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2000
Volume 16, Issue 1
  • ISSN: 2772-574X
  • E-ISSN: 2772-5758

Abstract

Hyperlipidemia, characterized by elevated levels of lipids in the blood, represents a major risk factor for cardiovascular diseases, a leading cause of morbidity and mortality worldwide. Conventional pharmacological interventions have been effective in managing hyperlipidemia, but concerns about side effects and long-term use have prompted interest in alternative approaches, particularly the use of nutraceuticals. This comprehensive review aims to summarize and critically evaluate the current body of knowledge surrounding the role of nutraceuticals in the management of hyperlipidemia. We provide an overview of the different classes of nutraceuticals, including plant sterols, omega-3 fatty acids, soluble fiber, antioxidants, and various herbal extracts, which have been investigated for their lipid-lowering properties. The mechanisms of action of these nutraceuticals are discussed, highlighting their ability to modulate lipid metabolism, reduce oxidative stress, and promote cardiovascular health.

Furthermore, we review the results of clinical trials and epidemiological studies that have assessed the efficacy of nutraceutical interventions in lowering cholesterol levels, improving lipid profiles, and reducing the risk of cardiovascular events. In addition to their lipid-lowering effects, we examine the safety profile, dosage recommendations, and potential interactions of nutraceuticals with conventional lipid-lowering medications. We also address the importance of patient adherence to dietary and lifestyle modifications in conjunction with nutraceutical supplementation. While nutraceuticals offer a promising avenue for managing hyperlipidemia, we emphasize the need for further research to establish evidence-based guidelines for their use in clinical practice. Challenges related to standardization, quality control, and regulatory considerations are also discussed. In conclusion, this comprehensive review provides valuable insights into the potential of nutraceuticals as adjunctive or alternative therapies for managing hyperlipidemia. While further research is needed, the accumulating evidence suggests that nutraceuticals can play a valuable role in promoting cardiovascular health and reducing the burden of hyperlipidemia-related diseases.

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References

  1. RothG.A. MensahG.A. JohnsonC.O. AddoloratoG. AmmiratiE. BaddourL.M. BarengoN.C. BeatonA.Z. BenjaminE.J. BenzigerC.P. BonnyA. BrauerM. BrodmannM. CahillT.J. CarapetisJ. CatapanoA.L. ChughS.S. CooperL.T. CoreshJ. CriquiM. DeCleeneN. EagleK.A. Emmons-BellS. FeiginV.L. Fernández-SolàJ. FowkesG. GakidouE. GrundyS.M. HeF.J. HowardG. HuF. InkerL. KarthikeyanG. KassebaumN. KoroshetzW. LavieC. Lloyd-JonesD. LuH.S. MirijelloA. TemesgenA.M. MokdadA. MoranA.E. MuntnerP. NarulaJ. NealB. NtsekheM. Moraes de