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Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel
Open accessAbstract
Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, reaching 31% of deaths in 2012 [1]. In particular, atherosclerosis and ischemic heart disease (IHD) are the main causes of premature death in Europe and are responsible for 42% of deaths in women and 38% in men under 75 years old [2]. The global economic impact of CVD is estimated to have been US $906 billion in 2015 and is expected to rise by 22% by 2030 [3]. Cardiovascular diseases also represent the major cause of disability in developed countries. It has been estimated that their growing burden could lead to a global increase in loss of disability-adjusted life years (DALYs), from a loss of 85 million DALYs in 1990 to a loss of ~150 million DALYs in 2020, becoming a major non-psychological cause of lost productivity [4]. Several risk factors contribute to the etiology and development of CVD; they are divided into those modifiable through lifestyle changes or by taking a pharmacologic treatment (e.g. for hypertension, smoking, diabetes mellitus, hypercholesterolemia) and those that are not modifiable (age, male gender, and family history) [5]. Elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) blood concentrations are the major modifiable risk factors for coronary heart disease (CHD), whereas high concentrations of plasma high-density lipoprotein cholesterol (HDL-C) in certain conditions are considered protective [6]. Moreover, LDL-C remains a fundamental CV risk factor (and a main target of therapy) even when statins are largely used in the general population [7]. An examination of the data of 18 053 participants aged ≥ 20 years who participated in the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2006 showed that the unadjusted prevalence of hypercholesterolemia ranged from 53.2% to 56.1% in United States adults [8]. Differences related to gender and race or ethnicity were observed; in particular, a lower rate of control was found among women than men and lower rates of having a cholesterol check and being told about hypercholesterolemia were reported by African Americans and Mexican Americans than whites [8]. A recent report from the American Heart Association confirmed that in the US only 75.7% of children and 46.6% of adults present targeted TC levels (TC < 170 mg/dl for children and < 200 mg/dl for adults, in untreated individuals) [9]. The pattern is similar in other Western countries [10, 11].
Overview
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Written from the paper’s full text.
TL;DR
This International Lipid Expert Panel position paper reviews lipid-lowering nutraceuticals and their combinations, grading evidence and recommending selected agents as adjuncts for mild dyslipidemia or statin intolerance. It emphasizes that nutraceuticals cannot replace indicated lipid-lowering therapy and that outcome data proving CVD event reduction are still lacking.
Key findings
- Red yeast rice (RYR) reduced LDL-C by 1.02 mmol/l (39.4 mg/dl) versus placebo in a meta-analysis of 20 trials, comparable to moderate-intensity statins; it was graded Class I, Level A, with expected LDL-C reduction of –15% to –25%.
- Berberine, in a meta-analysis of 27 clinical studies with 2569 participants, reduced LDL-C by –0.65 mmol/l (25.14 mg/dl), TG by –0.39 mmol/l (34.5 mg/dl), and increased HDL-C by 0.07 mmol/l (2.71 mg/dl); it was graded Class I, Level A.
- The RYR–policosanol–berberine combination, in a meta-analysis of 14 RCTs with 3159 subjects, improved LDL-C by –0.61 mmol/l (23.6 mg/dl), HDL-C by 0.07 mmol/l (2.71 mg/dl), TG by –0.16 mmol/l (14.2 mg/dl), and glucose by –0.14 mmol/l (2.52 mg/dl); it was graded Class I, Level A.
- Omega-3 EPA/DHA, in a meta-analysis of 47 RCTs with 16,511 hypercholesterolemic participants using a mean 3.25 g/day for 24 weeks, reduced TG by 14% (–0.34 mmol/l/30.12 mg/dl), with no significant HDL-C difference; it was graded Class I, Level A for TG lowering.
Methods
- Position paper/consensus from an International Lipid Expert Panel, endorsed by multiple national societies, providing a narrative review of clinical evidence on individual lipid-lowering nutraceuticals and nutraceutical combinations.
- Evidence was drawn from randomized controlled trials and meta-analyses; treatment options were graded by Class of recommendation (I–III) and Level of evidence (A–C) as defined in Tables I and II.
- For each nutraceutical, the paper describes mechanism of action, active principles, effective dosages, effects on lipid profile, extra-lipid-lowering properties, and safety profile where available.
Limitations
- The paper states that there are still no outcome studies proving that nutraceuticals can prevent CVD morbidity or mortality; many combinations have been tested only in a single study and results have not been confirmed, and some tested combinations contained underdosed components.
- The paper notes long-term safety data are lacking for some agents, such as plant sterols beyond 2 years, beta-glucan long-term efficacy/safety, and silymarin safety data.
- Evident from the text: the evidence base is heterogeneous, with small or short trials, inconsistent RCT results for some agents (e.g., curcumin, policosanols), and bergamot efficacy data largely from a single research unit and not confirmed elsewhere.
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Claims the paper makes
313 Not checked yet · 32 No basis given · 21 Own interpretation · 3 Own method · 1 Own result
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In the paper
“glucose by –0.14 mmol/l (2.52 mg/dl) (p = 0.010)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
plaindirectn = 3,159 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“HDL-C by 0.07 mmol/l (2.71 mg/dl) (p < 0.001)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
plaindirectn = 3,159 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“TG by –0.16 mmol/l (14.2 mg/dl) (p < 0.001)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
plaindirectn = 3,159 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“A recent meta-analysis of 14 RCTs including data from 3159 subjects showed than the red yeast rice-policosanol-berberine association improved the plasma level of LDL-C by –0.61 mmol/l (23.6 mg/dl) (p < 0.001)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
plaindirectn = 3,159 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“Three polymorphisms in the 3′ UTR region of LDLR and two in the 5′ UTR region of PCSK9 were associated with response to the treatment.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [247] De Castro-Orós I Solà R Valls RM Genetic variants of LDLR and PCSK9 associated with variations in response to antihypercholesterolemic effects of armolipid plus with berberine PLoS One 2016 11 e0150785 27015087 PMC4807809
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In the paper
“Based on the data from all above-mentioned studies, no serious safety concerns have been raised.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.1. Red yeast rice and policosanols
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, the improvement in both lipid and glucose profile appeared to be maintained in the long-term observation [243].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [243] Pirro M Mannarino MR Bianconi V The effects of a nutraceutical combination on plasma lipids and glucose: a systematic review and meta-analysis of randomized controlled trials Pharmacol Res 2016 110 76 88 27157250
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“After 3 months of treatment a reduction of LDL-C (−23%) (p < 0.001) was reported”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [244] Pirro M Mannarino MR Ministrini S Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial Sci Rep 2016 6 23587 27004462 PMC4804276
plaindirectn = 100 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“It was also observed that endothelial function and PWV were improved by the combination of red yeast rice and berberine in dyslipidaemic patients [248, 249].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [248] Affuso F Ruvolo A Micillo F Saccà L Fazio S Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study Nutr Metab Cardiovasc Dis 2010 20 656 61 19699071
- Not checked yetcites [249] Cicero AF Parini A Rosticci M Effect of a lipid-lowering nutraceutical on pulse-wave-velocity in hypercholesterolemic patients with or without chronic kidney disease Open Hypertens J (TOJH) 2013 5 18 22
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“hs-CRP and endothelial microparticle changes were also related to each other (p = 0.005)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [244] Pirro M Mannarino MR Ministrini S Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial Sci Rep 2016 6 23587 27004462 PMC4804276
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Low dosed soy proteins and plant sterols have been demonstrated to have mild but additive cholesterol-lowering effects in humans [264].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.8. Soy proteins and plant sterols
What the sources say
- Not checked yetcites [264] Cicero AF Fiorito A Panourgia MP Sangiorgi Z Gaddi A Effects of a new soy/beta-sitosterol supplement on plasma lipids in moderately hypercholesterolemic subjects J Am Diet Assoc 2002 102 1807 11 12487546
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“significant reductions of TC levels were observed in all groups (each one with 25 subjects), in particular lupin protein + cellulose (–0.3 mmol/l (11.6 mg/dl), –4.2%), casein + apple pectin (–0.39 mmol/l (15 mg/dl), –5.3%), pea protein + oat fiber (–0.35 mmol/l (13.5 mg/dl), –4.7%) and pea protein + apple pectin (–0.43 mmol/l (16.6 mg/dl), –6.4%) (p < 0.05).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [273] Sirtori CR Triolo M Bosisio R Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals Br J Nutr 2012 107 1176 83 22032303
boosteddirectn = 25 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, this nutraceutical compound has also shown potential in normalizing blood pressure [268].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [268] Lee IT Lee WJ Tsai CM Su IJ Yen HT Sheu WH Combined extractives of red yeast rice, bitter gourd, chlorella, soy protein, and licorice improve total cholesterol, low-density lipoprotein cholesterol, and triglyceride in subjects with metabolic syndrome Nutr Res 2012 32 85 92 22348456
hedgedconditionaln = 106- Asserted: passes — The authors put it forward as true.
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In the paper
“The intake of soy proteins with plant sterols in patients with MetS and LDL-C ≥ 160 mg/dl (4.1 mmol/l) showed a significant (p < 0.05) improvement in LDL-C, non-HDL-C, cholesterol/HDL-C and TG/HDL-C ratios, apoB, apoB/apoA-1 ratio, homocysteine, total LDL particle number and large HDL particle number, in particular after 12 weeks of treatment [265].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.8. Soy proteins and plant sterols
What the sources say
- Not checked yetcites [265] Lerman RH Minich DM Darland G Subjects with elevated LDL cholesterol and metabolic syndrome benefit from supplementation with soy protein, phytosterols, hops rho iso-alpha acids, and Acacia nilotica proanthocyanidins J Clin Lipidol 2010 4 59 68 21122628
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The group treated with the nutraceutical association experienced a LDL-C reduction by –27.0% and apoB decrease by –19.0% (both, p < 0.001) [252].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.3. Red yeast rice and plant sterols
What the sources say
- Not checked yetcites [252] Cicero AF Fogacci F Rosticci M Effect of a short-term dietary supplementation with phytosterols, red yeast rice or both on lipid pattern in moderately hypercholesterolemic subjects: a three-arm, double-blind, randomized clinical trial Nutr Metab 2017 In press PMC5613479 29021813
plaindirectn = 90- Asserted: passes — The authors put it forward as true.
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In the paper
“No significant difference was observed with respect to effects on TG, HDL-C and safety parameters [258].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.5. Red yeast rice, policosanol, and silymarin
What the sources say
- Not checked yetcites [258] Cicero AF Colletti A Rosticci M Grandi E Borghi C Efficacy and tolerability of a combined lipid-lowering nutraceutical on cholesterolemia, hs-CRP level and endothelial function in moderately hypercholesterolemic subjects J Biol Regul Homeost Agents 2016 30 593 8 27358154
plainn = 80- Asserted: passes — The authors put it forward as true.
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In the paper
“All tested inflammatory parameters (soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, soluble E-selectin, MMP-2 and -9, hs-CRP, IL-6 and TNF-α) were reduced by the nutraceutical combination [257].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.5. Red yeast rice, policosanol, and silymarin
What the sources say
- Not checked yetcites [257] 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 28 317 24 25001663
plaindirectn = 134- Asserted: passes — The authors put it forward as true.
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In the paper
“The results showed a reduction of LDL-C of 33% (1.37 mmol/l (53 mg/dl)) after 6 weeks of treatment (p < 0.05) [251].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.3. Red yeast rice and plant sterols
What the sources say
- Not checked yetcites [251] Feuerstein JS Bjerke WS Powdered red yeast rice and plant stanols and sterols to lower cholesterol J Diet Suppl 2012 9 110 5 22531006
plaindirectn = 18 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“The results showed an improvement of lipid parameters: LDL-C –21%, TG –37%, VLDL –36.7%, TC/HDL-C ratio –23.4%, HDL-C +5.1% [271].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [271] Jeyaraj S Shivaji G Jeyaraj SD Vengatesan A Effect of combined supplementation of fish oil with garlic pearls on the serum lipid profile in hypercholesterolemic subjects Indian Heart J 2005 57 327 31 16350679
plaindirectn = 16- Asserted: passes — The authors put it forward as true.
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In the paper
“No significant differences were observed with respect to TGs, HDL-C, and safety parameters [259].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.6. Red yeast rice and antioxidants
What the sources say
- Not checked yetcites [259] Cicero AF Derosa G Parini A Red yeast rice improves lipid pattern, high-sensitivity C-reactive protein, and vascular remodeling parameters in moderately hypercholesterolemic Italian subjects Nutr Res 2013 33 622 8 23890351
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Based on the available data, no serious safety concerns have been raised.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, the study highlighted a greater decrease in TG levels only in patients with baseline TG > 500 mg/dl, who showed a 11% reduction (p < 0.001 vs. subjects with baseline TG < 150 mg/dl) [267].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [267] Cicero AF Derosa G Pisciotta L Barbagallo C SISA-PUFACOL Study Group Testing the short-term efficacy of a lipid-lowering nutraceutical in the setting of clinical practice: a multicenter study J Med Food 2015 18 1270 3 26274827 PMC4638196
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, LDL-C was significantly reduced in pea protein + apple pectin combinations (–0.27 mmol/l (10.4 mg/dl), 9.2%) (p < 0.004 vs. control).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [273] Sirtori CR Triolo M Bosisio R Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals Br J Nutr 2012 107 1176 83 22032303
plaindirectn = 25 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“After 3 months of treatment, it was observed that this treatment was as effective as statins in moderate doses (LDL-C –37%, TG –23%) [290].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.3. Ezetimibe, red yeast rice, policosanol and berberine
What the sources say
- Not checked yetcites [290] Pisciotta L Bellocchio A Bertolini S Nutraceutical pill containing berberine versus ezetimibe on plasma lipid pattern in hypercholesterolemic subjects and its additive effect in patients with familial hypercholesterolemia on stable cholesterol-lowering treatment Lipids Health Dis 2012 11 123 22998978 PMC3477057
plaincorrelationaln = 26- Asserted: passes — The authors put it forward as true.
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In the paper
“Combinations of lipid-lowering nutraceuticals could improve their safety (reducing the dosages of the single components), but their efficacy has been rarely tested in more than one study/RCT, while some of the tested nutraceutical combinations contained underdosed components.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
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In the paper
“No patient experienced important undesirable effects [289].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.3. Ezetimibe, red yeast rice, policosanol and berberine
What the sources say
- Not checked yetcites [289] Marazzi G Pelliccia F Campolongo G Usefulness of nutraceuticals (Armolipid Plus) versus ezetimibe and combination in statin-intolerant patients with dyslipidemia with coronary heart disease Am J Cardiol 2015 116 1798 801 26611120
plainn = 86- Asserted: passes — The authors put it forward as true.
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In the paper
“However, it has to be clearly stressed that there are still no outcome studies proving that nutraceuticals can prevent CVD morbidity or mortality.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The effect of PUFAs in statin-treated subjects is simply addictive in terms of dose-related TG reduction [282, 283].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
What the sources say
- Not checked yetcites [282] Maki KC Orloff DG Nicholls SJ A highly bioavailable omega-3 free fatty acid formulation improves the cardiovascular risk profile in high-risk, statin-treated patients with residual hypertriglyceridemia (the ESPRIT trial) Clin Ther 2013 35 1400-11.e1 -3 23998969
- Not checked yetcites [283] Kim SH Kim MK Lee HY Kang HJ Kim YJ Kim HS Prospective randomized comparison between omega-3 fatty acid supplements plus simvastatin versus simvastatin alone in Korean patients with mixed dyslipidemia: lipoprotein profiles and heart rate variability Eur J Clin Nutr 2011 65 110 6 20877395
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The combination of the tocotrienol-rich fraction (50 mg) and lovastatin (10 mg) plus the AHA step-1 diet was demonstrated to significantly reduce LDL-C by 25% (p < 0.001), an additional 10% in comparison to statin therapy alone [294].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.6. Statins and tocotrienols
What the sources say
- Not checked yetcites [294] Qureshi AA Sami SA Salser WA Khan FA Synergistic effect of tocotrienol-rich fraction (TRF 25) of rice bran and lovastatin on lipid parameters in hypercholesterolemic humans J Nutr Biochem 2001 12 318 29 11516635
boosteddirectn = 28- Asserted: passes — The authors put it forward as true.
