An American randomised controlled trial has compared the lipid-lowering effects of lifestyle changes plus dietary supplements with a standard dose of a statin drug. The study enrolled 74 patients with hypercholesterolaemia and randomised them to an alternative treatment group (AG) or simvastatin (40 mg / d). The alternative treatment included therapeutic lifestyle changes (weekly education meetings, adherence to a Mediterranean diet, aerobic exercise, relaxation with tai chi and yoga, and weight loss) and ingestion of red yeast rice and fish oil supplements for 12 weeks. The simvastatin group received medication and traditional counselling. There was a statistically significant reduction in LDL cholesterol levels in both the AG (-42.4%) and the simvastatin group (-39.6%). No significant differences were noted between groups. The AG also demonstrated significant reductions in triglycerides (-29% vs -9.3%) and weight (-5.5% vs -0.4%) compared with the simvastatin group. (Simvastatin vs therapeutic lifestyle changes and supplements: randomized primary prevention trial. Mayo Clin Proc. 2008 Jul;83(7):758-64).

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