OliveiraG. OttoC. OwolabiM. PrattM. RajagopalanS. ReitsmaM. RibeiroA.L.P. RigottiN. RodgersA. SableC. ShakilS. Sliwa-HahnleK. StarkB. SundströmJ. TimpelP. TleyjehI.M. ValgimigliM. VosT. WheltonP.K. YacoubM. ZuhlkeL. MurrayC. FusterV. RothG.A. MensahG.A. JohnsonC.O. AddoloratoG. AmmiratiE. BaddourL.M. BarengoN.C. BeatonA. BenjaminE.J. BenzigerC.P. BonnyA. BrauerM. BrodmannM. CahillT.J. CarapetisJ.R. CatapanoA.L. ChughS. CooperL.T. CoreshJ. CriquiM.H. DeCleeneN.K. EagleK.A. Emmons-BellS. FeiginV.L. Fernández-SolaJ. FowkesF.G.R. GakidouE. GrundyS.M. HeF.J. HowardG. HuF. InkerL. KarthikeyanG. KassebaumN.J. KoroshetzW.J. LavieC. Lloyd-JonesD. LuH.S. MirijelloA. MisganawA.T. MokdadA.H. MoranA.E. MuntnerP. NarulaJ. NealB. NtsekheM. OliveiraG.M.M. OttoC.M. OwolabiM.O. PrattM. RajagopalanS. ReitsmaM.B. RibeiroA.L.P. RigottiN.A. RodgersA. SableC.A. ShakilS.S. SliwaK. StarkB.A. SundströmJ. TimpelP. TleyjehI.I. ValgimigliM. VosT. WheltonP.K. YacoubM. ZuhlkeL.J. Abbasi-KangevariM. AbdiA. AbediA. AboyansV. AbrhaW.A. Abu-GharbiehE. AbushoukA.I. AcharyaD. AdairT. AdebayoO.M. AdemiZ. AdvaniS.M. AfshariK. AfshinA. AgarwalG. AgasthiP. AhmadS. AhmadiS. AhmedM.B. AjiB. AkaluY. Akande-SholabiW. AkliluA. AkunnaC.J. AlahdabF. Al-EyadhyA. AlhabibK.F. AlifS.M. AlipourV. AljunidS.M. AllaF. Almasi-HashianiA. AlmustanyirS. Al-RaddadiR.M. AmegahA.K. AminiS. AminorroayaA. AmuH. AmugsiD.A. AncuceanuR. AnderliniD. AndreiT. AndreiC.L. Ansari-MoghaddamA. AntenehZ.A. AntonazzoI.C. AntonyB. AnwerR. AppiahL.T. ArablooJ. ÄrnlövJ. ArtantiK.D. AtaroZ. AusloosM. Avila-BurgosL. AwanA.T. AwokeM.A. AyeleH.T. AyzaM.A. AzariS. B, D.B.; Baheiraei, N.; Baig, A.A.; Bakhtiari, A.; Banach, M.; Banik, P.C.; Baptista, E.A.; Barboza, M.A.; Barua, L.; Basu, S.; Bedi, N.; Béjot, Y.; Bennett, D.A.; Bensenor, I.M.; Berman, A.E.; Bezabih, Y.M.; Bhagavathula, A.S.; Bhaskar, S.; Bhattacharyya, K.; Bijani, A.; Bikbov, B.; Birhanu, M.M.; Boloor, A.; Brant, L.C.; Brenner, H.; Briko, N.I.; Butt, Z.A.; Caetano dos Santos, F.L.; Cahill, L.E.; Cahuana-Hurtado, L.; Cámera, L.A.; Campos-Nonato, I.R.; Cantu-Brito, C.; Car, J.; Carrero, J.J.; Carvalho, F.; Castañeda-Orjuela, C.A.; Catalá-López, F.; Cerin, E.; Charan, J.; Chattu, V.K.; Chen, S.; Chin, K.L.; Choi, J-Y.J.; Chu, D-T.; Chung, S-C.; Cirillo, M.; Coffey, S.; Conti, S.; Costa, V.M.; Cundiff, D.K.; Dadras, O.; Dagnew, B.; Dai, X.; Damasceno, A.A.M.; Dandona, L.; Dandona, R.; Davletov, K.; De la Cruz-Góngora, V.; De la Hoz, F.P.; De Neve, J-W.; Denova-Gutiérrez, E.; Derbew Molla, M.; Derseh, B.T.; Desai, R.; Deuschl, G.; Dharmaratne, S.D.; Dhimal, M.; Dhungana, R.R.; Dianatinasab, M.; Diaz, D.; Djalalinia, S.; Dokova, K.; Douiri, A.; Duncan, B.B.; Duraes, A.R.; Eagan, A.W.; Ebtehaj, S.; Eftekhari, A.; Eftekharzadeh, S.; Ekholuenetale, M.; El Nahas, N.; Elgendy, I.Y.; Elhadi, M.; El-Jaafary, S.I.; Esteghamati, S.; Etisso, A.E.; Eyawo, O.; Fadhil, I.; Faraon, E.J.A.; Faris, P.S.; Farwati, M.; Farzadfar, F.; Fernandes, E.; Fernandez