19. [Epub ahead of print]

  • 266

    Mukamal KJ, MacDermott K, Vinson JA, et al. A 6-month randomized pilot study of black tea and cardiovascular risk factors. Am Heart J. 2007;154:724.e1-6.

  • 267

    Baum L, Cheung SK, Mok VC, et al. Curcumin effects on blood lipid profile in a 6-month human study. Pharmacol Res. 2007 Sep 18. [Epub ahead of print]

  • 268

    Linares E, Thimonier C, Degre M. The effect of NeOpuntia® on blood lipid parameters-risk factors for the metabolic syndrome (syndrome X). Adv Ther. 2007;24:1115-1125.

  • 269

    Zhang W, Wang X, Liu Y, et al. Dietary flaxseed lignan extract lowers plasma cholesterol and glucose concentrations in hypercholesterolaemic subjects. Br J Nutr. 2007 Dec 6.

  • 270

    Tay J, Brinkworth GD, Noakes M, et al. Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. J Am Coll Cardiol. 2008;51:59-67.

  • 271

    Howard BV, Van Horn L, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006;295:655-666.

  • 272

    Berglund L, Lefevre M, Ginsberg HN, et al. Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: studies in the fasting and postprandial states. Am J Clin Nutr. 2007;86:1611-1620.

  • 273

    Pelkman CL, Fishell VK, Maddox DH, et al. Effects of moderate-fat (from monounsaturated fat) and low-fat weight-loss diets on the serum lipid profile in overweight and obese men and women. Am J Clin Nutr. 2004;79:204-212.

  • 274

    Lichtenstein AH. Dietary fat and cardiovascular disease risk: quantity or quality? J Womens Health (Larchmt). 2003;12:109-114.

  • 275

    Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA. 2002;288:2569-2578.

  • 276

    Sacks FM, Katan M. Randomized clinical trials on the effects of dietary fat and carbohydrate on plasma lipoproteins and cardiovascular disease. Am J Med. 2002;113:13S-24S.

  • 277

    Gardner CD, Messina M, Kiazand A, et al. Effect of two types of soy milk and dairy milk on plasma lipids in hypercholesterolemic adults: a randomized trial. J Am Coll Nutr. 2007;26:669-677.

  • 278

    Plana N, Nicolle C, Ferre R, et al. Plant sterol-enriched fermented milk enhances the attainment of LDL-cholesterol goal in hypercholesterolemic subjects. Eur J Nutr. 2008 Jan 14.

  • 279

    Vissers MN, Trip MD, Pritchard PH, et al. Efficacy and safety of disodium ascorbyl phytostanol phosphates in men with moderate dyslipidemia. Eur J Clin Pharmacol. 2008 Mar 5. [Epub ahead of print]

  • 280

    Allen RR, Carson L, Kwik-Uribe C, et al. Daily consumption of a dark chocolate containing flavanols and added sterol esters affects cardiovascular risk factors in a normotensive population with elevated cholesterol. J Nutr. 2008;138:725-731.

  • 281

    Griel AE, Cao Y, Bagshaw DD, et al. A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. J Nutr. 2008;138:761-767.

  • 282

    Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab. 2008 Apr 8.

  • 283

    Bundy R, Walker AF, Middleton RW, et al. Artichoke leaf extract ( Cynara scolymus ) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: A randomized, double blind placebo controlled trial. Phytomedicine. 2008 Apr 16.

  • 284

    Bloedon LT, Balikai S, Chittams J, et al. Flaxseed and cardiovascular risk factors: results from a double blind, randomized, controlled clinical trial. J Am Coll Nutr. 2008;27:65-74.

  • 285

    Tapola NS, Lyyra ML, Kolehmainen RM, et al. Safety aspects and cholesterol-lowering efficacy of chitosan tablets. J Am Coll Nutr. 2008;27:22-30.

  • 286

    Micallef MA, Garg ML. The lipid-lowering effects of phytosterols and (n-3) polyunsaturated fatty acids are synergistic and complementary in hyperlipidemic men and women. J Nutr. 2008;138:1086-1090.

  • 287

    Harland JI, Haffner TA. Systematic review, meta-analysis and regression of randomised controlled trials reporting an association between an intake of circa 25g soya protein per day and blood cholesterol. Atherosclerosis. 2008 Apr 15.

  • 288

    Thorp AA, Howe PR, Mori TA, et al. Soy food consumption does not lower LDL cholesterol in either equol or nonequol producers. Am J Clin Nutr. 2008;88:298-304.

  • 289

    Sood N, Baker WL, Coleman CI. Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis. Am J Clin Nutr. 2008;88:1167-1175.

  • 290

    Rios DR, Rodrigues ET, Cardoso AP, et al. Lack of effects of isoflavones on the lipid profile of Brazilian postmenopausal women. Nutrition. 2008;24:1153-1158.

  • 291

    Wei ZH, Wang H, Chen XY, et al. Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials. Eur J Clin Nutr. 2008 Nov 5.

  • 292

    Liu ZL, Liu JP, Zhang AL, Wu Q, Ruan Y, Lewith G, Visconte D. Chinese herbal medicines for hypercholesterolemia. Cochrane Database Syst Rev. 2011;(7):CD008305.

  • 293

    Kim A, Chiu A, Barone MK, et al. Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis. J Am Diet Assoc. 2011;111(11):1720-1729.

  • 294

    Kianbakht S, Abasi B, Perham M, Hashem Dabaghian F. Antihyperlipidemic effects of Salvia officinalis L. leaf extract in patients with hyperlipidemia: a randomized double-blind placebo-controlled clinical trial. Phytother Res. 2011;25(12):1849-1853.

  • 295

    Allen RW, Schwartzman E, et al. Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Ann Fam Med. 2013;11(5):452-459.