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In the paper
“In the control group, in which only berberine/silymarin was administered, there was also a reduction of LDL-C (LDL-C –17% and –26% respectively after 6 and 12 months).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.4. Ezetimibe or statins and berberine with silymarin
What the sources say
- Not checked yetcites [291] Di Pierro F Bellone I Rapacioli G Putignano P Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins Diabetes Metab Syndr Obes 2015 8 89 96 25678808 PMC4322873
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In the paper
“Patients who received simvastatin (10 mg), plus black seed (500 mg) and garlic (250 mg) for 8 weeks showed a greater improvement of lipid parameters, LDL-C (–29.4%), TG (–20.1%), non-HDL-C (–27.4%), and HDL-C (+21.4%) (p = 0.01).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.8. Statins and garlic
What the sources say
- Not checked yetcites [295] Ahmad Alobaidi AH Effect of Nigella sativa and Allium sativum coadminstered with simvastatin in dyslipidemia patients: a prospective, randomized, double-blind trial Antiinflamm Antiallergy Agents Med Chem 2014 13 68 74 23848231
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In the paper
“At 1-year follow-up, 58 (72.5%) patients of the combined therapy group (n = 86) reached the therapeutic goal (LDL-C < 2.58 mmol/l (100 mg/dl)).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.3. Ezetimibe, red yeast rice, policosanol and berberine
What the sources say
- Not checked yetcites [289] Marazzi G Pelliccia F Campolongo G Usefulness of nutraceuticals (Armolipid Plus) versus ezetimibe and combination in statin-intolerant patients with dyslipidemia with coronary heart disease Am J Cardiol 2015 116 1798 801 26611120
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In the paper
“Glycemic control improved in all groups.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.4. Ezetimibe or statins and berberine with silymarin
What the sources say
- Not checked yetcites [291] Di Pierro F Bellone I Rapacioli G Putignano P Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins Diabetes Metab Syndr Obes 2015 8 89 96 25678808 PMC4322873
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In the paper
“Combinations of lipid-lowering nutraceuticals could improve their safety (reducing the dosages of the single components), but their efficacy has been rarely tested in more than one study/RCT, while some of the tested nutraceutical combinations contained underdosed components.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
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In the paper
“Furthermore, in a report from the CTT Collaboration on more than 170 000 subjects, it was stated that with the cholesterol-lowering drug therapy, each further reduction of LDL-C by 1 mmol/l (~40 mg/dl) decreased by about one-fifth the risk of revascularization, coronary artery disease and ischemic stroke”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.2. The importance of treating dyslipidemia to reduce cardiovascular risk
What the sources say
- Not checked yetcites [13] Baigent C Blackwell L Emberson J Cholesterol Treatment Trialists’ (CTT) Collaboration Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials Lancet 2010 376 1670 81 21067804 PMC2988224
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In the paper
“but their use seems to be cost-effective only for a limited number of patients [41].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [41] Banach M Aronow WS Serban MC Rysz J Voroneanu L Covic A Lipids, blood pressure and kidney update 2015 Lipids Health Dis 2015 14 167 26718096 PMC4696333
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In the paper
“Therefore, nutraceuticals might cost-effectively fill these gaps.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
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In the paper
“Furthermore, a relatively large amount of epidemiological and clinical data supports the tolerability and safety of many nutraceuticals with demonstrated lipid-lowering action, including in patients intolerant to statins [34].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [34] Cicero AF Fogacci F Colletti A Food and plant bioactives for reducing cardiometabolic disease risk: an evidence based approach Food Funct 2017 8 2076 88 28541356
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In the paper
“The recent 2016 European guidelines for dyslipidemia management consider the possibility to use some lipid-lowering nutraceuticals, not considering fully a number of prospective and observational studies as well as a positive meta-analysis of randomized clinical trials (RCTs) supporting the possible use of a relatively large number of natural compounds [18].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [18] Catapano AL Graham I De Backer G Authors/Task Force Members 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR) Atherosclerosis 2016 253 281 344 27594540
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In the paper
“Moreover, LDL-C remains a fundamental CV risk factor (and a main target of therapy) even when statins are largely used in the general population [7].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.1. Cardiovascular disease and dyslipidemia: prevalence and global economic impact
What the sources say
- Not checked yetcites [7] Colantonio LD Bittner V Reynolds K Association of serum lipids and coronary heart disease in contemporary observational studies Circulation 2016 133 256 64 26659948 PMC4718875
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In the paper
“Moreover, it has been estimated that every 1% reduction in LDL-C level corresponds to a reduction of the relative risk for CV events greater than about 1% [14, 15].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.2. The importance of treating dyslipidemia to reduce cardiovascular risk
What the sources say
- Not checked yetcites [14] Heart Protection Study Collaborative Group MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial Lancet 2002 360 7 22
- Not checked yetcites [15] Shepherd J Blauw GJ Murphy MB PROSPER Study Group Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial Lancet 2002 360 1623 30 12457784
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In the paper
“and that statin intolerance represents one of the main reasons for statin discontinuation and non-adherence and consequently failure of lipid-lowering treatment [37–39].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [37] Reiner Ž Resistance and intolerance to statins Nutr Metab Cardiovasc Dis 2014 24 1057 66 24996502
- Not checked yetcites [38] Banach M Rizzo M Toth PP Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel Arch Med Sci 2015 11 1 23 25861286 PMC4379380
- Not checked yetcites [39] Patel J Martin SS Banach M Expert opinion: the therapeutic challenges faced by statin intolerance Expert Opin Pharmacother 2016 17 1497 507 27254275
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In the paper
“Based on current knowledge, nutraceuticals could exert significant lipid-lowering activity, and their intake has many advantages.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
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In the paper
“Elevated triglycerides (TGs) are also an independent risk factor for CVD”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.3. Lipid targets
What the sources say
- Not checked yetcites [19] Reiner Ž Hypertriglyceridemia and risk of coronary artery disease Nat Rev Cardiol 2017 3 16 [Epub ahead of print] 10.1038/nrcardio.2017.3 28300080
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“highlighting that a reduction of LDL-C of 3.2 mmol/l (125 mg/dl) could lead to a decrease in risk of about 40–50%”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.2. The importance of treating dyslipidemia to reduce cardiovascular risk
What the sources say
- Not checked yetcites [13] Baigent C Blackwell L Emberson J Cholesterol Treatment Trialists’ (CTT) Collaboration Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials Lancet 2010 376 1670 81 21067804 PMC2988224
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“First of all, the lipid-lowering effect of most nutraceuticals occurs through multiple mechanisms: the possibility of acting simultaneously on multiple stages of lipid-induced vascular damage makes them potential candidates for improving the lipid-lowering effects when used in combination with diet, drugs or other nutraceuticals [32].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [32] Sahebkar A Serban MC Gluba-Brzózka A Lipid-modifying effects of nutraceuticals: an evidence-based approach Nutrition 2016 32 1179 92 27324061
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In the paper
“an amount that, if maintained over a long period, may result in meaningful CVD risk reduction [5, 26, 27].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.4. Lifestyle improvement
What the sources say
- Not checked yetcites [5] National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report Circulation 2002 106 3143 421 12485966
- Not checked yetcites [26] Appel LJ Sacks FM Carey VJ OmniHeart Collaborative Research Group Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial JAMA 2005 294 2455 64 16287956
- Not checked yetcites [27] Brown MS Goldstein JL Biomedicine. Lowering LDL – not only how low, but how long? Science 2006 311 1721 31 16556829
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In the paper
“LDL-C (and non-HDL-C) reductions with lifestyle improvements are most often in the range of 5% to 15%”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.4. Lifestyle improvement
What the sources say
- Not checked yetcites [5] National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report Circulation 2002 106 3143 421 12485966
- Not checked yetcites [26] Appel LJ Sacks FM Carey VJ OmniHeart Collaborative Research Group Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial JAMA 2005 294 2455 64 16287956
- Not checked yetcites [27] Brown MS Goldstein JL Biomedicine. Lowering LDL – not only how low, but how long? Science 2006 311 1721 31 16556829
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In recent years, nutraceuticals and functional foods have shown their role as possible supporting therapies for lowering plasma TC, LDL-C and TG, especially for hypercholesterolemic subjects, whose blood cholesterol level is moderately elevated”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [30] Chen ZY Jiao R Ma KY Cholesterol-lowering nutraceuticals and functional foods J Agric Food Chem 2008 56 8761 73 18778072
- Not checked yetcites [31] Cicero AF Colletti A Role of phytochemicals in the management of metabolic syndrome Phytomedicine 2016 23 1134 44 26778479
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In the paper
“According to the European Atherosclerosis Society (EAS) consensus document, in the last 10 years a number of observational studies have reported unfavorable side effects related to statins, in particular musculoskeletal disorders (statin-associated muscle symptoms (SAMS)), gastrointestinal disorders and fatigue [35].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [35] Stroes ES Thompson PD Corsini A European Atherosclerosis Society Consensus Panel Statin-associated muscle symptoms: impact on statin therapy – European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management Eur Heart J 2015 36 1012 22 25694464 PMC4416140
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In the paper
“Many available clinical trials and meta-analyses have shown a relationship between a decrease in the levels of LDL-C and a reduction in relative risk of CVD [12].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.2. The importance of treating dyslipidemia to reduce cardiovascular risk
What the sources say
- Not checked yetcites [12] Hobbs FD Banach M Mikhailidis DP Malhotra A Capewell S Is statin-modified reduction in lipids the most important preventive therapy for cardiovascular disease? A pro/con debate BMC Med 2016 14 4 26769594 PMC4714436
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In particular, a meta-analysis of the Cholesterol Treatment Trialists’ (CTT) Collaboration, based on data from 14 randomized controlled trials (RCTs), which involved 90 056 individuals, demonstrated a greater reduction in coronary and vascular events, which was related to a greater decrease in absolute levels of LDL-C [10].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.2. The importance of treating dyslipidemia to reduce cardiovascular risk
What the sources say
- Not checked yetcites [10] Baigent C Keech A Kearney PM Cholesterol Treatment Trialists’ (CTT) Collaborators Efficacy and safety of cholesterol-lowering treatment: prospective metaanalysis of data from 90,056 participants in 14 randomised trials of statins Lancet 2005 366 1267 78 16214597
boostedcorrelationaln = 90,056- Asserted: passes — The authors put it forward as true.
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In the paper
“With random-effect meta-regression, a significant dose-response relationship was found between doses (3–20.4 g/day) and total cholesterol or LDL-C changes.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [59] Wei ZH Wang H Chen XY Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials Eur J Clin Nutr 2009 63 821 7 18985059
plaincorrelationaln = 687- Asserted: passes — The authors put it forward as true.
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In the paper
“However, psyllium has shown no significant effects on vascular function [63].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [63] Pal S Khossousi A Binns C Dhaliwal S Radavelli-Bagatini S The effects of 12-week psyllium fibre supplementation or healthy diet on blood pressure and arterial stiffness in overweight and obese individuals Br J Nutr 2012 107 725 34 21787454
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, psyllium showed good efficacy also in children and adolescents, with the percentage of LDL-C reduction similar to the one in adults [60].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [60] Ribas SA Cunha DB Sichieri R Santana da Silva LC Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial Br J Nutr 2015 113 134 41 25391814
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“For the last several years, some studies have focused on the lipid-lowering properties of soluble fibers, including pectin, guar gum, mucilage, oats and psyllium, showing a reduction in TC and LDL-C [51, 52].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [51] Brown L Rosner B Willett WW Sacks FM Cholesterol-lowering effects of dietary fiber: a meta-analysis Am J Clin Nutr 1999 69 30 42 9925120
- Not checked yetcites [52] Doi K Effect of konjac fibre (glucomannan) on glucose and lipids Eur J Clin Nutr 1995 49 Suppl 3 S190 7 8549522
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In the paper
“The increase of plasma levels of sitosterol and campesterol showed a dose-dependent trend: in fact, in the subgroup analysis a “high dose” of PS (2.0 to 3.2 g/day) showed the highest levels of sitosterol and campesterol (on average 3.56 and 7.64 μmol/l, respectively).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“A meta-analysis of 21 studies, which enrolled a total of 1030 and 687 subjects receiving psyllium or placebo, respectively, concluded that compared with placebo, consumption of psyllium lowered serum LDL-C by 0.278 mmol/l (10.8 mg/dl) (95% CI: 0.213; 0.312 mmol/l).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [59] Wei ZH Wang H Chen XY Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials Eur J Clin Nutr 2009 63 821 7 18985059
plaindirectn = 1,030- Asserted: passes — The authors put it forward as true.
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In the paper
“in general, plant sterols have higher bioavailability than stanols, probably due to a different arrangement in the intestinal micelles [44, 45].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
- Not checked yetcites [45] Ferguson JJ Stojanovski E MacDonald-Wicks L Garg ML Fat type in phytosterol products influence their cholesterol-lowering potential: a systematic review and meta-analysis of RCTs Prog Lipid Res 2016 64 16 29 27497855
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In the paper
“A meta-analysis of 17 RCTs with 916 patients showed that β-glucan consumption in a hypercholesterolemic population significantly reduced LDL-C (–0.21 mmol/l (8.1 mg/dl) (95% CI: 0.27; –0.14) p < 0.00001).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [53] Zhu X Sun X Wang M Quantitative assessment of the effects of beta-glucan consumption on serum lipid profile and glucose level in hypercholesterolemic subjects Nutr Metab Cardiovasc Dis 2015 25 714 23 26026211
plaindirectn = 916- Asserted: passes — The authors put it forward as true.
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In the paper
“According to the American and European guidelines for the management of dyslipidemia, the consumption of 5–15 g/day (European guidelines) or 10–25 g/day (US guidelines) of soluble fibers derived from oat rich in β-glucan can essentially reduce the levels of cholesterol in the blood [55, 56].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [55] Reiner Z Catapano A De Backer G The task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). ESC/EAS guidelines for the management of dyslipidaemias Eur Heart J 2011 32 1769 818 21712404
- Not checked yetcites [56] Cleeman J Grundy S Becker D Clark L Expert panel on Detection, Evaluation and Treatment of High blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP III) JAMA 2001 285 2486 97 11368702
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The effect of PS on endothelial function has been recently investigated in two large RCTs that furnished conflicting results [49, 50].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [49] Ras RT Fuchs D Koppenol WP The effect of a low-fat spread with added plant sterols on vascular function markers: results of the Investigating Vascular Function Effects of Plant Sterols (INVEST) study Am J Clin Nutr 2015 101 733 41 25809853 PMC4381780
- Not checked yetcites [50] Gylling H Halonen J Lindholm H The effects of plant stanol ester consumption on arterial stiffness and endothelial function in adults: a randomised controlled clinical trial BMC Cardiovasc Disord 2013 13 50 23841572 PMC3717082
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“All available clinical trials and meta-analyses confirm the good safety profile of psyllium (at doses up to 20 g/day)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [64] Anderson JW Allgood LD Lawrence A Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials Am J Clin Nutr 2000 71 472 9 10648260
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“A recent meta-analysis including 14 RCTs with 531 patients concluded that the use of glucomannan (at doses ranging between 1.24 and 15.1 g/day) significantly reduces LDL-C and TG respectively by –0.41 mmol/l (15.9 mg/dl) and –0.13 mmol/l (11.5 mg/dl) (p < 0.05 for both) compared to placebo.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [66] Sood N Baker WL Coleman CI Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis Am J Clin Nutr 2008 88 1167 75 18842808
plaindirectn = 531 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“but also an average increase in levels of sitosterol 2.24 μmol/l (+31%) and campesterol 5.00 μmol/l (+37%) compared to controls [44].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
plaindirectn = 2,084- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“but has no effect on flow-mediated dilatation (FMD) [57].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [57] Tabesh F Sanei H Jahangiri M The effects of beta-glucan rich oat bread on serum nitric oxide and vascular endothelial function in patients with hypercholesterolemia Biomed Res Int 2014 2014 481904 25025057 PMC4082950
plainn = 60- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The reduction of cholesterol was more pronounced in American subjects with hypercholesterolemia, who consumed a high-fat diet (LDL-C –8/20%) [61].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [61] Anderson JW Zettwoch N Feldman T Tietyen-Clark J Oeltgen P Bishop CW Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic men Arch Intern Med 1988 148 292 6 3277558
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“As a result, PS have extremely low bioavailability (0.5–2% rapidly excreted by the liver vs. 55–60% of exogenous cholesterol)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
- Not checked yetcites [45] Ferguson JJ Stojanovski E MacDonald-Wicks L Garg ML Fat type in phytosterol products influence their cholesterol-lowering potential: a systematic review and meta-analysis of RCTs Prog Lipid Res 2016 64 16 29 27497855
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Psyllium supplementation might also have a positive effect on glucose metabolism related parameters [62].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [62] Gibb RD McRorie JW Jr Russell DA Hasselblad V D’Alessio DA Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus Am J Clin Nutr 2015 102 1604 14 26561625
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“In conclusion, PS produce a mean reduction of LDL-C by 8–12% in subjects with hypercholesterolemia.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
- Not checked yetcites [50] Gylling H Halonen J Lindholm H The effects of plant stanol ester consumption on arterial stiffness and endothelial function in adults: a randomised controlled clinical trial BMC Cardiovasc Disord 2013 13 50 23841572 PMC3717082
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“However, there were no significant differences in HDL-C and TG.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [53] Zhu X Sun X Wang M Quantitative assessment of the effects of beta-glucan consumption on serum lipid profile and glucose level in hypercholesterolemic subjects Nutr Metab Cardiovasc Dis 2015 25 714 23 26026211
plainn = 916- Asserted: passes — The authors put it forward as true.
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In the paper
“No adverse effects were reported among the eligible trials [53].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [53] Zhu X Sun X Wang M Quantitative assessment of the effects of beta-glucan consumption on serum lipid profile and glucose level in hypercholesterolemic subjects Nutr Metab Cardiovasc Dis 2015 25 714 23 26026211
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“PS could also have some impact on TG but only in patients with high TG levels at baseline [46].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [46] Demonty I Ras RT van der Knaap HC The effect of plant sterols on serum triglyceride concentrations is dependent on baseline concentrations: a pooled analysis of 12 randomised controlled trials Eur J Nutr 2013 52 153 60 22252793 PMC3549411
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“It also increases the activity of 7α-hydroxylase, an enzyme that converts cholesterol into bile acids [65].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [65] Behera SS Ray RC Konjac glucomannan, a promising polysaccharide of Amorphophallus konjac K. Koch in health care Int J Biol Macromol 2016 92 942 56 27481345
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Another meta-analysis of RCTs showed that two of the best fat carriers for PS are rapeseed or canola because of their high content of monounsaturated fatty acids and ω-3 that enhances the functionality of PS [45].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [45] Ferguson JJ Stojanovski E MacDonald-Wicks L Garg ML Fat type in phytosterol products influence their cholesterol-lowering potential: a systematic review and meta-analysis of RCTs Prog Lipid Res 2016 64 16 29 27497855
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Following an average intake of psyllium of 10 g/day, an average reduction of LDL-C of 7% was observed [59].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [59] Wei ZH Wang H Chen XY Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials Eur J Clin Nutr 2009 63 821 7 18985059
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“PS reduce LDL-C by decreasing intestinal absorption of exogenous cholesterol, competing with it in the formation of solubilized micelles [44, 45].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
- Not checked yetcites [45] Ferguson JJ Stojanovski E MacDonald-Wicks L Garg ML Fat type in phytosterol products influence their cholesterol-lowering potential: a systematic review and meta-analysis of RCTs Prog Lipid Res 2016 64 16 29 27497855
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, total PS level remained below 1% of total sterols and stanols circulating in the blood [44].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Finally, the study of Tabesh et al. showed that the consumption of β-glucan for 4 weeks in 60 patients with hypercholesterolemia increases the serum levels of nitric oxide (NO) (p = 0.017)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [57] Tabesh F Sanei H Jahangiri M The effects of beta-glucan rich oat bread on serum nitric oxide and vascular endothelial function in patients with hypercholesterolemia Biomed Res Int 2014 2014 481904 25025057 PMC4082950
plaindirectn = 60 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“At doses up to 3 g/day there were no differences in efficacy on cholesterolemia, between stanols and sterols [48].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [48] Talati R Sobieraj DM Makanji SS Phung OJ Coleman CI The comparative efficacy of plant sterols and stanols on serum lipids: a systematic review and meta-analysis J Am Diet Assoc 2010 110 719 26 20430133
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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In the paper
“Moreover, PS supplementation has a mild but significant improving effect on high-sensitivity C-reactive protein (hs-CRP) [47].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [47] Athyros VG Kakafika AI Papageorgiou AA Effect of a plant stanol ester-containing spread, placebo spread, or Mediterranean diet on estimated cardiovascular risk and lipid, inflammatory and haemostatic factors Nutr Metab Cardiovasc Dis 2011 21 213 21 19939653
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“The chronic ingestion of citrinin is nephrotoxic in various animal species, gradually leading to hyperplasia of the renal tubular epithelium, renal adenomas and in some cases to renal tumors”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [97] Arai M Hibino T Tumorigenicity of citrinin in male F344 rats Cancer Lett 1983 17 281 7 6831385
- Not checked yetcites [98] Chan WH Shiao NH Effect of citrinin on mouse embryonic development in vitro and in vivo Reprod Toxicol 2007 24 120 5 17572064
- Not checked yetcites [99] Singh ND Sharma AK Dwivedi P Patil RD Kumar M Experimentally induced citrinin and endosulfan toxicity in pregnant Wistar rats: histopathological alterations in liver and kidneys of fetuses J Appl Toxicol 2008 28 901 7 18493935
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“which was not different from moderate-intensity statins (pravastatin 40 mg, simvastatin 10 mg, lovastatin 20 mg) (0.003 mmol/l; –0.36; 0.41) (0.12 mg/dl).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [89] Gerards MC Terlou RJ Yu H Koks CH Gerdes VE Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis Atherosclerosis 2015 240 415 23 25897793
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A small increase of HDL-C (0.007 mmol/l; 0.03; 0.11) (0.3 mg/dl) and decrease of TG (–0.26 mmol/l; –0.35; –0.17) (23 mg/dl) compared to placebo was observed.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [89] Gerards MC Terlou RJ Yu H Koks CH Gerdes VE Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis Atherosclerosis 2015 240 415 23 25897793
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The abovementioned results have been confirmed in a further study by the same authors on a larger sample of 120 hypercholesterolemic children [70].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [70] Martino F Puddu PE Pannarale G Low dose chromium-polynicotinate or policosanol is effective in hypercholesterolemic children only in combination with glucomannan Atherosclerosis 2013 228 198 202 23453352
plaindirectn = 120- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The results showed a significant reduction in LDL-C (–7.3%, p = 0.008) and non-HDL-C (–7.2%, p = 0.002) compared to placebo.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [68] Guardamagna O Abello F Cagliero P Visioli F Could dyslipidemic children benefit from glucomannan intake? Nutrition 2013 29 1060 5 23759268
plaindirectn = 36 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A recent meta-analysis including 14 RCTs with 531 patients concluded that the use of glucomannan (at doses ranging between 1.24 and 15.1 g/day) significantly reduces LDL-C and TG respectively by –0.41 mmol/l (15.9 mg/dl) and –0.13 mmol/l (11.5 mg/dl) (p < 0.05 for both) compared to placebo.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [66] Sood N Baker WL Coleman CI Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis Am J Clin Nutr 2008 88 1167 75 18842808
plaindirectn = 531 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The EFSA has established as 0.2 μg/kg b.w. per day the highest quantity of citrinin which can be taken by humans with no nephrotoxic effects [100].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [100] EFSA, Scientific Opinion on the risks for public and animal health related to the presence of citrinin in food and feed. EFSA Panel on Contaminants in the Food Chain (CONTAM). European Food Safety Authority (EFSA), Parma, Italy EFSA J 2012 10 2605
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Side effects were not significantly different between the groups [93].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [93] DFG Permanent Senate Commission on Food Safety Toxicological evaluation of red mould rice: an update 2012
plainn = 1,445- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“RYR supplementation has shown relevant efficacy in reducing CVD risk in adult and elderly patients in secondary prevention [92].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [92] Zhao SP Liu L Cheng YC Xuezhikang, an extract of cholestin, protects endothelial function through antiinflammatory and lipid-lowering mechanisms in patients with coronary heart disease Circulation 2004 110 915 20 15313947
boosteddirectn = 1,445 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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In the paper
“There were no cases of rhabdomyolysis or myopathy with CK levels increased more than 10 times the upper limit [89].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [89] Gerards MC Terlou RJ Yu H Koks CH Gerdes VE Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis Atherosclerosis 2015 240 415 23 25897793
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In a subgroup analysis, the maximum reduction in LDL-C was obtained in studies that included hypercholesterolemic subjects, with higher levels of cholesterol at baseline [81].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [81] Cho YA Kim J Effect of probiotics on blood lipid concentrations: a meta-analysis of randomized controlled trials Medicine 2015 94 e1714 26512560 PMC4985374
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Since other trials have yielded conflicting results with a significant reduction of all lipid parameters [72]”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.3. Chitosan
What the sources say
- Not checked yetcites [72] Rizzo M Giglio RV Nikolic D Effects of chitosan on plasma lipids and lipoproteins: a 4-month prospective pilot study Angiology 2014 65 538 42 23785043
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The results showed that (after 2–24 months) RYR reduced LDL-C on average by 1.02 mmol/l (–1.20; –0.83) (39.4 mg/dl) compared to placebo”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [89] Gerards MC Terlou RJ Yu H Koks CH Gerdes VE Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis Atherosclerosis 2015 240 415 23 25897793
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The same author highlighted the beneficial effect on blood pressure of garlic [105]”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.2. Garlic (Allium sativum)
What the sources say
- Not checked yetcites [105] Ried K Garlic lowers blood pressure in hypertensive individuals, regulates serum cholesterol, and stimulates immunity: an updated meta-analysis and review J Nutr 2016 146 389S 396S 26764326
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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In the paper
“These effects had a more pronounced trend in females than in males [68].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [68] Guardamagna O Abello F Cagliero P Visioli F Could dyslipidemic children benefit from glucomannan intake? Nutrition 2013 29 1060 5 23759268
plaincorrelationaln = 36- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“the EFSA has expressed a scientific opinion on the substantiation of health claims about the relationship between administration of RYR and the maintenance of plasma LDL-C levels – the relationship is possible using a dose of RYR which contains 10 mg of MonK (maximum daily dose in Europe as dietary supplement) [101].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [101] EFSA, Scientific Opinion on the substantiation of health claims related to monacolin K from red yeast rice and maintenance of normal blood LDL-cholesterol concentrations (ID 1648, 1700) pursuant to Article 13(1) of Regulation (EC) No 1924/20061; EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA), European Food Safety Authority (EFSA), Parma, Italy EFSA J 2011 9 2304
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“According to a recent meta-analysis of RCTs, garlic seems not to have any effect on lipoprotein (a) (Lp(a)) level [107].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.2. Garlic (Allium sativum)
What the sources say
- Not checked yetcites [107] Sahebkar A Serban C Ursoniu S Banach M Effect of garlic on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of randomized controlled clinical trials Nutrition 2016 32 33 40 26522661
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“and an improvement in insulin-resistance related parameters [74].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.3. Chitosan
What the sources say
- Not checked yetcites [74] Kim HJ Ahn HY Kwak JH The effects of chitosan oligosaccharide (GO2KA1) supplementation on glucose control in subjects with prediabetes Food Funct 2014 10 2662 9 25222285
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“RYR also improves endothelial function in humans.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [92] Zhao SP Liu L Cheng YC Xuezhikang, an extract of cholestin, protects endothelial function through antiinflammatory and lipid-lowering mechanisms in patients with coronary heart disease Circulation 2004 110 915 20 15313947
plaindirectn = 50 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“the incidence of cases of liver abnormalities and kidney injury was between 0 and 5% in both groups (RYR and control).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [89] Gerards MC Terlou RJ Yu H Koks CH Gerdes VE Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis Atherosclerosis 2015 240 415 23 25897793
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“However, chitosan supplementation is associated with mild weight loss [73]”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.3. Chitosan
What the sources say
- Not checked yetcites [73] Jull AB Ni Mhurchu C Bennett DA Dunshea-Mooij CA Rodgers A Chitosan for overweight or obesity Cochrane Database Syst Rev 2008 3 CD003892 PMC12547488 18646097
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“A recent meta-analysis included 30 RCTs to investigate the effect of probiotics on TC, HDL-C and TG and 27 RCTs on LDL-C.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [81] Cho YA Kim J Effect of probiotics on blood lipid concentrations: a meta-analysis of randomized controlled trials Medicine 2015 94 e1714 26512560 PMC4985374
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Guardamagna et al. conducted a study with 36 dyslipidemic children (6–15 years old) treated with glucomannan twice daily for 8 weeks. The results showed a significant reduction in LDL-C (–7.3%, p = 0.008) and non-HDL-C (–7.2%, p = 0.002) compared to placebo.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [68] Guardamagna O Abello F Cagliero P Visioli F Could dyslipidemic children benefit from glucomannan intake? Nutrition 2013 29 1060 5 23759268
plaindirectn = 36 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“The pooled mean net change in LDL-C was –0.19 mmol/l (7.35 mg/dl) (p < 0.01) compared to controls.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [81] Cho YA Kim J Effect of probiotics on blood lipid concentrations: a meta-analysis of randomized controlled trials Medicine 2015 94 e1714 26512560 PMC4985374
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To date, the clinical findings are still not sufficient to recommend probiotics as a nonpharmacologic alternative to improve the lipid profile.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The cited meta-analyses and RCTs are of sufficient methodological quality and their results are valid for the populations studied.
