Dear Dr. Roach: I read the letter from the man who took niacin to lower his cholesterol, which resulted in diabetes. I am not sure if you are aware that red yeast rice, which I have been taking, is supposed to reduce cholesterol. To my knowledge, it has no side-effects. My doctor said my last tests were good. You might mention this to people as a way of reducing cholesterol. They can buy it over the counter.
J.D.
Red yeast rice is a fermented rice product that has been used in China to promote “blood circulation.” One well-done but short study from UCLA showed that red yeast rice does indeed lower cholesterol with very few side-effects. However, there are several issues that must be considered before recommending the product.
The first is that a chemical analysis of red yeast rice shows that it contains monacolin K, the very same active ingredient in lovastatin, one of the statin drugs. Although there are other compounds in red yeast rice as well, many experts think its primary effectiveness is through the same enzyme that the statins work on, which would imply that red yeast rice has risks similar to all the bad side- effects of statins, including increased blood sugar and muscle aches.
Secondly, there have been no long-term safety studies of red yeast rice that would confirm or deny that implication.
The last is the same issue I bring up with any supplement: Most supplements are not standardized or independently tested, and contents may vary dramatically. The amount of monacolin K varied from 0.1 mg per capsule to over 10 mg, depending on the batch and manufacturer. Also, many of the brands tested contained citrinin, a fungus-derived kidney toxin. Because of the 100-fold potential variability in effectiveness, potential for toxicity and lack of long-term safety studies, I can't recommend red yeast rice for general use.
Dear Dr. Roach: I’ve been diagnosed with midstage prostate cancer. I understand that sugars feed cancer, but what about sugar alcohols? I’m sure there are many of us out here who would like to know.
D.P.
Cancers are very good at using whatever energy supply they can get, including sugar. However, even if you eat no sugar at all, your body will make sugar, which is necessary for your brain. There is no way to change your diet so effectively that it can prevent a cancer, of any type, from using sugar to grow.
However, excess sugar isn’t good for anyone, especially someone fighting off cancer, and particularly so in someone being treated with radiation, chemotherapy or recovering from surgery. So, most cancer experts recommend a diet high in fruits and vegetables and low in refined grains and simple sugars. The natural sugars found in fruits will not adversely affect your cancer treatment.
You asked also about sugar alcohols. Sugar alcohols, like xylitol and sorbitol, are poorly absorbed sweeteners. They almost certainly are less harmful than plain sugar, but many people can be very sensitive to their laxative effects. While they will not cause problems with your cancer treatment, foods that have these products are generally less nutritious than the diet above.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