Prendes, C.; Ferrara, P.; Filip, I.; Fischer, F.; Flood, D.; Fukumoto, T.; Gad, M.M.; Gaidhane, S.; Ganji, M.; Garg, J.; Gebre, A.K.; Gebregiorgis, B.G.; Gebregzabiher, K.Z.; Gebremeskel, G.G.; Getacher, L.; Obsa, A.G.; Ghajar, A.; Ghashghaee, A.; Ghith, N.; Giampaoli, S.; Gilani, S.A.; Gill, P.S.; Gillum, R.F.; Glushkova, E.V.; Gnedovskaya, E.V.; Golechha, M.; Gonfa, K.B.; Goudarzian, A.H.; Goulart, A.C.; Guadamuz, J.S.; Guha, A.; Guo, Y.; Gupta, R.; Hachinski, V.; Hafezi-Nejad, N.; Haile, T.G.; Hamadeh, R.R.; Hamidi, S.; Hankey, G.J.; Hargono, A.; Hartono, R.K.; Hashemian, M.; Hashi, A.; Hassan, S.; Hassen, H.Y.; Havmoeller, R.J.; Hay, S.I.; Hayat, K.; Heidari, G.; Herteliu, C.; Holla, R.; Hosseini, M.; Hosseinzadeh, M.; Hostiuc, M.; Hostiuc, S.; Househ, M.; Huang, J.; Humayun, A.; Iavicoli, I.; Ibeneme, C.U.; Ibitoye, S.E.; Ilesanmi, O.S.; Ilic, I.M.; Ilic, M.D.; Iqbal, U.; Irvani, S.S.N.; Islam, S.M.S.; Islam, R.M.; Iso, H.; Iwagami, M.; Jain, V.; Javaheri, T.; Jayapal, S.K.; Jayaram, S.; Jayawardena, R.; Jeemon, P.; Jha, R.P.; Jonas, J.B.; Jonnagaddala, J.; Joukar, F.; Jozwiak, J.J.; Jürisson, M.; Kabir, A.; Kahlon, T.; Kalani, R.; Kalhor, R.; Kamath, A.; Kamel, I.; Kandel, H.; Kandel, A.; Karch, A.; Kasa, A.S.; Katoto, P.D.M.C.; Kayode, G.A.; Khader, Y.S.; Khammarnia, M.; Khan, M.S.; Khan, M.N.; Khan, M.; Khan, E.A.; Khatab, K.; Kibria, G.M.A.; Kim, Y.J.; Kim, G.R.; Kimokoti, R.W.; Kisa, S.; Kisa, A.; Kivimäki, M.; Kolte, D.; Koolivand, A.; Korshunov, V.A.; Koulmane Laxminarayana, S.L.; Koyanagi, A.; Krishan, K.; Krishnamoorthy, V.; Kuate Defo, B.; Kucuk Bicer, B.; Kulkarni, V.; Kumar, G.A.; Kumar, N.; Kurmi, O.P.; Kusuma, D.; Kwan, G.F.; La Vecchia, C.; Lacey, B.; Lallukka, T.; Lan, Q.; Lasrado, S.; Lassi, Z.S.; Lauriola, P.; Lawrence, W.R.; Laxmaiah, A.; LeGrand, K.E.; Li, M-C.; Li, B.; Li, S.; Lim, S.S.; Lim, L-L.; Lin, H.; Lin, Z.; Lin, R-T.; Liu, X.; Lopez, A.D.; Lorkowski, S.; Lotufo, P.A.; Lugo, A.; M, N.K.; Madotto, F.; Mahmoudi, M.; Majeed, A.; Malekzadeh, R.; Malik, A.A.; Mamun, A.A.; Manafi, N.; Mansournia, M.A.; Mantovani, L.G.; Martini, S.; Mathur, M.R.; Mazzaglia, G.; Mehata, S.; Mehndiratta, M.M.; Meier, T.; Menezes, R.G.; Meretoja, A.; Mestrovic, T.; Miazgowski, B.; Miazgowski, T.; Michalek, I.M.; Miller, T.R.; Mirrakhimov, E.M.; Mirzaei, H.; Moazen, B.; Moghadaszadeh, M.; Mohammad, Y.; Mohammad, D.K.; Mohammed, S.; Mohammed, M.A.; Mokhayeri, Y.; Molokhia, M.; Montasir, A.A.; Moradi, G.; Moradzadeh, R.; Moraga, P.; Morawska, L.; Moreno Velásquez, I.; Morze, J.; Mubarik, S.; Muruet, W.; Musa, K.I.; Nagarajan, A.J.; Nalini, M.; Nangia, V.; Naqvi, A.A.; Narasimha Swamy, S.; Nascimento, B.R.; Nayak, V.C.; Nazari, J.; Nazarzadeh, M.; Negoi, R.I.; Neupane Kandel, S.; Nguyen, H.L.T.; Nixon, M.R.; Norrving, B.; Noubiap, J.J.; Nouthe, B.E.; Nowak, C.; Odukoya, O.O.; Ogbo, F.A.; Olagunju, A.T.; Orru, H.; Ortiz, A.; Ostroff, S.M.; Padubidri, J.R.; Palladino, R.; Pana, A.; Panda-Jonas, S.; Parekh, U.; Park, E-C.; Parvizi, M.; Pashazadeh Kan, F.; Patel, U.K.; Pathak, M.; Paudel, R.; Pepito, V.C.F.; Perianayagam, A.; Perico, N.; Pham, H.Q.; Pilgrim, T.; Piradov, M.A.; Pishgar, F.; Podder, V.; Polibin, R.V.; Pourshams, A.; Pribadi, D.R.A.; Rabiee, N.; Rabiee, M.; Radfar, A.; Rafiei, A.; Rahim, F.; Rahimi-Movaghar, V.; Ur