- Rests on an assumption: The effects of nutraceuticals observed in trials generalize to clinical practice in the broader patient populations for whom they are recommended.
In the paper
“The same correlation was also found in the study of Martino et al., where 40 children were treated with 2–3 g/day of glucomannan and benefited by a reduction of LDL-C of 30% in females and 9% in males (p = 0.046).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [69] Martino F Martino E Morrone F Carnevali E Forcone R Niglio T Effect of dietary supplementation with glucomannan on plasma total cholesterol and low density lipoprotein cholesterol in hypercholesterolemic children Nutr Metab Cardiovasc Dis 2005 15 174 80 15955465
plaindirectn = 40 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“In fact it has been clearly shown that the safety profile of RYR is similar to that of low-dose statins [90].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [90] Mazzanti G Moro PA Raschi E Da Cas R Menniti-Ippolito F Adverse reactions to dietary supplements containing red yeast rice: assessment of cases from the Italian surveillance system Br J Clin Pharmacol 2017 1 17 [Epub ahead of print] 10.1111/bcp.13171 PMC5346868 28093797
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“A small increase of HDL-C (0.007 mmol/l; 0.03; 0.11) (0.3 mg/dl) and decrease of TG (–0.26 mmol/l; –0.35; –0.17) (23 mg/dl) compared to placebo was observed.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [89] Gerards MC Terlou RJ Yu H Koks CH Gerdes VE Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis Atherosclerosis 2015 240 415 23 25897793
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Transient side effects such as abdominal pain, diarrhea, vomiting, and constipation occur in rare cases at doses ranging between 1 and 6 g/day (indicative daily doses) [75].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.3. Chitosan
What the sources say
- Not checked yetcites [75] Mhurchu CN Poppitt S McGill A The effect of the dietary supplement, chitosan, on body weight: a randomised controlled trial in 250 overweight and obese adults Int J Obes 2004 28 1149 56 15311218
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“the incidence of developing muscular symptoms was lower in RYR groups (0 to 23.8%) compared to control groups (0–36%).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [89] Gerards MC Terlou RJ Yu H Koks CH Gerdes VE Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis Atherosclerosis 2015 240 415 23 25897793
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“but they could not prove any significant improvements in either HDL-C or TG [83].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [83] Shimizu M Hashiguchi M Shiga T Tamura HO Mochizuki M Meta-analysis: effects of probiotic supplementation on lipid profiles in normal to mildly hypercholesterolemic individuals PLoS One 2015 10 e0139795 26473340 PMC4608827
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“No significant differences were detected in the levels of aspartate transaminase (AST), alanine transaminase (ALT), and creatinine in comparison to the control group [140].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [140] Sosnowska B Penson P Banach M The role of nutraceuticals in the prevention of cardiovascular disease Cardiovasc Diagn Ther 2017 7 Suppl 1 S21 31 28529919 PMC5418215
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, the groups treated with BPF (either alone or in combination) experienced a reduction of some biomarkers of vascular oxidative damage including malonyldialdehyde (MDA; one of the major aldehydes formed during lipid peroxidation) and oxidized LDLs [120].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [120] Gliozzi M Walker R Muscoli S Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia Int J Cardiol 2013 170 140 5 24239156
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“In a further 16-week triple-blinded RCT carried out on mildly hypercholesterolemic subjects pantethine 600–900 mg/day reduced LDL-C level by 11% [115].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Pantethine
What the sources say
- Not checked yetcites [115] Evans M Rumberger JA Azumano I Napolitano JJ Citrolo D Kamiya T Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol in low to moderate cardiovascular risk subjects eligible for statin therapy: a triple-blinded placebo and diet-controlled investigation Vasc Health Risk Manag 2014 10 89 100 24600231 PMC3942300
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Second, BBR acts directly on the expression of LDLR via two identified mechanisms, causing up-regulation of the receptors through a post-transcriptional mechanism that stabilizes their mRNA (activation of extracellular signal regulated kinases (ERK) and Jun amino-terminal kinase (JNK)-dependent pathways) [131, 132].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [131] Abidi P Zhou Y Jiang JD Liu J Extracellular signal-regulated kinase-dependent stabilization of hepatic low-density lipoprotein receptor mRNA by herbal medicine berberine Arterioscler Thromb Vasc Biol 2005 25 2170 6 16100034
- Not checked yetcites [132] Li H Dong B Park SW Lee HS Chen W Liu J Hepatocyte nuclear factor 1alpha plays a critical role in PCSK9 gene transcription and regulation by the natural hypocholesterolemic compound berberine J Biol Chem 2009 284 28885 95 19687008 PMC2781434
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Neither policosanols from rice nor wheat germ showed any significant effect on LDL-C, HDL-C, TG, oxLDL, apoB, Lp(a), homocysteine, CRP, fibrinogen or blood coagulation factors [128, 129].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.4. Policosanols
What the sources say
- Not checked yetcites [128] Reiner Ž Tedeschi-Reiner E Romić Ž Effects of rice policosanol on serum lipoproteins, homocysteine, fibrinogen and C-reactive protein in hypercholesterolaemic patients Clin Drug Invest 2005 25 701 7 17532716
- Not checked yetcites [129] Reiner Ž Tedeschi-Reiner E Rice policosanol does not have any effects on blood coagulation factors in hypercholesterolemic patients Coll Antropol 2007 31 315 9 18217459
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“These data were confirmed by the study of Backes et al., where policosanols did not significantly change the lipid profile of hypercholesterolemic subjects in either of the two treatment groups (treated with policosanol or policosanol in addition to statin therapy) or placebo compared to the control [127].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.4. Policosanols
What the sources say
- Not checked yetcites [127] Backes JM Gibson CA Ruisinger JF Moriarty PM Modified-policosanol does not reduce plasma lipoproteins in hyperlipidemic patients when used alone or in combination with statin therapy Lipids 2011 46 923 9 21739240
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“In a randomized cross-over study, 33 hyper-cholesterolaemic subjects (TC > 6.6 mmol/l/255 mg/dl) were included and treated for 8 weeks with 25 g/day of lupin protein isolate (LPI) followed by 4 weeks of washout and 8 weeks of treatment with milk protein isolate (MPI). Compared to baseline, a significant reduction of LDL-C was already observed in both groups after 4 weeks (–12%, p < 0.008).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [158] Bähr M Fechner A Krämer J Kiehntopf M Jahreis G Lupin protein positively affects plasma LDL cholesterol and LDL:HDL cholesterol ratio in hypercholesterolemic adults after four weeks of supplementation: a randomized, controlled crossover study Nutr J 2013 12 107 23902673 PMC3735452
plaindirectn = 33- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Group C (placebo) did not show significant reductions in serum cholesterol.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [123] Mollace V Sacco I Janda E Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies Fitoterapia 2011 82 309 16 21056640
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There are also no data on its influence on TG and HDL-C.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.2. Green tea extracts
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“It is also worth mentioning that exposure to isoflavone-containing soy products modestly, but significantly, improved endothelial function, as demonstrated in a meta-analysis of 17 RCTs [155].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [155] Beavers DP Beavers KM Miller M Stamey J Messina MJ Exposure to isoflavone-containing soy products and endothelial function: a Bayesian meta-analysis of randomized controlled trials Nutr Metab Cardiovasc Dis 2012 22 182 91 20709515
boosteddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Therefore, overall the consumption of green tea might be associated with a decreased risk of CVD morbidity and mortality [147].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.2. Green tea extracts
What the sources say
- Not checked yetcites [147] Zhang C Qin YY Wei X Yu FF Zhou YH He J Tea consumption and risk of cardiovascular outcomes and total mortality: a systematic review and meta-analysis of prospective observational studies Eur J Epidemiol 2015 30 103 13 25354990
hedgedcorrelationaln = 1,536- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The cited meta-analyses and RCTs are of sufficient methodological quality and their results are valid for the populations studied.
- Rests on an assumption: The effects of nutraceuticals observed in trials generalize to clinical practice in the broader patient populations for whom they are recommended.
In the paper
“A meta-analysis of 20 RCTs and 1536 participants showed a reduction of LDL-C (mean difference (MD): –0.19 mmol/l (7.35 mg/dl); 95% CI: –0.3; –0.09, p = 0.0004).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.2. Green tea extracts
What the sources say
- Not checked yetcites [143] Onakpoya I Spencer E Heneghan C Thompson M The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials Nutr Metab Cardiovasc Dis 2014 24 823 36 24675010
plaindirectn = 1,536- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The lipid-lowering effects of green tea were found to be greater in RCTs with longer duration.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.2. Green tea extracts
What the sources say
- Not checked yetcites [143] Onakpoya I Spencer E Heneghan C Thompson M The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials Nutr Metab Cardiovasc Dis 2014 24 823 36 24675010
plaincorrelationaln = 1,536- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“If isoflavones seem not to add significantly to the lipid-lowering effect of soy proteins”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, green tea extract exerts a mild but significant antihypertensive effect.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.2. Green tea extracts
What the sources say
- Not checked yetcites [143] Onakpoya I Spencer E Heneghan C Thompson M The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials Nutr Metab Cardiovasc Dis 2014 24 823 36 24675010
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In addition, both groups showed a reduction in the levels of interleukin 6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) (p < 0.05 for each), as well as hs-CRP, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and matrix metallopeptidase 9 (MMP-9) (p < 0.001 for all) compared to baseline.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [137] Meng S Wang LS Huang ZQ Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention Clin Exp Pharmacol Physiol 2012 39 406 11 22220931
plaindirectn = 130 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The mean tested dose was 30 g/day.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [154] Tokede OA Onabanjo TA Yansane A Gaziano JM Djoussé L Soya products and serum lipids: a meta-analysis of randomised controlled trials Br J Nutr 2015 114 831 43 26268987
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“first, it is an inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9) through the ubiquitination and degradation of hepatocyte nuclear factor 1α (HNF-1α), causing increased levels and limited degradation of the hepatic LDL receptor (LDLR).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [131] Abidi P Zhou Y Jiang JD Liu J Extracellular signal-regulated kinase-dependent stabilization of hepatic low-density lipoprotein receptor mRNA by herbal medicine berberine Arterioscler Thromb Vasc Biol 2005 25 2170 6 16100034
- Not checked yetcites [132] Li H Dong B Park SW Lee HS Chen W Liu J Hepatocyte nuclear factor 1alpha plays a critical role in PCSK9 gene transcription and regulation by the natural hypocholesterolemic compound berberine J Biol Chem 2009 284 28885 95 19687008 PMC2781434
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the most recent meta-analysis of 10 RCTs with 925 patients Mazidi et al. showed significant reduction of serum CRP and TNF-α concentrations following L-carnitine administration (–0.60 mg/l (5.71 nmol/l), 95% CI: –0.87 to –0.32, and –0.36 pg/dl, 95% CI: –0.56 to –0.15, respectively) [207].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.5. L-carnitine
What the sources say
- Not checked yetcites [207] Mazidi M Rezaie P Banach M Impact of L-carnitine on C-reactive proteIn: a systematic review and meta-analysis of 10 randomized control trials with 925 patients 2017 7 Presentation at 2nd CPPEI Congress in Vienna (data unpublished)
plaindirectn = 925- Asserted: passes — The authors put it forward as true.
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In the paper
“Similar data were obtained by Cicero et al. [175].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [175] Cicero AF Rosticci M Morbini M Lipid-lowering and anti-inflammatory effects of omega 3 ethyl esters and krill oil: a randomized, cross-over, clinical trial Arch Med Sci 2016 12 507 12 27279841 PMC4889684
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The meta-analysis of Eslick et al. included 47 RCTs with 16 511 participants with hypercholesterolemia to assess the effects of the average daily dose of 3.25 g of EPA/DHA for 24 weeks. The results showed a significant reduction in TG of 14% (–0.34 mmol/l (30.12 mg/dl), 95% CI: –0.41; –0.27).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [166] Eslick GD Howe PR Smith C Priest R Bensoussan A Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis Int J Cardiol 2009 136 4 16 18774613
plaindirectn = 16,511- Asserted: passes — The authors put it forward as true.
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In the paper
“A recent meta-analysis of 11 RCTs showed that rice bran oil consumption resulted in a significant decrease in concentrations of LDL-C (–0.18 mmol/l (7 mg/dl), 95% CI: –0.26; –0.09, p < 0.001).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.2. γ-oryzanol
What the sources say
- Not checked yetcites [185] Jolfaie NR Rouhani MH Surkan PJ Siassi F Azadbakht L Rice bran oil decreases total and LDL cholesterol in humans: a systematic review and meta-analysis of randomized controlled clinical trials Horm Metab Res 2016 48 417 26 27311126
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In recent years the EFSA, the AHA and the Food Standards of Australia and New Zealand (FSANZ) organizations have recognized ω-3 fatty acids as preventive nutraceuticals for CVD [27].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [27] Brown MS Goldstein JL Biomedicine. Lowering LDL – not only how low, but how long? Science 2006 311 1721 31 16556829
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“A dose-dependent effect of ω-3 was also observed by Di Stasi et al. with additional benefits obtainable for lipid profile when supplementation of ω-3 was raised as high as 4.9 g/day [168].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [168] Di Stasi D Bernasconi R Marchioli R Early modifications of fatty acid composition in plasma phospholipids, platelets and mononucleates of healthy volunteers after low doses of n-3 polyunsaturated fatty acids Eur J Clin Pharmacol 2004 60 183 90 15069592
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“EFSA established a claim in 2010 indicating that the intake of at least 2 g/day of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) has the ability to maintain normal blood TG levels [162, 163].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [162] EFSA Panel on Dietetic Products NaAN Scientific Opinion on the substantiation of health claims related to eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and maintenance of normal cardiac function (ID 504, 506, 516, 527, 538, 703, 1128, 1317, 1324, 1325), maintenance of normal blood glucose concentrations (ID 566), maintenance of normal blood pressure (ID 506, 516, 703, 1317, 1324), maintenance of normal blood HDL-cholesterol concentrations (ID 506), maintenance of normal (fasting) blood concentrations of triglycerides (ID 506, 527, 538, 1317, 1324, 1325),
- Not checked yetcites [163] Howe P Mori T Buckley J Long chain omega-3 fatty acids and cardiovascular disease – FSANZ consideration of a commissioned review 2013 FSANZ PDF: http://www.foodstandards.gov.au/consumer/labelling/nutrition/documents/FSANZ%20consideration%20of%20omega-3%20review1.pdf. Last accessed: 31 March, 2017
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Flaxseed seems also to exert a mild but significant antihypertensive effect [178].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [178] Ursoniu S Sahebkar A Andrica F Serban C Banach M Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Effects of flaxseed supplements on blood pressure: a systematic review and meta-analysis of controlled clinical trial Clin Nutr 2016 35 615 25 26071633
hedgedconditional- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In conclusion, the intake of soy and lupine represents a potential, relatively weak adjuvant therapy in the treatment of hypercholesterolemia, especially in individuals with moderate cholesterol levels.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: The lipid-lowering effects of nutraceuticals observed in short-term trials translate into reduced cardiovascular risk.
In the paper
“All these effects seem to be related to the main metabolic effect of curcumin, which is an improvement of insulin resistance [200].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [200] Derosa G Limas CP Macías PC Estrella A Maffioli P Dietary and nutraceutical approach to type 2 diabetes Arch Med Sci 2014 10 336 44 24904670 PMC4042055
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Safety: Overall, no side effects have been registered with rice bran oil consumption [186].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.2. γ-oryzanol
What the sources say
- Not checked yetcites [186] Nagaoka S Shimizu K Kaneko H A novel protein C-phycocyanin plays a crucial role in the hypocholesterolemic action of Spirulina platensis concentrate in rats J Nutr 2005 135 2425 30 16177207
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, at the same dose, krill oil appears to be more effective than fish oil in the adjustment of lipid profile.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“L-carnitine has no effect on LDL-C levels, but a meta-analysis of 7 RCTs including data from 375 patients showed a significant reduction of Lp(a) levels following L-carnitine supplementation (–0.31 μmol/l (8.82 mg/dl), 95% CI: –0.36; –0.27, p < 0.001) [205].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.5. L-carnitine
What the sources say
- Not checked yetcites [205] Serban MC Sahebkar A Mikhailidis DP Impact of L-carnitine on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of randomized controlled trials Sci Rep 2016 6 19188 26754058 PMC4709689
plaindirectn = 375- Asserted: passes — The authors put it forward as true.
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In the paper
“Ulven et al. reported that the effects on the reduction of TG of a dose of 543 mg of DHA and EPA contained in krill oil are comparable to doses of 2.66 g of EPA and DHA present in fish oil [174].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [174] Ulven SM Kirkhus B Lamglait A Metabolic effects of krill oil are essentially similar to those of fish oil but at lower dose of EPA and DHA, in healthy volunteers Lipids 2011 46 37 46 21042875 PMC3024511
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Nevertheless, a rich source of ALA, the flaxseed (Linum usitatissimum, ALA = 50–62% of flaxseed oil or 22% of whole flaxseed), an oilseed crop grown on all continents, showed lipid-lowering activity regarding LDL-C (–0.08 mmol/l).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [177] Pan A Yu D Demark-Wahnefried W Franco OH Lin X Meta-analysis of the effects of flexseed interventions on blood lipids Am J Clin Nutr 2009 90 288 97 19515737 PMC3361740
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The increase in HDL-C levels was considerable only in men (0.17 mmol/l (6.6 mg/dl); 95% CI: 0.06; 0.28, p = 0.002) [185].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.2. γ-oryzanol
What the sources say
- Not checked yetcites [185] Jolfaie NR Rouhani MH Surkan PJ Siassi F Azadbakht L Rice bran oil decreases total and LDL cholesterol in humans: a systematic review and meta-analysis of randomized controlled clinical trials Horm Metab Res 2016 48 417 26 27311126
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, in the large long-term Gruppo Italiano per lo Studio della Sopravvivenza nell’ Infarto miocardico (GISSI) Prevenzione trial that involved 11 324 patients surviving recent MI, supplementation with 1 g of EPA/DHA significantly reduced the risk of CV death [172].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [172] Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico (GISSI) Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial Lancet 1999 354 447 55 10465168
plaindirectn = 11,324- Asserted: passes — The authors put it forward as true.
