Two recent articles have dealt blows to the nutri-tional supplement market. Research suggests that neither supplemental policosanol nor garlic has a cholesterol lowering effect.1,2 Neither outcome surprises me; in fact, I would have been surprised if either helped, and here is why….
In the policosanol trial there were 143 subjects (56 men and 87 women). The average age was 56 (the range was 23-78). The average body mass index was 27.3, which means that most were overweight. Approximately 75 percent of all subjects were overweight, and just less than 20 percent of all subjects were obese.
The word exercise was not mentioned in the article, so we have no idea about a key lifestyle factor; however, considering that so many subjects were overweight, it is likely that few exercised. Additionally, about 5 percent of subjects were smokers, and various medications were being taken. We are not given the total number of patients out of the 143 on medications, or how many were taking more than one medication. However, we are told that 15 percent were on beta-blockers, 10 percent on ACE inhibitors, 13 percent on thyroid hormones, and 13 percent on aspirin/NSAID’s. Other medications included additional anti-hypertensive agents, estrogen replacement, and anti-depressants.
We also know nothing about the quality of the subjects’ diets, just that they were consistent among subjects during the study trial. This omission is important, as dietary content influences cholesterol levels. It is estimated that the average American consumes about 150 pounds of sugar per year.3 We know that high-glycemic index foods (sugar and refined flour) lower HDL-cholesterol levels, and we know that trans-fat consumption lowers HDL and also raises atherogenic LDL-cholesterol levels.4
To put this dietary situation into better perspective, consider that about 75 percent of the average American’s caloric intake comes from dairy products, refined cereals, refined sugars and flours, refined vegetable oils, and alcohol.3 Few fresh vegetables and fruits are consumed, and the meat we eat today bears little resemblance to the wild game consumed by generations past. Only about 2-4 percent of wild game is fat by weight, with relatively high levels of omega-3 fatty acids. Our modern meat is about 20 percent to 25 percent fat by weight, much of which is saturated fat, and a raiser of total cholesterol levels. Our modern meat is also rich in n-6 fatty acids, with very little anti-inflammatory n-3’s.4
In short, our modern dietary pattern is recipe for high total cholesterol, high LDL, and low HDL. The problem from which most American’s suffer is a dietary express train to hypercholesterolemia, coronary artery disease, and other chronic inflammatory conditions. Accordingly, taking 10-80 mgs of policosanol should not be expected to appreciably influence this process. Similarly, taking garlic should also not be expected to have an appreciable effect.
If you were depressed by the recent findings about policosanol and garlic, this means that you likely view supplements as natural medications that can be swapped in the place of drugs. This thinking is terribly erroneous. High total cholesterol and LDL levels are two of the measurable manifestations of a lifestyle that is very unhealthy. We cannot counteract an unhealthy lifestyle with drugs or supplements. No supplement or medication can take the place of exercise and a diet that consists mainly of vegetation, fish, and lean meat. However, we can take supplements to support this diet, and our best basic options are a multivitamin/mineral, magnesium, fish oil, and vitamin D. Garlic and other herbs, like ginger, are still appropriate for consumption and supplementation; however, the purpose of ingesting such herbs should be to help reduce the inflammatory state, and not to “treat” high LDL levels.
Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. He is also a faculty member at Palmer College of Chiropractic Florida, where he teaches nutrition and subluxation theories. He can be reached by e-mail at [email protected]
1. Berthold HK, Unverdorben S, Degenhardt R, Bulitta M, Gouni-Berthold I. Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial. J Am Med Assoc 2006; 295:2262-69
2. Gardner CD, Lawson LD, Block E et al. Effect of raw garlic vs. commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia. Arch Intern Med 2007;167:346-53
3. Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the western diet: health implications for the 21st century. Am J Clin Nutr. 2005; 81:341-54
4. O’Keefe JH Jr, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer. Mayo Clin Proc 2004; 79(1):101-8