Nutraceutical alternatives to red yeast rice extract/monacolin K for moderate hypercholesterolaemia: Current evidence and knowledge gaps

Nutraceuticals and hypercholesterolaemia

Laura Comi
Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milan, Milan, Italy
Claudia Giglione
Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milan, Milan, Italy
Fationa Tolaj
Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milan, Milan, Italy
Cinzia Parolini
Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milan, Milan, Italy
Chiara Olivieri
Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milan, Milan, Italy
Marco Ruzza
Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milan, Milan, Italy
Valentina Tollemeto
Truffini & Reggè, Milan, Italy
Maria Zurlo
Truffini & Reggè, Milan, Italy
Federico Pialorsi
Truffini & Reggè, Milan, Italy
Antonio Seneci
Truffini & Reggè, Milan, Italy
Paolo Magni
Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università degli Studi di Milan, Milan, Italy and IRCCS MultiMedica, Sesto S. Giovanni, Milan, Italy


The nutraceutical approach to moderate hypercholesterolaemia is an interesting option in the context of appropriate conditions associated with low cardiovascular risk, and red yeast rice (RYR) extract is one of the most utilized products in this field. Monacolin k, its main active component, reduces serum LDL-C levels via inhibition of β-Hydroxy β-methylglutaryl-CoA reductase, similarly to statins. In 2011, EFSA approved the claim regarding monacolin k from RYR extract and maintenance of normal cholesterol levels. However, in 2018, EFSA issued a warning about potential adverse effects of this nutraceutical and, in 2022, the European Commission published a Regulation with several limitations of its use. Therefore, current research and development efforts are aiming at assessing efficacy and safety of other known and novel nutraceutical products which may benefit patients with moderate hypercholesterolaemia. These active agents range from phytosterols, probiotics and berberine to bergamot, cabbage and artichoke extracts and soy protein. Moreover, plant extracts from traditional medicine, for example from African countries, are also a subject of study in this direction. The full clinical exploitation of many of them, however, still requires robust clinical evidence, which should be the objective of future research.


  1. Roth GA, Mensah GA, Johnson CO, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol 2020;76:2982-3021.
  2. Wang T, Zhao Z, Yu X, et al. Age-specific modifiable risk factor profiles for cardiovascular disease and all-cause mortality: a nationwide, population-based, prospective cohort study. Lancet Reg Health West Pac 2021;17:100277.
  3. Chareonrungrueangchai K, Wongkawinwoot K, Anothaisintawee T, Reutrakul S. Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review. Nutrients 2020;12.
  4. Gallucci G, Tartarone A, Lerose R, Lalinga AV, Capobianco AM. Cardiovascular risk of smoking and benefits of smoking cessation. J Thorac Dis 2020;12:3866-3876.
  5. Hoek AG, van Oort S, Mukamal KJ, Beulens JWJ. Alcohol Consumption and Cardiovascular Disease Risk: Placing New Data in Context. Curr Atheroscler Rep 2022;24:51-59.
  6. Lavie CJ, Ozemek C, Carbone S, Katzmarzyk PT, Blair SN. Sedentary Behavior, Exercise, and Cardiovascular Health. Circ Res 2019;124:799-815.
  7. Lao XQ, Liu X, Deng HB, et al. Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults. J Clin Sleep Med 2018;14:109-117.
  8. Osborne MT, Shin LM, Mehta NN, et al. Disentangling the Links Between Psychosocial Stress and Cardiovascular Disease. Circ Cardiovasc Imaging 2020;13:e010931.
  9. Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012;33:1635-1701.
  10. Rippe JM. Lifestyle Strategies for Risk Factor Reduction, Prevention, and Treatment of Cardiovascular Disease. Am J Lifestyle Med 2019;13:204-212.
  11. Dimovski K, Orho-Melander M, Drake I. A favorable lifestyle lowers the risk of coronary artery disease consistently across strata of non-modifiable risk factors in a population-based cohort. BMC Public Health 2019;19:1575.
  12. Rafieian-Kopaei M, Setorki M, Doudi M, Baradaran A, Nasri H. Atherosclerosis: process, indicators, risk factors and new hopes. Int J Prev Med 2014;5:927-946.
  13. Mach F, Baigent C, Catapano A, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European heart journal 2020;41.
  14. Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2021;42:3227-3337.