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In the paper
“The AHA has indicated doses from 2 to 4 g/day of EPA/DHA to reduce TG levels by 25–30% [164].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [164] Miller M Stone NJ Ballantyne C Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association Circulation 2011 123 2292 333 21502576
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Nevertheless, the results of RCTs regarding the effects of curcumin on lipid profile are still inconsistent; a meta-analysis by Sahebkar et al. showed no significant effects on LDL-C, HDL-C or TG when considering heterogeneous populations [195].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [195] Sahebkar A A systematic review and meta-analysis of randomized controlled trials investigating the effects of curcumin on blood lipid levels Clin Nutr 2014 33 406 14 24139527
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, L-carnitine seems to have a positive impact on body weight management [206].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.5. L-carnitine
What the sources say
- Not checked yetcites [206] Pooyandjoo M Nouhi M Shab-Bidar S Djafarian K Olyaeemanesh A The effect of (L-) carnitine on weight loss in adults: a systematic review and meta-analysis of randomized controlled trials Obes Rev 2016 17 970 6 27335245
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Finally curcumin consumption is also associated with an improvement in FMD [201] and PWV [202].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [201] Nakayama H Tsuge N Sawada H A single consumption of curry improved postprandial endothelial function in healthy male subjects: a randomized, controlled crossover trial Nutr J 2014 13 67 24972677 PMC4082484
- Not checked yetcites [202] Chuengsamarn S Rattanamongkolgul S Phonrat B Tungtrongchitr R Jirawatnotai S Reduction of atherogenic risk in patients with type 2 diabetes by curcuminoid extract: a randomized controlled trial J Nutr Biochem 2014 25 144 50 24445038
plaincorrelational- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Other nutraceuticals commonly cited as improving cholesterol metabolism are resveratrol and Hibiscus sabdarrifa L. (sour tea), but their lipid-lowering effects are not substantiated by available data [232, 233].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.11. Other nutraceuticals
What the sources say
- Not checked yetcites [232] Sahebkar A Serban C Ursoniu S Lipid and Blood Pressure Meta-analysis Collaboration Group Lack of efficacy of resveratrol on C-reactive protein and selected cardiovascular risk factors: results from a systematic review and meta-analysis of randomized controlled trials Int J Cardiol 2015 189 47 55 25885871
- Not checked yetcites [233] Aziz Z Wong SY Chong NJ Effects of Hibuscus sabdariffa L. on serum lipids: a systematic review and meta-analysis and meta-analysis J Ethnopharmacol 2013 150 442 50 24120746
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Epidemiological data suggest that higher dietary intakes of anthocyanins are associated with lower carotid-femoral PWV and carotid intima-media thickness [224].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.8. Anthocyanins
What the sources say
- Not checked yetcites [224] Jennings A Welch AA Fairweather-Tait SJ Higher anthocyanin intake is associated with lower arterial stiffness and central blood pressure in women Am J Clin Nutr 2012 96 781 8 22914551
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Safety: In humans, doses of tocotrienols up to 1000 mg/day have been reported as safe [220].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.7. Vitamin E
What the sources say
- Not checked yetcites [220] Sen CK Khanna S Rink C Roy S Tocotrienols: the emerging face of natural vitamin E Vitam Horm 2007 76 203 61 17628176 PMC3681510
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“The lipid-lowering mechanisms of artichoke seem to be essentially two: the interaction of luteolin with the HMG-CoA reductase enzyme and the pathways of regulation in the liver of sterol regulatory element-binding proteins (SREBPs) (paradoxically elevated in patients with non-alcoholic steatohepatitis (NASH)) and acetyl-CoA C-acetyltransferase (ACAT) [210].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
What the sources say
- Not checked yetcites [210] Rangboo V Noroozi M Zavoshy R Rezadoost SA Mohammadpoorasl A The effect of artichoke leaf extract on alanine aminotransferase and aspartate aminotransferase in the patients with nonalcoholic steatohepatitis Int J Hepatol 2016 2016 4030476 27293900 PMC4879230
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“The efficacy of the combination of red yeast rice extract (200 mg, corresponding to 3 mg of MonK) with linear aliphatic alcohols (10 mg) was also evaluated in the treatment of primary-moderate hypercholesterolemia with a placebo-controlled clinical trial on 240 patients with overall coronary risk < 20% (FRS); after 4 months a significant reduction in LDL-C (–29%) and non-HDL-C (–26%) (p < 0.001) w”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.1. Red yeast rice and policosanols
What the sources say
- Not checked yetcites [240] Stefanutti C Mazza F Vivenzio A Combined treatment with Dif1stat and diet reduce plasma lipid indicators of moderate hypercholesterolemia more effectively than diet alone: a randomized trial in parallel groups Lipids 2009 44 1141 8 19911216
plaindirectn = 240 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“The results of a small RCT suggest that CLA supplementation could impair endothelial function [231].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.10. Conjugated linoleic acid
What the sources say
- Not checked yetcites [231] Taylor JS Williams SR Rhys R James P Frenneaux MP Conjugated linoleic acid impairs endothelial function Arterioscler Thromb Vasc Biol 2006 26 307 12 16339498
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Efficacy: Data from clinical trials are however disappointing, showing minimal effects of vitamin E on lipid pattern [216].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.7. Vitamin E
What the sources say
- Not checked yetcites [216] Ajuluchukwu JN Okubadejo NU Mabayoje M Comparative study of the effect of tocotrienols and -tocopherol on fasting serum lipid profiles in patients with mild hypercholesterolaemia: a preliminary report Niger Postgrad Med J 2007 14 30 3 17356586
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“In addition to lipid-lowering effects, anthocyanins are potent antioxidants, reducing the oxidative stress and inflammation; in humans maqui berry extract significantly decreased lipid peroxidation, urinary F2-isoprostanes and inflammatory mediators [223].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.8. Anthocyanins
What the sources say
- Not checked yetcites [223] Davinelli S Bertoglio JC Zarrelli A Pina R Scapagnini G A randomized clinical trial evaluating the efficacy of an anthocyanin-Maqui Berry Extract (Delphinol®)on oxidative stress biomarkers J Am Coll Nutr 2015 34 Suppl 1 28 33 26400431
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In prospective observational studies, dietary linoleic acid (LA) intake is inversely associated with CHD risk in a dose-response manner [229].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.10. Conjugated linoleic acid
What the sources say
- Not checked yetcites [229] Farvid MS Ding M Pan A Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies Circulation 2014 130 1568 78 25161045 PMC4334131
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Therefore, in addition to improving cholesterol profile, there is potential for this combination of nutraceuticals to attenuate the degree of systemic inflammation and endothelial injury in subjects with low-grade systemic inflammation [244].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [244] Pirro M Mannarino MR Ministrini S Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial Sci Rep 2016 6 23587 27004462 PMC4804276
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“However, sour tea could have a significant blood pressure decreasing effect [234].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.11. Other nutraceuticals
What the sources say
- Not checked yetcites [234] Serban C Sahebkar A Ursoniu S Andrica F Banach M Effect of sour tea (Hibiscus sabdariffa L) on arterial hypertension: a systematic review and meta-analysis of randomized controlled trials J Hypertens 2015 33 1119 27 25875025
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Many available data, including the most recent studies with PCSK9 inhibitors, support the LDL-C concept that “lower is better” [276].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy
What the sources say
- Not checked yetcites [276] Sabatine MS Advances in the treatment of dyslipidemia Cleve Clin J Med 2016 83 181 6 26974988
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“On the other side, even with the good statin therapy tolerability, the LDL-C targeted levels might not be achieved for 30–70% of patients (depending on the risk), even in the combination with ezetimibe for high and very high risk patients [279].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy
What the sources say
- Not checked yetcites [279] Reiner Ž Combined therapy in the treatment of dyslipidemia Fundam Clin Pharmacol 2010 24 19 28 19682080
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Many nutraceutical options are available either alone or in combination with statins to help to reach recommended goals in a safe and tolerable way for most patients [280].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy
What the sources say
- Not checked yetcites [280] Cicero AF Morbini M Bove M Additional therapy for cholesterol lowering in ezetimibe-treated, statin-intolerant patients in clinical practice: results from an internal audit of a university lipid clinic Curr Med Res Opin 2016 6 8 1 6 [Epub ahead of print] 27175514
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the low lipid-lowering activity of components different from berberine, it is not clear whether the observed effects are related to berberine per se or not.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.7. Berberine combined with bioactive lipid-lowering agents other than red yeast rice
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“At the end of the treatment, subjects who received vitamin D supplementation had an increased level of serum 25-hydroxyvitamin D concentrations compared with placebo (+16.3 ±11.4 compared with +2.4 ±7.1 ng/ml; p < 0.001).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [296] Qin XF Zhao LS Chen WR Yin da W Wang H Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial Clin Nutr 2015 34 201 6 24844869
plaindirectn = 28- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Combinations of lipid-lowering nutraceuticals could improve their safety (reducing the dosages of the single components), but their efficacy has been rarely tested in more than one study/RCT, while some of the tested nutraceutical combinations contained underdosed components.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
In the paper
“Moreover, in patients with 25-hydroxyvitamin D level < 30 ng/ml at baseline (n = 43), serum TC and TG levels were further reduced by –0.74 ±0.31 mmol/l (28 mg/dl) (p < 0.001) and –0.42 ±0.22 mmol/l (37 mg/dl) (p < 0.001), respectively.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [296] Qin XF Zhao LS Chen WR Yin da W Wang H Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial Clin Nutr 2015 34 201 6 24844869
plaindirectn = 43 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is, however, important to once again emphasize that nutraceuticals cannot replace lipid-lowering therapy but might essentially help to optimize it (reducing CV residual risk).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, the differences in TC and TG levels between the statin + vitamin D group and statin + placebo group were significant: –0.57 mmol/l (22 mg/dl) (95% CI: –0.83; –0.32, p < 0.001) and –0.32 mmol/l (28.3 mg/dl) (95% CI: –0.55; –0.09, p < 0.001), respectively.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [296] Qin XF Zhao LS Chen WR Yin da W Wang H Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial Clin Nutr 2015 34 201 6 24844869
plaindirectn = 56 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is, however, important to once again emphasize that nutraceuticals cannot replace lipid-lowering therapy but might essentially help to optimize it (reducing CV residual risk).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, in patients with 25-hydroxyvitamin D level < 30 ng/ml at baseline (n = 43), serum TC and TG levels were further reduced by –0.74 ±0.31 mmol/l (28 mg/dl) (p < 0.001) and –0.42 ±0.22 mmol/l (37 mg/dl) (p < 0.001), respectively.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [296] Qin XF Zhao LS Chen WR Yin da W Wang H Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial Clin Nutr 2015 34 201 6 24844869
plaindirectn = 43 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the other hand, both single components and some combinations (in particular red yeast rice, berberine, policosanol combination) have proved to maintain their efficacy in the long term (years), to have a positive impact on CVD risk factors other than LDL-C, and to improve some markers of vascular aging (endothelial function, pulse wave velocity).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the other hand, both single components and some combinations (in particular red yeast rice, berberine, policosanol combination) have proved to maintain their efficacy in the long term (years), to have a positive impact on CVD risk factors other than LDL-C, and to improve some markers of vascular aging (endothelial function, pulse wave velocity).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These results support the use of stanol ester with only moderate doses of statin and resin to control LDL-C levels in hypercholesterolemic patients [293].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.5. Statins/ezetimibe and plant sterols
What the sources say
- Not checked yetcites [293] Gylling H Miettinen TA LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects Nutr Metab Cardiovasc Dis 2002 12 19 23 12125225
plaindirectn = 11 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the other hand, both single components and some combinations (in particular red yeast rice, berberine, policosanol combination) have proved to maintain their efficacy in the long term (years), to have a positive impact on CVD risk factors other than LDL-C, and to improve some markers of vascular aging (endothelial function, pulse wave velocity).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, the differences in TC and TG levels between the statin + vitamin D group and statin + placebo group were significant: –0.57 mmol/l (22 mg/dl) (95% CI: –0.83; –0.32, p < 0.001) and –0.32 mmol/l (28.3 mg/dl) (95% CI: –0.55; –0.09, p < 0.001), respectively.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [296] Qin XF Zhao LS Chen WR Yin da W Wang H Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial Clin Nutr 2015 34 201 6 24844869
plaindirectn = 56 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The higher (2.1 to 2.9 times) results obtained with simvastatin plus black seed and garlic as compared to the other group demonstrated the synergetic effect of this association of a nutraceutical combination with pharmacological treatment [295].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.8. Statins and garlic
What the sources say
- Not checked yetcites [295] Ahmad Alobaidi AH Effect of Nigella sativa and Allium sativum coadminstered with simvastatin in dyslipidemia patients: a prospective, randomized, double-blind trial Antiinflamm Antiallergy Agents Med Chem 2014 13 68 74 23848231
boosteddirectn = 258 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, some nutraceuticals have been shown to significantly improve the efficacy of standard pharmacological treatments.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A large number of nutraceuticals have been tested in available trials, demonstrating their lipid-lowering effects.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
In the paper
“Therefore, the intake of vitamin D together with statin can be a useful tool in the management of hypercholesterolemic subjects [296].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [296] Qin XF Zhao LS Chen WR Yin da W Wang H Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial Clin Nutr 2015 34 201 6 24844869
plainconditionaln = 56 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Low vitamin D status is associated with hyperlipidemia.
- It may state two separate claims as one. 181
- The quote only partly states this claim. 17
- Probably not a substantial claim. 20
In the paper
“Then, the improvement of lipid profile was not dependent on duration of supplementation or baseline lipid levels”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [244] Pirro M Mannarino MR Ministrini S Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial Sci Rep 2016 6 23587 27004462 PMC4804276
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This combination has also been tested in adult and elderly patients previously intolerant to statins [245, 246], being well tolerated in 80% of cases.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [245] Marazzi G Cacciotti L Pelliccia F Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients Adv Ther 2011 28 1105 13 22113535
- Not checked yetcites [246] Cicero AF Derosa G Borghi C Red yeast rice and statin-intolerant patients Am J Cardiol 2010 105 1504 20451704
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The association of the lipid-lowering properties of red yeast rice (3 mg MonK), policosanols (10 mg) and berberine (500 mg) is the most studied in RCTs and the only one for which meta-analyses of RCTs are available.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
plaincorrelationaln = 3,159- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It was highlighted that LDL-C change was positively associated with hs-CRP (p = 0.04) and endothelial microparticle changes (p < 0.001)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [244] Pirro M Mannarino MR Ministrini S Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial Sci Rep 2016 6 23587 27004462 PMC4804276
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“hs-CRP and endothelial microparticle levels were also significantly decreased (–41% and –16%, respectively)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [244] Pirro M Mannarino MR Ministrini S Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial Sci Rep 2016 6 23587 27004462 PMC4804276
plaindirectn = 100- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“while a greater glucose-lowering effect was found with higher baseline glucose levels and longer durations of supplementation [244]”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [244] Pirro M Mannarino MR Ministrini S Effects of a nutraceutical combination on lipids, inflammation and endothelial integrity in patients with subclinical inflammation: a randomized clinical trial Sci Rep 2016 6 23587 27004462 PMC4804276
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In the available studies none of the participants reported any muscle pains and no abnormal liver function tests were observed while taking this supplement.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.3. Red yeast rice and plant sterols
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“the authors observed a reduction of LDL-C by 14.3% (–0.57 mmol/l (22 mg/dl), 95% CI: –0.8; –0.31), as well as TC, apoB100 and apoB100/apoA-I ratio, without modifying safety parameters [254].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.4. Red yeast rice and artichoke
What the sources say
- Not checked yetcites [254] Barrat E Zaïr Y Ogier N A combined natural supplement lowers LDL cholesterol in subjects with moderate untreated hypercholesterolemia: a randomized placebo-controlled trial Int J Food Sci Nutr 2013 64 882 9 23815518
plaindirectn = 100- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“After 8 weeks of treatment, the results showed a significant decrease in LDL-C (–0.97 ±0.35 mmol/l (37.5 mg/dl); –22 ±3%), TG (–0.22 ±0.28 mmol/l (19.5 mg/dl); –9 ±5%) and non-HDL-C (–21 ±3%) and a significant increase in HDL-C (+1.5 ±0.5%) (p < 0.001 for all), without the modification of safety parameters.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [267] Cicero AF Derosa G Pisciotta L Barbagallo C SISA-PUFACOL Study Group Testing the short-term efficacy of a lipid-lowering nutraceutical in the setting of clinical practice: a multicenter study J Med Food 2015 18 1270 3 26274827 PMC4638196
plaindirectn = 107 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Based on the available data, no serious safety concerns have been raised, but further studies with longer follow-up are necessary to conclusively confirm this.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.4. Red yeast rice and artichoke
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“After 3 months of treatment, the nutraceutical supplement decreased LDL-C compared to baseline (p = 0.041) and to placebo (p = 0.037, respectively).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.5. Red yeast rice, policosanol, and silymarin
What the sources say
- Not checked yetcites [257] 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 28 317 24 25001663
plaindirectn = 134 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Triglycerides were reduced by the active product (p = 0.039), but not by the placebo, even though, in the group-to-group comparison, no significant difference was recorded (p = 0.061).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.5. Red yeast rice, policosanol, and silymarin
What the sources say
- Not checked yetcites [257] 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 28 317 24 25001663
plaindirectn = 134 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“after 16 weeks of treatment, LDL-C was reduced by 21.4% (95% CI: –13.3; –24.9%, p < 0.001), while TG decreased by 12.2% (95% CI: –24.4; –0.1%, p < 0.05) [253].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.4. Red yeast rice and artichoke
What the sources say
- Not checked yetcites [253] Ogier N Amiot MJ Georgé S LDL-cholesterol-lowering effect of a dietary supplement with plant extracts in subjects with moderate hypercholesterolemia Eur J Nutr 2013 52 547 57 22527287
plaindirectn = 39 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one. The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Based on the available data, no serious safety concerns have been raised.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“An improvement of lipid parameters was assessed after the treatment (LDL-C 2.9 ±0.2 mmol/l (112 mg/dl) vs. control group 3.6 ±0.2 mmol/l (140 mg/dl), p < 0.05). Plasma lathosterol concentrations, an index of cholesterol biosynthesis, were lowered after the combination treatment (p < 0.05), as well [274].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [274] Yoshida M Vanstone CA Parsons WD Zawistowski J Jones PJ Effect of plant sterols and glucomannan on lipids in individuals with and without type II diabetes Eur J Clin Nutr 2006 60 529 37 16391591
plaindirectn = 34 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“after their intake for 4 weeks, there was reported a reduction of LDL-C of 35.0 ±3.1% (p < 0.001), and the ratio of LDL-C to HDL-C (30.0 ±3.5%, p < 0.001) [266].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.8. Soy proteins and plant sterols
What the sources say
- Not checked yetcites [266] Jenkins DJ Kendall CW Marchie A The effect of combining plant sterols, soy protein, viscous fibers, and almonds in treating hypercholesterolemia Metabolism 2003 52 1478 83 14624410
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plainn = 107- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“When compared to placebo, nutraceutical combination treated patients experienced a more favorable percentage change in LDL-C (–23.3%), hs-CRP (–2.4%), and endothelial function (pulse volume displacement vs. baseline: +17%).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.5. Red yeast rice, policosanol, and silymarin
What the sources say
- Not checked yetcites [258] Cicero AF Colletti A Rosticci M Grandi E Borghi C Efficacy and tolerability of a combined lipid-lowering nutraceutical on cholesterolemia, hs-CRP level and endothelial function in moderately hypercholesterolemic subjects J Biol Regul Homeost Agents 2016 30 593 8 27358154
plaindirectn = 80- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“After 2 months of treatment, there was a significant reduction of LDL-C by 14% (p < 0.003), VLDL dropped by 20% (p < 0.01) and sdLDL particles fell by 25% (type III and IV) [275].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [275] Houston M Sparks W Effect of combination pantethine, plant sterols, green tea extract, delta-tocotrienol and phytolens on lipid profiles in patients with hyperlipidemia JANA 2010 13 15 20
plaindirectn = 30 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Based on the available data, no safety concerns have been raised, but further studies with a long follow-up are still necessary to confirm this.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.8. Soy proteins and plant sterols
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“When compared to the placebo group, monacolins/CoQ10-treated patients experienced a more favorable percent change in LDL-C (–21.99%, 95% CI: –26.63; –17.36), non-HDL-C (–14.67%, 95% CI: –19.22; –10.11), MMP-2 (–28.05%, 95% CI: –35.18; –20.93), MMP-9 (–27.19%, 95% CI: –36.21; –18.15), and hs-CRP (–23.77%, 95% CI: –30.54; –17.01).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.6. Red yeast rice and antioxidants
