Red yeast rice
Red yeast rice is a traditional Chinese medicine that may help lower cholesterol. Several types of the extract are sold as supplements.
Red yeast rice may be appealing because it's "natural", but you need to be careful. Experts have not studied it extensively. The ideal dose and long-term safety are unclear and it may not be suitable for everyone. Seek medical advice if you have concerns.
What is red yeast rice?
Red yeast rice is a substance that's extracted from rice that's been fermented with a type of yeast called Monascus purpureus. It's been used in China and other Asian countries for centuries as a traditional medicine. It's also used as a food colouring, additive, and preservative.
Red yeast rice naturally contains several ingredients that may help maintain healthy cholesterol levels, but this is not proven. The ingredients include a number of monacolins, most importantly monacolin K. It also contains sterols, isoflavones, and monounsaturated fatty acids, or "healthy fats."
Is red yeast rice a drug or a supplement?
Confusingly, the answer is both. One of the most important ingredients in red yeast rice is monacolin K. It's also known as lovastatin, the active ingredient in a cholesterol-lowering prescription medicine.
The European Food Safety Authority (EFSA) is responsible for approving health claims made about food substances. It has approved a claim that monacolin K from red yeast rice contributes to the maintenance of normal blood cholesterol levels
How well does red yeast help manage cholesterol?
Some studies have shown that red yeast rice can significantly lower levels of total cholesterol and specifically LDL, or "bad" cholesterol.
One 2007 study published in the European Journal of Cardiovascular Prevention and Rehabilitation found a twice daily dose of red yeast rice “reduced lipid ratios in hypercholesterolaemic patients” after eight weeks.
An earlier multi-centre clinical trial carried out by Chinese researchers and published in Current Therapeutic Research, showed that a red yeast rice preparation reduced LDL levels by 30% and total cholesterol by 22% in eight weeks.
Researchers concluded: “this traditional Chinese rice preparation used as a dietary supplement is extremely effective and well tolerated in reducing elevated serum cholesterol and triglycerides.”
However, the studies of red yeast rice have so far been fairly small and didn't last long enough to reveal the long-term effects.
What is the correct dosage of red yeast rice?
Since research into red yeast rice is still in its early stages, experts still aren't sure of what the ideal dose should be. The amounts taken in some studies have varied from 1.2 to 2.4 grams per day. In China and other countries, estimates of average daily consumption are much higher.
Keep in mind that the amount of monacolin - perhaps the most important ingredient - in a red yeast rice extract can vary a lot. There are many different strains of the yeast. Different types of fermentation are used. One 2004 study of different brands of red yeast rice supplements showed that the amount of monacolin ranged from 0% to 0.58%.
So even though studies have shown that red yeast rice can lower cholesterol, you can't really know if the supplement brand you're using will have that effect.