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Study Disputes Supplement's Cholesterol Claims

May 17, 2006

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A new study suggests that use of the nutritional supplement policosanol, often promoted as a "natural" substitute for statin drugs, does not lower cholesterol levels any more than a placebo.

That finding, published in the May 17 issue of JAMA, is at odds with previous studies, which did find some beneficial effect.

In none of the five treatment groups did LDL-C levels decrease more than 10 percent from baseline. No statistically significant difference between policosanol and placebo was observed.

"Our results suggest that [policosanol] is devoid of clinically relevant lipoprotein-lowering properties in white patients," the authors concluded. "Still, more independent studies are required to counterbalance the vast body of available positive trials."

Policosanol is a natural substance produced from the waxy coating of sugar cane.

Cuban sugar cane policosanol is sold in more than 40 countries mainly because of its supposed lipid-lowering effects, according to background information in the article.

Numerous policosanol products from a variety of sources (sugar cane, wheat germ, rice bran, beeswax) are available over-the-counter and on the Internet in several countries.

Most of the published scientific literature, more than 80 trials, supporting the beneficial effects of policosanol on lipids has been authored by a single research group from Cuba.

One clinical trial from the Netherlands showed wheat germ–derived policosanol ineffective in lowering total cholesterol and low-density lipoprotein cholesterol (LDL-C), sometimes called "bad" cholesterol.

Heiner K. Berthold, M.D., Ph.D., of the University of Cologne, Germany, and colleagues conducted a study to determine the lipid-lowering effects of policosanol.

The multicenter, randomized, double-blind, placebo-controlled, trial included 143 patients with hypercholesterolemia (high cholesterol) or combined hyperlipidemia (excess of fats or lipids in the blood) having baseline LDL-C levels of at least 150 mg/dL and either no or 1 cardiovascular risk factor other than known coronary heart disease, or baseline LDL-C levels of between 150 and 189 mg/dL and 2 or more risk factors.

The patients were randomized into 5 groups: 10, 20, 40, or 80 mg/d of policosanol or placebo. The study was conducted from September 2000 to May 2001.

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