What the sources say
- Not checked yetcites [259] Cicero AF Derosa G Parini A Red yeast rice improves lipid pattern, high-sensitivity C-reactive protein, and vascular remodeling parameters in moderately hypercholesterolemic Italian subjects Nutr Res 2013 33 622 8 23890351
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“LDL-C decreased significantly after the treatment (3.4 ±0.7 (131 mg/dl) to 2.7 ±0.5 mmol/l (104 mg/dl), p < 0.001). In addition, TGs were reduced (–0.2 ±0.3 mmol/l (18 mg/dl), p = 0.039).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [268] Lee IT Lee WJ Tsai CM Su IJ Yen HT Sheu WH Combined extractives of red yeast rice, bitter gourd, chlorella, soy protein, and licorice improve total cholesterol, low-density lipoprotein cholesterol, and triglyceride in subjects with metabolic syndrome Nutr Res 2012 32 85 92 22348456
plaindirectn = 106- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The results showed a reduction of LDL-C and TG, and an increase of HDL-C after the first 3 months of treatment; the lipid profile worsened after a 2-month washout period and improved again when the nutraceutical combination was reintroduced for a further 3 months [263].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.7. Berberine combined with bioactive lipid-lowering agents other than red yeast rice
What the sources say
- Not checked yetcites [263] Derosa G Bonaventura A Bianchi L Berberis aristata/Silybum marianum fixed combination on lipid profile and insulin secretion in dyslipidemic patients Expert Opin Biol Ther 2013 13 1495 506 23971720
plaindirectn = 102- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In particular, 75% of subjects reached an LDL-C target of less than 160 mg/dl and 25% of less than 130 mg/dl.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [267] Cicero AF Derosa G Pisciotta L Barbagallo C SISA-PUFACOL Study Group Testing the short-term efficacy of a lipid-lowering nutraceutical in the setting of clinical practice: a multicenter study J Med Food 2015 18 1270 3 26274827 PMC4638196
plainn = 107- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The combination of γ-oryzanol (40 mg) with ω-3 polyunsaturated fatty acids (1100 mg) was demonstrated to improve lipid profile (LDL-C –0.93 ±0.97 mmol/l (36 mg/dl), p < 0.0001, TG –0.60 ±0.63 mmol/l (23.2 mg/dl), all p < 0.001), as well as inflammatory and oxidative status in dyslipidemic volunteers [272].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [272] Accinni R Rosina M Bamonti F Effects of combined dietary supplementation on oxidative and inflammatory status in dyslipidemic subjects Nutr Metab Cardiovasc Dis 2006 16 121 7 16487912
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The improvement in lipid profile included a reduction of LDL-C from 3.5 ±0.7 mmol/l (135 mg/dl) to 3.1 ±0.8 mmol/l (120 mg/dl) after the intake of the nutraceutical product (p < 0.01). Moreover, this combination led to a reduction of plasma apoB concentrations (p < 0.01) [269].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [269] Shrestha S Volek JS Udani J A combination therapy including psyllium and plant sterols lowers LDL cholesterol by modifying lipoprotein metabolism in hypercholesterolemic individuals J Nutr 2006 136 2492 7 16988115
plaindirectn = 33 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Based on the available data, no serious safety concerns have been raised, but further studies with a long follow-up are still necessary to confirm this.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.7. Berberine combined with bioactive lipid-lowering agents other than red yeast rice
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“After 8 weeks of treatment, there was observed a significant improvement in LDL-C (–24%), TG (–19%), non-HDL-C (–22%), fasting insulin (–5%) and HOMA index (–10%) [262].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.7. Berberine combined with bioactive lipid-lowering agents other than red yeast rice
What the sources say
- Not checked yetcites [262] Cicero AF Rosticci M Parini A Short-term effects of a combined nutraceutical of insulin-sensitivity, lipid level and indexes of liver steatosis: a double-blind, randomized, cross-over clinical trial Nutr J 2015 14 30 25886384 PMC4410738
plaindirectn = 40- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plainn = 107- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“The association of pea protein + oat fiber also showed 4% glucose reduction, 57% insulin reduction and 25% decrease of the HOMA index [273].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [273] Sirtori CR Triolo M Bosisio R Hypocholesterolaemic effects of lupin protein and pea protein/fibre combinations in moderately hypercholesterolaemic individuals Br J Nutr 2012 107 1176 83 22032303
plaindirectn = 25- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Doubling the daily dose seemed not to add additional benefits, while there were no safety concerns also with the higher dosage [255].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.4. Red yeast rice and artichoke
What the sources say
- Not checked yetcites [255] Barrat E Zaïr Y Sirvent P Effect on LDL-cholesterol of a large dose of a dietary supplement with plant extracts in subjects with untreated moderate hypercholesterolaemia: a randomised, double-blind, placebo-controlled study Eur J Nutr 2013 52 1843 52 23266743
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“The association of plant sterols/stanols with certain lipid-lowering ingredients was demonstrated to strengthen cholesterol-lowering efficacy and add TG-lowering effects [250].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.3. Red yeast rice and plant sterols
What the sources say
- Not checked yetcites [250] Kamal-Eldin A Moazzami A Plant sterols and stanols as cholesterol-lowering ingredients in functional foods Recent Pat Food Nutr Agric 2009 1 1 14 20653521
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“After the active treatment, there was observed a significant improvement in LDL-C (–18.2%), non-HDL-C (–15%), glutamic oxaloacetic transaminase (–10%), glutamate-pyruvate transaminase (–30.9%), and hs-CRP (–18.2%) vs. placebo.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.4. Red yeast rice and artichoke
What the sources say
- Not checked yetcites [256] Cicero AF Colletti A Fogacci F Bove M Rosticci M Borghi C Effects of a combined nutraceutical on lipid pattern, glucose metabolism and inflammatory parameters in moderately hypercholesterolemic subjects: a double-blind, cross-over, randomized clinical trial High Blood Press Cardiovasc Prev 2016 24 13 8 27339779 PMC5315731
plaindirectn = 30- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“After 6 months of active treatment, the results showed a more favourable percentage change in LDL-C (–26.3%; p < 0.05), endothelial reactivity (PV displacement: +6.0%; p < 0.05) and arterial stiffness (PWV: –4.7%; p < 0.05) [260].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.6. Red yeast rice and antioxidants
What the sources say
- Not checked yetcites [260] Cicero AF Morbini M Rosticci M D’Addato S Grandi E Borghi C Middle-term dietary supplementation with red yeast rice plus coenzyme Q10 improves lipid pattern, endothelial reactivity and arterial stiffness in moderately hypercholesterolemic subjects Ann Nutr Metab 2016 68 213 9 27055107
plaindirectn = 40 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
In the paper
“After 4 weeks of the active treatment patients experienced an improvement of cholesterol levels (LDL-C –22.36%; non-HDL-C –22.83%), hs-CRP –2.33% and endothelial function (PV displacement after monacolin treatment, 18.59%) [261].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.6. Red yeast rice and antioxidants
What the sources say
- Not checked yetcites [261] Cicero AF Morbini M Parini A Effect of red yeast rice combined with antioxidants on lipid pattern, hs-CRP level, and endothelial function in moderately hypercholesterolemic subjects Ther Clin Risk Manag 2016 12 281 6 26966368 PMC4770063
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The combination of phytosterols and ω-3 PUFAs reduced LDL-C by 12.5% (p = 0.002) and TG by 25.9% (p = 0.005); moreover, it increased HDL-C (8.6%, p = 0.04) [270].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
What the sources say
- Not checked yetcites [270] Micallef MA Garg ML The lipid-lowering effects of phytosterols and (n-3) polyunsaturated fatty acids are synergistic and complementary in hyperlipidemic men and women J Nutr 2008 138 1085 90 18492838
plaindirectn = 60 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Clinical trials have reported that many nutraceuticals have an additive effect to lipid-lowering drugs, allowing the statin doses to be reduced without diminishing the results in terms of TC and LDL-C reduction and significantly limiting adverse effects [281].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy
What the sources say
- Not checked yetcites [281] Cicero AF Colletti A Banach M Statins and nutraceuticals/functional food: could they be combined? Combination Therapy In Dyslipidemia 2016 127 42
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns. Very limited data; further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“All reported side effects lasted a few days and did not lead to interruption of treatment [291].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.4. Ezetimibe or statins and berberine with silymarin
What the sources say
- Not checked yetcites [291] Di Pierro F Bellone I Rapacioli G Putignano P Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins Diabetes Metab Syndr Obes 2015 8 89 96 25678808 PMC4322873
plainn = 45- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In addition, TGs were reduced by 36% and HDL-C increased by 37%, an effect that was significantly higher when compared to the use of rosuvastatin alone.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.7. Statins and bergamot
What the sources say
- Not checked yetcites [120] Gliozzi M Walker R Muscoli S Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia Int J Cardiol 2013 170 140 5 24239156
plaindirectn = 77- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
In the paper
“It also increased the serum lathosterol/cholesterol ratio (p < 0.01), thus showing upregulation of cholesterol synthesis, and increased the serum sitosterol ratio (p < 0.01).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.5. Statins/ezetimibe and plant sterols
What the sources say
- Not checked yetcites [293] Gylling H Miettinen TA LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects Nutr Metab Cardiovasc Dis 2002 12 19 23 12125225
plaindirectn = 11 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The results highlighted that simvastatin reduced LDL-C by 39% (p < 0.001) and additional stanol ester margarine reduced it by a further 13% (p < 0.05).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.5. Statins/ezetimibe and plant sterols
What the sources say
- Not checked yetcites [293] Gylling H Miettinen TA LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects Nutr Metab Cardiovasc Dis 2002 12 19 23 12125225
plaindirectn = 11 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Ezetimibe and nutraceuticals have been both introduced, alone or in association, as alternative therapies for statin-intolerant patients and proved to be effective and well tolerated.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.3. Ezetimibe, red yeast rice, policosanol and berberine
plaindirectn = 86- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
hedged- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
In the paper
“Compared with baseline, atorvastatin 40 mg showed a reduction of LDL-C (22%, p < 0.05), and increased β-sitosterol, campesterol/cholesterol, and β-sitosterol/cholesterol ratios (39%, 47%, and 32%, respectively, p < 0.05); ezetimibe 10 mg reduced campesterol and campesterol/cholesterol ratio (67% and 70%, respectively, p < 0.05), while the combined therapy decreased LDL-C (38%, p < 0.05), campester”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.5. Statins/ezetimibe and plant sterols
What the sources say
- Not checked yetcites [292] Malina DM Fonseca FA Barbosa SA Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens J Clin Lipidol 2015 9 542 52 26228672
plaindirectn = 86 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Among patients treated with highly effective lipid-lowering therapy, the intake of 25 g of fibers added favorable effects: a reduction of phytosterolemia, improvement in blood glucose (p = 0.047), weight loss (p = 0.04) and reduced body mass index (p = 0.002) [288].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.2. Statins and soluble fibers
What the sources say
- Not checked yetcites [288] Ramos SC Fonseca FA Kasmas SH The role of soluble fiber intake in patients under highly effective lipid-lowering therapy Nutr J 2011 10 80 21810257 PMC3159132
plaindirectn = 28 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It was observed that the combined therapy significantly reduced LDL-C (–53%) compared to rosuvastatin alone, an effect which was nearly the same as the one produced by 20 mg of rosuvastatin.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.7. Statins and bergamot
What the sources say
- Not checked yetcites [120] Gliozzi M Walker R Muscoli S Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia Int J Cardiol 2013 170 140 5 24239156
plaindirectn = 77- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The intake of berberine/silymarin with statins led to an improvement of lipid parameters (LDL-C –15% and –28%, respectively after 6 and 12 months) and also when added to ezetimibe (LDL-C –20% and –33% respectively after 6 and 12 months).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.4. Ezetimibe or statins and berberine with silymarin
What the sources say
- Not checked yetcites [291] Di Pierro F Bellone I Rapacioli G Putignano P Clinical role of a fixed combination of standardized Berberis aristata and Silybum marianum extracts in diabetic and hypercholesterolemic patients intolerant to statins Diabetes Metab Syndr Obes 2015 8 89 96 25678808 PMC4322873
plaindirectn = 45- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The triple treatment led to 67% reduction from baseline (p < 0.001), with all LDL-C values being < 2.6 mmol/l, and increased HDL-C by 15% (p < 0.01).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.5. Statins/ezetimibe and plant sterols
What the sources say
- Not checked yetcites [293] Gylling H Miettinen TA LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects Nutr Metab Cardiovasc Dis 2002 12 19 23 12125225
plaindirectn = 11 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Data from a long-term randomized clinical trial support the concept that combining statins with ω-3 fatty acids seems to further decrease CHD risk by 19% in primary prevention [284] and CHD mortality by 17% in secondary prevention [285].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
What the sources say
- Not checked yetcites [284] Yokoyama M Origasa H Matsuzaki M Japan EPA lipid intervention study (JELIS) investigators Lancet 2007 369 1090 8
- Not checked yetcites [285] Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico Lancet 1999 354 447 55 10465168
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
In the paper
“After 8 weeks, the mean lowering of LDL-C (–63 mg/dl/–1.63 mmol/l; p = 0.03) in the group receiving 20 mg of simvastatin plus placebo was the same as that in the group receiving 10 mg of simvastatin plus psyllium and was greater than that obtained with 10 mg of simvastatin plus placebo (55 mg/dl/1.42 mmol/l; p = 0.03).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.2. Statins and soluble fibers
What the sources say
- Not checked yetcites [287] Moreyra AE Wilson AC Koraym A Effect of combining psyllium fiber with simvastatin in lowering cholesterol Arch Intern Med 2005 165 1161 6 15911730
plaindirectn = 68 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
In the paper
“This study demonstrated that the addition of plant sterols further reduced LDL-C by ~6.5% in the atorvastatin therapy group and 5.0% and 4.0% in the combined therapy group (p < 0.05 for all) [292].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.5. Statins/ezetimibe and plant sterols
What the sources say
- Not checked yetcites [292] Malina DM Fonseca FA Barbosa SA Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens J Clin Lipidol 2015 9 542 52 26228672
boosteddirectn = 6 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Similar results were reported for apoB and TC, while there were not observed significant changes of TG or HDL-C levels [287].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.2. Statins and soluble fibers
What the sources say
- Not checked yetcites [287] Moreyra AE Wilson AC Koraym A Effect of combining psyllium fiber with simvastatin in lowering cholesterol Arch Intern Med 2005 165 1161 6 15911730
plainn = 68- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These therapies led to similar reductions in LDL-C and TC (p < 0.001 vs. baseline), while no change was observed in HDL-C.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.2. Statins and soluble fibers
What the sources say
- Not checked yetcites [288] Ramos SC Fonseca FA Kasmas SH The role of soluble fiber intake in patients under highly effective lipid-lowering therapy Nutr J 2011 10 80 21810257 PMC3159132
plaindirectn = 116 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients who followed 8-week treatment with simvastatin (10 mg) plus placebo obtained a significant reduction in non-HDL-C (–10.8%), TG (–6.9%), and LDL-C (–11.6%) (p ≤ 0.01), and an increase in HDL-C (+10.4%) (p = 0.02).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.8. Statins and garlic
What the sources say
- Not checked yetcites [295] Ahmad Alobaidi AH Effect of Nigella sativa and Allium sativum coadminstered with simvastatin in dyslipidemia patients: a prospective, randomized, double-blind trial Antiinflamm Antiallergy Agents Med Chem 2014 13 68 74 23848231
plaindirectn = 258 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“After 4 weeks of treatment, the mean LDL-C and TG levels in the group receiving 20 mg of lovastatin plus 10 g of psyllium fell by 30.9% and 26.2% from baseline compared with 24.8% and 32.9% in the group receiving 20 mg of lovastatin and 3.6% and 10.9% in the group receiving 10 g of psyllium, respectively [286].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.2. Statins and soluble fibers
What the sources say
- Not checked yetcites [286] Agrawal AR Tandon M Sharma PL Effect of combining viscous fibre with lovastatin on serum lipids in normal human subjects Int J Clin Pract 2007 61 1812 8 17935545
plaindirectn = 36- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.1. Statins and polyunsaturated fatty acids
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
In the paper
“Moreover, a significant reduction of biomarkers used for detecting oxidative vascular damage was reported, suggesting antioxidant activity of bergamot in patients on statin therapy [120].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.7. Statins and bergamot
What the sources say
- Not checked yetcites [120] Gliozzi M Walker R Muscoli S Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia Int J Cardiol 2013 170 140 5 24239156
hedgedconditionaln = 77- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This is particularly relevant since it is estimated that the range of people intolerant to conventional statin treatment is between 45 000 and 290 000 individuals/year [36]”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [36] Bangalore S Fayyad R Hovingh GK Treating to New Targets Steering Committee and Investigators Statin and the risk of renal-related serious adverse events: analysis from the IDEAL, TNT, CARDS, ASPEN, SPARCL, and other placebo-controlled trials Am J Cardiol 2014 113 2018 20 24793673
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Another group of patients who might benefit from such nutraceuticals consists of very old patients (especially those aged over 75) or patients with sarcopenia [40].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [40] Banach M Serban MC Discussion around statin discontinuation in older adults and patients with wasting diseases J Cachexia Sarcopenia Muscle 2016 7 396 99 27030814 PMC4782254
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The development of new powerful (and very expensive) lipid-lowering drugs will be able to fill the gap (and in consequence reduce the residual CV risk)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [41] Banach M Aronow WS Serban MC Rysz J Voroneanu L Covic A Lipids, blood pressure and kidney update 2015 Lipids Health Dis 2015 14 167 26718096 PMC4696333
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“in the absence of an increased risk of cancer or non-CV-related death [13].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.2. The importance of treating dyslipidemia to reduce cardiovascular risk
What the sources say
- Not checked yetcites [13] Baigent C Blackwell L Emberson J Cholesterol Treatment Trialists’ (CTT) Collaboration Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials Lancet 2010 376 1670 81 21067804 PMC2988224
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Levels of LDL-C < 100 mg/dl (~2.5 mmol/l) are associated with a low risk for CHD and are considered optimal in the absence of CVD or other risk factors [17].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.3. Lipid targets
What the sources say
- Not checked yetcites [17] Law MR Wald NJ Thompson SG By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ 1994 308 367 72 8043072 PMC2539460
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Moreover, they can have a large number of positive pleiotropic effects, including improvement of endothelial dysfunction and arterial stiffness, as well as anti-inflammatory and anti-oxidative properties [33].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [33] Houston M The role of nutraceutical supplements in the treatment of dyslipidemia J Clin Hypertens 2012 14 121 32 PMC9645405 22277145
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“(complete statin intolerance is estimated at less than 5%)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.5. Indication of lipid-lowering nutraceuticals in clinical practice
What the sources say
- Not checked yetcites [36] Bangalore S Fayyad R Hovingh GK Treating to New Targets Steering Committee and Investigators Statin and the risk of renal-related serious adverse events: analysis from the IDEAL, TNT, CARDS, ASPEN, SPARCL, and other placebo-controlled trials Am J Cardiol 2014 113 2018 20 24793673
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) blood concentrations are the major modifiable risk factors for coronary heart disease (CHD), whereas high concentrations of plasma high-density lipoprotein cholesterol (HDL-C) in certain conditions are considered protective [6].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.1. Cardiovascular disease and dyslipidemia: prevalence and global economic impact
What the sources say
- Not checked yetcites [6] Australian Institute of Health and Welfare High Blood Cholesterol. Cat. No. AUS 156 2012-2013 Canberra Australian Institute of Health and Welfare
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“PS also intensify the expression of ABCA1 transporter and inhibit the acyl-CoA:cholesterol O-acyltransferase (ACAT) enzyme, reducing the amount of cholesterol absorbed from 30% to 50%.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
- Not checked yetcites [45] Ferguson JJ Stojanovski E MacDonald-Wicks L Garg ML Fat type in phytosterol products influence their cholesterol-lowering potential: a systematic review and meta-analysis of RCTs Prog Lipid Res 2016 64 16 29 27497855
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In 2010 the European Food Safety Authority (EFSA) confirmed that oat β-glucan is able to reduce plasmatic cholesterol levels; however, at least 3 g/day of β-glucan is necessary [54].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [54] EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific opinion on the substantiation of a health claim related to oat beta-glucan and lowering blood cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006 EFSA J 2010 8 188
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“β-glucan has high viscosity, which confers lipid-lowering action [32].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [32] Sahebkar A Serban MC Gluba-Brzózka A Lipid-modifying effects of nutraceuticals: an evidence-based approach Nutrition 2016 32 1179 92 27324061
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The reduction of cholesterol obtained by soluble fibers described in the literature is variable and dependent on the type of fiber, doses, subjects treated, study size and different diets: the effective range of the reduction of TC varies from 0 to 18% for oat-based fibers, 3–17% for psyllium, 5–16% for pectin, and 4–17% for guar gum [51].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [51] Brown L Rosner B Willett WW Sacks FM Cholesterol-lowering effects of dietary fiber: a meta-analysis Am J Clin Nutr 1999 69 30 42 9925120
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The level of evidence and the strength of recommendation of particular lipid-lowering treatment options have been weighed and graded according to predefined scales, as outlined in Tables I and II.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.6. Clinical evidence on individual lipid-lowering nutraceuticals
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“However, in some cases minor gastrointestinal side effects were reported (especially with micronized fibers) that might slightly reduce the adherence to this nutraceutical [64].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [64] Anderson JW Allgood LD Lawrence A Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials Am J Clin Nutr 2000 71 472 9 10648260
