Generality
What is fermented red rice?
Fermented red rice is a dietary food, obtained by fermenting kitchen rice ( Oryza sativa ) by a particular yeast, called Monascus purpureus or "red yeast".
Functions
Used since time immemorial in traditional Chinese medicine, today red fermented rice is very well known also in the West, thanks to the precious hypolipidemic phytotherapeutic virtues, which allow to lower cholesterol in the blood in a natural way .
Effectiveness against cholesterol
How does red fermented rice work?
The enormous scientific and economic interest surrounding fermented red rice is linked to the metabolism of Monascus purpureus .
Through fermentation, this yeast enriches the rice of a group of substances called " monacolins ", to which a marked cholesterol-lowering activity has been scientifically attributed.
The "K" type (monacolin K), faithfully imitating the chemical structure and the pharmacological action of "lovastatin" (a synthetic drug), is considered the most effective and important monacolin.
Statins
Statins, also known as HMG-CoA reductase enzyme inhibitors, represent a class of lipid-lowering drugs.
They are widely used to combat hypercholesterolemia, cardiovascular diseases and related mortality in high-risk individuals.
They are very effective as secondary prevention, or in the treatment of cardiovascular disease at the first pathological stages, but seem almost useless in primary prevention, that is in the treatment of advanced disease.
Effectiveness of monacolin K
As shown in the figure, similar to pharmacological statins, the monacolin K of fermented red rice is able to inhibit the key enzyme of cholesterol biosynthesis (found in hepatocytes - liver cells).
Since cholesterolemia is at least 70% dependent on the endogenous biosynthetic pathway and since the diet's contribution does not exceed 30%, integration with fermented red rice is effective for:
- Normalize total cholesterol levels
- Normalize LDL cholesterol levels (Low Density Lipoprotein - vulgarly bad cholesterol)
- Normalize the levels of triglyceridemia (which is beyond this mechanism).
Statins or Red Rice?
Fermented red rice VS statins
Fermented red rice has proved more effective than the administration of equivalent doses of lovastatin. This shows that its lipid-lowering effects are the sum of various beneficial factors and are not attributable exclusively to the impact of monacolin K. Also for this, besides the well documented lipid-lowering activity, it is believed that red fermented rice can reduce cardiovascular risk thanks to to "parallel" anti-atherosclerotic actions; among these we mention the effects:
- Anti-inflammatory
- vasodilator
- Reduction of lipoprotein A.
Lipoprotein A
Said Lp (a), is a lipoprotein similar to LDL, of which very little is known; the researchers claim that it may represent (similar to hyperhomocysteinemia) an independent risk factor for cardiovascular diseases.
Furthermore, controlled fermentation in the laboratory can slightly vary the composition of Monascus purpureus and allow the selection of strains rich in Monacolin K or in other substances endowed with particular pharmacological actions.
Unlike synthetic statins (considered a real drug), the use of fermented red rice extracts is also allowed in the production of food supplements, as long as it remains within certain limits set by the Ministry (to ensure adequate safety guarantees of use).
Some studies have indicated that certain people who are intolerant to statins have been able to withstand red fermented rice. It is not clear whether this could be due to the lower quantity of monacolin K compared to the concentration of the drugs or not.
Video
Fermented Red Rice - Video
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All this has helped to fuel the already thriving business of fermented red rice, frequently promoted in an excessive and unprofessional manner. Furthermore, supplements based on fermented red rice tend to provide only and exclusively the quantitative value of the latter, not of the active ingredient monacolin K.
The composition of fermented red rice products varies according to the yeast strains and the production conditions in the production. The strains and conditions used to produce culinary red rice fermented are different from those used for food supplements. The tests carried out by the FDA (Food and Drug Administration) indicate that fermented red rice sold as a food product contains only traces of monacolin K or is completely devoid of it.
On the other hand, the average buyer is attracted by the possibility of improving his "lipid picture" by resorting to a natural product, not synthetically processed and therefore deemed to be free of side effects. Although the scientific premises to satisfy this desire are all there, it is very important that the use of fermented red rice takes place under the supervision of a doctor.
Side effects
Integration with fermented red rice: are there any side effects?
If taken at high doses and for long periods, fermented red rice could follow the side effects of statins:
- Liver toxicity
- Myopathy
- Rhabdomyolysis
The same applies to unwanted interactions with certain specific drugs:
- fibrates
- Some antibiotics
- Certain antivirals etc.
In this regard, however, there are no reliable data, so much so that the clinical studies conducted to date have not found significant side effects.
The most known and documented ones concern the possible onset of headache and mild gastrointestinal disorders such as:
- Stomach pains and burns
- Gastroesophageal reflux
- Flatulence.
WARNING! Some products based on fermented red yeast contain a mycotoxin (considered an unwanted contaminant) called "citrinin". Produced by the fungus Penicillium citrinum, if in excess it can cause renal failure.
In a 2011 analysis carried out on fermented red yeast rice products, sold as food supplements, 4 out of 11 contained this contaminant.
Contraindications
When is the use of red fermented rice not recommended?
The use of fermented red rice is contraindicated in pregnancy, lactation and in children.
Caution is advised when administered to alcoholics and patients with liver dysfunctions.
Simultaneous association with lipid-lowering drugs should be avoided, particularly if they contain gemfibrozil and other fibrates.
Since the HMG-CoA reductase inhibitors, including fermented red rice, lower the synthesis of ubiquinone (a powerful antioxidant known as coenzyme Q10), in the case of prolonged use it is appropriate to supplement this element, which becomes still more important considering its positive action on the health of the cardiovascular system.