Rahman, M.H.; Rahman, M.A.; Rahmani, A.M.; Rakovac, I.; Ram, P.; Ramalingam, S.; Rana, J.; Ranasinghe, P.; Rao, S.J.; Rathi, P.; Rawal, L.; Rawasia, W.F.; Rawassizadeh, R.; Remuzzi, G.; Renzaho, A.M.N.; Rezapour, A.; Riahi, S.M.; Roberts-Thomson, R.L.; Roever, L.; Rohloff, P.; Romoli, M.; Roshandel, G.; Rwegerera, G.M.; Saadatagah, S.; Saber-Ayad, M.M.; Sabour, S.; Sacco, S.; Sadeghi, M.; Saeedi Moghaddam, S.; Safari, S.; Sahebkar, A.; Salehi, S.; Salimzadeh, H.; Samaei, M.; Samy, A.M.; Santos, I.S.; Santric-Milicevic, M.M.; Sarrafzadegan, N.; Sarveazad, A.; Sathish, T.; Sawhney, M.; Saylan, M.; Schmidt, M.I.; Schutte, A.E.; Senthilkumaran, S.; Sepanlou, S.G.; Sha, F.; Shahabi, S.; Shahid, I.; Shaikh, M.A.; Shamali, M.; Shamsizadeh, M.; Shawon, M.S.R.; Sheikh, A.; Shigematsu, M.; Shin, M-J.; Shin, J.I.; Shiri, R.; Shiue, I.; Shuval, K.; Siabani, S.; Siddiqi, T.J.; Silva, D.A.S.; Singh, J.A.; Mtech, A.S.; Skryabin, V.Y.; Skryabina, A.A.; Soheili, A.; Spurlock, E.E.; Stockfelt, L.; Stortecky, S.; Stranges, S.; Suliankatchi Abdulkader, R.; Tadbiri, H.; Tadesse, E.G.; Tadesse, D.B.; Tajdini, M.; Tariqujjaman, M.; Teklehaimanot, B.F.; Temsah, M-H.; Tesema, A.K.; Thakur, B.; Thankappan, K.R.; Thapar, R.; Thrift, A.G.; Timalsina, B.; Tonelli, M.; Touvier, M.; Tovani-Palone, M.R.; Tripathi, A.; Tripathy, J.P.; Truelsen, T.C.; Tsegay, G.M.; Tsegaye, G.W.; Tsilimparis, N.; Tusa, B.S.; Tyrovolas, S.; Umapathi, K.K.; Unim, B.; Unnikrishnan, B.; Usman, M.S.; Vaduganathan, M.; Valdez, P.R.; Vasankari, T.J.; Velazquez, D.Z.; Venketasubramanian, N.; Vu, G.T.; Vujcic, I.S.; Waheed, Y.; Wang, Y.; Wang, F.; Wei, J.; Weintraub, R.G.; Weldemariam, A.H.; Westerman, R.; Winkler, A.S.; Wiysonge, C.S.; Wolfe, C.D.A.; Wubishet, B.L.; Xu, G.; Yadollahpour, A.; Yamagishi, K.; Yan, L.L.; Yandrapalli, S.; Yano, Y.; Yatsuya, H.; Yeheyis, T.Y.; Yeshaw, Y.; Yilgwan, C.S.; Yonemoto, N.; Yu, C.; Yusefzadeh, H.; Zachariah, G.; Zaman, S.B.; Zaman, M.S.; Zamanian, M.; Zand, R.; Zandifar, A.; Zarghi, A.; Zastrozhin, M.S.; Zastrozhina, A.; Zhang, Z-J.; Zhang, Y.; Zhang, W.; Zhong, C.; Zou, Z.; Zuniga, Y.M.H.; Murray, C.J.L.; Fuster, V. Global burden of cardiovascular diseases and risk factors, 1990–2019.J. Am. Coll. Cardiol.202076252982302110.1016/j.jacc.2020.11.010 33309175
    [Google Scholar]
  2. HajarR. Risk factors for coronary artery disease: Historical perspectives.Heart Views201718310911410.4103/HEARTVIEWS.HEARTVIEWS_106_17 29184622
    [Google Scholar]
  3. BandyopadhyayD. QureshiA. GhoshS. AshishK. HeiseL.R. HajraA. GhoshR.K. Safety and efficacy of extremely low ldl-cholesterol levels and its prospects in hyperlipidemia management.J. Lipids201820181810.1155/2018/8598054 29850255
    [Google Scholar]
  4. EnkhmaaB. SurampudiP. AnuuradE. BerglundL. Lifestyle changes: Effect of diet, exercise, functional food, and obesity treatment on lipids and lipoproteins.Available from: https://www.ncbi.nlm.nih.gov/books/NBK326737/ (Accessed Oct. 31, 2023).
