February 1, 2023

CLEVELAND, Ohio — If you’re taking fish oil or garlic pills to lower cholesterol, a new Cleveland Clinic study suggests it’s a waste of money.

Six commonly used dietary supplements marketed for improving heart health did not lower “bad cholesterol” when compared to a low-dose cholesterol-lowering medication or placebo, in the Clinic study.

The low-dose cholesterol-lowering drug, which belongs to a class of drugs called statins, also had beneficial impact on blood triglycerides and total cholesterol, which help reduce cardiovascular risk.

“If you’ve had discussions with your physician about starting cholesterol medicines, and you’re considering taking supplements instead, don’t waste your money,” said Dr. Luke Laffin, study co-author and co-director of the Center for Blood Pressure Disorders in the Heart, Vascular & Thoracic Institute at Cleveland Clinic.

“You’re unlikely to get the benefit that you would from even just a low dose of statins,” Laffin said.

Statins are drugs commonly prescribed to lower cholesterol and decrease the risk of strokes and heart attacks.

Having high levels of low-density lipoprotein, also known as LDL or “bad” cholesterol, is a major cause of coronary heart disease. This type of cholesterol causes the build-up of fatty deposits within the arteries, reducing or blocking the flow of blood and oxygen to the heart.

Lowering LDL cholesterol reduces the risk for coronary heart disease, which is the leading cause of death for Americans, according to the Centers for Disease Control and Prevention. About 697,000 people in the United States died from heart disease in 2020.

Fish oil, garlic, cinnamon, turmeric, plant sterols and red yeast rice — the supplements included in the Clinic study — are often advertised as “support for cardiovascular health” or “cholesterol’s natural enemy.”

But supplements do not need to meet the same standards for safety and efficacy required as pharmaceuticals, and aren’t regulated by the Food and Drug Administration. Unlike pharmaceuticals, most supplements have not been tested in large, randomized trials, he said.

“How are consumers supposed to know the difference? It’s a little bit a little tricky,” Laffin said.

The Clinic’s research results were recently published in the Journal of the American College of Cardiology. Dr. Steven Nissen, chief academic officer of the Heart, Vascular & Thoracic Institute at the Clinic, was the senior author.

Statins, not supplements, decrease cholesterol in study

The Clinic’s randomized, single-blind clinical trial analyzed health data for 190 adults between ages 40 and 75 with no history of cardiovascular disease.

The participants, recruited through the Clinic’s electronic health portal, were randomly placed in groups receiving 5 mg daily of a low-dose statin, fish oil, cinnamon, garlic, turmeric, plant sterols, red yeast rice or placebo for 28 days.

A small number of study participants were taking supplements before enrolling in the trial, but were asked to stop taking them for at least a month before the study started, Laffin said.

Results showed that the percent of LDL cholesterol reduction with the statin was greater than all supplements and the placebo. None of the dietary supplements demonstrated any significant decrease in LDL cholesterol compared with placebo.

Trial participants who took the statin had an almost 40% reduction in average LDL cholesterol after 28 days. Changes in LDL cholesterol levels among those who took any dietary supplement were similar to those in the placebo group.

Participants who took a statin saw their total cholesterol drop an average of 24%. Both the placebo group and groups taking all dietary supplements showed no benefit.

Julie Washington covers healthcare for cleveland.com. Read previous stories at this link. Also:

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