Nutraceuticals for Hyperchloestemia

Nutraceuticals are oral dietary elements that are naturally present in food and are thought to have health or medicinal benefits. The name was invented in 1989 by Dr. Stephen Defelice, who merged the words “nutrition” and “pharmaceutical.” Here, some dermatologic nutraceuticals’ theoretical effects and clinical advantages are examined. Since ancient times, various pathological illnesses have been treated with plant, animal, and vegetable derivatives in traditional medicine as well as in pure holistic techniques (1).

In principle, any food has the ability to go beyond its nutritional value as a source of macro and micronutrients and can also be employed as a medicine depending on the dose due to its inclusion of active chemicals. The safety of the starting material, the absence of allergenic substances, the absence of toxicity, the absence of exogenous and endogenous contaminants, the potential presence of toxic secondary metabolites and/or environmental pollutants that may pose a health threat are all potential risk factors related to the use of vegetal matrixes.

Over 40 nutraceuticals were listed in the literature as having a positive impact on lipid metabolism. Some of these compounds have been shown to be effective in lowering serum lipid levels as well as CV risk. In addition, some of these compounds have been shown to have positive effects on surrogate vascular damage markers like arterial intima-media thickness (IMT), endothelial dysfunction, and arterial stiffness (2). However, several studies looking into how nutraceuticals affect lipid metabolism have significant methodological flaws in research design, demographic characterization, and outcome selection. The data we offer are not intended as guidelines for clinical treatment; rather, this article must be viewed as an informational document. We made an effort to choose and publish the results that, in our opinion, appeared to be the most reliable.

Some of the commonly used nutraceuticals

Soy derivatives:

Soybeans include compounds that may help lower the risk of cardiovascular disease. Since they are thought to be the key components of soy products’ health benefits, isoflavones and soy protein have been the subject of much research over the past 30 years. Genistein, daidzin, and glycitin are the three main isoflavones found in soybeans, and they share structural similarities with 17-beta estradiol. They serve as insufficient estrogenic agonists by binding to oestrogen A and B receptors. The majority of research on the lipid-lowering effects of soy derivatives used a variety of soy products, varying levels of soy protein, various subject selection criteria, and various methods. An average soy protein intake of 47 gram per day decreased total cholesterol (TC) by 9%, LDL-C by 12.9%, and triglycerides (TGs) by 10.5%, with a non-significant effect on high density lipoprotein cholesterol, according to Anderson et al meta-analysis of 29 controlled trials (HDL-C) (3).

Phytosterols:

Plants naturally contain phytosterols and stanols, which are phytosterols’ saturated derivatives. They resemble human cholesterol structurally, but the intestinal tract does not effectively absorb them. There are more than 40 plant sterols known to exist. They compete with cholesterol for intestinal absorption because they have a higher affinity for mixed micelles, and they also upregulate the sterol transporters ATP-binding cassette subfamily G member 5 (ABCG5) and ABCG8, which further reduces cholesterol absorption. Since the 1950s, plant sterols have been known to decrease cholesterol. Esterified phytosterols were proposed by Mattson et al. in 1977 as a way to render plant sterols soluble in dietary fat (4).

Policosanol

The term “policosanol” refers to a mixture of eight long-chain aliphatic alcohols produced during the fermentation of sugarcane, rice, wheat germ, or sunflower seeds. A study from Cuba in 1991 first described lipid-lowering characteristics, and until 2004 most of the medical literature on the subject was created there (5). In these investigations, policosanol and statins both had equivalent lipid-lowering efficacy, but policosanol was more effective at boosting HDL-C and had fewer adverse effects.

Red yeast rice

Red yeast rice (RYR) is a fermented rice product that has been used for hundreds of years in China to manufacture rice wine, improve flavour, colour meals, and “help digestion and circulation.” Numerous randomised trials have thoroughly demonstrated the RYR’s ability to decrease lipid levels. A dose-dependent effect on plasma blood lipids was seen in placebo-controlled investigations, with TC, LDL-C, and TGs all decreasing by 0% to 36%, 22% to 32%, and 16% to 31%, respectively. The amount of change in HDL-C ranged from zero to a 20% rise.

References:

1. Chauhan B, Kumar G, … NK-J of advanced, 2013 undefined. Current concepts and prospects of herbal nutraceutical: A review. ncbi.nlm.nih.gov [Internet]. [cited 2022 Sep 21]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645360/
2. Aquila G, Marracino L, Martino V, … DC-… M and C, 2019 undefined. The use of nutraceuticals to counteract atherosclerosis: the role of the notch pathway. hindawi.com [Internet]. [cited 2022 Sep 21]; Available from: https://www.hindawi.com/journals/omcl/2019/5470470/
3. Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R. Efficacy and Safety of Plant Stanols and Sterols in the Management of Blood Cholesterol Levels. Mayo Clin Proc. 2003 Aug 1;78(8):965–78.
4. Souyoul SA, Saussy KP, Lupo MP. Nutraceuticals: A Review. Dermatol Ther (Heidelb). 2018 Mar 1;8(1):5–16.
5. Sosnowska B, Penson P, diagnosis MB-C, 2017 undefined. The role of nutraceuticals in the prevention of cardiovascular disease. ncbi.nlm.nih.gov [Internet]. [cited 2022 Sep 21]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418215/
6. Mannarino MR, Ministrini S, Pirro M. Nutraceuticals for the treatment of hypercholesterolemia. Eur J Intern Med. 2014;25(7):592–9.