  5. RaoCh.S. SubashY.E. The effect of chronic tobacco smoking and chewing on the lipid profile.J. Clin. Diagn. Res.201371313410.7860/JCDR/2012/5086.2663 23449989
    [Google Scholar]
  6. RosenthalR.L. Effectiveness of altering serum cholesterol levels without drugs.Proc. Bayl. Univ. Med. Cent.200013435135510.1080/08998280.2000.11927704 16389340
    [Google Scholar]
  7. JeschE.D. CarrT.P. Food ingredients that inhibit cholesterol absorption.Prev. Nutr. Food Sci.2017222678010.3746/PNF.2017.22.2.67 28702423
    [Google Scholar]
  8. AlloubaniA. NimerR. SamaraR. Relationship between hyperlipidemia, cardiovascular disease and stroke: A systematic review.Curr. Cardiol. Rev.2021176e05112118901510.2174/1573403X16999201210200342 33305711
    [Google Scholar]
  9. GomezG. Beason-HeldL.L. BilgelM. AnY. WongD.F. StudenskiS. FerrucciL. ResnickS.M. Metabolic syndrome and amyloid accumulation in the aging brain.J. Alzheimers Dis.201865262963910.3233/JAD‑180297 30103324
    [Google Scholar]
  10. NelsonR.H. Hyperlipidemia as a risk factor for cardiovascular disease.Prim. Care201340119521110.1016/j.pop.2012.11.003 23402469
    [Google Scholar]
  11. NunesV.S. de CamposE.V.S. BaracatJ. FrançaV. GomesÉ.I.L. CoelhoR.P. NakandakareE.R. ZagoV.H.S. de FariaE.C. QuintãoE.C.R. Plasma campesterol is positively associated with carotid plaques in asymptomatic subjects.Int. J. Mol. Sci.202223191199710.3390/ijms231911997 36233298
    [Google Scholar]
  12. JacksonK.A. SuterD.A.I. ToppingD.L. Oat bran, barley and malted barley lower plasma cholesterol relative to wheat bran but differ in their effects on liver cholesterol in rats fed diets with and without cholesterol.J. Nutr.199412491678168410.1093/jn/124.9.1678 8089735
    [Google Scholar]
  13. ChengZ. BlackfordJ. WangQ. YuL.L. Acid treatment to improve psyllium functionality.J. Funct. Foods200911444910.1016/j.jff.2008.09.007
    [Google Scholar]
  14. JayachandranM. ChristudasS. ZhengX. XuB. Dietary fiber konjac glucomannan exerts an antidiabetic effect via inhibiting lipid absorption and regulation of PPAR-γ and gut microbiome.Food Chem.202340313433610.1016/j.foodchem.2022.134336 36191423
    [Google Scholar]
  15. LiuC. RadebeS.M. ZhangH. JiaJ. XieS. ShiM. YuQ. Effect of Bacillus coagulans on maintaining the integrity intestinal mucosal barrier in broilers.Vet. Microbiol.202226610935710.1016/j.vetmic.2022.109357 35101712
    [Google Scholar]
  16. CiceroA.F.G. FogacciF. BoveM. GiovanniniM. BorghiC. Impact of a short-term synbiotic supplementation on metabolic syndrome and systemic inflammation in elderly patients: A randomized placebo-controlled clinical trial.Eur. J. Nutr.202160265566310.1007/s00394‑020‑02271‑8 32417946
    [Google Scholar]
  17. Effects of garlic on cholesterol: Not down but not out either reply.Available from: https://www.researchgate.net/publication/245823167_Effects_of_Garlic_on_Cholesterol_Not_Down_But_Not_Out_Either_Reply (Accessed Jan. 31, 2024).
