All the Benefits of Red Yeast Rice

Red Yeast Rice Fights Heart Disease Not
Just Through Cholesterol Reduction

Natural statins reduce levels of an inflammatory protein implicated in heart disease

east is important to the origin of many of life's true joys - beer, for example, and wine, and bread too. Life just wouldn't be the same without that tiny organism, yeast, in one of its many forms, fermenting like crazy to change basic foodstuffs into more complex and savory forms. Of course, the process for producing each of these delights is not the same, nor is the type of yeast involved.

The production of beer and wine requires a special type of yeast called brewer's yeast (a well-known source of B-complex vitamins), which converts sugar into alcohol during the fermentation process. Baking raised breads, on the other hand, requires baker's yeast. In this process, carbon dioxide gas (CO2) is produced and trapped in the dough, which causes it to rise. As we will see, though, the benefits of yeast are not limited to culinary circles.

There are thousands of different strains of yeast (which, surprisingly, are a type of fungus related to mushrooms). In addition to the economically important varieties, such as brewer's yeast and baker's yeast, one species in particular has important medicinal value and has been used in China for centuries. This purple-colored yeast (Monascus purpureus) grows on rice and gives it a red color when the rice ferments. The resulting product, appropriately called red yeast rice, is used in the Orient as both a food and a food-coloring agent. Of greater interest to modern science, however, is that red yeast rice has proven cholesterol-lowering properties.1 (See the March, April, and August 2001 issues of Life Enhancement.)

Red yeast rice contains a compound called lovastatin as well as a number of related compounds in the class called statins. They are highly effective in reducing blood cholesterol levels and are, in fact, the basis for several pharmaceutical drugs. Some examples, in addition to lovastatin, are simvastatin, mevastatin, pravastatin, atorvastatin, and fluvastatin. Statins lower blood cholesterol by inhibiting an important enzyme that is required for the synthesis of cholesterol in the liver. The enzyme is hydroxymethylglutaryl-coenzyme A reductase. That's quite a mouthful, so this protein (all enzymes are proteins) usually goes by the simpler name HMG-CoA reductase. If your cholesterol level is too high, inhibiting HMG-CoA reductase is a good thing to do.

Many studies have demonstrated, in fact, that this is the most effective way (aside from diet and exercise) to regulate total blood cholesterol levels. Lower cholesterol levels generally mean a decreased risk of atherosclerosis, and therefore of heart attack, so statins are very important drugs indeed. But the news about statins - and, therefore, about red yeast rice - gets even better. Recent research indicates that statin therapy can also reduce the level of another protein, called C-reactive protein, with consequences that may lower the risk of several additional types of coronary events.2

C-reactive protein (CRP) is a compound that the immune system instructs the liver to produce and release into the bloodstream to ensure that bacteria, viruses, and other foreign invaders do not set up camp in your body and hang around for extended periods. CRP is an "inflammatory marker," a compound that signals the presence of an infection. The proteins act as molecular "tags," and when they bind to bacteria, they signal your white blood cells to destroy the bacteria to alleviate the infection. This sounds like a good system, right? And it is. When your body becomes infected, your liver starts cranking out large amounts of CRP to tag bacteria that should be destroyed - in fact, the level of CRP in your blood can increase as much as 500-fold during a severe infection!3 After the bacteria are tagged and eradicated, the infection subsides, and the CRP level returns to normal.

In some individuals, however, CRP levels may remain elevated for extended periods of time, and this can cause serious trouble.* Recently, researchers at Brigham and Women's Hospital in Boston found that chronically elevated CRP levels increase the risk of certain coronary events, such as angina pectoris (severe chest pain), myocardial infarction (heart attack), and sudden death from cardiac causes (e.g., arrhythmias, which are disruptions in the heart muscle's rhythmic contractions). In fact, of 11 different risk factors that were assessed in a population of 14,916 male physicians, two factors - the ratio of total cholesterol to HDL (the "good" cholesterol), and the blood level of C-reactive protein - were particularly well tied to an increased risk of atherosclerosis and subsequent cardiovascular disease. As it turns out, the best way to identify individuals with increased risk is to use these criteria in combination.4

*Besides infections, such as bronchitis, gastritis, and periodontitis, other conditions that may lead to sustained high levels of CRP in the blood are smoking, obesity, and, if it can be called a "condition," aging.

Recently, a drug intervention study was conducted in Texas on 5742 men and women (aged 45-73) who had a median LDL level of 149.3 mg/dL (milligrams per deciliter).2 LDL is the "bad" cholesterol, and a level above 130 mg/dL is considered undesirable. The purpose of the study was to assess the risk of future coronary events. The participants were given 20 mg/day of the cholesterol-lowering drug lovastatin (recall that this is the principal statin found in red yeast rice) for one year, and their cholesterol and CRP levels were measured at the beginning and end of the study. Those patients with high initial LDL levels who responded favorably to lovastatin (i.e., whose LDL levels were reduced) were found to have a reduced risk of future coronary events. That is consistent with the results of many previous studies, so it came as no surprise.

The researchers also found, however, that the lovastatin treatment significantly reduced the risk of future coronary events in patients with more normal LDL levels but above-normal CRP levels. Even though the lovastatin did not reduce cholesterol levels substantially in these patients, it did reduce CRP levels by 14.8% - and it is this effect that was associated with a decreased risk in those individuals.

