The latest “food fad” for health – at least in the media – is fermented red rice. Known as hong qu mi (what else? red yeast rice), this popular oriental garnish was featured in an article (http://featuresblogs.chicagotribune.com/features_julieshealthclub/2009/10/red-yeast-rice-for-high-cholesterol.html) for (as you can read in the link) high cholesterol.
When Chicago’s Adele Simmons discovered she had high cholesterol and a blocked artery, she chose a drug-free treatment approach that included red yeast rice, the product of yeast grown on white rice.
The powdery yeast-rice mixture, a dietary stable in many parts of Asia that’s used in traditional Chinese medicine, contains monacolin K, the same ingredient as in the prescription cholesterol drug lovastatin (Mevacor).
But while red yeast rice is available over the counter, don’t take it unless you’re under the care of a physician, said Simmons’ doctor, preventive cardiologist Steve Devries, who is on staff at Northwestern Memorial Hospital.
The drug-like supplement can have side effects (though they’re less likely than with prescription statins) and patients need blood tests to monitor safety.
In fact, Devries said that red yeast rice is a good cholesterol-lowering option in only two situations: “in those who are absolutely philosophically opposed to taking a prescription statin, or in those who have tried to take prescription statins but cannot tolerate them.”
Other key points to remember:
Don’t take red yeast rice when you’re pregnant.The same is true for any prescription statin.
Brands vary by dosage and purity. Devries recommends a specific brand that has been tested by an independent lab and asks patients to use only this brand.
Red yeast is only one option. “Prescription statins are an excellent choice for those in need of cholesterol lowering when lifestyle changes have been tried and found to be inadequate to achieve the desired cholesterol result,” Devries said.
Red Yeast Rice
Now before I go on to cite other studies I’d like to point out that I believe that the process of fermentation does a lot in terms of preserving what I call “digestive energy.” This is my personal term for Spleen Qi, which in Chinese medicine is in charge of digestion. (Hmmm, perhaps another time I’ll talk about the Spleen and western pancreas…)
The thing about Chinese dietary theory is that you can’t just eat anything you want. Well, you can if your Spleen Qi is as strong as a bull on steroids – but you’ll still wear it down. The key to maintaining long term health is to make things easier on the Spleen. This is why raw foods is a no-no in oriental medicine because it takes more fuel to light the fire to burn it down (or is the proper term burn it up?)
Hmmm, another future article idea – Spleen health.
Anyway fermentation is seen as a precursor to digestion. In fact, the classical chinese words for digestion can be literally translated as “rotting” and “ripening”. Of course, that doesn’t mean that you should go ahead and ferment everything you eat – Chinese medicine never encourages excessive consumption of one type of flavor or taste. Variety is the spice of life, as the old saying goes.
So what we have here is a fermented foodstuff, making it easier to digest food, and thus, maintaining Spleen Qi. I think.
But on to the modern studies. There is a prepared Chinese medicine made from Red Yeast Rice, known as Xue Zhi Kang:
Xue Zhi Kang
Derived from red yeast rice, Xue Zhi Kang has been the subject of many a study. Here are some sample excerpts:
Liu ZG and Yu XY. “Effects of Xuezhikang capsule on blood lipids, platelet activation and coagulation-fibrinolysis activity in patients with hyperlipidemia” Chinese Journal of Integrative Medicine Volume 10, Number 4 / December, 2004 pp. 259-262. 27 October 2009 <http://www.springerlink.com/content/d474443332748t6v/>
Abstract   Objective: To investigate the effects of Xuezhikang capsule (XZK) on blood lipids level, platelet activation and coagulation-fibrinolysis activity in patients with hyerlipidemia.Methods: Seventy-six patients of hyperlipidemia were randomly divided into two groups, the XZK group (n = 38) treated with XZK 600mg, taken two times per day and the Simvastatin (SIM) group (n = 38) treated with SIM 20mg per day, with the treatment lasting 8 weeks for both groups. Levels of fasting serum lipids, including total cholesterol (TC), triglyceride (TG), high and low density lipoprotein cholesterol (HDL-C and LDL-C), plasma GMP-140, fibrinogen (FIB), tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-) and prothrombin time (PT) were all measured before and 8 weeks after treatment. Data were compared before and after treatment and also compared with those measured in 20 healthy subjects of control.Results: Before treantment the levels of TC, TG and LDL-C were obviously higher and HDL-C level was significantly lower in hyperlipidemia patients than those in healthy subjects (P<0.05 orP<0.01). After 4–8 weeks of XZK treatment, the levels of TC, TG, LDL-C and FIB and activities of GMP-140 and PAI-1 were obviously lowered (P<0.05 orP<0.01). But in the SIM group there was no obvious change in FIB (P>0.05), instead it showed obvious increase of HDL-C and decrease of TC and LDL-C after treatment (P<0.05 orP<0.01).Conclusion: XZK could inhibit platelet activity and improve coagulation-fibrinolysis function, besides its lipids lowering effect. (emphasis mine)
This shows that Xuezhikang works by preventing formation of atherosclerotic plaques, as also seen in this study published in the American Journal of Cardiology:
Lu et al. “Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction.” Am J Cardiol. 2008 Jun 15;101(12):1689-93. Epub 2008 Apr 11. accessed 27 October 2009 (http://www.ncbi.nlm.nih.gov/pubmed/18549841)
Results of well-controlled prospective clinical trials showed the efficacy of lipid-lowering therapies in the reduction of cardiovascular (CV) events in western populations, but they were not reported with a Chinese population. This multicenter study was conducted to determine the effects of Xuezhikang (XZK), a partially purified extract of red yeast rice, on lipoprotein and CV end points in Chinese patients who experienced a previous myocardial infarction. Nearly 5,000 of these patients with average low-density lipoprotein cholesterol levels at baseline were randomly assigned either to placebo or to XZK daily for an average of 4.5 years. The primary end point was a major coronary event that included nonfatal myocardial infarction and death from coronary heart disease. Frequencies of the primary end point were 10.4% in the placebo group and 5.7% in the XZK-treated group, with absolute and relative decreases of 4.7% and 45%, respectively. Treatment with XZK also significantly decreased CV and total mortality by 30% and 33%, the need for coronary revascularization by 1/3, and lowered total and low-density lipoprotein cholesterol and triglycerides, but raised high-density lipoprotein cholesterol levels. In conclusion, long-term therapy with XZK significantly decreased the recurrence of coronary events and the occurrence of new CV events and deaths, improved lipoprotein regulation, and was safe and well tolerated. (emphasis mine)
Some news articles report similar side effects as statins. This makes me wonder if there are any differences in side effect profile if taken in raw form as opposed to processed with alcohol into pill form.
Sources:
Deardorff, Julie. “Red yeast rice: A natural approach to high cholesterol” Chicago Tribune. 26 October 2009. Accessed 27 October 2009 <http://featuresblogs.chicagotribune.com/features_julieshealthclub/2009/10/red-yeast-rice-for-high-cholesterol.html>
Liu ZG and Yu XY. “Effects of Xuezhikang capsule on blood lipids, platelet activation and coagulation-fibrinolysis activity in patients with hyperlipidemia” Chinese Journal of Integrative MedicineVolume 10, Number 4 / December, 2004 pp. 259-262. 27 October 2009 < http://www.springerlink.com/content/d474443332748t6v/>
Lu et al. “Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction.” Am J Cardiol. 2008 Jun 15;101(12):1689-93. Epub 2008 Apr 11. accessed 27 October 2009 (http://www.ncbi.nlm.nih.gov/pubmed/18549841)