  18. JafariT. MahmoodniaL. TahmasebiP. MemarzadehM.R. SedehiM. BeigiM. FallahA.A. Effect of cumin (Cuminum cyminum) essential oil supplementation on metabolic profile and serum leptin in pre-diabetic subjects: A randomized double-blind placebo-controlled clinical trial.J. Funct. Foods20184741642210.1016/j.jff.2018.06.009
    [Google Scholar]
  19. RojasÁ. GallegoP. Gil-GómezA. Muñoz-HernándezR. RojasL. MaldonadoR. Gallego-DuránR. García-ValdecasasM. CampoJ.A.D. BautistaJ.D. Romero-GómezM. Natural extracts abolished lipid accumulation in cells harbouring non-favourable PNPLA3 genotype.Ann. Hepatol.201817224224910.5604/01.3001.0010.8642 29469041
    [Google Scholar]
  20. PangB. ZhaoL.H. ZhouQ. ZhaoT.Y. WangH. GuC.J. TongX.L. Application of berberine on treating type 2 diabetes mellitus.Int. J. Endocrinol.2015201511210.1155/2015/905749 25861268
    [Google Scholar]
  21. WangD. ChenC. WangY. LiuJ. LinR. Effect of black tea consumption on blood cholesterol: A meta-analysis of 15 randomized controlled trials.PLoS One201499e10771110.1371/journal.pone.0107711 25237889
    [Google Scholar]
  22. Amir ShaghaghiM. HardingS.V. JonesP.J.H. Water dispersible plant sterol formulation shows improved effect on lipid profile compared to plant sterol esters.J. Funct. Foods20146128028910.1016/j.jff.2013.10.017
    [Google Scholar]
  23. GyllingH. PlatJ. TurleyS. GinsbergH.N. EllegårdL. JessupW. JonesP.J. LütjohannD. MaerzW. MasanaL. SilbernagelG. StaelsB. BorénJ. CatapanoA.L. De BackerG. DeanfieldJ. DescampsO.S. KovanenP.T. RiccardiG. TokgözogluL. ChapmanM.J. Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease.Atherosclerosis2014232234636010.1016/j.atherosclerosis.2013.11.043 24468148
    [Google Scholar]
  24. SurampudiP. EnkhmaaB. AnuuradE. BerglundL. Lipid lowering with soluble dietary fiber.Curr. Atheroscler. Rep.201618127510.1007/s11883‑016‑0624‑z 27807734
    [Google Scholar]
  25. SamavatH. NewmanA.R. WangR. YuanJ.M. WuA.H. KurzerM.S. Effects of green tea catechin extract on serum lipids in postmenopausal women: A randomized, placebo-controlled clinical trial.Am. J. Clin. Nutr.201610461671168210.3945/ajcn.116.137075 27806972
    [Google Scholar]
  26. CartolanoF.D.C. DiasG.D. MiyamotoS. DamascenoN.R.T. Omega-3 fatty acids improve functionality of high-density lipoprotein in individuals with high cardiovascular risk: A randomized, parallel, controlled and double-blind clinical trial.Front. Nutr.2022876753510.3389/fnut.2021.767535 35281761
    [Google Scholar]
  27. BayanL. KoulivandP.H. GorjiA. Garlic: A review of potential therapeutic effects.Avicenna J. Phytomedicine2014411
    [Google Scholar]
  28. BergerA. JonesP.J.H. AbumweisS.S. Plant sterols: Factors affecting their efficacy and safety as functional food ingredients.Lipids Health Dis.200431510.1186/1476‑511X‑3‑5 15070410
    [Google Scholar]
  29. CohenD.E. Balancing cholesterol synthesis and absorption in the gastrointestinal tract.J. Clin. Lipidol.200822S1S310.1016/j.jacl.2008.01.004 19343078
    [Google Scholar]
  30. TrautweinE. VermeerM. HiemstraH. RasR. LDL-Cholesterol lowering of plant sterols and stanols—which factors influence their efficacy?Nutrients2018109126210.3390/nu10091262 30205492
    [Google Scholar]
  31. ProticO. BonfigliA.R. AntonicelliR. Nutraceutical combinations in hypercholesterolemia: Evidence from randomized, placebo-controlled clinical trials.Nutrients2021139312810.3390/nu13093128 34579005
    [Google Scholar]
  32. BakrA.F. FaragM.A. Soluble dietary fibers as antihyperlipidemic agents: A comprehensive review to maximize their health benefits.ACS Omega2023828246802469410.1021/acsomega.3c01121 37483202
    [Google Scholar]
