In this author’s last post, dyslipidemia was explored as well as its relationship to the lipid-lowering capacity of red yeast rice (RYR). In addition to outlining the cardiovascular benefits of RYR, research was also considered that identified the potential of coenzyme Q10 (CoQ10) induced deficiency from RYR intake, and physiological consequences of the same. Thus, in the following sections, this author would like to consider the synergistic benefits of implementing RYR and CoQ10 upon cardiovascular biomarkers.
Metabolic syndrome (MS) is a condition with wide-reaching prevalence affecting 8%-43% men and 7%-56% women, globally.1 MS is defined as a cluster of conditions that interact with each other, in a synergistic fashion, increasing risk of liver disease, type 2 diabetes, cardiovascular disease, and high blood pressure.1(992),2 Of particular interest is the relationship between visceral fat and its influence upon the development of dyslipidemia; a condition characterized by low high-density lipoproteins (HDL-C), high low-density lipoproteins (LDL-C), and high triglycerides (TG).1(992) As such, and as covered previously, RYR supplementation can support a return to normal lipid levels and ratios.3 However, research suggests that fusing RYR with COQ10 can also have beneficial changes regarding the same.
Mazza et al1(993) conducted a study whereby 104 participants were recruited (51% male mean age 57 years) who successfully met the criteria for MS, including fasting HDL-C level <40 mg/dl (men), and fasting TG level >150 mg/dl. Total cholesterol, HDL-C, TGs, and LDL-C (estimated by Friedewald’s formula) were collected at baseline among other measures (i.e., glucose and blood pressure).1(993) 52 subjects (experimental group) were treated with a daily oral formulation containing coenzyme Q10 (30 mg) and red yeast rice (10 mg monacolin K) added to their diet for 2 months and were compared with the 52 patients following a diet-only program (control group).1(993) Both groups were instructed to consume moderate intake of alcohol/lean meats in addition to generous consumption of unrefined whole grains, olive oil, legumes, vegetables, fruits and fish.1(993)
Upon completion of the study, biomarkers were gathered to compare baseline measures in both groups. In the control group, Mazza et al1(992) stated that significant reductions were noted in blood pressure and glucose levels as well as reductions in LDL-C, TC, with no changes in HDL-C. In the experimental group, systolic and diastolic blood pressure values were stated as significantly lower when compared to baseline values.1(992) Furthermore, significant reductions in serum glucose, TG, LDL-C, and TC were not only lower when compared to baseline measures; said follow-up results were lower when compared to baseline markers in the control group.1(992) However, no changes in HDL-C were noted in the experimental group when compared to baseline.1(992)
Although the study had limitations (i.e., small sample size and short in duration), the researchers did note that that the sample was large enough to show statistical relevance of the primary endpoints. Furthermore, the experiment showed promising results of RYR+CoQ10, in addition to the benefits of a Mediterranean diet. Such nutraceuticals have an additional appeal beyond their beneficial effects; many patients (i.e., 10-15%) are intolerant to statins and approximately 30% of individuals using statins discontinue use after a year.1(992) However, as Mazza et al1(992) noted nutraceuticals are indeed well-tolerated with significantly less side effects compared to statins, which can cause diabetes, lowered energy, fatigue, hyperglycemia, increased liver enzymes, muscle weakness, and myalgias (muscle pain).4
In conclusion, MS/dyslipidemia are conditions with a worldwide reach that increases risk of liver disease, type 2 diabetes, high blood pressure, and cardiovascular disease. Although statins can help reduce CVD risk, many side effects (some serious) can ensue from said intervention. Evidence suggests that RYR and COQ10, with a whole food diet largely devoid of processed items, can have a synergistic effect compounding in a way that elicits larger, safer, and more favorable outcomes than statins or a Mediterranean diet as stand-alone modalities.
References
1. Mazza A, Lenti S, Schiavon L, et al. Effect of monacolin K and COQ10 supplementation in hypertensive and hypercholesterolemic subjects with metabolic syndrome. Biomed Pharmacother. 2018;105:992-996. doi:10.1016/j.biopha.2018.06.076.
2. Agyemang-Yeboah F, Eghan BAJ, Annani-Akollor ME, et al. Evaluation of metabolic syndrome and its associated risk factors in Type 2 diabetes: A descriptive cross-sectional study at the komfo anokye teaching hospital, Kumasi, Ghana.Biomed Res Int. 2019;2019:1-8. doi:https://doi.org/10.1155/2019/4562904.
3. Shu-Jun F, Zhi-Han T, Ting W, et al. Potential protective effects of red yeast rice in endothelial function against atherosclerotic cardiovascular disease. Chin J Nat Med. 2019;17(1):50-58. doi:10.1016/S1875-5364(19)30009-3.
4. Li Y, Jiang L, Jia Z, et al. A meta-analysis of red yeast rice: A effective and relatively safe alternative approach for dyslipidemia.Plos One. 2014;9(6):1-10. doi:10.1371/journal.pone.0098611.
-Michael McIsaac