  15. Averna M, Banach M, Bruckert E, et al. Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force. Atherosclerosis 2021;325:99-109.
  16. Parham JS, Goldberg AC. Review of recent clinical trials and their impact on the treatment of hypercholesterolemia. Prog Cardiovasc Dis 2022;75:90-96.
  17. Kim KA, Park HJ. New Therapeutic Approaches to the Treatment of Dyslipidemia 2: LDL-C and Lp(a). J Lipid Atheroscler 2023;12:37-46.
  18. Claas SA, Arnett DK. The Role of Healthy Lifestyle in the Primordial Prevention of Cardiovascular Disease. Curr Cardiol Rep 2016;18:56.
  19. Doughty KN, Del Pilar NX, Audette A, Katz DL. Lifestyle Medicine and the Management of Cardiovascular Disease. Curr Cardiol Rep 2017;19:116.
  20. Janse Van Rensburg WJ. Lifestyle Change Alone Sufficient to Lower Cholesterol in Male Patient With Moderately Elevated Cholesterol: A Case Report. Am J Lifestyle Med 2018;13:148-155.
  21. Wilkinson MJ, Laffin LJ, Davidson MH. Overcoming toxicity and side-effects of lipid-lowering therapies. Best Pract Res Clin Endocrinol Metab 2014;28:439-452.
  22. Björnsson E. Hepatotoxicity of statins and other lipid-lowering agents. Liver international : official journal of the International Association for the Study of the Liver 2017;37.
  23. Magni P, Macchi C, Morlotti B, Sirtori CR, Ruscica M. Risk identification and possible countermeasures for muscle adverse effects during statin therapy. European Journal of Internal Medicine 2015;26.
  24. Mancini GB, Baker S, Bergeron J, et al. Diagnosis, prevention, and management of statin adverse effects and intolerance: proceedings of a Canadian Working Group Consensus Conference. Can J Cardiol 2011;27:635-662.
  25. Carter AA, Gomes T, Camacho X, et al. Risk of incident diabetes among patients treated with statins: population based study. BMJ 2013;346:f2610.
  26. Ruscica M, Macchi C, Morlotti B, Sirtori CR, Magni P. Statin therapy and related risk of new-onset type 2 diabetes mellitus. Eur J Intern Med 2014;25:401-406.
  27. Santini A, Tenore GC, Novellino E. Nutraceuticals: A paradigm of proactive medicine. Eur J Pharm Sci 2017;96:53-61.
  28. Puri V, Nagpal M, Singh I, et al. A Comprehensive Review on Nutraceuticals: Therapy Support and Formulation Challenges. Nutrients 2022;14.
  29. Borghi C, Cicero AF. Nutraceuticals with a clinically detectable blood pressure-lowering effect: a review of available randomized clinical trials and their meta-analyses. Br J Clin Pharmacol 2017;83:163-171.
  30. Fernandes I, Oliveira J, Pinho A, Carvalho E. The Role of Nutraceutical Containing Polyphenols in Diabetes Prevention. Metabolites 2022;12.
  31. Penson PE, Banach M. Nutraceuticals for the Control of Dyslipidaemias in Clinical Practice. Nutrients 2021;13.
  32. Protic O, Bonfigli AR, Antonicelli R. Nutraceutical Combinations in Hypercholesterolemia: Evidence from Randomized, Placebo-Controlled Clinical Trials. Nutrients 2021;13.
  33. Osadnik T, Goławski M, Lewandowski P, et al. A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults. Pharmacol Res 2022;183:106402.
  34. Alberts A, Chen J, Kuron G, et al. Mevinolin: a highly potent competitive inhibitor of hydroxymethylglutaryl-coenzyme A reductase and a cholesterol-lowering agent. Proceedings of the National Academy of Sciences of the United States of America 1980;77.
  35. Rasheva T, Nedeva T, Hallet J, Kujumdzieva A. Characterization of a non-pigment producing Monascus purpureus mutant strain. Antonie van Leeuwenhoek 2003;83.
  36. Singh ND SA, Dwivedi P, Patil RD, Kumar M. Experimentally induced citrinin and endosulfan toxicity in pregnant Wistar rats: histopathological alterations in liver and kidneys of fetuses. Journal of applied toxicology : JAT 2008;28.