  33. BarberT.M. KabischS. PfeifferA.F.H. WeickertM.O. The health benefits of dietary fibre.Nutrients20201210320910.3390/nu12103209 33096647
    [Google Scholar]
  34. TrautweinE.A. McKayS. The role of specific components of a plant-based diet in management of dyslipidemia and the impact on cardiovascular risk.Nutrients2020129267110.3390/nu12092671 32883047
    [Google Scholar]
  35. LiA. LiM. GuoJ. YunW. HeQ. Efficacy of oats for dyslipidaemia: protocol for a systematic review and meta-analysis.BMJ Open2022124e05829110.1136/bmjopen‑2021‑058291 35487520
    [Google Scholar]
  36. CiceroA.F.G. D’AddatoS. BorghiC. A randomized, double-blinded, placebo-controlled, clinical study of the effects of a nutraceutical combination (LEVELIP DUO®) on LDL cholesterol levels and lipid pattern in subjects with sub-optimal blood cholesterol levels (NATCOL Study).Nutrients20201210312710.3390/nu12103127 33066334
    [Google Scholar]
  37. BelorioM. GómezM. Psyllium: A useful functional ingredient in food systems.Crit. Rev. Food Sci. Nutr.202262252753810.1080/10408398.2020.1822276 32951436
    [Google Scholar]
  38. WeiZ. WangH. ChenX. WangB. RongZ. WangB. SuB. ChenH. Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: A meta-analysis of controlled clinical trials.Eur. J. Clin. Nutr.200963782182710.1038/ejcn.2008.49 18985059
    [Google Scholar]
  39. HoH.V.T. JovanovskiE. ZurbauA. Blanco MejiaS. SievenpiperJ.L. Au-YeungF. JenkinsA.L. DuvnjakL. LeiterL. VuksanV. A systematic review and meta-analysis of randomized controlled trials of the effect of konjac glucomannan, a viscous soluble fiber, on LDL cholesterol and the new lipid targets non-HDL cholesterol and apolipoprotein B.Am. J. Clin. Nutr.201710551239124710.3945/ajcn.116.142158 28356275
    [Google Scholar]
  40. OoiL.G. LiongM.T. Cholesterol-lowering effects of probiotics and prebiotics: A review of in vivo and in vitro findings.Int. J. Mol. Sci.2010112499252210.3390/ijms11062499
    [Google Scholar]
  41. GoyaM.E. XueF. Sampedro-Torres-QuevedoC. ArnaouteliS. Riquelme-DominguezL. RomanowskiA. BrydonJ. BallK.L. Stanley-WallN.R. DoitsidouM. Probiotic bacillus subtilis protects against α-synuclein aggregation in C. elegans.Cell Rep.2020302367380.e710.1016/j.celrep.2019.12.078 31940482
    [Google Scholar]
  42. LiuY. ZhangL. SongH. JiG. Update on berberine in nonalcoholic Fatty liver disease.Evid. Based Complement. Alternat. Med.201320131810.1155/2013/308134 23843872
    [Google Scholar]
  43. KosmasC.E. Rodriguez PolancoS. BousvarouM.D. PapakonstantinouE.J. Peña GenaoE. GuzmanE. KostaraC.E. The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio as a risk marker for metabolic syndrome and cardiovascular disease.Diagnostics202313592910.3390/diagnostics13050929 36900073
    [Google Scholar]
  44. YokozawaT. NakagawaT. KitaniK. Antioxidative activity of green tea polyphenol in cholesterol-fed rats.J. Agric. Food Chem.200250123549355210.1021/jf020029h 12033827
    [Google Scholar]
  45. XiaoC.W. HendryA. Hypolipidemic effects of soy protein and isoflavones in the prevention of non-alcoholic fatty liver disease: A review.Plant Foods Hum. Nutr.202277331932810.1007/s11130‑022‑00984‑1 35678936
    [Google Scholar]
  46. OscarssonJ. Hurt-CamejoE. Omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and their mechanisms of action on apolipoprotein B-containing lipoproteins in humans: A review.Lipids Health Dis.201716114910.1186/s12944‑017‑0541‑3 28797250
    [Google Scholar]
  47. CollettiA. CravottoG. CitiV. MartelliA. TestaiL. CiceroA.F.G. Advances in technologies for highly active omega-3 fatty acids from krill oil: Clinical applications.Mar. Drugs202119630610.3390/md19060306 34073184