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The experts of the writing and reviewing panels completed Declaration of interest forms where real or potential sources of conflicts of interest might be perceived (at the end of the paper).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 1. Introduction > 1.6. Clinical evidence on individual lipid-lowering nutraceuticals
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The mechanisms of action of psyllium are similar to those of other fibers discussed, including increased excretion of bile acids (stimulating 7α-hydroxylase), reduced absorption of intestinal cholesterol and a reduction of hepatic cholesterol synthesis (via the short-chain fatty acid byproducts of fiber fermentation) [58].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [58] Anderson JW Dietary fibre, complex carbohydrate and coronary artery disease Can J Cardiol 1995 11 Suppl G 55G 62G 7585294
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Unlike other fibers, glucomannan does not act by binding bile acids, but it seems to reduce the absorption of cholesterol in the jejunum and the absorption of bile acids in the ileum, yielding improvements in apolipoprotein B (ApoB) and plasma LDL-C levels.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [65] Behera SS Ray RC Konjac glucomannan, a promising polysaccharide of Amorphophallus konjac K. Koch in health care Int J Biol Macromol 2016 92 942 56 27481345
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“PS have also shown a high safety profile in the middle-term; however, data for treatment longer than 2 years are still not available [44, 50].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
- Not checked yetcites [50] Gylling H Halonen J Lindholm H The effects of plant stanol ester consumption on arterial stiffness and endothelial function in adults: a randomised controlled clinical trial BMC Cardiovasc Disord 2013 13 50 23841572 PMC3717082
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The lipid-lowering effect of PS is dose dependent and proportional up to the attainment of a plateau (reached at approximately 3 g/day of PS achieving an average effect on LDL-C of –12%)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [48] Talati R Sobieraj DM Makanji SS Phung OJ Coleman CI The comparative efficacy of plant sterols and stanols on serum lipids: a systematic review and meta-analysis J Am Diet Assoc 2010 110 719 26 20430133
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The meta-analysis showed not only the significant reduction of LDL-C of 0.33 mmol/l (12.8 mg/dl) (–8.5%)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.1. Plant sterols and stanols
What the sources say
- Not checked yetcites [44] Ras RT Hiemstra H Lin Y Vermeer MA Duchateau GS Trautwein EA Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations: a meta-analysis of randomized controlled studies Atherosclerosis 2013 230 336 46 24075766
plaindirectn = 2,084- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“The lipid-lowering mechanisms of action of soluble fibers are different, including prolonged gastric emptying time, an increase of satiety, the inhibition of hepatic cholesterol synthesis and an increase of fecal excretion of cholesterol and bile salts [52].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [52] Doi K Effect of konjac fibre (glucomannan) on glucose and lipids Eur J Clin Nutr 1995 49 Suppl 3 S190 7 8549522
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A meta-analysis of 6 RCTs including 416 patients with hypercholesterolemia concluded that it has a significant effect on TC (–0.3 mmol/l (11.6 mg/dl), p = 0.002), but not on LDL-C, HDL-C or TG [71].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.3. Chitosan
What the sources say
- Not checked yetcites [71] Baker WL Tercius A Anglade M White CM Coleman CI A meta-analysis evaluating the impact of chitosan on serum lipids in hypercholesterolemic patients Ann Nutr Metab 2008 55 368 74 19923803
plaindirectn = 416 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It was also estimated that following RYR treatment for 4 years, the number needed to treat (NNT) to prevent one coronary event, one coronary death and one mortality due to all causes in elderly patients were respectively 18, 33 and 23. In adults, however, these numbers were 23, 82 and 51.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [93] DFG Permanent Senate Commission on Food Safety Toxicological evaluation of red mould rice: an update 2012
hedgeddirectn = 1,445- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Probiotics are considered to be generally very safe, and side effects are rare.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [84] Doron S Snydman DR Risk and safety of probiotics Clin Infect Dis (Review) 2015 60 Suppl 2 S129 34 PMC4490230 25922398
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A stronger cholesterol-lowering effect of Lactobacillus was confirmed in the meta-analysis of RCTs by Shimizu et al., where the most promising results were obtained after a treatment period of more than 4 weeks”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [83] Shimizu M Hashiguchi M Shiga T Tamura HO Mochizuki M Meta-analysis: effects of probiotic supplementation on lipid profiles in normal to mildly hypercholesterolemic individuals PLoS One 2015 10 e0139795 26473340 PMC4608827
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a meta-analysis of 39 RCTs enrolling 2298 mild-to-moderate hypercholesterolemic subjects the consumption of garlic extracts for at least 2 months showed a reduction of LDL-C (–0.23 mmol/l (9 mg/dl), more evident in individuals with TC < 5.17 mmol/l (200 mg/dl) at baseline) [103].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.2. Garlic (Allium sativum)
What the sources say
- Not checked yetcites [103] Ried K Toben C Fakler P Effect on garlic on serum lipids: an updated meta-analysis Nutr Rev 2013 71 282 99 23590705
plaindirectn = 2,298- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This gender-dependent effect was also observed with other soluble fibers, and it would seem to be caused by the interaction between sex hormones and lipid metabolism; nevertheless, further corroboration is necessary [69].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [69] Martino F Martino E Morrone F Carnevali E Forcone R Niglio T Effect of dietary supplementation with glucomannan on plasma total cholesterol and low density lipoprotein cholesterol in hypercholesterolemic children Nutr Metab Cardiovasc Dis 2005 15 174 80 15955465
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“RYR supplementation showed a reduction in the risk of CHD (31.0%, p = 0.04), all-cause mortality (31.9%, p = 0.01), stroke (44.1%, p = 0.04), the need for coronary artery bypass graft (CABG) or a percutaneous coronary intervention (PCI) (48.6%, p = 0.07) and malignancies (51.4%, p = 0.03).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [93] DFG Permanent Senate Commission on Food Safety Toxicological evaluation of red mould rice: an update 2012
plaindirectn = 1,445 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The results showed that the group treated with RYR at the end of the 6-week follow-up obtained a reduction of hs-CRP and the area under the curve (AUC) of triglyceride (TG-AUC) (p < 0.001 for each), in addition to an improvement of postprandial and pre-prandial FMD (p < 0.001). There were no significant changes in serum lipids and FMD in the placebo group [92].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
What the sources say
- Not checked yetcites [92] Zhao SP Liu L Cheng YC Xuezhikang, an extract of cholestin, protects endothelial function through antiinflammatory and lipid-lowering mechanisms in patients with coronary heart disease Circulation 2004 110 915 20 15313947
plaindirectn = 50 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The intake of glucomannan may interfere with the absorption of certain drugs, in particular lipophilic drugs/nutraceuticals: for example, glucomannan could reduce the absorption of vitamin E, calcium and other minerals, whereas it does not hinder the absorption of water-soluble vitamins.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [32] Sahebkar A Serban MC Gluba-Brzózka A Lipid-modifying effects of nutraceuticals: an evidence-based approach Nutrition 2016 32 1179 92 27324061
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Jung et al. [106] underlined that it is able to reduce apoB and increase the LDL/Apo B ratio.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.2. Garlic (Allium sativum)
What the sources say
- Not checked yetcites [106] Jung ES Park SH Choi EK Reduction of blood lipid parameters by a 12-wk supplementation of aged black garlic: a randomized controlled trila Nutrition 2014 30 1034 9 24976429
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“TG and HDL-C did not change significantly compared to the control groups.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [81] Cho YA Kim J Effect of probiotics on blood lipid concentrations: a meta-analysis of randomized controlled trials Medicine 2015 94 e1714 26512560 PMC4985374
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The report released by the Agency for Healthcare Research and Quality (2011) concluded that, although the existing probiotic clinical trials reveal no evidence of increased risk, there are not enough data to answer questions on the safety of probiotics in intervention studies with confidence [84].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [84] Doron S Snydman DR Risk and safety of probiotics Clin Infect Dis (Review) 2015 60 Suppl 2 S129 34 PMC4490230 25922398
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The consumption of probiotics is considered safe and free of serious side effects [76].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.4. Probiotics
What the sources say
- Not checked yetcites [76] Guarner F Schaafsma GJ Probiotics Int J Food Microbiol 1998 39 237 8 9553803
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The reduction of serum triglycerides is a peculiarity of glucomannan, probably due to its high viscosity and its ability to interact with the hepatic cholesterol and lipoprotein metabolism, but not of other soluble fibers, which have only a very modest action on triglyceride levels [66].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [66] Sood N Baker WL Coleman CI Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis Am J Clin Nutr 2008 88 1167 75 18842808
hedgedconditionaln = 531- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Side effects are usually minimal (mostly gastrointestinal) and the extracts are well tolerated [104].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.2. Garlic (Allium sativum)
What the sources say
- Not checked yetcites [104] Ackermann RT Mulrow CD Ramirez G Gardner CD Morbidoni L Lawrence VA Garlic shows promise for improving some cardiovascular risk factors Arch Intern Med 2001 161 813 24 11268223
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Data on weight reduction are controversial; in general it can be said that glucomannan is able to promote the maintenance of weight and in some cases (with at least 5.2 weeks of treatment) it can cause a small reduction of weight (according to some meta-analyses significant, according to others not), although only less than 1 kg [67].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
What the sources say
- Not checked yetcites [67] Onakpoya I Posadzki P Ernst E The efficacy of glucomannan supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials J Am Coll Nutr 2014 33 70 8 24533610
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The effects of berberine on lipids were: LDL-C: –0.65 mmol/l (95% CI: –0.75; –0.56, p = 0.00001) (25.14 mg/dl); TG: –0.39 mmol/l (95% CI: –0.59; –0.19, p = 0.0001) (34.5 mg/dl); HDL-C: 0.07 mmol/l (95% CI: 0.04; 0.10, p = 0.00001) (2.71 mg/dl).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [138] Lan J Zhao Y Dong F Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension J Ethnopharmacol 2015 161 69 81 25498346
plaindirectn = 2,569- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The tolerability of policosanols is usually very good.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.4. Policosanols
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“The authors showed that following an adequate diet in comparison with placebo, pantethine 600–900 mg/day demonstrated significant (p < 0.005) and sustained reductions (from baseline to week 16) in TC (3% – 0.16 mmol/l (6 mg/dl)), LDL-C (4% – 0.10 mmol/l (4 mg/dl)) and apoB (5% – 0.0001 mmol/l (4 mg/dl)).”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Pantethine
What the sources say
- Not checked yetcites [113] Rumberger JA Napolitano J Azumano I Kamiya T Evans M Pantethine, a derivative of vitamin B(5) used as a nutritional supplement, favorably alters low-density lipoprotein cholesterol metabolism in low- to moderate-cardiovascular risk North American subjects: a triple-blinded placebo and diet-controlled investigation Nutr Res 2011 31 608 15 21925346
boosteddirectn = 120 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The cholesterol-lowering properties of lupin were also highlighted in a third RCT proving a reduction of LDL-C (–12%) comparable to the studies described previously [160].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [160] Fechner A Kiehntopf M Jahreis G The formation of short-chain fatty acids is positively associated with the blood lipid-lowering effect of lupin kernel fiber in moderately hypercholesterolemic adults J Nutr 2014 144 599 607 24572041
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a recent one including 35 RCTs and 2670 subjects concluded that soy proteins (in particular B-conglycinin globulin) have a cholesterol-lowering effect with a mean reduction in LDL-C of 3% (–0.12 mmol/l/4.6 mg/dl), TC of 2% (–0.14 mmol/l/5.4 mg/dl) and TG of 4% (–0.06 mmol/l/5.3 mg/dl) and is able to increase HDL-C by 3% (+0.04 mmol/l/1.6 mg/dl), the effect being proportional to the baseline LDL-C”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [154] Tokede OA Onabanjo TA Yansane A Gaziano JM Djoussé L Soya products and serum lipids: a meta-analysis of randomised controlled trials Br J Nutr 2015 114 831 43 26268987
plaindirectn = 2,670- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“They found that the treated group experienced a marked reduction of small dense LDL (sdLDL) and TG, and increased HDL-C levels compared to placebo.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [121] Gliozzi M Carresi C Musolino V The effect of Bergamot-derived polyphenolic fraction on LDL small dense particles and non alcoholic fatty liver disease in patients with metabolic syndrome Adv Biol Chem 2014 4 129 37
plaindirectn = 107- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“These effects seem to be additive to those of statins and associated with a positive impact on glucose metabolism and blood pressure as well [138].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [138] Lan J Zhao Y Dong F Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension J Ethnopharmacol 2015 161 69 81 25498346
hedgedcorrelationaln = 2,569- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The main limitation of the evidence on bergamot efficacy is related to the fact that the greater part of the clinical literature has been provided by a single research unit and not confirmed elsewhere.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Clinical studies conducted to date with dosages between 500 and 1500 mg/day showed a good safety profile, with no side effects detected.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, the evidence indicates that bergamot has lipid-lowering effects, both quantitative and qualitative, especially by reducing the levels of sdLDL and TG and significantly increasing HDL-C levels.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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It may state two separate claims as one.
- Rests on an assumption: The cited meta-analyses and RCTs are of sufficient methodological quality and their results are valid for the populations studied.
- Rests on an assumption: The effects of nutraceuticals observed in trials generalize to clinical practice in the broader patient populations for whom they are recommended.
In the paper
“In the LPI group, the levels of HDL-C increased significantly (p < 0.036) and the LDL/HDL ratio decreased (p = 0.003), compared to the MPI group [158].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [158] Bähr M Fechner A Krämer J Kiehntopf M Jahreis G Lupin protein positively affects plasma LDL cholesterol and LDL:HDL cholesterol ratio in hypercholesterolemic adults after four weeks of supplementation: a randomized, controlled crossover study Nutr J 2013 12 107 23902673 PMC3735452
plaindirectn = 33 ·- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“they seem to have direct positive effects on endothelial function [155] and arterial stiffness [156].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [155] Beavers DP Beavers KM Miller M Stamey J Messina MJ Exposure to isoflavone-containing soy products and endothelial function: a Bayesian meta-analysis of randomized controlled trials Nutr Metab Cardiovasc Dis 2012 22 182 91 20709515
- Not checked yetcites [156] Hazim S Curtis PJ Schär MY Acute benefits of the microbial-derived isoflavone metabolite equol on arterial stiffness in men prospectively recruited according to equol producer phenotype: a double-blind randomized controlled trial Am J Clin Nutr 2016 103 694 702 26843154 PMC4763500
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The BBR group showed a marked reduction in TG (26% BBR vs. 13% control; the difference did not reach statistical significance due to large inter-individual variations) and LDL-C (24% vs. 17% BBR control: p < 0.001) compared to the control group.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [137] Meng S Wang LS Huang ZQ Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention Clin Exp Pharmacol Physiol 2012 39 406 11 22220931
plaindirectn = 130 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“In vitro it inhibits fatty acid synthesis and HMG-CoA reductase [109, 110].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Pantethine
What the sources say
- Not checked yetcites [109] Cighetti G Del Puppo M Paroni R Galli Kienle M Modulation of HMG-CoA reductase activity by pantetheine/pantethine Biochim Biophys Acta 1988 963 389 93 3196742
- Not checked yetcites [110] Cighetti G Del Puppo M Paroni R Fiorica E Galli Kienle M Pantethine inhibits cholesterol and fatty acid syntheses and stimulates carbon dioxide formation in isolated rat hepatocytes J Lipid Res 1987 28 152 61 3106549
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“In particular, the 3-hydroxy-3-methyl-glutaryl flavanone enriched fraction (HMGF: brutieridin, melitidin and HMG-neoeriocitrin) has been extracted from the bergamot peel; they act as statins by inhibiting HMG-CoA reductase and ACAT, reducing the formation of cholesterol esters and limiting the transport of cholesterol in the blood.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [118] Di Donna L De Luca G Mazzotti F Napoli A Salerno R Taverna D Sindona G Statin-like principles of bergamot fruit (Citrus bergamia): isolation of 3-hydroxymethylglutaryl flavonoid glycosides J Nat Prod 2009 72 1352 4 19572741
- Not checked yetcites [119] Miceli N Mondello MR Monforte MT Hypolipidemic effects of Citrus bergamia Risso et Poiteau juice in rats fed a hypercholesterolemic diet J Agric Food Chem 2007 55 10671 7 18038978
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The data suggest that pantethine supplementation for 16 weeks (600 mg/day for weeks 1–8 then 900 mg/day for weeks 9–16) is safe and significantly lowers TC and LDL-C (although with relatively limited clinical relevance) over and above the effect of therapeutic lifestyle changes (TLC) or diet alone [114].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Pantethine
What the sources say
- Not checked yetcites [114] Bertolini S Donati C Elicio N Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children Int J Clin Pharmacol Ther Toxicol 1986 24 630 7 3098691
hedgeddirectn = 120 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“These results were confirmed by the same author in the next randomized, controlled, double-blind three-phase crossover trial, including 72 patients with hypercholesterolemia treated for 28 days with LPI, MP (milk protein) or MPA (milk protein 1.6 g/day of arginine). In addition to reducing LDL-C levels (in MPA and LPI groups), the LPI group showed an improvement in the levels of homocysteine (comp”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.3. Soy and lupin proteins
What the sources say
- Not checked yetcites [159] Bähr M Fechner A Kiehntopf M Jahreis G Consuming a mixed diet enriched with lupin protein beneficially affects plasma lipids in hypercholesterolemic subjects: a randomized controlled trial Clin Nutr 2015 34 7 14 24746974
plaindirectn = 72- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, the use of BBR at doses ranging between 500 and 1500 mg has proved to be effective in lipid lowering and relatively safe both in primary and secondary prevention.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Rests on an assumption: The cited meta-analyses and RCTs are of sufficient methodological quality and their results are valid for the populations studied.
- Rests on an assumption: The effects of nutraceuticals observed in trials generalize to clinical practice in the broader patient populations for whom they are recommended.
- Rests on an assumption: The safety data from clinical trials adequately reflect real-world safety of these nutraceuticals.
In the paper
“Based on the abovementioned data, side effects are mild to moderate, mostly gastrointestinal (diarrhea, constipation, abdominal distension) and comparable to the control groups [139].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [139] Derosa G Maffioli P Cicero AF Berberine on metabolic and cardiovascular risk factors: an analysis from preclinical evidences to clinical trials Expert Opin Biol Ther 2012 12 1113 24 22780092
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, the amount of atherogenic sdLDL significantly decreased (–35%), while large buoyant LDLs increased (+38%; both p < 0.05) compared to baseline levels.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [121] Gliozzi M Carresi C Musolino V The effect of Bergamot-derived polyphenolic fraction on LDL small dense particles and non alcoholic fatty liver disease in patients with metabolic syndrome Adv Biol Chem 2014 4 129 37
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Usually the consumption of green tea is well tolerated; however, in some cases rash, transient elevation of blood pressure and mild gastrointestinal disorders may occur. Moreover, high doses of green tea can cause a deficiency of iron and folate due to its capacity to bind and reduce their intestinal absorption.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.2. Green tea extracts
What the sources say
- Not checked yetcites [143] Onakpoya I Spencer E Heneghan C Thompson M The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials Nutr Metab Cardiovasc Dis 2014 24 823 36 24675010
plainconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Compared to nutraceuticals with a statin-similar mechanism of action, BBR has a greater effect in the reduction of triglyceridemia, partly related to its positive effect on insulin-resistance [139].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.1. Berberine
What the sources say
- Not checked yetcites [139] Derosa G Maffioli P Cicero AF Berberine on metabolic and cardiovascular risk factors: an analysis from preclinical evidences to clinical trials Expert Opin Biol Ther 2012 12 1113 24 22780092
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, green tea is associated with an improvement in FMD [144] and pulse wave velocity (PWV) [145], despite no apparent effect on hs-CRP levels [146].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 4. Inducer of LDL-cholesterol excretion > 4.2. Green tea extracts
What the sources say
- Not checked yetcites [144] Park CS Kim W Woo JS Green tea consumption improves endothelial function but not circulating endothelial progenitor cells in patients with chronic renal failure Int J Cardiol 2010 145 261 2 19962201
- Not checked yetcites [145] Lin QF Qiu CS Wang SL A cross-sectional study of the relationship between habitual tea consumption and arterial stiffness J Am Coll Nutr 2016 35 354 61 26709673
- Not checked yetcites [146] Serban C Sahebkar A Antal D Ursoniu S Banach M Effects of supplementation with green tea catechins on plasma C-reactive protein concentrations: a systematic review and meta-analysis of randomized controlled trials Nutrition 2015 31 1061 71 26233863
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The study by Berthold et al. showed that the administration of policosanols in hypercholesterolemic patients does not statistically improve the levels of TC, TG, HDL-C and LDL-C. This trial included 143 subjects divided into five groups each treated with 10, 20, 40, 80 mg of policosanols or placebo. Nobody in any group at the end of the study (12 weeks) showed a reduction of more than 10% in LDL-C”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.4. Policosanols
What the sources say
- Not checked yetcites [126] Berthold HK Unverdorben S Degenhardt R Bulitta M Gouni-Berthold I Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial JAMA 2006 295 2262 9 16705107
plainn = 143- Asserted: passes — The authors put it forward as true.