  37. Scientific opinion on the safety of monacolins in red yeast rice - - 2018 - EFSA Journal - Wiley Online Library.
  38. Fernández-Friera L, Fuster V, López-Melgar B, et al. Normal LDL-Cholesterol Levels Are Associated With Subclinical Atherosclerosis in the Absence of Risk Factors. J Am Coll Cardiol 2017;70:2979-2991.
  39. Catapano AL, Graham I, De Backer G, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. European heart journal 2016;37.
  40. Cicero A, Fogacci F, Zambon A. Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar. Journal of the American College of Cardiology 2021;77.
  41. Ruscica M, Gomaraschi M, Mombelli G, et al. Nutraceutical approach to moderate cardiometabolic risk: results of a randomized, double-blind and crossover study with Armolipid Plus. J Clin Lipidol 2014;8:61-68.
  42. Ruscica M, Pavanello C, Gandini S, et al. Nutraceutical approach for the management of cardiovascular risk - a combination containing the probiotic Bifidobacterium longum BB536 and red yeast rice extract: results from a randomized, double-blind, placebo-controlled study. Nutr J 2019;18:13.
  43. Cicolari S, Pavanello C, Olmastroni E, et al. Interactions of Oxysterols with Atherosclerosis Biomarkers in Subjects with Moderate Hypercholesterolemia and Effects of a Nutraceutical Combination (Nutrients 2021;13.
  44. Singh DK, Li L, Porter TD. Policosanol inhibits cholesterol synthesis in hepatoma cells by activation of AMP-kinase. J Pharmacol Exp Ther 2006;318:1020-1026.
  45. Menéndez R AA, Rodeiro I, González RM, González PC, Alfonso JL, Más R. Policosanol modulates HMG-CoA reductase activity in cultured fibroblasts. Archives of medical research 2001;32.
  46. Pereira CPM, Souza ACR, Vasconcelos AR, Prado PS, Name JJ. Antioxidant and anti‑inflammatory mechanisms of action of astaxanthin in cardiovascular diseases (Review). Int J Mol Med 2021;47:37-48.
  47. Setnikar I, Senin P, Rovati LC. Antiatherosclerotic efficacy of policosanol, red yeast rice extract and astaxanthin in the rabbit. Arzneimittelforschung 2005;55:312-317.
  48. Wu M WJ, Liu LT. Advance of studies on anti-atherosclerosis mechanism of berberine. Chinese journal of integrative medicine 2010;16.
  49. Xie X MX, Zeng S, Tang W, Xiao L, Zhu C, Yu R. Mechanisms of Berberine for the Treatment of Atherosclerosis Based on Network Pharmacology. Evidence-based complementary and alternative medicine : eCAM 2020;2020.
  50. Spigoni V, Aldigeri R, Antonini M, et al. Effects of a New Nutraceutical Formulation (Berberine, Red Yeast Rice and Chitosan) on Non-HDL Cholesterol Levels in Individuals with Dyslipidemia: Results from a Randomized, Double Blind, Placebo-Controlled Study. International journal of molecular sciences 2017;18.
  51. Cicero AFG, Fogacci F, Stoian AP, et al. Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? Curr Atheroscler Rep 2021;23:57.
  52. Marangoni F, Poli A. Phytosterols and cardiovascular health. Pharmacological research 2010;61.
  53. Poli A, Marangoni F, Corsini A, et al. Phytosterols, Cholesterol Control, and Cardiovascular Disease. Nutrients 2021;13.
  54. Ras RT, Geleijnse JM, Trautwein EA. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. Br J Nutr 2014;112:214-219.
  55. Visioli F, Poli A. Prevention and Treatment of Atherosclerosis: The Use of Nutraceuticals and Functional Foods. 2022.
  56. Klingberg S, Ellegård L, Johansson I, et al. Inverse relation between dietary intake of naturally occurring plant sterols and serum cholesterol in northern Sweden. Am J Clin Nutr 2008;87:993-1001.
  57. Katan MB, Grundy SM, Jones P, et al. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 2003;78:965-978.
  58. Ying J, Zhang Y, Yu K. Phytosterol compositions of enriched products influence their cholesterol-lowering efficacy: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 2019;73:1579-1593.
  59. Li X, Zhao Z, Huang M, et al. Effect of Berberine on promoting the excretion of cholesterol in high-fat diet-induced hyperlipidemic hamsters. Journal of translational medicine 2015;13.
