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Red mold rice: Federal Institute advises against alternative cholesterol lowering
Dietary supplements with red mold rice are advertised as alternative cholesterol-lowering drugs, especially on the Internet. The effect of natural products should be as good as with cholesterol-lowering drugs. But experts advise against taking such preparations - and if so, only after consulting a doctor.
Elevated cholesterol, along with other factors such as smoking, obesity, high blood pressure, alcohol abuse and lack of exercise, are a risk factor for the development of arteriosclerosis (arteriosclerosis). In addition to regular exercise, the reduction of excess weight and a healthy diet, medication can also help to bring blood lipid levels into balance. However, dietary supplements containing red mold rice to lower cholesterol are not recommended.
Ingredients can damage health
As the Federal Institute for Risk Assessment (BfR) explains in a current statement, red mold rice (also known as red rice or red yeast rice) has its traditional origin in China.
The red rice arises when cooked white rice is fermented with mold strains of the genus Monascus. This creates substances that give the rice an intense red color. That is why red mold rice is used primarily in East Asia for coloring food.
In addition, fermentation creates ingredients that, according to the BfR, may have a pharmacological effect (like a drug) and may damage health.
Kidney and liver function disorders may occur
Monacolines, chemical compounds that occur naturally in mold strains, are important in this context. These compounds can also be found in red mold rice and can inhibit an enzyme in the liver that the body needs to produce cholesterol.
Particularly noteworthy here is Monakolin K, which is most abundant in red mold rice. In terms of structure and effect, Monakolin K is identical to the active ingredient lovastatin, which is used in medicinal products subject to authorization to lower cholesterol levels.
Possible side effects of lovastatin include headache, nausea, diarrhea, weakness, rashes and muscle cramps. In rare cases, kidney and liver function disorders and skeletal muscle damage (rhabdomyolysis) can also occur.
Medicines with the active ingredient lovastatin are prescription-only in Germany. A medical risk-benefit assessment is always required to determine whether the treatment is meaningful for the patient.
Cure digestive disorders and diseases of the cardiovascular system
Because of its cholesterol-lowering effects, red mold rice has long been consumed in various regions of Asia to cure digestive problems and diseases of the cardiovascular system.
Dietary supplements with red mold rice are also offered in various dosages in European countries. The Monakolin K contained therein can also cause the undesirable side effects mentioned above. The intake of the dietary supplement is usually not accompanied by a doctor.
In addition, under certain circumstances, the toxic substance citrinin can form during fermentation. This can trigger genetic changes and damage the kidney and unborn child in the womb.
According to the BfR, the maximum permitted level of citrinin in dietary supplements based on rice has been reduced by the EU Commission from 2,000 micrograms per kilogram (µg / kg) to 100 µg / kg and will apply from April 1, 2020.
Health concerns have not been addressed
The safety of Monakolin K in food supplements has recently been assessed by the European Food Safety Authority (EFSA) on behalf of the European Commission.
Result: It is not possible to determine an intake of monacolines that is considered harmless to health. The BfR agrees with this assessment.
In March 2019, a meta-analysis was published on the question of how compatible and safe red mold rice products with Monakolin K as a dietary supplement are. One conclusion was that there was no increased risk of developing muscular complaints.
The BfR has examined the publication and comes to the conclusion that it has significant limitations and is not sufficiently informative overall. The meta-analysis is therefore unsuitable to alleviate the essential health concerns for red mold rice products with Monakolin K as a dietary supplement.
Dietary supplements with red mold rice should not be consumed
No regulatory approval is required for the placing on the market of food supplements in Germany, as these do not fall under pharmaceutical law, but rather under food law. Before placing them on the market for the first time, they must be reported to the Federal Office of Consumer Protection and Food Safety (BVL).
Due to considerable health safety concerns, the BfR recommends not to eat dietary supplements with red mold rice.
Should such products be taken anyway, this should only be done after medical consultation or under medical supervision. Above all, it should also be taken into account that the products contain different doses of Monakolin K.
The health insurance company Barmer also points out that dietary supplements with red rice can be dangerous.
"For example, anyone who is sensitive to medical cholesterol-lowering agents, the so-called statins, will most likely also experience similar health problems when taking red mold rice products," said Barmer drug expert Heidi Günther in a message.
In addition, an additional intake to the medicinally prescribed medication can easily lead to an overdose.
According to the pharmacist, there is also the fact that the so-called Red Rice products are not standardized like medicines on the main active ingredient Monakolin K and therefore the dose per capsule can fluctuate. (ad)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Federal Institute for Risk Assessment (BfR): Cholesterol reduction with consequences: Take dietary supplements with red mold rice only after consultation with a doctor, (accessed: January 18, 2020), Federal Institute for Risk Assessment (BfR)
- Barmer: Caution: Red rice can be dangerous !, (accessed: January 18, 2020), Barmer