Therapeutic lifestyle (lifestyle changes, red yeast rice, fish oil)

Indication: Lipid-lowering


Source: Mayo Clin Proc, July 2008;83(7):758-64.

Research: The point of this study was to compare the lipid-lowering effects of an alternative regimen (lifestyle changes, red yeast rice, and fish oil) with a standard dose of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin). The trial en­rolled 74 patients with hypercholesterolemia who met Adult Treatment Panel III criteria for primary prevention using statin therapy. All participants were randomized to an alternative treatment group (AG) or to receive simvastatin (40 mg/d). The alternative treatment included therapeutic lifestyle changes, along with ingestion of red yeast rice and fish oil supplements for 12 weeks. The simvastatin group received medication and traditional counseling. The primary outcome measure was the percentage change in low-density lipo­protein cholesterol (LDL-C). Secondary measures were changes in other lipoproteins and weight loss.

Results: There was a statistically significant reduction in LDL-C levels in both the AG (42%) and the simvastatin group (39%). No significant differences were noted between groups. The AG also demonstrated significant reductions in triglycerides (29%) and weight (5%) compared with the simvastatin group. These results led researchers to conclude that lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL-C in proportions similar to standard therapy with simvastatin. Pending confirmation in larger trials, they believe this multifactorial, alternative approach to lipid-lowering has promise for a subset of patients unwilling or unable to take statins.