  60. Derosa G, Maffioli P, Cicero A. Berberine on metabolic and cardiovascular risk factors: an analysis from preclinical evidences to clinical trials. Expert opinion on biological therapy 2012;12.
  61. Lan J, Zhao Y, Dong F, et al. 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.
  62. Bertuccioli A, Moricoli S, Amatori S, et al. Berberine and Dyslipidemia: Different Applications and Biopharmaceutical Formulations Without Statin-Like Molecules-A Meta-Analysis. J Med Food 2020;23:101-113.
  63. Liu X, Li W, Zhang H, et al. Biodistribution and pharmacokinetic profile of berberine and its metabolites in hepatocytes. Phytomedicine : international journal of phytotherapy and phytopharmacology 2022;104.
  64. Adorni MP, Zimetti F, Lupo MG, Ruscica M, Ferri N. Naturally Occurring PCSK9 Inhibitors. Nutrients 2020;12.
  65. Stein K. FDA approves health claim labeling for foods containing soy protein. Journal of the American Dietetic Association 2000;100.
  66. Sirtori C, Lovati M. Soy proteins and cardiovascular disease. Current atherosclerosis reports 2001;3.
  67. Dewell A, Piper L, Hollenbeck C. A critical evaluation of the role of soy protein and isoflavone supplementation in the control of plasma cholesterol concentrations. The Journal of Clinical Endocrinology & Metabolism 2006;91:772-780.
  68. Keshun L. Soybeans: Chemistry, Technology and Utilization; 2022.
  69. Cicero AFG, Colletti A, Bajraktari G, et al. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutr Rev 2017;75:731-767.
  70. Harland J, Haffner T. Systematic review, meta-analysis and regression of randomised controlled trials reporting an association between an intake of circa 25 g soya protein per day and blood cholesterol. 2008.
  71. Ruscica M, Pavanello C, Gandini S, et al. Effect of soy on metabolic syndrome and cardiovascular risk factors: a randomized controlled trial. European journal of nutrition 2018;57.
  72. Mannarino M, Ministrini S, Pirro M. Nutraceuticals for the treatment of hypercholesterolemia. European journal of internal medicine 2014;25.
  73. Scientific Opinion on the substantiation of a health claim related to isolated soy protein and reduction of blood LDL‐cholesterol concentrations pursuant to Article 14 of Regulation (EC) No 1924/2006 - - 2012 - EFSA Journal - Wiley Online Library.
  74. Reiner Z, Catapano A, De Backer G, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European heart journal 2011;32.
  75. Cosentino F, Grant P, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. European heart journal 2020;41.
  76. Casula M, Catapano AL, Magni P. Nutraceuticals for Dyslipidaemia and Glucometabolic Diseases: What the Guidelines Tell Us (and Do Not Tell, Yet). Nutrients 2022;14.
  77. Parolini C, Rigamonti E, Marchesi M, et al. Cholesterol-lowering effect of dietary Lupinus angustifolius proteins in adult rats through regulation of genes involved in cholesterol homeostasis. Food chemistry 2012;132.
  78. Lammi C, Zanoni C, Scigliuolo G, D'Amato A, Arnoldi A. Lupin peptides lower low-density lipoprotein (LDL) cholesterol through an up-regulation of the LDL receptor/sterol regulatory element binding protein 2 (SREBP2) pathway at HepG2 cell line. Journal of agricultural and food chemistry 2014;62.
  79. Lammi C, Zanoni C, Aiello G, Arnoldi A, Grazioso G. Lupin Peptides Modulate the Protein-Protein Interaction of PCSK9 with the Low Density Lipoprotein Receptor in HepG2 Cells. Scientific reports 2016;6.
  80. 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. The Journal of nutrition 2014;144.
  81. 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. Clinical nutrition (Edinburgh, Scotland) 2015;34.
  82. Pavanello C, Lammi C, Ruscica M, et al. Effects of a lupin protein concentrate on lipids, blood pressure and insulin resistance in moderately dyslipidaemic patients: A randomised controlled trial | Elsevier Enhanced Reader. 2017;37:8-15.
  83. Ben Salem M, Affes H, Ksouda K, et al. Pharmacological Studies of Artichoke Leaf Extract and Their Health Benefits. Plant foods for human nutrition (Dordrecht, Netherlands) 2015;70.