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In the paper
“Group D showed a reduction of LDL-C and TG (–25.0% and –27.6%, respectively; p < 0.001 for all), without any side effects [123].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [123] Mollace V Sacco I Janda E Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies Fitoterapia 2011 82 309 16 21056640
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Moreover, this was accompanied by a significant reduction of serum glucose, transaminases, γ-glutamyl-transferase, and inflammatory biomarkers such as hs-CRP and tumor necrosis factor-α (TNF-α) [121].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [121] Gliozzi M Carresi C Musolino V The effect of Bergamot-derived polyphenolic fraction on LDL small dense particles and non alcoholic fatty liver disease in patients with metabolic syndrome Adv Biol Chem 2014 4 129 37
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The tolerability of pantethine is overall high, with acceptable safety confirmed also in children [114] and patients in hemodialysis [116].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Pantethine
What the sources say
- Not checked yetcites [114] Bertolini S Donati C Elicio N Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children Int J Clin Pharmacol Ther Toxicol 1986 24 630 7 3098691
- Not checked yetcites [116] Donati C Barbi G Cairo G Prati GF Degli Esposti E Pantethine improves the lipid abnormalities of chronic hemodialysis patients: results of a multicenter clinical trial Clin Nephrol 1986 25 70 4 3516477
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The results showed dose-dependent lipid-lowering action of bergamot (groups A and B respectively LDL-C: –24.1% and –30.6%, TG: –28.2% and –37.9%, HDL-C: +22.3% and +40.1%, p < 0.001 for all) compared to baseline.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Bergamot (Citrus bergamia)
What the sources say
- Not checked yetcites [123] Mollace V Sacco I Janda E Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies Fitoterapia 2011 82 309 16 21056640
plaindirectn = 237 ·- Asserted: passes — The authors put it forward as true.
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The quote only partly states this claim.
In the paper
“γ-oryzanol is a mix of triterpene alcohol and sterol ferulates with lipid-lowering actions by the inhibition of HMG-CoA reductase and the reduction of intestinal cholesterol absorption [183].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.2. γ-oryzanol
What the sources say
- Not checked yetcites [183] Mäkynen K Chitchumroonchokchai C Adisakwattana S Failla M Ariyapitipun T Effect of gamma-oryzanol on the bioaccessibility and synthesis of cholesterol Eur Rev Med Pharmacol Sci 2012 16 49 56 22338548
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Nevertheless, a major problem is its oral bioavailability: curcumin has low solubility in water and it is a substrate of rapid metabolism. New strategies of release have been studied and tested such as phytosomal complexation with phosphatidylcholine, coadministration of piperine, using turmeric oleoresin, reducing particle size, and changing the formulation (nanoemulsion, solid lipid nanoparticle”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [203] Rahimi HR Nedaeinia R Sepehri Shamloo A Nikdoust S Kazemi Oskuee R Novel delivery system for natural products: nano-curcumin formulations Avicenna J Phytomed 2016 6 383 98 27516979 PMC4967834
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The ω-3 present in krill oil (EPA + DHA) appears to be better absorbed in the gastrointestinal tract than that found in fish oil: this is possible because of phosphatidylcholine (the main phospholipid present in krill (40%), which binds EPA and DHA), which confers greater stability to fatty acids.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [173] Cicero AF Colletti A Krill oil: evidence of a new source of polyunsaturated fatty acids with high bioavailability Clin Lipidol 2015 10 1 4
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“PUFAs might also be associated with an improvement of FMD and PWV, and, with larger dosages, with positive effects on inflammatory diseases and mood [171].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [171] Cicero AF Reggi A Parini A Borghi C Application of polyunsaturated fatty acids in internal medicine: beyond the established cardiovascular effects Arch Med Sci 2012 8 784 93 23185186 PMC3506235
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In a study including MetS patients, treatment with 1 g/day of curcuminoids as an add-on to the standard therapy resulted in a significant reduction of LDL-C (–0.78 mmol/l (30 mg/dl), p < 0.001), TG (–0.2 mmol/l (17.7 mg/dl), p = 0.006), and Lp(a) (–0.286 μmol/l (8 mg/dl), p < 0.001) and an elevation of HDL-C (+0.18 mmol/l (7 mg/dl), p = 0.003) [196].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [196] Yang YS Su YF Yang HW Lee YH Chou JI Ueng KC Lipid-lowering effects of curcumin in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled trial Phytother Res 2014 28 1770 7 25131839
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In conclusion, omega-3 EPA and DHA represent a valid nutraceutical to reduce TG in the blood (by 18–25%) while their effects on LDL-C and HDL-C are clinically insignificant.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
- Rests on an assumption: The lipid-lowering effects of nutraceuticals observed in short-term trials translate into reduced cardiovascular risk.
In the paper
“In the most recent meta-analysis of 7 RCTs with 662 participants Ursoniu et al. found a significant reduction in plasma concentrations of LDL-C (–15.52 mg/dl (0.4 mmol/l); 95% CI: –28.43 to –2.61; p = 0.018), and TG (–14.03 mg/dl (0.16 mmol/l); 95% CI: –21.38 to –6.67; p < 0.001), and significant elevation in plasma concentrations of HDL-C (6.65 mg/dl (0.17 mmol/l); 95% CI: 2.30 to 10.99; p = 0.00”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [176] Ursoniu S Sahebkar A Serban MC Lipid and Blood Pressure Meta-analysis Collaboration Group Lipid-modifying effects of krill oil in humans: systematic review and meta-analysis of randomized controlled trials Nutr Rev 2017 75 361 73 28371906
plaindirectn = 662 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“A relatively recent meta-analysis including data from 63 030 patients from 20 clinical trials showed that treatment with ω-3 did not have an impact on a composite CVD endpoint or total mortality but was associated with a significantly decreased rate of vascular death [181].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [181] Kotwal S Jun M Sullivan D Perkovic V Neal B Omega 3 fatty acids and cardiovascular outcomes: systematic review and meta-analysis Circ Cardiovasc Qual Outcomes 2012 5 808 18 23110790
plaincorrelationaln = 63,030- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Especially, it needs be noted that smaller doses than 2–4 g/day such as a low dose supplementation of a margarine with n-3 PUFAs (400 mg/day EPA + DHA) or α-linolenic acid (2 g/day) do not significantly reduce TG levels, as was confirmed in an RCT involving 4837 post-MI patients. Such supplementation also did not reduce the rate of major CVD events [180].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [180] Kromhout D Giltay EJ Geleijnse JM Alpha Omega Trial Group n-3 fatty acids and cardiovascular events after myocardial infarction N Engl J Med 2010 363 2015 26 20929341
plainn = 4,837- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, it has to be stressed that CVD outcome studies with ω-3 have produced inconsistent results and their clinical efficacy appears to be related to non-lipid effects.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“A recent meta-analysis that included 7 clinical trials to assess the effect of spirulina supplementation on plasma lipid concentrations showed the lipid-lowering efficacy of spirulina, with a reduction of LDL-C by –1.07 mmol/l (41.32 mg/dl) (95% CI: –1.57; –0.57, p < 0.001), TC by 1.21 mmol/l (46.76 mg/dl) (95% CI: –1.74; –0.68, p < 0.001) and TG by –0.5 mmol/l (44.23 mg/dl) (95% CI: –0.57; –0.43,”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.3. Spirulina
What the sources say
- Not checked yetcites [188] Pulido-Moran M Moreno-Fernandez J Ramirez-Tortosa C Ramirez-Tortosa M Curcumin and health Molecules 2016 21 264 26927041 PMC6273481
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“C-phycocyanin, a particular essential pigment of Spirulina, contains a phycocyanobilin, which can activate atheroprotective heme oxygenase-1 (HMOX-1), a key enzyme in the heme catabolic pathway in endothelial cells. Moreover, phycocyanin has proven antioxidant, anti-inflammatory and radical scavenging properties [187].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.3. Spirulina
What the sources say
- Not checked yetcites [187] Serban MC Sahebkar A Dragan S A systematic review and meta-analysis of the impact of Spirulina supplementation on plasma lipid concentrations Clin Nutr 2016 35 842 51 26433766
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“It was also observed that the administration of EPA or DHA individually gave comparable effects in the reduction of TG, but not other lipid parameters; in fact, DHA showed a very modest reduction of LDL-C by 5% and slightly increased HDL-C, while EPA produced no significant changes [169, 170].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [169] Trumbo P Schlicker S Yates AA Poos M Food and Nutrition Board of the Institute of Medicine, The National Academies Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids J Am Diet Assoc 2002 102 1621 30 12449285
- Not checked yetcites [170] Wei MY Jacobson TA Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysis Curr Atheroscler Rep 2011 13 474 83 21975919
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In addition, there was a small insignificant reduction of LDL-C of 0.06 mmol/l (2.3 mg/dl), but no differences in HDL-C [166].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [166] Eslick GD Howe PR Smith C Priest R Bensoussan A Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis Int J Cardiol 2009 136 4 16 18774613
plainn = 511- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Spirulina (Arthrospira platensis) is a filamentous microalga with known lipid-lowering effects, but with an unclear mechanism of action [186].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.3. Spirulina
What the sources say
- Not checked yetcites [186] Nagaoka S Shimizu K Kaneko H A novel protein C-phycocyanin plays a crucial role in the hypocholesterolemic action of Spirulina platensis concentrate in rats J Nutr 2005 135 2425 30 16177207
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These results were confirmed in normolipidemic and borderline subjects in the meta-analysis by Leslie et al. that included 2270 individuals with optimal lipid or suboptimal TG profiles (TG < 2 mmol/l (177 mg/dl)). In studies that used more than 4 g/day of ω-3 TG were reduced by 9–26%, while a reduction of 4–51% was found with doses from 1 to 5 g/day of ω-3 [167].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [167] Leslie MA Cohen DJ Liddle DM Robinson LE Ma DW A review of the effect of omega-3 polyunsaturated fatty acids on blood triacylglycerol levels in normolipidemic and borderline hyperlipidemic individuals Lipids Health Dis 2015 14 53 26048287 PMC4488064
plaindirectn = 2,270- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Safety: No serious side effects have been reported; most of them have been defined as mild gastrointestinal [169].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [169] Trumbo P Schlicker S Yates AA Poos M Food and Nutrition Board of the Institute of Medicine, The National Academies Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids J Am Diet Assoc 2002 102 1621 30 12449285
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In recent RCTs, supplementation with curcumin (1 g/day) was associated with a reduction of serum uric acid (p < 0.001) [199], increase of adiponectin (+76.78%, p = 0.033) levels and reduction of leptin (–26.49%, p = 0.238) [189].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [199] Panahi Y Kianpour P Mohtashami R Jafari R Simental-Mendía LE Sahebkar A Curcumin lowers serum lipids and uric acid in subjects with non-alcoholic fatty liver disease: a randomized controlled trial J Cardiovasc Pharmacol 2016 68 223 9 27124606
- Not checked yetcites [189] Panahi Y Hosseini MS Khalili N Effects of supplementation with curcumin on serum adipokine concentrations: A randomized controlled trial Nutrition 2016 32 1116 22 27297718
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“As reported in recent meta-analyses of RCTs, curcuminoids showed an increase in serum activities of superoxide dismutase (p = 0.0007) and catalase (p = 0.005) and glutathione concentrations (p = 0.01) and a reduction in serum lipid peroxides (p = 0.008) [189] and of TNF-α [190].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [189] Panahi Y Hosseini MS Khalili N Effects of supplementation with curcumin on serum adipokine concentrations: A randomized controlled trial Nutrition 2016 32 1116 22 27297718
- Not checked yetcites [190] Sahebkar A Cicero AF Simental-Mendía LE Aggarwal BB Gupta SC Curcumin downregulates human tumor necrosis factor-alpha levels: a systematic review and meta-analysis of randomized controlled trials Pharmacol Res 2016 107 234 42 27025786
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These data have since been confirmed in a further trial carried out on 100 MetS patients [197] and in another one with 80 NAFLD patients [198].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [197] Panahi Y Khalili N Hosseini MS Abbasinazari M Sahebkar A Lipid-modifying effects of adjunctive therapy with curcuminoids-piperine combination in patients with metabolic syndrome: results of a randomized controlled trial Complement Ther Med 2014 22 851 7 25440375
- Not checked yetcites [198] Rahmani S Asgary S Askari G Treatment of non-alcoholic fatty liver disease with curcumin: a randomized placebo-controlled trial Phytother Res 2016 6 8 [Epub ahead of print] 10.1002/ptr.5659 27270872
plaindirectn = 100- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A recent meta-analysis of RCTs showed that sesame fractions intake is associated with a significant TG reduction (–0.24 mmol/l (21.3 mg/dl); 95% CI: –0.32; –0.15, p < 0.001), while no changes occurred with LDL-C or HDL-C levels [179].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [179] Khalesi S Paukste E Nikbakht E Khosravi-Boroujeni H Sesame fractions and lipid profiles: a systematic review and meta-analysis of controlled trials Br J Nutr 2016 115 764 73 26758593
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The mechanisms through which ω-3 reduce TG are: the reduction of synthesis of hepatic VLDL, the reduction of available substrate for the synthesis of new TG (ω-3 are false substrates), the reduction of the activity of TG-synthesizing enzymes (diacylglycerol acyltransferase or phosphatidic acid phosphohydrolase), the increase of β-oxidation of fatty acids, the reduction of the endogenous synthesis”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [165] Harris WS Bulchandani D Why do omega-3 fatty acids lower serum triglycerides? Curr Opin Lipidol 2006 17 387 93 16832161
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The cholesterol-lowering effects were more significant in females (in particular in postmenopausal women) and in individuals with high cholesterol levels at baseline [177].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
What the sources say
- Not checked yetcites [177] Pan A Yu D Demark-Wahnefried W Franco OH Lin X Meta-analysis of the effects of flexseed interventions on blood lipids Am J Clin Nutr 2009 90 288 97 19515737 PMC3361740
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The lipid-lowering mechanisms of action of curcuminoids are unclear; nevertheless, it seems that curcumin inhibits the expression of the NPC1L1 transporter via the SREBP2 transcription factor [191], and that it increases the efflux of cholesterol via expression of ABCA1 and activating AMPK-SIRT1-LXRα signaling in THP-macrophage-derived foam cells [192]. Furthermore, curcumin enhances the number of”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.4. Curcumin
What the sources say
- Not checked yetcites [191] Kumar P Malhotra P Ma K SREBP2 mediates the modulation of intestinal NPC1L1 expression by curcumin Am J Physiol Gastrointest Liver Physiol 2011 301 G148 55 21527728 PMC3129937
- Not checked yetcites [192] Liu XL Liu MH Hu HJ Curcumin enhanced choelsterol efflux by upregulating ABCA1 expression through AMPK-SIRT1-LXRalpha signaling in THP-1 macrophage-derived foam cells DNA Cell Biol 2015 34 561 72 26102194
- Not checked yetcites [193] Tai MH Chen PK Chen PY Wu MJ Ho CT Yen JH Curcumin enhances cell-surface LDLR level and promotes LDL uptake through downregulation of PCSK9 gene expression in HepG2 cells Mol Nutr Food Res 2014 58 2133 45 25164566
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The combination of red yeast rice extract (200 mg, corresponding to 3 mg of Monacolin K) with policosanol (10 mg) was also tested in a large single-blind, randomized, multicenter study in 411 centers, comparing the effect of the nutraceutical association plus diet versus diet alone with a follow-up of 16 weeks. In 2408 eligible subjects (1665 adults and 743 elderly), LDL-C was reduced by 21%, wh”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.1. Red yeast rice and policosanols
What the sources say
- Not checked yetcites [241] Cicero AF Benvenuti C ARMoweb study Group Efficacy of a red yeast rice based nutraceutical in large subgroups of hypercholesterolemic subjects in every day clinical practice Med J Nutr Metab 2010 3 239 46
plaindirectn = 2,408- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“In diabetic patients, silymarin improves fasting plasma glucose (FPG) and HbA1c, but not lipid parameters [227].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.9. Silymarin (Silybum marianum)
What the sources say
- Not checked yetcites [227] Voroneanu L Nistor I Dumea R Apetrii M Covic A Silymarin in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials J Diabetes Res 2016 2016 5147468 27340676 PMC4908257
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Most of them are used in combination with a low dosage of other nutraceuticals, statins and other lipid-lowering drugs, because that allows the risk of side effects to be reduced and the efficacy to be improved (reducing the residual CV risk) [237].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations
What the sources say
- Not checked yetcites [237] Cicero AF Ferroni A Ertek S Tolerability and safety of commonly used dietary supplements and nutraceuticals with lipid-lowering effects Expert Opin Drug Saf 2012 11 753 66 22788832
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There are preliminary studies suggesting a potential role of silymarin as lipid-lowering agent; studies in vitro have shown an inhibitory effect of silybin on HMG-CoA reductase and in vivo an improved uptake of LDL by the liver and a reduction of hepatic cholesterol synthesis [227].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.9. Silymarin (Silybum marianum)
What the sources say
- Not checked yetcites [227] Voroneanu L Nistor I Dumea R Apetrii M Covic A Silymarin in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials J Diabetes Res 2016 2016 5147468 27340676 PMC4908257
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“According to some pre-clinical and clinical investigations, artichoke leaf extract (ALE) has potential hypolipidemic and hepatoprotective effects. The beneficial effects of artichoke can be attributed to its antioxidant action.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
What the sources say
- Not checked yetcites [208] Capasso F Gaginella TS Grandolini G Izzo AA Phytotherapy: a Quick Reference to Herbal Medicine 2003 Berlin Springer
- Not checked yetcites [209] Safaa M Hanaa A Abdel F Nahila A Abdelaaty S Cynara scolymus for relieving on nonalcoholic steatohepatitis induced in rat Int J Pharm Pharmac Sci 2013 5 57 66
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Even if vitamin E seems not to be an effective lipid-lowering treatment, its supplementation seems to be associated with reduced risk of fatal myocardial infarction [219].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.7. Vitamin E
What the sources say
- Not checked yetcites [219] Loffredo L Perri L Di Castelnuovo A Iacoviello L De Gaetano G Violi F Supplementation with vitamin E alone is associated with reduced myocardial infarction: a meta-analysis Nutr Metab Cardiovasc Dis 2015 25 354 63 25779938
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In 58 diabetic patients, 320 mg/day of anthocyanins for 24 weeks significantly decreased LDL-C (–7.9%, p < 0.05), TG (–23%, p < 0.01), apoB48 (–16.5%, p < 0.05), and apoCIII (–11%, p < 0.01) and increased HDL-C (+19.4%, p < 0.05) compared to placebo.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.8. Anthocyanins
What the sources say
- Not checked yetcites [222] Li D Zhang Y Liu Y Sun R Xia M Purified anthocyanin supplementation reduces dyslipidemia, enhances antioxidant capacity, and prevents insulin resistance in diabetic patients J Nutr 2015 145 742 8 25833778
plaindirectn = 58 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In fact it is well known that the bioavailability of anthocyanins is low and they are rapidly biotransformed into derivates of phenolic acid [225].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.8. Anthocyanins
What the sources say
- Not checked yetcites [225] Marques C Fernandes I Norberto S Pharmacokinetics of blackberry anthocyanins consumed with or without ethanol: a randomized and crossover trial Nutr Food Res 2016 60 2319 30 27306520
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The most recent meta-analysis of 9 RCTs with 702 subjects suggested a significant decrease in plasma concentrations of TC (weighted mean difference (WMD): –17.6 mg/dl (0.46 mmol/l), 95% CI: –22.0, –13.3, p < 0.001), LDL-C (–14.9 mg/dl (0.39 mmol/l), 95% CI: –20.4, –9.5, p = 0.011) and triglycerides (WMD: –9.2 mg/dl (0.1 mmol/l), 95% CI: –16.2, –2.1, p = 0.011) [214].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
What the sources say
- Not checked yetcites [214] Sahebkar A Pirro M Banach M Mikhailidis DP Atkin SL Cicero AFG Lipid-lowering activity of artichoke extracts: a systematic review and meta-analysis Crit Rev Food Sci Nutr 2017 6 13 10.1080/10408398.2017.1332572 28609140
hedgeddirectn = 702 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Moreover, the anthocyanin group showed an improvement of fasting plasma glucose (–8.5%, p < 0.05), of homeostasis model assessment (HOMA) for insulin resistance index (p < 0.05) and of adiponectin concentrations (+23.4%, p < 0.01) [222].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.8. Anthocyanins
What the sources say
- Not checked yetcites [222] Li D Zhang Y Liu Y Sun R Xia M Purified anthocyanin supplementation reduces dyslipidemia, enhances antioxidant capacity, and prevents insulin resistance in diabetic patients J Nutr 2015 145 742 8 25833778
plaindirectn = 58 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In addition, artichoke extract showed pleiotropic activities in the improvement of certain liver enzymes such as AST and ALT (p < 0.001), blood sugar (p = 0.029) and systolic blood pressure (p = 0.004) [210].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
What the sources say
- Not checked yetcites [210] Rangboo V Noroozi M Zavoshy R Rezadoost SA Mohammadpoorasl A The effect of artichoke leaf extract on alanine aminotransferase and aspartate aminotransferase in the patients with nonalcoholic steatohepatitis Int J Hepatol 2016 2016 4030476 27293900 PMC4879230
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“An RCT (75 patients treated for 12 weeks with 1280 mg/day of artichoke leaf extract or placebo) showed a mean reduction of TC by 4.2% compared to baseline and an increasing trend of TC levels in the placebo group. The total difference between the two groups was statistically significant (p = 0.0025). No significant difference between groups was observed for LDL-C, HDL-C or TG levels [211].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
What the sources say
- Not checked yetcites [211] Bundy R Walker AF Middleton RW Wallis C Simpson HC Artichoke leaf extract (Cynara scolymus) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: a randomized, double blind placebo controlled trial Phytomedicine 2008 15 668 75 18424099
plaindirectn = 75- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“At doses between 50 and 200 mg it showed an improvement of endothelial function (reducing the serum levels of hs-CRP, advanced glycation end products, metalloproteinases and cell adhesion molecules) and arterial stiffness (improving PWV, pulse volume (PV) and the augmentation index (AI)) [217, 218].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.7. Vitamin E
What the sources say
- Not checked yetcites [217] Rasool AH Rahman AR Yuen KH Wong AR Arterial compliance and vitamin E blood levels with a self emulsifying preparation of tocotrienol rich vitamin E Arch Pharm Res 2008 31 1212 7 18806966
- Not checked yetcites [218] Prasad K Tocotrienols and cardiovascular health Curr Pharm Des 2011 17 2147 54 21774782
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In conclusion, ALE could represent an adjuvant in the regulation of lipid profile and liver levels of AST and ALT; however, the available clinical data are still preliminary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The lipid-lowering effects of nutraceuticals observed in short-term trials translate into reduced cardiovascular risk.
