Cholestin comes from a strain of Chinese red yeast that has been used as a natural flavoring agent and food coloring in Chinese cooking for many years. Cholestin has an active component called lovastatin, which is in the prescription drug Mevacor (a cholesterol-lowering drug approved by FDA). Cholestin has been successful in reducing blood cholesterol in numerous studies. However, currently FDA does not regulate this product based on the limitation put on FDA by Congress with regard to dietary supplements. Cholestin is labeled as a dietary supplement and can be put-chased in many stores. However, to self-prescribe cholestin as a drug in the treatment of high blood cholesterol is not recommended by many physicians, due to lack of regulation by FDA. The lack of FDA oversight means that consumers cannot be sure the dietary supplement contains the active ingredient or the amount specified on the bottle. Cholestin is also very expensive. Overall, high blood cholesterol is a serious disease that requires medical supervision. In addition, if a physician does not follow a person, how will the person know that cholestin is actually lowering blood cholesterol? For this reason, cholestin should be used in conjunction with a physician’s supervision.
FDA has approved two margarines that have positive effects on blood cholesterol levels-Benecol and Take Control. These margarines contain plant stanol/sterols, which have been researched since the 1950s for their cholesterol-lowering effects. However, it wasn’t until the mid- 1990s that researchers modified the plant stanols to be fat-soluble and found a suitable medium for consumption. The plant stanol/sterols work by binding cholesterol in the intestine, thereby decreasing absorption of cholesterol and lowering its return to the liver through enterohepatic circulation. The liver responds by taking up more cholesterol from the blood. The studies done on the cholesterol-lowering effect of these margarines have found that 2 to5 g of plant stanols/sterols per day reduces total blood cholesterol by 8 to 10% and LDL-cholesterol by 9 to 14% (similar t what is seen with some blood cholesterol-lowering drugs).
Benecol is made from plant stanols called sitostanols, which are extracted from wood pulp. This product is sold as margarine and has been added to salad dressings. Take Control is made form plant sterols called sitosterols, which are isolated from soybeans. The recommended amount for both is about 2 to 3 grams per day. Use would cost about $1.00 per day.
In people who have borderline high total blood cholesterol (between 200 and 239mg/dl), these margarines can be helpful in avoiding future drug therapy. Even though these products exhibit significant results, it is still important to follow a balanced diet low in saturated fat, cholesterol, and trans fatty acids, as well as to exercise on a regular basis. People with high total blood cholesterol who plan to consume these margarines should inform their physicians because, if they are currently on cholesterol-lowering drug therapy, their physicians may be able to decrease the dosage. For healthy individuals with total blood cholesterol within normal limits, the use of these margarines is unnecessary, especially because their cholesterol-lowering effect is not needed and they are expensive.
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