By the way, doctor: Does red yeast rice reduce cholesterol?
Q. I've heard that red yeast rice can help lower cholesterol. What can you tell me about its effectiveness and safety?
A. Red yeast rice is white rice fermented with a species of yeast that gives it a red color. It's been used medicinally in China for hundreds of years and is a dietary staple in many Asian countries, where it's also ground into an extract and used as a coloring agent in various dishes. Red yeast rice contains compounds called monacolins, which inhibit HMG-CoA reductase, an enzyme critical to cholesterol production in the body. This is the same enzyme that's blocked by statin drugs, which reduce cholesterol and cardiovascular risk. In fact, one of the monacolins in red yeast rice — monacolin-K — is lovastatin, the active ingredient in the prescription statin drug Mevacor.
In studies of people with elevated cholesterol, red yeast rice taken for two to three months has been shown to lower total cholesterol, LDL cholesterol, and triglycerides. The only long-term study of its impact on cardiovascular risk is a trial from China in which 5,000 participants with a history of heart attack took either red yeast rice extract or a placebo. Over five years, the red yeast rice takers were less likely to have another heart attack or to die from one and were less likely to need angioplasty or heart surgery. The red yeast rice extract tested in this study contained less than half the monacolin-K found in Mevacor. Experts think its effectiveness may be due, in part, to the nine other monacolins in red yeast rice, including lovastatin's potent hydroxy acid form.