Red yeast rice

What is red yeast rice?

It is not a rice paddy: red yeast rice is a traditional Chinese product that is obtained by fermenting white rice by the yeast Monascus purpureus, which is what gives rice its red color.

Certain strains of this yeast, under certain fermentation conditions, produce substances called monacolins. One of these monacolins, specifically monacolin K, is responsible for the effect of red yeast rice on cholesterol.

An ancient medicinal substance

Monacolins are a family of more than ten substances that are extracted from rice fermentation with the yeast Monascus purpureus, giving rice a red hue.

Among this group of monacolins, monacolin K stands out, which has been used in Asia for centuries for different purposes:

For preserving meat, as a food coloring, as a flavor enhancer and also as a medicinal substance.

Red yeast rice: properties and risks

From time to time certain foods become fashionable, not so much for their nutritional properties, but for their "healing" virtues. The last is red yeast rice, which is reputed to lower cholesterol. Effectively acts against hypercholesterolemia, but supplements should not be taken lightly, because they carry risks: find out well.

That our health begins on the plate is a known fact. From time to time certain products strive to become the panacea for our ills, sometimes with scientific evidence, and others without it.

One such beneficial new food is red rice, also known as red yeast rice or, by its literal translation, red yeast rice. There are different names given to a product that has gained fame for its cholesterol-lowering effect.

Red yeast rice supplements do lower cholesterol

Red yeast rice supplements contain monacolin and act similar to statins by reducing cholesterol production in the liver. They are useful in mild and moderate hypercholesterolemia.

Monacolin and cholesterol control

Hypercholesterolemia is an important cardiovascular risk factor because it favors the formation of atherosclerotic plaque.

• The ideal is to have levels below 200 mg/dl.
• Between 200 mg/dl and 239 mg/dl is considered to be high or borderline advisable, so it is advisable to control it with a healthy diet and exercise.

It is just at this point, when supplements based on red yeast rice could be recommended.

When total cholesterol levels are belowabove 240 mg/dlOther pharmacological or dietary measures are considered.

In any case, if only cholesterol is elevated but blood pressure or blood glucose are within normal limits, dietary measures should be emphasized to control it without resorting to drugs such as statins.

Effective in effective in mild hypercholesterolemia

The people who benefit the most from the action of red yeast rice are those who have total cholesterol levels between 200 mg/dl and 239 mg/dl.

In these cases, recalls the UOC professor, "it has been shown that supplementation with red yeast rice for a period of at least 8 weeks can reduce both total cholesterol (the sum of LDL and HDL cholesterol) by 20% ) as LDL".

• LDL cholesterol (bound to low-density proteins) or "bad cholesterol" accumulates in the arteries and favors arteriosclerosis.
• HDL cholesterol (bound to high-density proteins) or "good cholesterol" is responsible for transporting cholesterol deposited in the arteries to the liver for elimination.

Basically themonacolinIt works by inhibiting the activity of an enzyme – hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase – that limits theendogenous cholesterol production.

People who have high cholesterol and find it difficult to control it with diet is because the liver naturally produces too much cholesterol.

anti-cholesterol effects

Monacolin K has the same structure and behavior as lovastatin., an active substance authorized as a medicine for the treatment of hypercholesterolemia, which reduces LDL-cholesterol levels (the so-called "bad cholesterol").

Evidence shows that the effect of red yeast rice on cholesterol is felt after 10 mg of monacolin K is taken daily.

In view of the fact that this result is verified, the European Food Safety Agency (EFSA), in 2011, approved the scientific claim "Monacolin K from red yeast rice contributes to the maintenance of normal blood cholesterol levels".

Red Yeast Rice Health Risks

Of course, you can eat this red rice just because you like it. But if you have high cholesterol and want to resort to red yeast rice supplements to try to lower it, be careful, because like lovastatin, monacolin K also produces adverse effects.

In the year 2018, theEFSA published a report on the safety of monacolin K from red yeast rice and established that its intake produced adverse effects similar to lovastatin and statins in general, specifically:

• Myopathy or muscle damage (manifested either as muscle pain and/or muscle weakness), and even rhabdomyolysis, which is an extreme and very severe form of muscle damage, had been documented.
• Gastrointestinal disorders (diarrhea, nausea, abdominal pain).
• Liver damage and skin disorders (itching, hives).

When to be careful with red yeast rice

Monacolin K behaves like lovastatin, so the same restrictions on use should apply. Specifically, there are groups of people who should avoid their consumption:

• Pregnant and lactating women, because there are not enough security guarantees.
• children and adolescents: because safety and efficacy are unknown,
• People over 70 years of age, more susceptible to the adverse effects of statins, especially muscle damage.
• People with a history of liver, kidney or muscle problems.

In addition, as with lovastatin, you should avoid taking substances that increase the risk of adverse effects:

• Alcohol.Alcohol should not be drunk if red yeast rice supplements are taken. The combination increases the risk of liver damage.
• Certain medicines and foods:
  • Consuming red yeast rice supplements can interact with certain foods and drugs, cytochrome P450 enzyme inhibitors (such as erythromycin, clarithromycin, cyclosporine, grapefruit juice, etc.).
  • Other statin-based cholesterol medications: Taking red yeast rice supplements along with other statins may increase the risk of serious adverse effects.

Normally red yeast rice is ingested in the form of food supplements, which are those that provide a sufficient amount of the active substance to help lower blood cholesterol levels.

The problem is that, while it is clear what is the daily dose of monacolin K necessary to lower cholesterol levels, the EFSA experts, after their latest evaluation, have not been able to establish what is the maximum daily dose that could be considered safe for consumption as a food supplement.

they are not harmless

In fact, the EFSA in its report concludes that "it has not been possible to identify an intake of monacolins from red yeast rice that does not give rise to concern regarding the harmful effects on health that may occur both in the general population and in vulnerable population subgroups.

How to take these supplements

Today it is very easy to find these supplements in pharmacies or dietetic establishments in different formats (capsules, sticks).

It can occur accompanied by other substances such as policosanols, berberine, resveratrol, coenzyme Q10 or group B vitamins.

As established by European regulations, the effective dose in regulating cholesterol is 10 mg/dl per day.

Although it is a natural substance, its intake must be supervised by a doctor or health professional.

Interactions with other drugs

• They may interact with CYP3A4 inhibitors (such as those used to treat high blood pressure), as it would increase monacolin levels and the risk of side effects.

• Obviously, they should not be taken together with cholesterol-lowering drugs such as statins, as the combination could potentiate side effects.

Nor should they be taken with grapefruit juice and are contraindicated in pregnant or lactating women, in children or adolescents and in people over seventy years of age.