  84. Arnaboldi L, Corsini A, Bellosta S. Artichoke and bergamot extracts: a new opportunity for the management of dyslipidemia and related risk factors. Minerva Med 2022;113:141-157.
  85. Santos HO, Bueno AA, Mota JF. The effect of artichoke on lipid profile: A review of possible mechanisms of action. Pharmacol Res 2018;137:170-178.
  86. Sahebkar A, Serban MC, Gluba-Brzózka A, et al. Lipid-modifying effects of nutraceuticals: An evidence-based approach. Nutrition 2016;32:1179-1192.
  87. Illiano P, Brambilla R, Parolini C. The mutual interplay of gut microbiota, diet and human disease. The FEBS journal 2020;287.
  88. Gomaa E. Human gut microbiota/microbiome in health and diseases: a review. Antonie van Leeuwenhoek 2020;113.
  89. Hill C, Guarner F, Reid G, et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology 2014;11:506-514.
  90. Vourakis M, Mayer G, Rousseau G. The Role of Gut Microbiota on Cholesterol Metabolism in Atherosclerosis. Int J Mol Sci 2021;22.
  91. Li HY, Zhou DD, Gan RY, et al. Effects and Mechanisms of Probiotics, Prebiotics, Synbiotics, and Postbiotics on Metabolic Diseases Targeting Gut Microbiota: A Narrative Review. Nutrients 2021;13.
  92. Mo R, Zhang X, Yang Y. Effect of probiotics on lipid profiles in hypercholesterolaemic adults: A meta-analysis of randomized controlled trials. Med Clin (Barc) 2019;152:473-481.
  93. Wang C, Li S, Xue P, et al. The effect of probiotic supplementation on lipid profiles in adults with overweight or obesity: A meta-analysis of randomized controlled trials. 2021.
  94. Di Donna L, De Luca G, Mazzotti F, et al. Statin-like principles of bergamot fruit (Citrus bergamia): isolation of 3-hydroxymethylglutaryl flavonoid glycosides. J Nat Prod 2009;72:1352-1354.
  95. Rondanelli M, Peroni G, Riva A, et al. Bergamot phytosome improved visceral fat and plasma lipid profiles in overweight and obese class I subject with mild hypercholesterolemia: A randomized placebo controlled trial. Phytother Res 2021;35:2045-2056.
  96. Nauman MC, Johnson JJ. Clinical application of bergamot (Integr Food Nutr Metab 2019;6.
  97. Perna S, Spadaccini D, Botteri L, et al. Efficacy of bergamot: From anti-inflammatory and anti-oxidative mechanisms to clinical applications as preventive agent for cardiovascular morbidity, skin diseases, and mood alterations. Food Sci Nutr 2019;7:369-384.
  98. Gliozzi M, Walker R, Muscoli S, et al. 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;170:140-145.
  99. Uuh-Narvaez JJ S-CM. Cabbage (Brassica oleracea var. capitata): A food with functional properties aimed to type 2 diabetes prevention and management. Journal of food science 2021;86.
  100. Rungapamestry V DA, Fuller Z, Ratcliffe B. Changes in glucosinolate concentrations, myrosinase activity, and production of metabolites of glucosinolates in cabbage (Brassica oleracea Var. capitata) cooked for different durations. Journal of agricultural and food chemistry 2006;54.
  101. Galvez J, Rodríguez-Cabezas M, Zarzuelo A. Effects of dietary fiber on inflammatory bowel disease. Molecular nutrition & food research 2005;49.
  102. Nawaz H, Shad MA, Muzaffar S, et al. Phytochemical Composition and Antioxidant Potential of Brassica. 2018.
  103. Wang P, Fang J, Gao Z, Zhang C, Xie S. Higher intake of fruits, vegetables or their fiber reduces the risk of type 2 diabetes: A meta-analysis. Journal of diabetes investigation 2016;7.
  104. Kurotani K, Nanri A, Goto A, et al. Vegetable and fruit intake and risk of type 2 diabetes: Japan Public Health Center-based Prospective Study. Br J Nutr 2013;109:709-717.
  105. Suido H, Tanaka T, Tabei T, et al. A mixed green vegetable and fruit beverage decreased the serum level of low-density lipoprotein cholesterol in hypercholesterolemic patients. J Agric Food Chem 2002;50:3346-3350.