Medical Complications of High Cholesterol

Because cholesterol is a lipid (a fatty substance), it is not easily transported in the blood, which is mostly water. To facilitate its transport, our bodies incorporate cholesterol into particles called lipoproteins, which are composed of lipids and proteins - hence their name. Some of the cholesterol and other lipids in low-density lipoprotein (LDL, the "bad" cholesterol) may become oxidized, especially through the destructive action of free radicals. When this occurs, the LDL particles are more likely to become attached to the inner walls of blood vessels and contribute to the formation of atherosclerotic plaque. This reduces the diameter of the blood vessels and thus their blood-carrying capacity.

If too much plaque forms in the coronary arteries, which supply the heart muscle with blood, the resulting myocardial ischemia (inadequate blood supply to the heart) can deprive heart cells of oxygen and vital nutrients. In mild cases, this can impair the cells' function without killing them, and surprisingly, it may not produce any detectable symptoms. Severe ischemia, however, can produce the pain of angina pectoris, and a complete blockage of one of the coronary arteries can cause cell death and a heart attack. Depending on the extent of damage to the heart tissue, a heart attack can range from minor discomfort to sudden death.

It is important to realize that hypercholesterolemia (high cholesterol) is the leading cause of atherosclerosis, which in turn is the leading cause of coronary artery disease (CAD). Hypercholesterolemia is what heart researchers refer to as a "modifiable risk." That is, you can control this factor to some degree, just as you can change your sedentary lifestyle, lose weight if you are obese, quit smoking, or reduce your homocysteine levels (all of which are strong predictors of CAD). Because CAD causes approximately one-third of all deaths in the United States, it behooves you to do everything in your power to modify heart disease risks to your advantage.

Additional results from the study put this finding into perspective. Of 696 individuals with normal cholesterol levels and high CRP levels in the control group, 35 suffered coronary events during the one-year study. In the lovastatin group, however, this number was cut in half: only 17 of the 650 participants with normal cholesterol and high CRP suffered coronary events. Thus, this research indicates that even people without high blood cholesterol levels can decrease their risk for coronary events by taking cholesterol-lowering drugs.

Researchers in Finland also concluded that inflammatory markers, such as CRP, are positively correlated with the incidence of heart disease.5 Further, they suggest that cholesterol-lowering drugs, such as HMG-CoA reductase inhibitors, may have an anti-inflammatory effect that provides added benefit in reducing the risk of coronary heart disease. All this is good news for individuals with heart problems, since there are a number of compounds available for inhibiting HMG-CoA reductase.

Because red yeast rice is a natural product, it is a much more complex mixture of compounds than pharmaceutical drugs such as lovastatin. While red yeast rice contains lovastatin, it also contains eight other statins, all with an ability to inhibit HMG-CoA reductase.6 It should come as no surprise, therefore, that scientific studies have demonstrated that red yeast rice extracts significantly reduce LDL levels. One of these studies was conducted at UCLA and showed that red yeast rice extract (2.4 g/day) lowered total cholesterol by 16% after 12 weeks of treatment.1

The health benefits of red yeast rice are further enhanced by the presence of certain isoflavones (cholesterol-lowering compounds found in soy products) and phytosterols (compounds that inhibit cholesterol absorption in the digestive tract). It is worth noting that red yeast rice has been used safely and effectively for over 1200 years in China. Although the ancient Chinese may not have known about the valuable compounds locked inside this food product, they were well aware of its health benefits, and their descendants have used it to treat circulatory problems for centuries.7

Cardiovascular disease is a generic term encompassing many different medical complications that can arise in the heart and circulatory system. Some of the most important of these complications can be traced back to cholesterol and CRP levels in the blood. Because red yeast rice is an effective means for reducing cholesterol and CRP levels, it may thus also reduce the risk of serious coronary events.

There are many products available for reducing the risk of cardiovascular disease. But when you consider that red yeast rice is a natural product with a proven history of over 1200 years, and costs only about one-fifth as much as prescription drugs, the best choice for the right cholesterol-lowering agent is pretty clear.


  1. Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr 1999;69:231-6.
  2. Ridker PM, Rifai N, Clearfield M, et al. Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events. New Engl J Med 2001;344:1959-65.
  3. Munford RS. Statins and the acute-phase response. New Engl J Med 2001;344:2016-8.
  4. Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic atherosclerosis. A comparison of C-reactive protein, fibrinogen, homocysteine, lipoproteins (a), and standard cholesterol screening as predictors of peripheralarterial disease. J Am Med Assoc 2001;285:2481-5.
  5. Jouslilahti P, Salomaa V, Rasi V, Vahtera E, Palosuo T. The association of c-reactive protein, serum amyloid a and fibrinogen with prevalent coronary heart disease - baseline findings of the PAIS project. Atherosclerosis 2001;156:451-6.
  6. Patrick L, Uzick M. Cardiovascular disease: C-reactive protein and the inflammatory disease paradigm: HMG-CoA reductase inhibitors, alpha-tocopherol, red yeast rice, and olive oil polyphenols. A review of the literature. Alt Med Rev 2001;6:248-71.
  7. Elkins, R. Chinese Red Yeast Rice: A Remarkable Compound for the Promotion of Healthy Cholesterol Levels. Woodland Publishing, Pleasant Grove, UT, 1998.

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