Skip to content
2000
image of The Effect of Nutraceuticals on Lipid Profiles: A Systematic Review and Meta-Analysis

Abstract

Introduction

Dyslipidaemia is a major risk factor for atherosclerotic cardiovascular disease. Nutraceuticals have been investigated as lipid-lowering strategies, particularly for patients at low–moderate cardiovascular risk or with statin intolerance.

Methods

We systematically reviewed randomized controlled trials (RCTs) and meta-analyses evaluating nutraceutical interventions for lipid management. A total of 27 studies were included, following PRISMA 2020 guidelines.

Results

Evidence supports the beneficial effects of phytosterols, red yeast rice, polyphenols, prebiotics, and omega-3 fatty acids. Red yeast rice reduced LDL-C levels by 20–30%, comparable to low-dose statins; typical effective preparations contained 3–10 mg/day monacolin K. Phytosterols lowered LDL-C by ~10%, omega-3 fatty acids reduced triglycerides, and polyphenols and prebiotics demonstrated modest improvements across lipid parameters.

Discussion

This meta-analysis provides a comprehensive synthesis of current evidence regarding the effectiveness of nutraceuticals in managing dyslipidemia, particularly in lowering LDL-C levels. The results reinforce the clinical potential of many bioactive compounds as valid adjuncts or alternatives to pharmacologic therapy, especially in statin-intolerant patients with low to moderate cardiovascular risk.

Conclusion

Nutraceuticals demonstrate clinically relevant lipid-lowering potential, though effects vary by compound and dosage. They may complement pharmacological therapy, especially in patients unable or unwilling to take statins. Large RCTs remain needed to clarify long-term efficacy and safety.

© 2026 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cnf/10.2174/0115734013417004251209211055
2026-01-13
2026-02-02