  106. Guo X-f, Li Z-h, Cai H, Li D. The effects of Lycium barbarum L. (L. barbarum) on cardiometabolic risk factors: a meta-analysis of randomized controlled trials. 2017.
  107. Luo Q CY, Yan J, Sun M, Corke H. Hypoglycemic and hypolipidemic effects and antioxidant activity of fruit extracts from Lycium barbarum. Life sciences 2004;76.
  108. Zhao R LQ, Li J, Zhang T. Protective effect of Lycium barbarum polysaccharide 4 on kidneys in streptozotocin-induced diabetic rats. Canadian journal of physiology and pharmacology 2009;87.
  109. Jing L, Cui G, Feng Q, Xiao Y. Evaluation of hypoglycemic activity of the polysaccharides extracted from Lycium barbarum. African journal of traditional, complementary, and alternative medicines : AJTCAM 2009;6.
  110. De Souza Zanchet M, Nardi G, de Oliveira Souza Bratti L, Filippin-Monteiro F, Locatelli C. Lycium barbarum Reduces Abdominal Fat and Improves Lipid Profile and Antioxidant Status in Patients with Metabolic Syndrome. Oxidative medicine and cellular longevity 2017;2017.
  111. Romani A, Ieri F, Urciuoli S, et al. Health Effects of Phenolic Compounds Found in Extra-Virgin Olive Oil, By-Products, and Leaf of. Nutrients 2019;11.
  112. Razmpoosh E, Abdollahi S, Mousavirad M, Clark CCT, Soltani S. The effects of olive leaf extract on cardiovascular risk factors in the general adult population: a systematic review and meta-analysis of randomized controlled trials. Diabetol Metab Syndr 2022;14:151.
  113. Lockyer S, Rowland I, Spencer JPE, Yaqoob P, Stonehouse W. Impact of phenolic-rich olive leaf extract on blood pressure, plasma lipids and inflammatory markers: a randomised controlled trial. Eur J Nutr 2017;56:1421-1432.
  114. Stevens Y, Winkens B, Jonkers D, Masclee A. The effect of olive leaf extract on cardiovascular health markers: a randomized placebo-controlled clinical trial. European Journal of Nutrition 2020;60:2111-2120.
  115. Olmez E, Vural K, Gok S, et al. Olive Leaf Extract Improves the Atherogenic Lipid Profile in Rats Fed a High Cholesterol Diet. Phytother Res 2015;29:1652-1657.
  116. Cicolari S, Dacrema M, Tsetegho S, AJ, et al. Hydromethanolic Extracts from Adansonia digitata L. Edible Parts Positively Modulate Pathophysiological Mechanisms Related to the Metabolic Syndrome. Molecules (Basel, Switzerland) 2020;25.
  117. Ebaid H, Bashandy SAE, Alhazza IM, Hassan I, Al-Tamimi J. Efficacy of a Methanolic Extract of Adansonia digitata Leaf in Alleviating Hyperglycemia, Hyperlipidemia, and Oxidative Stress of Diabetic Rats. Biomed Res Int 2019;2019:2835152.
  118. Atchan Nwakiban AP, Sokeng AJ, Dell'Agli M, et al. Hydroethanolic plant extracts from Cameroon positively modulate enzymes relevant to carbohydrate/lipid digestion and cardio-metabolic diseases. Food Funct 2019;10:6533-6542.
  119. Nwakiban APA, Cicolari S, Piazza S, et al. Oxidative Stress Modulation by Cameroonian Spice Extracts in HepG2 Cells: Involvement of Nrf2 and Improvement of Glucose Uptake. Metabolites 2020;10.
  120. Atchan Nwakiban AP, Passarelli A, Da Dalt L, et al. Cameroonian Spice Extracts Modulate Molecular Mechanisms Relevant to Cardiometabolic Diseases in SW 872 Human Liposarcoma Cells. Nutrients 2021;13.
  121. Nwakiban Atchan AP, Shivashankara ST, Piazza S, et al. Polyphenol-Rich Extracts of Xylopia and Aframomum Species Show Metabolic Benefits by Lowering Hepatic Lipid Accumulation in Diet-Induced Obese Mice. ACS Omega 2022;7:11914-11928.

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