Harvard Heart Letter

Heart Beat: Policosanol: A sweet nothing for high cholesterol

Heart Beat

Policosanol: A sweet nothing for high cholesterol

A dietary supplement made from sugar cane doesn't lower cholesterol as advertised. Posts on the Internet and magazine ads claim that taking policosanol, which is extracted from the waxy coating of sugar cane, lowers LDL (bad) cholesterol by 25%. That's about as much as a modestly powerful statin. One problem with this claim is that the lion's share of the evidence comes from a single commercial lab in Cuba that markets the supplement.

An independent study done in Germany tested policosanol in men and women with high cholesterol. Groups of 20 volunteers with high cholesterol got either a placebo or 10, 20, 40, or 80 milligrams of policosanol a day. After 12 weeks, LDL levels were no better in any of the policosanol groups than in the placebo group. The supplements also had no effect on related factors, either, including HDL (good) cholesterol, triglycerides, and lipoprotein(a).

Why believe this one negative study rather than the dozens of positive ones from the Cuban lab? It was sponsored and partly designed by a company hoping for positive results because it wanted to market policosanol in Germany. Neither the participants nor the researchers knew who was getting what treatment. Participants had their cholesterol tested several times; the tests were done in a single, certified lab; and the results of the study were analyzed by an independent expert. In other words, this was a rigorous study with a clear message: If you are serious about lowering your cholesterol, don't waste your time or your money on policosanol; ask your doctor about strategies that work.

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