Dietary supplements: clinical cholesterol-lowering efficacy and potential mechanisms of action.
Level 5 - mechanism / opinion, no new human data
Narrative review summarizing meta-analyses and mechanistic literature without systematic search details provided.
PubMed 38659110 · doi:10.1080/09637486.2024.2342301
What was done
The authors reviewed evidence from meta-analyses of randomized controlled clinical trials alongside human, animal, and in vitro mechanistic studies to evaluate the cholesterol-lowering efficacy and physiological mechanisms of various dietary supplements.
What was found
Specific dietary supplements—including phytosterols, berberine, viscous soluble dietary fibers, garlic supplements, soy protein, select probiotic strains, and certain polyphenol extracts—reduced plasma total and low-density lipoprotein (LDL) cholesterol by 3% to 25% in hypercholesterolemic patients. Reductions in LDL cholesterol were greater in hypercholesterolemic individuals compared to normocholesterolemic individuals. Mechanisms identified across preclinical and clinical literature include increased bile acid excretion, inhibition of intestinal cholesterol absorption, upregulated hepatic LDL receptor expression, suppression of cholesterol synthesis enzymes, and activation of the AMPK signaling pathway.
Why it matters
This review aggregates clinical trial meta-analyses showing that specific nutraceuticals can meaningfully lower LDL cholesterol in hypercholesterolemic patients through distinct biological pathways.
Limits
The abstract does not report the total number of studies or participants analyzed, effect sizes for individual supplement classes, statistical heterogeneity, or adverse event data. As a narrative review, it lacks a documented systematic search strategy or risk-of-bias assessment.
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- supports Dietary soluble fiber lowers blood cholesterol by binding bile salts in the gut rather than directly binding cholesterol.