  • From This Site

    /content/journals/cnf/10.2174/0115734013417004251209211055
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Mach F. Baigent C. Catapano A.L. “Guidelines for the management of dyslipidaemias,” lipid modification to reduce cardiovascular risk. Eur. Heart J. 2020 41 1 111 188 10.1093/eurheartj/ehz455 31504418
    [Google Scholar]
  2. Ference B.A. Ginsberg H.N. Graham I. Low-density lipoproteins cause atherosclerotic cardiovascular disease. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur. Heart J. 2017 38 32 2459 2472 10.1093/eurheartj/ehx144 28444290
    [Google Scholar]
  3. Borén J. Chapman M.J. Krauss R.M. Low-density lipoproteins cause atherosclerotic cardiovascular disease. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur. Heart J. 2020 41 24 2313 2330 10.1093/eurheartj/ehz962 32052833
    [Google Scholar]
  4. Banach M. Catapano A.L. Cicero A.F.G. Red yeast rice for dyslipidaemias and cardiovascular risk reduction: A position paper of the International Lipid Expert Panel. Pharmacol. Res. 2022 183 106370 10.1016/j.phrs.2022.106370 35901940
    [Google Scholar]
  5. Fogacci F. Banach M. Mikhailidis D.P. Safety of red yeast rice supplementation: A systematic review and meta-analysis of randomized controlled trials. Pharmacol. Res. 2019 143 1 16 10.1016/j.phrs.2019.02.028
    [Google Scholar]
  6. Cicero F. Nutraceuticals in the management of dyslipidemia: Which, when, and for whom? Could nutraceuticals help low-risk individuals with non-optimal lipid levels? Curr. Atheroscler. Rep. 2021 23 10 57 10.1007/s11883‑021‑00955‑y
    [Google Scholar]
  7. Cicero A.F.G. Colletti A. Bajraktari G. Descamps O. Djuric D.M. Ezhov M. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutr. Rev. 2017 75 9 731 767 10.1093/nutrit/nux047
    [Google Scholar]
  8. Rahmani P. Melekoglu E. Tavakoli S. Malekpour A.N. Rohani P. Sohouli M.H. Impact of red yeast rice supplementation on lipid profile: A systematic review and meta-analysis of randomized-controlled trials. Expert Rev. Clin. Pharmacol. 2022 16 73 10.1080/17512433.2023.2138342
    [Google Scholar]
  9. Ference B.A. Ginsberg H.N. Graham I. Low-density lipoproteins cause atherosclerotic cardiovascular disease: Pathophysiological, genetic, and therapeutic insights: A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur. Heart J. 2020 41 24 2313 2330 10.1093/eurheartj/ehx144 32052833
    [Google Scholar]
  10. Borén J. Watts G.F. Adiels M. Kinetic and related determinants of plasma triglyceride concentration in abdominal obesity. Arterioscler. Thromb. Vasc. Biol. 2015 35 10 2218 2224 10.1161/ATVBAHA.115.305614 26315407
    [Google Scholar]
  11. Balk E.M. Lichtenstein A.H. Chung M. Kupelnick B. Chew P. Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review. Atherosclerosis 2006 189 19 10.1016/j.atherosclerosis.2006.02.012
    [Google Scholar]
  12. Page M.J. McKenzie J.E. Bossuyt P.M. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021 372 n71 10.1136/bmj.n71 33782057
    [Google Scholar]
  13. Protić O. Di Pillo R. Montesanto A. Randomized, double-blind, placebo-controlled trial to test the effects of a nutraceutical combination monacolin K free on the lipid and inflammatory profile of subjects with hypercholesterolemia. Nutrients 2022 14 14 2812 10.3390/nu14142812 35889769
    [Google Scholar]
  14. Landi F. Martone A.M. Salini S. Effects of a new combination of medical food on endothelial function and lipid profile in dyslipidemic subjects: a pilot randomized trial. BioMed Res. Int. 2019 2019 1 7 10.1155/2019/1970878 30723735
    [Google Scholar]
  15. Sangouni A.A. Sangouni M. Mirahmadi J. Effects of curcumin and/or coenzyme Q10 supplementation on metabolic control in subjects with metabolic syndrome: A randomized clinical trial. Nutr. J. 2022 21 62 10.1186/s12937‑022‑00816‑7
    [Google Scholar]
  16. Machado V.A. Santisteban A.R.N. Martins C.M. Effects of phytosterol supplementation on lipoprotein subfractions and LDL particle quality. Sci. Rep. 2024 14 11108 10.1038/s41598‑024‑61897‑4
    [Google Scholar]
  17. Xu D. Feng M. Chu Y.F. Wang S. The prebiotic effects of oats on blood lipids, gut microbiota, and short-chain fatty acids in mildly hypercholesterolemic subjects compared with rice: A randomized, controlled trial. Front. Immunol. 2021 12 787797 10.3389/fimmu.2021.787797
    [Google Scholar]
  18. Rinott E. Meir A.Y. Tsaban G. The effects of the Green-Mediterranean diet on cardiometabolic health are linked to gut microbiome modifications: A randomized controlled trial. Genome Med. 2022 14 1 29 10.1186/s13073‑022‑01015‑z 35264213
