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Numerous randomized clinical studies have shown that psyllium fiber lowers serum cholesterol in patients with hyperlipidemia and is thus recognized by the US Food and Drug Administration (FDA) as a dietary fiber that may help reduce the risk of coronary heart disease (CHD) by lowering cholesterol. The purpose of this paper is to assess the potential economic implications for health-care cost savings and quality of life productivity gains if the cholesterol-lowering effect of psyllium, consumed daily as a fiber supplement, could be applied to a broad at-risk population.

A cost-benefit analysis tool was used to examine evidence that the use of psyllium as a cholesterol-lowering agent can reduce overall CHD-attributed medical care service costs in the USA among those at high risk of experiencing disease-related events.

Results of the analysis showed that the potential net annual avoided medical care service costs and annual quality of life productivity gains among US adults 45 and older with low-density lipoprotein (LDL) cholesterol levels = 130 mg/dL could be up to an average of $870m per year from 2013 to 2020 if everyone in the target population used seven grams of soluble fiber from psyllium daily, corresponding to a net benefit-cost ratio of $1.19 savings in annual medical service cost and annual productivity gains per $1 spent on a psyllium regimen.

Thus, the use of psyllium fiber as a daily supplement could be recommended as a means to help control the risk for potentially costly cardiovascular-related medical events and to maximize the economic potential for an improved quality of life in adults 45 and older with LDL cholesterol levels =130 mg/dL.

In March 2015, Amgen is preparing for the launch of Repatha, a new molecule that has demonstrated a remarkable ability to treat high cholesterol. Through a series of clinical trials, Amgen has proven that the molecule is both safe and effective for patients with high cholesterol. It also is effective for patients with familial hypercholesterolemia, a difficult-to-treat population that has exceptionally high levels of cholesterol. Amgen expects the FDA to approve the molecule before the end of the year. Now, the Repatha team has to develop a revenue forecast.

Various studies suggest that some of natural agents create a specific action of hypocholesterolemic effect. Considering this fact, the aim of this paper is to work on describing selected natural agents that may reduce cholesterol concentrations by different mechanism of actions.

The advantages, phytochemical components and the mechanisms of the agents were reviewed and supported from the findings of the in vitro, double-blind and clinical studies from published journals, books and articles. The journals used in this review were published between 1987 and 2016, and are available from PubMed, ScienceDirect and Google Scholar.

Plant stanols and sterols, turmeric, fenugreek, avocado, tomato, artichoke, red yeast rice and garlic showed a positive effect in maintaining cholesterol levels by specific mechanisms or actions. These agents each had a specific action in creating a hypocholesterolemic effect either by inhibition of the enzyme significant to the synthesis process, disturbing the absorption of cholesterol, conversion of cholesterol to other related forms and through the reduction of the oxidative stress.

However, this field still needs more studies as, currently, there is not any detailed information regarding the main active ingredients responsible for the mechanism to reduce cholesterol levels in humans.

This paper enlightens the authors’ understanding of some natural agents that have the potential to be used in controlling cholesterol.

This paper aims to investigate the preventive effects of a concomitant supplementation of a lyophilized aqueous extract of Globularia alypum (Ga) leaves in a high cholesterol-diet (HC-D) on lipid profile and lecithin cholesterol acyltransferase (LCAT) activity in hypercholesterolemic rats.

Twenty-four male Wistar rats weighing 232 ± 10 g were divided into four groups (n = 6). Two control groups were fed a standard-diet (St-D) supplemented (C-Ga) or not (C) with 1.66% Ga leaf extract. The two others experimental groups were fed HC-D, which contains the St-D plus 1% of cholesterol and 0.5% of cholic acid supplemented (HC-Ga) or not (HC) with the same amount of Ga. At d28, feces were collected and fasting rats were anesthetized; bloods and livers were removed to measure biochemical parameters.

