CAM for Hyperlipidemia includes Dietary Supplements (Omega-3 Fatty Acids, Plant sterols and stanols, Soy protein, Flax seed, Red yeast rice), Herbal Supplements (Ginger, Garlic, Ginseng) and Mind – Body Practices (Transcendental Meditation and Yoga).

1. Complementary and
Alternative Therapies for
Hyperlipidemia
Dr. P.Naina Mohamed PhD
Pharmacologist

2. Introduction
 The therapies which could be combined with conventional
medicine is termed “Complementary Medicine”.
 “Alternative Medicine” includes therapies that are used in
place of conventional medicine.
 “Complementary and Alternative Medicine” (CAM)
refers to a wide range of clinical therapies outside the
conventional medicine.
 “Conventional Medicine” is a type of medicine practiced
by medical doctors and by allied health professionals, such
as physical therapists, psychologists, and registered nurses. It
is also called Western or Allopathic medicine.
 “Integrative Medicine” represents a combination of
conventional medicine, CAM, and evidence-based medicine.

3. CAM Use
 An US study reported that the Complementary and Alternative
Medicine (CAM) use is high and continues to increase.
 The most important reason cited by patients for the
supplemental CAM use is the perception that CAM is harmless.
 CAM use is highest in patients include
 Female
 Nonsmokers
 Physically active
 Having normal body mass index (BMI)
 Eating low-fat diets with a high fruit and vegetable content
 Individuals aged 35 to 54 years with a high level of education.

4. Types of CAM Practices
 Mind-Body and Manipulative
Practices
 Traditional Medical Systems
 "Modern" Medical Systems

5. Mind and Body
Practices

 Acupuncture and Acupressure
 Yoga
 Hypnosis
 Massage
 Meditation
 Reflexology Alexander technique
 Tai chi
 Spinal manipulation
 Therapeutic touch
 Guided imagery
 Rolfing/structural integration

6. Traditional Medical Systems

• Ayurvedic medicine
• Siddha medicine
• Unani medicine
• Native American medicine
• Tibetan medicine
• Traditional Chinese medicine
• Curanderismo

7. "Modern" Medical Systems

•Homeopathy
•Naturopathy
•Osteopathy
•Chiropractic
•Anthroposophic medicine

8. Hyperlipidemia
 Excessively elevated levels of lipids or lipoproteins in the blood is
termed Hyperlipidemia.
 Any fat-soluble molecules is known as Lipids and the Lipoproteins
are the capsules surrounding lipids and transporting them.
 Cholesterol is one of the most common types of lipids. Elevated
levels of cholesterol in the blood is referred as
Hypercholesterolemia.
 Triglycerides are the esters derived from glycerol and three fatty
acids. Presence of high levels of Triglycerides in the blood is called
Hypertriglyceridemia.
 The risk factors of Hyperlipidemia include Obesity or Overweight,
excessive Alcohol consumption, Physical inactivity, preexisting health
conditions such as Diabetes, Hypothyroidism, or Kidney disease.

9. CAM used for Hyperlipidemia
 Dietary Supplements
Omega-3 Fatty Acids
Plant sterols and stanols
Soy protein
Flax seed
Red yeast rice
 Herbal Supplements
Ginger
Garlic
Ginseng
 Mind – Body Practices
Transcendental Meditation
Yoga

10. Omega-3 Fatty Acids
 Marine derived (Mackerel, Lake trout, Herring, Sardines, Albacore tuna, and Salmon) Omega-3
Fatty Acids such as Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA) and
Plant derived (walnuts, flaxseeds and Canola) Omega-3 Fatty Acids like Alpha linolenic acid
(ALA) are useful to reduce Triglyceride levels.
 Two to four grams per day of EPA+DHA supplementation, can lower 20% to 40%
triglycerides and may be useful in patients with hypertriglyceridemia.
 The American Heart Association (AHA) recommends ≈1 g of EPA and DHA
(combined) per day, for CHD patients.
 The AHA recommends that all adults eat fish at least two times a week.
 The AHA also recommends eating plant-derived omega-3 fatty acids.
http://atvb.ahajournals.org/content/23/2/151.full

11. Plant Sterols and Stanols
 Approximate consumption of 2 g per day of plant sterol esters can
decrease 9% to 20% of LDL cholesterol levels.
 Significant reduction of serum total and LDL cholesterol levels
found with the consumption of margarines providing 3.4 to 5.1 g a
day of plant stanol esters.
 Individuals with familial sitosterolemia should avoid stanol and
sterol esters.
http://content.onlinejacc.org/article.aspx?articleid=1136740

12. Soy
 Soybeans contain isoflavones which are similar to the structure female hormone
estrogen.
 Traditionally soy products are used to treat menopausal symptoms,
osteoporosis, memory problems, high blood pressure, high cholesterol levels,
breast cancer, and prostate cancer.
 Research suggests that daily intake of soy protein may slightly lower levels of
LDL cholesterol.
http://www.ncbi.nlm.nih.gov/pubmed/17981741