In the paper
“A second RCT (143 patients treated with 1800 mg/day of ALE for 6 weeks) showed a mean reduction of TC of 18.5% compared to 8.6% in the placebo group – the difference between the two groups was statistically significant (p < 0.00001). Moreover, the levels of LDL-C were also significantly decreased in the artichoke leaf extract group (mean: –1.26 mmol/l (48.7 mg/dl)) compared to the placebo group (”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
What the sources say
- Not checked yetcites [212] Englisch W Beckers C Unkauf M Ruepp M Zinserling V Efficacy of Artichoke dry extract in patients with hyperlipoproteinemia Arzneimittelforschung 2000 50 260 5 10758778
plaindirectn = 143 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These results could explain the variability observed in the response among patients with moderate hypercholesterolemia, and they may be useful in identifying subjects who could potentially benefit the most from this supplementation [247].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.2. Red yeast rice, policosanols and berberine
What the sources say
- Not checked yetcites [247] De Castro-Orós I Solà R Valls RM Genetic variants of LDLR and PCSK9 associated with variations in response to antihypercholesterolemic effects of armolipid plus with berberine PLoS One 2016 11 e0150785 27015087 PMC4807809
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Astaxanthin, a powerful antioxidant carotenoid, is often cited as having a lipid-lowering effect, but this effect is not supported by clinical evidence, while its supplementation is associated with a mild but significant improvement in fasting plasma glucose [235].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.11. Other nutraceuticals
What the sources say
- Not checked yetcites [235] Ursoniu S Sahebkar A Serban MC Banach M Lipid profile and glucose changes after supplementation with astaxanthin: a systematic review and meta-analysis of randomized controlled trials Arch Med Sci 2015 11 253 66 25995739 PMC4424245
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There are several suggested mechanisms of lipid-lowering action of vitamin E: peroxisome proliferator-activated receptor (PPAR-α, PPAR-β, and PPAR-γ) activation, HMG-CoA reductase inhibition and radical scavenger [215].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.7. Vitamin E
What the sources say
- Not checked yetcites [215] Li F Tan W Kang Z Wong CW Tocotrienol enriched palm oil prevents atherosclerosis through modulating the activities of peroxisome proliferators-activated receptors Atherosclerosis 2010 211 278 82 20138624
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The third study (44 patients treated with 1920 mg/day of ALE for 12 weeks) showed no significant differences in the lipid profile at the end of the treatment. However, according to a subgroup analysis, patients treated with artichoke leaf extract who had at baseline TC levels greater than 230 mg/dl showed a significant reduction of TC when compared with those treated with placebo (p = 0.0015) [213”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.6. Artichoke (Cynara scolymus, Cynara cardunculus)
What the sources say
- Not checked yetcites [213] Petrowicz O Gebhardt R Donner M Schwandt M Kraft K Effects of artichoke leaf extract (ALE) on lipoprotein metabolism in vitro and in vivo Atherosclerosis 1997 129 147
plainn = 44 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The association of red yeast rice extract (340 mg containing 5 mg of MonK) and octacosanols (10 mg) was tested in 111 patients with moderate hypercholesterolemia, normal/border-line triglyceridemia and low CVD risk (< 20% according to the Framingham Risk Score (FRS)). The reduction of LDL-C was 20% and it was similar to that obtained with pravastatin at the dose 20 mg/day, without any serious”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.1. Red yeast rice and policosanols
What the sources say
- Not checked yetcites [239] Cicero AF Brancaleoni M Laghi L Donati F Mino M Antihyperlipidaemic effect of a Monascus purpureus brand dietary supplement on a large sample of subjects at low risk for cardiovascular disease: a pilot study Complement Ther Med 2005 13 273 8 16338198
plaindirectn = 111- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Moreover, natural products with different mechanisms of action can be associated to achieve a potential synergetic effect, acting on the absorption of lipids from the bowel and/or increasing their excretion (soluble fibers, glucomannan, plant sterols, probiotics), enhancing the hepatic uptake of cholesterol (berberine, soybean proteins), inducing LDL-C excretion (berberine, soy proteins, chlor”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations
What the sources say
- Not checked yetcites [238] Cicero AF Parini A Rosticci M Nutraceuticals and cholesterol-lowering action Int J Cardiol Med Endocr 2015 6 1 4
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Among the biological activities exerted by anthocyanins, clinical trials have demonstrated particular antioxidant, anti-inflammatory and lipid-lowering effects [221].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.8. Anthocyanins
What the sources say
- Not checked yetcites [221] Wallace TC Slavin M Frankenfeld CL Systematic review of anthocyanins and markers of cardiovascular disease Nutrients 2016 8 pii: E32 10.3390/nu8010032 PMC4728646 26761031
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a recent systematic review and meta-analysis, CLA supplementation was associated with a significant decrease in LDL-C (MD: –0.22 mmol/l (8.5 mg/dl); 95% CI: –0.36; –0.08, p = 0.002), while non-significant results were obtained for HDL-C and TG [230].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.10. Conjugated linoleic acid
What the sources say
- Not checked yetcites [230] Derakhshande-Rishehri SM Mansourian M Kelishadi R Heidari-Beni M Association of foods enriched in conjugated linoleic acid (CLA) and CLA supplements with lipid profile in human studies: a systematic review and meta-analysis Public Health Nutr 2015 18 2041 54 25379623 PMC10271550
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Even knowing that statins are the drugs of choice in patients with high LDL-C levels and moderate-to-high CV risk, the use of high-intensity statins increases the side effects and therefore reduces the therapy adherence and compliance [277, 278].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy
What the sources say
- Not checked yetcites [277] Šimić I Reiner Ž Adverse effects of statins – myths and reality Curr Pharm Des 2015 21 1220 6 25312733
- Not checked yetcites [278] Banach M Stulc T Dent R Toth PP Statin non-adherence and residual cardiovascular risk: there is need for substantial improvement Int J Cardiol 2016 225 184 96 27728862
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For these combined products, due to lack of enough data, is not possible, at this moment, to suggest a final classification. The level of evidence might have been limited to “B” or “C” – expert opinion with the class of suggestion “IIb” waiting for confirmative trials.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, most of the combinations presented below have been tested only in a single study, and the obtained results have not been confirmed yet, so no recommendations can be made.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A double-blind, placebo-controlled trial was assessed on 56 hypercholesterolemic patients, who were randomly assigned to receive vitamin D 200 IU/day (n = 28) or a placebo (n = 28) as an add-on to statin for 6 months.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [296] Qin XF Zhao LS Chen WR Yin da W Wang H Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: a randomized placebo-controlled trial Clin Nutr 2015 34 201 6 24844869
plainn = 56 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Taking into consideration that low serum vitamin D level seems to be associated with CVD risk and development of statin-related myopathy, the supplementation of vitamin D should always be considered in subjects with low vitamin D levels [297].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
What the sources say
- Not checked yetcites [297] Michalska-Kasiczak M Sahebkar A Mikhailidis DP Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Analysis of vitamin D levels in patients with and without statin-associated myalgia – a systematic review and meta-analysis of 7 studies with 2420 patients Int J Cardiol 2015 178 111 6 25464233
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Safety: No safety concerns; limited data – further studies are necessary.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.9. Statins and vitamin D
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
The cited meta-analyses and RCTs are of sufficient methodological quality and their results are valid for the populations studied.
“Based on available data it seems that the best results were obtained with Lactobacillus strains.”
The paper relies on this without support.
The effects of nutraceuticals observed in trials generalize to clinical practice in the broader patient populations for whom they are recommended.
“In summary, the administration of RYR can be recommended because of its effects on LDL-C in patients with moderately elevated cholesterol, especially in primary prevention.”
The paper relies on this without support.
The safety data from clinical trials adequately reflect real-world safety of these nutraceuticals.
“Clinical studies conducted to date with dosages between 500 and 1500 mg/day showed a good safety profile, with no side effects detected.”
The paper relies on this without support.
The chronic use of a high quantity of soy products containing isoflavones could interfere with thyroid function and fertility.
“Safety: The chronic use of a high quantity of soy products containing isoflavones could interfere with thyroid function and fertility.”
The paper relies on this without support.
Soybean and its derivatives contain high amounts of phytic acid that reduces the absorption of minerals such as calcium, magnesium, copper, iron and zinc.
“Furthermore, soybean and its derivatives contain high amounts of phytic acid that reduces the absorption of minerals such as calcium, magnesium, copper, iron and zinc.”
The paper relies on this without support.
Lupine has a good safety profile, causing no severe side effects, and those which occurred were mostly gastrointestinal.
“Lupine has shown a good safety profile, causing no severe side effects, and those which occurred were mostly gastrointestinal.”
The paper relies on this without support.
In alloxan-injured mice, phycocyanin decreases TC and TG levels in serum, increases hepatic glycogen level and maintains glucokinase expression in the liver.
“According to experimental studies in alloxan-injured mice, phycocyanin decreases TC and TG levels in serum, increases the hepatic glycogen level and maintains glucokinase (GK) expression in the liver.”
The paper relies on this without support.
The lipid-lowering effects of nutraceuticals observed in short-term trials translate into reduced cardiovascular risk.
“In conclusion, the intake of soy and lupine represents a potential, relatively weak adjuvant therapy in the treatment of hypercholesterolemia, especially in individuals with moderate cholesterol levels.”
The paper relies on this without support.
The safety data from short-term studies are sufficient to establish long-term safety.
“Long-term safety studies are not available yet.”
The paper relies on this without support.
The cited studies' results are reliable and applicable to the populations described in the paper.
“Based on the available data, no serious safety concerns have been raised.”
The paper relies on this without support.
The absence of reported serious safety concerns in the available studies indicates that the nutraceutical combinations have no serious safety concerns.
“Based on the available data, no serious safety concerns have been raised.”
The paper relies on this without support.
Improvements in surrogate endpoints such as LDL-C, hs-CRP, and endothelial function translate into clinical cardiovascular benefit.
“Many available data, including the most recent studies with PCSK9 inhibitors, support the LDL-C concept that “lower is better” [276].”
The paper relies on this without support.
Low vitamin D status is associated with hyperlipidemia.
“Low vitamin D status has been associated with hyperlipidemia.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Some evidence of additive efficacy is available for the association of statins with PUFAs, soluble fibers, plant sterols, bergamot, tocotrienols, garlic, and vitamin D [107]”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [107]
In the citing paper
“In certain clinical situations, such as in patients who are unable to tolerate statin therapy and who also have persistent severe elevations in triglycerides (TGs), omega-3 acids might represent an important natural alternative choice (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Nutraceuticals can help achieve lipid therapeutic goals and reduce CV residual risk; however, data on the latter are still limited (19)”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Direct vascular effects, mainly on FMD, have been demonstrated (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Soybeans and their derivatives contain high amounts of phytic acid that reduces the absorption of some minerals (calcium, magnesium, copper, iron, and zinc) (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Based on available studies, some adverse effects have been reported, but the results are conflicting (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Clinical trials and meta-analyses have not shown any major safety concerns (131), nor is there any evidence of direct vascular effects after their persistent use (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Bergamot may potentially reduce overall CV risk, but effects on CV outcomes have not been demonstrated (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Substitution of soybean proteins in the diet has been used for the reduction of plasma cholesterol levels in hypercholesterolemic subjects (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“The chronic use of a high quantity of soy products containing isoflavones might interfere with thyroid function and fertility (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Bergamot has a good efficacy and safety profile in dyslipidemic and other cardiometabolic patients without any adverse effects detected.”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
In the citing paper
“Direct vascular effects (FMD, PWV) have been demonstrated, as well as their role in reduction of CV outcomes (19).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [19]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 8. Conclusions
“there are still no outcome studies proving that nutraceuticals can prevent CVD morbidity or mortality.”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
“RYR supplementation showed a reduction in the risk of CHD (31.0%, p = 0.04), all-cause mortality (31.9%, p = 0.01), stroke (44.1%, p = 0.04)”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
“At 1-year follow-up, 58 (72.5%) patients of the combined therapy group (n = 86) reached the therapeutic goal”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 7. Nutraceuticals combined with pharmacological therapy > 7.3. Ezetimibe, red yeast rice, policosanol and berberine
Reported 72.5 · recomputed 67.44186
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
“The EFSA has established as 0.2 μg/kg b.w. per day the highest quantity of citrinin which can be taken by humans with no nephrotoxic effects [100].”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
“the level of 20 μg/kg b.w. per day suggested by the EFSA [86].”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
“significantly reduced LDL-C (–0.21 mmol/l (8.1 mg/dl)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 2. Inhibitors of intestinal cholesterol absorption > 2.2. Soluble fibers
“(95% CI: 0.27; –0.14)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
“#### 6.9.4. Psyllium and n-3 polyunsaturated fatty acids”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
“The combination of phytosterols and ω-3 PUFAs reduced LDL-C by 12.5% (p = 0.002) and TG by 25.9% (p = 0.005)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Pantethine
“| IIa | A | 600–900 mg | Not applicable | Not demonstrated | Not demonstrated |”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.3. Pantethine
“In a further 16-week triple-blinded RCT carried out on mildly hypercholesterolemic subjects pantethine 600–900 mg/day reduced LDL-C level by 11% [115].”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
“A small increase of HDL-C (0.007 mmol/l; 0.03; 0.11)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 3. Inhibitors of liver cholesterol synthesis > 3.1. Red yeast rice extract
“(0.3 mg/dl)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 6. Nutraceutical combinations > 6.9. Different nutraceutical combinations supported by single RCTs
“TG –0.60 ±0.63 mmol/l (23.2 mg/dl)”
§ Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel > 5. Other nutraceuticals with mixed mechanisms of action > 5.1. Polyunsaturated ω-3 fatty acids
“TG of 14% (–0.34 mmol/l (30.12 mg/dl)”
Citations
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Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011
Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
Grundy, S. M., Becker, D. M., Clark, L. T., Cooper, R., Denke, M. A., Howard, J. L., Hunninghake, D. B., Illingworth, D. R., Luepker, R. V., McBride, P. E., et al. (2002) · Civil War Book Review · Cited by 12,198
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
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Cholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550
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- [207]Mazidi M Rezaie P Banach M Impact of L-carnitine on C-reactive proteIn: a systematic review and meta-analysis of 10 randomized control trials with 925 patients 2017 7 Presentation at 2nd CPPEI Congress in Vienna (data unpublished)
- [285]Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico Lancet 1999 354 447 55 10465168
Cited by
Sorted by citations
The Role of Nutraceuticals in Statin Intolerant Patients
Banach, M., Patti, A. M., Giglio, R. V., Cicero, A. F. G., Atanasov, A. G., Bajraktari, G., Bruckert, E., Descamps, O., Djuric, D. M., Ezhov, M., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.04.040 · Cited by 272
Self-citationJu, J., Li, J., Lin, Q., & Xu, H. (2018) · Phytomedicine · doi:10.1016/j.phymed.2018.09.212 · Cited by 124
Cicero, A. F. G., Fogacci, F., Stoian, A. P., Vrablik, M., Al Rasadi, K., Banach, M., Toth, P. P., & Rizzo, M. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00955-y · Cited by 110
Self-citationPontes, K. S. D. S., Guedes, M. R., Cunha, M. R. D., Mattos, S. D. S., Barreto Silva, M. I., Neves, M. F., Marques, B. C. A. A., & Klein, M. R. S. T. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.06.023 · Cited by 86
Fogacci, F., Grassi, D., Rizzo, M., & Cicero, A. F. G. (2019) · Phytotherapy Research · doi:10.1002/ptr.6282 · Cited by 61
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Metadata
- Authors
- Cicero, A. F. G., Colletti, A., Bajraktari, G., Descamps, O., Djuric, D. M., Ezhov, M., Fras, Z., Katsiki, N., Langlois, M., Latkovskis, G., Panagiotakos, D. B., Paragh, G., Mikhailidis, D. P., Mitchenko, O., Paulweber, B., Pella, D., Pitsavos, C., Reiner, Ž., Ray, K. K., Rizzo, M., Sahebkar, A., Serban, M.-C., Sperling, L. S., Toth, P. P., Vinereanu, D., Vrablík, M., Wong, N. D., & Banach, M.
- Affiliations
- University of Bologna (IT)
- University Clinical Center of Kosovo (XK)
- University of Belgrade (RS)
- University of Ljubljana (SI)
- Aristotle University of Thessaloniki (GR)
- University of Pavol Jozef Šafárik (SK)
- Harokopio University of Athens (GR)
- The Royal Free Hospital (GB)
- Paracelsus Medical University (AT)
- National and Kapodistrian University of Athens (GR)
- University Hospital Centre Zagreb (HR)
- Imperial College London (GB)
- Istituto Euro Mediterraneo di Scienza e Tecnologia (IT)
- Mashhad University of Medical Sciences (IR)
- Emory University (US)
- Johns Hopkins University (US)
- University of California, Irvine (US)
- Medical University of Lodz (PL)
- Corresponding author
- Cicero, Arrigo F.G.
- Banach, Maciej
- ORCID
- Cicero, Arrigo F.G.
- Colletti, Alessandro
- Bajraktari, Gani
- Descamps, Olivier
- Djuric, Dragan M.
- Katsiki, Niki
- Langlois, Michel
- Latkovskis, Gustavs
- Panagiotakos, Demosthenes B.
- Mikhailidis, Dimitri P.
- Mitchenko, Olena
- Paulweber, Bernhard
- Pella, Daniel
- Pitsavos, Christos
- Reiner, Željko
- Ray, Kausik K.
- Rizzo, Manfredi
- Sahebkar, Amirhossein
- Sperling, Laurence S.
- Toth, Peter P.
- Wong, Nathan D.
- Banach, Maciej
- Venue
- Archives of Medical Science
- Publisher
- Termedia Sp. z.o.o.
- Published
- 2017
- Volume
- 5
- Issue
- 5
- Pages
- 965-1005
- ISSN
- 1734-1922 (ISSN-L)
- PMC
- PMC5575230
- OpenAlex
- W2743820880
- Semantic Scholar
- ff099cb4733a1f447f72569bbb7dd31b1d41801e
- Cited by
- 281
- References
- 294
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 11 · 2023: 20 · 2022: 26 · 2021: 50 · 2020: 33 · 2019: 44 · 2018: 62 · 2017: 12
- FWCI
- 42.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Archives of Medical Science (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Repository of the Medical Faculty of the University of Zagreb (University of Zagreb) (acceptedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion, other-oa)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Natural Products and Biological Research
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Keywords
- nutraceuticals, lipid-lowering drugs, cardiovascular disease, hypercholesterolemia, LDL cholesterol, HDL cholesterol, total cholesterol, atherosclerosis, ischemic heart disease, coronary artery disease, cardiovascular risk factors, statins, dietary cholesterol, dietary fiber, phytosterols, omega-3 fatty acids, clinical guidelines
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-08, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-08 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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