    [Google Scholar]
  48. LiuR. QinS. LiW. Phycocyanin: Anti-inflammatory effect and mechanism.Biomed. Pharmacother.202215311336210.1016/j.biopha.2022.113362 36076518
    [Google Scholar]
  49. HanP. LiJ. ZhongH. XieJ. ZhangP. LuQ. LiJ. XuP. ChenP. LengL. ZhouW. Anti-oxidation properties and therapeutic potentials of spirulina.Algal Res.20215510224010.1016/j.algal.2021.102240
    [Google Scholar]
  50. AlAliM. AlqubaisyM. AljaafariM.N. AlAliA.O. BaqaisL. MoloukiA. AbushelaibiA. LaiK.S. LimS.H.E. Nutraceuticals: Transformation of conventional foods into health promoters/disease preventers and safety considerations.Molecules2021269254010.3390/molecules26092540 33925346
    [Google Scholar]
  51. CiceroA.F.G. CollettiA. BajraktariG. DescampsO. DjuricD.M. EzhovM. FrasZ. KatsikiN. LangloisM. LatkovskisG. PanagiotakosD.B. ParaghG. MikhailidisD.P. MitchenkoO. PaulweberB. PellaD. PitsavosC. ReinerŽ. RayK.K. RizzoM. SahebkarA. SerbanM.C. SperlingL.S. TothP.P. VinereanuD. VrablíkM. WongN.D. BanachM. Lipid lowering nutraceuticals in clinical practice: Position paper from an international lipid expert panel.Arch. Med. Sci.201755965100510.5114/aoms.2017.69326 28883839
    [Google Scholar]
  52. TrimarcoB. BenvenutiC. RozzaF. CimminoC.S. GiudiceR. CrispoS. Clinical evidence of efficacy of red yeast rice and berberine in a large controlled study versus diet.Med. J. Nutrition Metab.20114213313910.3233/s12349‑010‑0043‑6 21909461
    [Google Scholar]
  53. Kamal-EldinA. MoazzamiA. Plant sterols and stanols as cholesterol-lowering ingredients in functional foods.Recent Pat. Food Nutr. Agric.20091111410.2174/2212798410901010001 20653521
    [Google Scholar]
  54. CiceroA.F.G. FogacciF. BanachM. Red yeast rice for hypercholesterolemia.Methodist DeBakey Cardiovasc. J.201915319219910.14797/mdcj‑15‑3‑192 31687098
    [Google Scholar]
  55. CiceroA.F.G. Nutraceuticals in the management of dyslipidemia: Which, when, and for whom? could nutraceuticals help low-risk individuals with non-optimal lipid levels?Curr. Atheroscler. Reports2021231011410.1007/s11883‑021‑00955‑y
    [Google Scholar]
  56. NasriH. BaradaranA. ShirzadH. KopaeiM.R. New concepts in nutraceuticals as alternative for pharmaceuticals.Int. J. Prev. Med.20145121487
    [Google Scholar]
  57. RonisM.J.J. PedersenK.B. WattJ. Adverse effects of nutraceuticals and dietary supplements.Annu. Rev. Pharmacol. Toxicol.201858158360110.1146/annurev‑pharmtox‑010617‑052844 28992429
    [Google Scholar]
  58. Probiotics : Health professional fact sheet.Available from: https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/ (Accessed Oct. 31, 2023).
  59. Sharifi-RadJ. RayessY.E. RizkA.A. SadakaC. ZgheibR. ZamW. SestitoS. RapposelliS. Neffe-SkocińskaK. ZielińskaD. SalehiB. SetzerW.N. DosokyN.S. TaheriY. El BeyrouthyM. MartorellM. OstranderE.A. SuleriaH.A.R. ChoW.C. MaroyiA. MartinsN. Turmeric and its major compound curcumin on health: Bioactive effects and safety profiles for food, pharmaceutical, biotechnological and medicinal applications.Front. Pharmacol.2020110102110.3389/fphar.2020.01021 33041781
    [Google Scholar]
  60. ChackoS.M. ThambiP.T. KuttanR. NishigakiI. Beneficial effects of green tea: A literature review.Chin. Med.2010511310.1186/1749‑8546‑5‑13 20370896
    [Google Scholar]
  61. BanerjeeS.K. MaulikS.K. Effect of garlic on cardiovascular disorders: A review.Nutr. J.200211410.1186/1475‑2891‑1‑4 12537594
    [Google Scholar]
  62. SainiR. Coenzyme Q10: The essential nutrient.J. Pharm. Bioallied Sci.20113346646710.4103/0975‑7406.84471 21966175
    [Google Scholar]
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