    [Google Scholar]
  19. Angelopoulos N. Paparodis R.D. Androulakis I. Boniakos A. Argyrakopoulou G. Livadas S. Low dose monacolin k combined with coenzyme q10, grape seed, and olive leaf extracts lowers ldl cholesterol in patients with mild dyslipidemia: A multicenter, randomized controlled trial. Nutrients 2023 15 12 2682 10.3390/nu15122682
    [Google Scholar]
  20. Wang Q. Sun Y. Ma A. Li Y. Han X. Liang H. Effects of Vitamin E on plasma lipid status and oxidative stress in chinese women with metabolic syndrome. Int. J. Vitam. Nutr. Res. 2010 80 3 178 187 10.1024/0300‑9831/a000015
    [Google Scholar]
  21. Cai Y. Xing G. Shen T. Zhang S. Rao J. Shi R. Effects of 12-week supplementation of Citrus bergamia extracts-based formulation CitriCholess on cholesterol and body weight in older adults with dyslipidemia: a randomized, double-blind, placebo-controlled trial. Lipids Health Dis. 2017 16 1 251 10.1186/s12944‑017‑0640‑1 29273027
    [Google Scholar]
  22. Riva A. Petrangolini G. Allegrini P. Artichoke and Bergamot Phytosome Alliance: A randomized double blind clinical trial in mild hypercholesterolemia. Nutrients 2021 14 1 108 10.3390/nu14010108 35010984
    [Google Scholar]
  23. D’Addato S. Scandiani L. Mombelli G. Effect of a food supplement containing berberine, monacolin K, hydroxytyrosol and coenzyme Q10 on lipid levels: a randomized, double-blind, placebo controlled study. Drug Des. Devel. Ther. 2017 11 1585 1592 10.2147/DDDT.S128623 28579756
    [Google Scholar]
  24. Wang H. Ma C. Zhao Y. Zhou J. Zhang X. Liu Y. A double-blind, randomized, placebo-controlled clinical trial evaluating the lipid-lowering and anti-inflammatory effects of a nutraceutical combination containing berberine, policosanol and red-yeast-rice extract in subjects with mild hypercholesterolemia. Nutrients 2023 15 7 1612 10.3390/nu15071612 37049453
    [Google Scholar]
  25. Moosavi D. Vuckovic I. Zec M. Milosevic B. Ilic S. Stankovic R. Efficacy and safety of a novel nutraceutical combination of red-yeast-rice and coenzyme Q10 in patients with moderate dyslipidemia: a randomized, double-blind, placebo-controlled trial. Front. Pharmacol. 2022
    [Google Scholar]
  26. Pokushalov E. Ponomarenko A. Kalinina O. Lebedev D. Romanov A. Shkolnikova M. A randomized clinical trial evaluating the effects of a combined nutraceutical therapy on lipid profile and vascular inflammation in post-cardiac-surgery patients. Cardiol. Ther. 2024 13 2 215 227 10.1007/s40119‑024‑00362‑7
    [Google Scholar]
  27. Cicero A.F.G. D’Addato S. Borghi C. A randomized, double-blind, placebo-controlled clinical study of a nutraceutical combination (LEVELIP DUO®) on LDL-cholesterol levels and lipid pattern in subjects with sub-optimal blood cholesterol levels (NATCOL Study). Nutrients 2020 12 10 3127 10.3390/nu12103127
    [Google Scholar]
  28. Trotter R.E. Vazquez A.R. Grubb D.S. Bacillus subtilis DE111 intake may improve blood lipids and endothelial function in healthy adults. Benef. Microbes 2020 11 7 621 630 10.3920/BM2020.0039 33161737
    [Google Scholar]
  29. Shen T. Xing G. Zhu J. Effects of 12-week supplementation of marine Omega-3 PUFA-based formulation Omega3Q10 in older adults with prehypertension and/or elevated blood cholesterol. Lipids Health Dis. 2017 16 1 253 10.1186/s12944‑017‑0617‑0 29282085
    [Google Scholar]
  30. Bays H.E. Evans J.L. Ahmad Z. Schulz S. Toth P.P. Kadonaga Y. Evaluation of red yeast rice-based nutraceuticals for lipid management: A randomized, double-blind, placebo-controlled clinical trial. Am. J. Cardiol. 2013 112 8 1222 1228 10.1016/j.amjcard.2013.05.065
    [Google Scholar]
  31. Chen B. Huang X. Liu H. Zhou Y. Li M. Qiu J. Randomized, double-blind, placebo-controlled trial of combined omega-3 fatty acids and phytosterols in adults with hypertriglyceridemia. Nutrients 2022 14 21 4493 10.3390/nu14214493 36364754
    [Google Scholar]
  32. Zhou Y. Zeng Y. Li Y. Liu Y. Zhao W. Chen R. Lipid-lowering and antioxidant efficacy of a nutraceutical combination containing berberine, policosanol, and red-yeast-rice in subjects with mild hypercholesterolemia: A randomized, double-blind, placebo-controlled clinical trial. Nutrients 2023 15 10 2224 10.3390/nu15102224 37242225
    [Google Scholar]