13. Flax Seed
(Linum Usitatissimum)
 Flax seeds are rich in Alpha Linolenic Acid (Omega-3 fatty acid),
dietary fiber, dietary lignans and natural antioxidants.
 Dietary flaxseed can be recommended for CVD patients due to its
antihyperlipidemic and antiplatelet actions.
http://jn.nutrition.org/content/early/2015/02/18/jn.114.204594.full.pdf

14. Red Yeast Rice
(Monascus Purpureus)
 Red yeast rice contains active constituents such as Monacolin K,
Sterols (Betasitosterol, Campesterol, Stigmasterol, Sapogenin),
Isoflavones and monounsaturated fatty acids.
 Monacolin K has the same chemical structure as lovastatin.
 One study reported that some commercial red yeast rice products
elevated the levels of citrinin (Nephrotoxic mycotoxin).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823761/

15. Blond Psyllium
 Patients who consume 10-12 grams of blond psyllium per day can
decrease total cholesterol by 3-14% and LDL cholesterol by 5-
10%.
 The US Food and Drug Administration recently authorized the
food products containing soluble fiber from psyllium to use health
claims that their use is associated with a decreased risk of coronary
heart disease.
http://ajcn.nutrition.org/content/71/2/472.long

16. Oat bran
 Oat bran can reduce LDL cholesterol by up to 26%
in some patients.
http://ajcn.nutrition.org/content/71/2/472.long

17. Whole Grain Foods
 The FDA permits the foods containing at least 51%
of whole grains (whole Wheat, whole Oats, Corn,
Barley) to use health claims that they reduce the risk
of coronary heart disease.
http://jama.jamanetwork.com/article.aspx?articleid=19021

18. Nuts
 Nuts (Walnuts, Almonds, etc.) are high in arginine,
magnesium, folate, plant sterols, and soluble fiber.
 A Physicians’ Health Study demonstrated that
consumption of nuts 2 or more times a week
significantly reduced the risk of sudden cardiac death.
http://content.onlinejacc.org/article.aspx?
articleid=1136740

19. Ginger (Zingiber officinale )
 Ginger (Zingiber officinale) is one of the most commonly used dietary
condiments in the world.
 Gingerols are the major constituents of fresh ginger and Shogaols
found abundantly in dry ginger.
 Evidences are available for ginger's beneficial effect on
hyperlipidemia, platelet aggregation, hypertension, inflammation
and free radicals.
http://www.sciencedirect.com/science/article/pii/S0167527307016853

20. Garlic (Allium Sativum)
 Traditionally, Garlic is used frequently as a dietary
supplement for the treatment of Hyperlipidemia,
Heart disease, Hypertension, Diabetes, etc.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103721/

21. Ginseng
 Major constituents of Ginseng (Ginsenosides), are
thought to possess antineoplastic, antistress,
vasorelaxation, anti-inflammation and antioxidant
effects.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213864/

22. Transcendental Meditation
http://archinte.jamanetwork.com/article.aspx?
articleid=410453

23. Yoga
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860
602/

24. General Nutritional
Recommendations
 Limit foods high in calories such as soft drinks and candy.
 Avoid foods high in saturated and trans fats, such as red meat, whole milk
products, and pastries.
 Eat a variety of fruits, vegetables, legumes, nuts, soy products, low-fat dairy
products, and whole grain breads, cereals, and pastas.
 Eat baked or broiled fish at least twice per week.
 Choose oils and margarines low in saturated and trans fat and high in omega-3
fat, such as canola, soybean, walnut, and flaxseed oils.
 Eat less than 6 g of salt or less than 2,400 mg of sodium per day.
 Get atleast 30 min of exercise daily.
 Achieve and maintain ideal body weight.
http://content.onlinejacc.org/article.aspx?articleid=1136740

25. Conclusion
 Before considering any dietary supplement, consult with
a health care provider.
 Do not replace scientifically proven antihyperlipidemics
with unproven health products or practices.
 Read and follow the label instructions for the safe use of
dietary supplements.
 Always remember that dietary supplements may interact
with medications or other dietary supplements.
 Discuss with the health care providers about the current
use of any CAM approaches.

26. References
 Hurst's The Heart, 13e
Valentin Fuster, Richard A. Walsh, Robert A. Harrington
 Harrison's Online
Featuring the complete contents of Harrison's Principles of
Internal Medicine, 18e
Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper, Stephen L.
Hauser, J. Larry Jameson, Joseph Loscalzo, Eds.
 CURRENT Medical Diagnosis & Treatment 2013
Maxine A. Papadakis, Stephen J. McPhee, Eds.
Michael W. Rabow, Associate Ed.
 Textbook of Complementary and Alternative Medicine
Chun-Su Yuan, Eric J. Bieber
 Evidence Based Guide to Complementary and Alternative
Medicine
Bradly P. Jacobs, Katherine Gundling

27. References
 https://nccih.nih.gov/health/providers/digest/ch
olesterol
 http://circ.ahajournals.org/content/103/16/2038.
full
 http://www.hindawi.com/journals/ecam/2013/6
72097/
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC
2823761/
 http://www.ncbi.nlm.nih.gov/pubmedhealth/PM
H0024707/