In hypercholesterolemic (HC) rats, Ga supplementation in HC-D induced a significant reduction in ALT (−64%, p = 0.002) and AST (−71%; p = 0.005) activities, in plasma TC (−55%; p = 0.03) and TG (−54%; p = 0.01) concentrations, in cholesterol contents of atherogenic lipoproteins VLDL (−78%; p = 0.004) and LDL-HDL1 (−64%; p = 0.003) and inversely, an increase in those of anti-atherogenic HDL2 (+14%; p = 0.002). Feeding the HC-D-Ga exhibited a reduction in atherogenic index Apo B/Apo A-I (−72%; p = 0.002), an increase in faecal lipids, cholesterol excretion and in plasma apo A-I (+60%; p = 0.002) and HDL2-cholesteryl esters (+32%, p = 0.04) and then improved LCAT activity (+31%; p = 0.03).

In hypercholesterolemic rats, Globularia alypum extract was effective in preventing lipid disorders by its hypolipidemic action, had an anti-atherogenic potential and a protective effect against cardiovascular risk by enhancing LCAT activity.

Research has shown that mycoprotein, a vegetable protein ingredient, can lower blood cholesterol. This paper aims to test this in a consumer setting.

In total, 21 healthy, free‐living adults, who were not usually mycoprotein consumers, were asked to eat mycoprotein, as Quorn™ products, daily for six weeks. Ten control group participants followed their habitual diets. Fasting lipids, blood pressure, blood glucose, weight, body mass index and waist circumference were measured at baseline and after six weeks.

A significant reducing effect of the intervention on total cholesterol levels was found among those participants with higher baseline blood cholesterol level. No significant differences were seen between the intervention and control groups for the sample as a whole, although there were compliance issues in the control group that may have reduced its validity. Good compliance with the mycoprotein‐rich diet also appeared to have a significant lowering effect on total blood cholesterol and LDL cholesterol. The findings confirm that mycoprotein may be a useful food ingredient for helping to manage blood cholesterol levels.

There was no randomisation or blinding, which may have influenced compliance with a habitual diet in the control group. The sample size was small and so further work in a larger population is warranted, particularly to determine optimal mycoprotein intakes and likely mechanisms of action.

The paper focuses on a trial that used commercially available products in a free‐living sample.

An elevated level of cholesterol in blood is quite common nowadays. People are becoming more health conscious. The purpose of this paper is to study the hypocholesterolemic effect of teent, as it is a rich source of dietary fiber.

Teent was processed and analyzed for proximate coposition and dietary fiber constituents. Fifteen obese volunteer subjects having high blood lipid profile were selected for the experiment. Fasting blood samples were analyzed for total, low‐density lipoprotein (LDL) and high‐density lipoprotein (HDL) cholesterol initially before start of feeding experiment and at the end of experiment. Teent was processed and various products using teent or teent powder were standardized. Best acceptable products, namely, chutney and biscuits were supplemented in the diets of the subjects for three months.

The nutritional evaluation of teent indicates that it contains a good amount of protein and fiber. A significant decrease in the total cholesterol (13 percent) and LDL cholesterol (16 percent) was noticed at the end of the experiment. However, no significant change in HDL cholesterol was witnessed.

In the present scenario due to urbanization more and more people are facing problem of obesity and related heart diseases. At the same time they also want to avoid consuming medicines due to their side effects so results indicate that teent supplementation may have an important role in nutritional management of hypercholesterolemia.

Watermelon (Citrullus lanatus) fruit and its rind are known to contain phytochemicals that may have health benefits. The aim of this paper is to investigate the potential hypocholesterolemic effect of watermelon fruit rind (WR) using rats who are fed a high-cholesterol diet.

Rats were divided into six groups and fed diets for eight weeks containing normal control diet or normal control diet with either 1% cholesterol, 5% WR, 10% WR, 1% cholesterol + 5% WR or 1% cholesterol + 10% WR. Triglycerides, total cholesterol and lipoprotein levels in serum and liver samples were determined, and histopathological examination of liver tissues was carried out.

Diets containing 1% cholesterol led to hypercholesterolemia, characterized by increased levels of total cholesterol and low-density lipoproteins in rat serum and liver samples. Incorporation of 10% WR into the diet of the otherwise hypercholesterolemic rats led to significant reduction in serum levels of total cholesterol (from 266.2 to 222.7 mg/dL) and low-density lipoproteins (from 159.5 to 94.4 mg/dL). In addition, these rats also exhibited improvements in hepatic tissue structure compared to the hypercholesterolemic rats.

These results support the potential use of WR as a hypocholesterolemic agent. Further research is needed to ascertain the hypocholesterolemic effect of WR in human.

