But just because your Uncle Jack says a supplement worked miracles on his cholesterol doesn’t mean it will work for you. In fact, his success may be due to a placebo effect or a diet overhaul he neglected to mention.
Though not always perfect, scientific studies are the best way to determine if nonprescription remedies really work. Below, we break down what the research does—and doesn’t—say about the benefits of the most popular alternative remedies for lowering cholesterol.
To see what these supplements look like, view this slideshow.
Artichoke leaf extract
• What it is: The dried extract of the artichoke leaf is also known as Cynara scolymus.
• The evidence: In 2000, German researchers performed a randomized, double-blind, placebo-controlled trial using nearly 150 adults with total cholesterol over 280—well into what the American Heart Association (AHA) considers “high risk” territory. The participants who took an artichoke supplement for six weeks saw their levels of low-density lipoprotein (LDL), or bad cholesterol, fall by 23%, on average, compared to just 6% in the placebo group.
These are promising numbers, but they haven’t been replicated. A more recent, three-month trial of similar design found that total cholesterol fell by an average of 4% among participants taking artichoke leaf extract, but the researchers found no measurable impact on either LDL or high-density lipoprotein (HDL), also known as good cholesterol. They suggested that differences in the health of the participants and the potency of the supplements—the patients in the second study received a dose about 30% smaller—could explain the discrepancy between the results of the two studies.
• The bottom line: There have been very few quality studies conducted on artichoke leaf extract, and the mixed results suggest that more evidence is needed to confirm its effect on cholesterol. Don’t expect your LDL to plummet if you take artichoke supplements.
Fenugreek
• What it is: Fenugreek is a seed (often ground into a powder) that has been used since the days of ancient Egypt and is available in capsule form.
• The evidence: Several studies from the 1990s have reported that, in high doses, various fenugreek seed preparations can lower total cholesterol and LDL, in some cases dramatically. (One study recorded an LDL drop of 38%.) Almost without exception, however, the studies have been small and of poor quality, which casts some doubt on the validity of the results.
Fenugreek contains a significant amount of dietary fiber (anywhere from 20% to 50%, analyses have shown), and some experts speculate that the purported cholesterol-lowering effect of fenugreek may in fact be attributed largely to its fiber content.
• The bottom line: Despite the studies frequently cited as proof of fenugreek’s ability to lower cholesterol, there is not enough evidence to support its use.
Fiber
• What it is: Soluble fiber is a type of dietary fiber found in oats, barley, bran, peas, and citrus fruits, as well as in dietary supplements. (Though it is good for the heart in other ways, insoluble fiber does not affect blood cholesterol.)
• The evidence: In 1999, a team of Harvard Medical School researchers conducted a meta-analysis of nearly 70 clinical trials that examined the effect of soluble fiber on cholesterol levels. High soluble fiber intake was associated with reductions in both LDL and total cholesterol in 60% to 70% of the studies they examined. For each gram of soluble fiber that the participants of the various studies added to their daily diet, their LDL levels fell by about 2 points. (The average time frame was seven weeks.)
The amount of fiber you’d need to eat to significantly lower your LDL is a bit unwieldy. Most people eat far less than the 25 grams of dietary fiber recommended as a minimum by most health organizations—and only about 20% of your total fiber intake is likely to be soluble. (Eating three bowls of oatmeal a day will only yield about 3 grams of soluble fiber, according to the Harvard researchers.) Taking daily fiber supplements can help, but they can cause some gastrointestinal side effects if taken regularly and can interfere with some prescription medications.
• The bottom line: A diet high in soluble fiber can lower your LDL. The effect is likely to be relatively modest, however, and loading up on soluble fiber may be impractical.