Natural sources of antidyslipidaemic agents: is there an evidence-based approach for their prescription?

Numerous randomized clinical trials, systematic reviews and meta-analyses have confirmed the antidyslipidaemic activity of different dietary supplements, nutraceuticals and herbal remedies. International guidelines for cardiovascular disease prevention have begun to consider dietary supplements as an evidence-based approach to improve patients’ plasma lipid levels. They already suggest to increasing or supplementing the dietary intake of soluble fibre (especially psyllium), soy proteins, plant sterols, niacin, and fish oil. Among the nutraceuticals, mevacoline and policosanol are both able to reduce plasma LDL-C by a mean of 20%. A preliminary clinical study of berberine has shown it to be the most powerful antihyperlipidaemic natural compound, reducing plasma LDL-C by 25% and triglycerides by 35%. Among the herbal remedies, several placebo-controlled randomized clinical trials have confirmed the anti-Numerous randomized clinical trials, systematic reviews and meta-analyses have confirmed the antidyslipidaemic activity of different dietary supplements, nutraceuticals and herbal remedies. International guidelines for cardiovascular disease prevention have begun to consider dietary supplements as an evidence-based approach to improve patients’ plasma lipid levels. They already suggest to increasing or supplementing the dietary intake of soluble fibre (especially psyllium), soy proteins, plant sterols, niacin, and fish oil. Among the nutraceuticals, mevacoline and policosanol are both able to reduce plasma LDL-C by a mean of 20%. A preliminary clinical study of berberine has shown it to be the most powerful antihyperlipidaemic natural compound, reducing plasma LDL-C by 25% and triglycerides by 35%. Among the herbal remedies, several placebo-controlled randomized clinical trials have confirmed the antihypercholesterolaemic, and antihypertriglyceridaemic properties of aged garlic powder, artichoke leaf extracts, guggul, and fenugreek. Single small clinical trials have also suggested that Korean ginseng, green tea, onion, yarrow, holy basil and arjun have an antihypercholesterolaemic effect.