  33. Mohammadi E. Rafraf M. Farzadi L. Asghari-Jafarabadi M. Sabour S. Effects of soy isoflavone supplementation on serum lipids, antioxidant status, and oxidative stress in hypercholesterolemic postmenopausal women: A randomized, double-blind, placebo-controlled clinical trial. Nutr. Metab. Cardiovasc. Dis. 2012 22 10 877 884 10.1016/j.numecd.2010.12.005
    [Google Scholar]
  34. Trimarco V. Izzo R. Mone P. Santoro M. Sorrentino A. Rozza F. Effects of a nutraceutical combination on blood pressure and lipid profile in patients with metabolic syndrome: A randomized, double-blind, crossover clinical trial. High Blood Press. Cardiovasc. Prev. 2015 24 13 10.1007/s40292‑015‑0087‑2
    [Google Scholar]
  35. Khongrum J. Yingthongchai P. Boonyapranai K. Safety and effects of Lactobacillus paracasei TISTR 2593 supplementation on improving cholesterol metabolism and atherosclerosis-related parameters in subjects with hypercholesterolemia: A randomized, double-blind, placebo-controlled clinical trial. Nutrients 2023 15 3 661 10.3390/nu15030661 36771367
    [Google Scholar]
  36. Shidfar F. Keshavarz A. Jallali M. Miri R. Eshraghian M. Comparison of the effects of simultaneous administration of vitamin C and omega-3 fatty acids on lipoproteins, apo A-I, apo B, and malondialdehyde in hyperlipidemic patients. Int. J. Vitam. Nutr. Res. 2003 73 3 163 170 10.1024/0300‑9831.73.3.163 12847992
    [Google Scholar]
  37. Vezza T. Guillamón E. García-García J. LDL-cholesterol-lowering effects of a dietary supplement containing onion and garlic extract used in healthy volunteers. Nutrients 2024 16 16 2811 10.3390/nu16162811
    [Google Scholar]
  38. Özdemir B. Ekbul A. Topal N.B. Effects of Origanum onites on endothelial function and serum biochemical markers in hyperlipidaemic patients. J. Int. Med. Res. 2008 36 6 1326 1334 10.1177/147323000803600621 19094443
    [Google Scholar]
  39. Ruscica M. Gomaraschi M. Mombelli G. Nutraceutical approach to moderate cardiometabolic risk: Results of a randomized, double-blind and crossover study with Armolipid Plus,”. J. Clin. Lipidol. 2014 61 8
    [Google Scholar]
  40. Venero C.V. Venero J.V. Wortham D.C. Thompson P.D. Lipid-lowering efficacy of red yeast rice in a population intolerant to statins. Am. J. Cardiol. 2010 105 5 664 666 10.1016/j.amjcard.2009.10.045 20185013
    [Google Scholar]
  41. Derosa G. Bonaventura A. Bianchi L. A randomized, placebo-controlled study on the effects of a nutraceutical combination of red yeast rice, silybum marianum and octasonol on lipid profile, endothelial and inflammatory parameters. J. Biol. Regul. Homeost. Agents 2014 28 2 317 324 25001663
    [Google Scholar]
  42. Becker D.J. Gordon R.Y. Halbert S.C. French B. Morris P.B. Rader D.J. Red yeast rice for dyslipidemia in statin-intolerant patients: A randomized trial. Ann. Intern. Med. 2009 150 12 830 839 10.7326/0003‑4819‑150‑12‑200906160‑00006
    [Google Scholar]
  43. Derosa G. D’Angelo A. Bonaventura A. Bianchi L. Romano D. Maffioli P. Effects of berberine on lipid profile in subjects with low cardiovascular risk. Expert Opin. Biol. Ther. 2013 13 4 475 482 10.1517/14712598.2013.776037 23441841
    [Google Scholar]
  44. Derosa G. Maffioli P. Nutraceuticals for the treatment of metabolic diseases: evidence from clinical practice. Expert Rev. Endocrinol. Metab. 2015 10 3 297 304 10.1586/17446651.2015.995630 30298772
    [Google Scholar]
  45. Stroes E.S. Thompson P.D. Corsini A. Statin-associated muscle symptoms: impact on statin therapy—European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur. Heart J. 2015 36 17 1012 1022 10.1093/eurheartj/ehv043 25694464
    [Google Scholar]
  46. Sirtori C.R. Galli C. Anderson J.W. Sirtori E. Arnoldi A. Functional foods for dyslipidaemia and cardiovascular risk prevention. Nutr. Res. Rev. 2009 22 2 244 261 10.1017/S0954422409990187 20003590
    [Google Scholar]
/content/journals/cnf/10.2174/0115734013417004251209211055
Loading
The Effect of Nutraceuticals on Lipid Profiles: A Systematic Review and Meta-Analysis
Bentham Science Publishers ; https://doi.org/10.2174/0115734013417004251209211055
/content/journals/cnf/10.2174/0115734013417004251209211055
/content/journals/cnf/10.2174/0115734013417004251209211055
Loading

Data & Media loading...

Supplements

PRISMA checklist is available as supplementary material on the publisher’s website along with the published article.

file format download Download

  • Article Type:     Research Article
Keywords: red yeast rice ; phytosterols ; lipid-lowering ; polyphenols ; Nutraceuticals ; dyslipidaemia ; omega-3 fatty acids ; meta-analysis

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test