Cardiovascular diseases (CVDs) are the most common causes of death worldwide. Diets rich in saturated and trans-fatty acids are nutritional risk factors that foster the development of CVDs. The aim of this experimental study was to investigate the effects of dietary feta cheese and butter on serum lipid profile and fatty acid composition.

In all, 24 Wistar rats (eight weeks old) were fed with balanced high fat diets (24 per cent fat) including canola (control group) and either cheese or butter (experimental groups) for eight weeks. At the end of the experiment, body weights were determined, and the amount of food intake was calculated. Blood samples were collected at the beginning and at the end of the experiment, and lipid profile including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride as well as serum fatty acid composition were determined.

Consumption of the butter-based diet resulted in a significant increase in serum triglycerides (p < 0.05), whereas no substantial changes were observed in rats that received a cheese-based diet. The butter-based diet significantly increased serum total cholesterol and LDL-C (p < 0.05), whereas remarkably reduced HDL-C level. In contrast, cheese-based diet resulted in a magnificent increase in HDL-C and a significant decrease in LDL-C/HDL-C ratio (p < 0.05). Serum saturated fatty acids increased and polyunsaturated fatty acids decreased by the consumption of butter, whereas the intake of cheese caused relatively minor alterations in serum fatty acid composition.

Butter lowered HDL-C and increased LDL-C, whereas cheese strongly enhanced HDL-C. Therefore, it can be concluded that cheese is a beneficially healthier dairy product than butter.

The purpose of this study is to investigate the lipid profile and prevalence of dyslipidemia, as serum lipid levels have a major contribution in the development of cardiovascular diseases, in adult urban women of Jaipur district, Rajasthan, India.

A house-to-house survey was done in four urban locations, and 501 women in the age group of 35-70 years were enrolled in the study. A general questionnaire was used to gather background information and general health status. Fasting blood samples were collected to determine the level of serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol. Dyslipidemia was assessed based on the criteria given in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP ATP-III).

Mean age of the women was 45.63 ± 9.91 years. Population mean levels of TC, LDL-C, HDL-C and TGs were 183.9 ± 15.3, 111.8 ± 18.0, 44.0 ± 6.2 and 140.6 ± 30.9 mg/dl, respectively. Prevalence of overweight and obesity was 33.9 and 18.7 per cent, respectively. Of a total of 500 subjects, 13.8 per cent had TC = 200 mg/dl, 12.6 per cent had LDL = 130 mg/dl, 85.4 per cent had HDL-C < 50 mg/dl and 23.0 per cent had TG = 150 mg/dl. An increase in serum lipids was most prominent in the 40-59 year age group.

High prevalence of overweight and obesity was observed in the community. Prevalence of low HDL-C was very high among the subjects.

Blood lipid and lipoprotein abnormalities are common among patients with diabetes. The study aimed to assess dietary fat intake and its association with blood lipids among patients with Type 2 diabetes mellitus (T2DM) considering sex differences.

A cross-sectional observational study was conducted with patients (207 males and 197 females) with T2DM. The daily food intake and its contents of fat and fat types were assessed through face-to-face interview. Anthropometric measurements, glycated hemoglobin (HbA1c), triglyceride, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol were initially recorded.

The results revealed that TC, LDL and HDL cholesterol levels were significantly higher in females than in males. However, the TC: HDL ratio was significantly higher in males than in females. The results also showed that the daily intake of saturated fatty acid (SFA) slightly exceeded the daily recommended allowance. However, the monounsaturated fatty acid + polyunsaturated fatty acid/SFA (MUFA + PUFA/SFA) ratio was within the recommended ratio. In addition, this study found that the main sources of SFA and cholesterol intake were milk and milk products. A significant association between high fat intake and HbA1c levels was observed (r = 0.234, p < 0.001).

As it is a cross-sectional observational study, this study has the natural limitation where it can only demonstrate an association.

The types of dietary fat intake may contribute to blood lipid abnormalities and differences effects may exist among male and female. Studies on the effect of daily fat intake and its types on blood lipids in patients with diabetes, in particular Saudi patients with diabetes are limited. This study focused on the amount and type of the consumed fat among male and female Saudi patients with T2DM and studied the relationship between the type of consumed fat and blood lipid profiles.