Studies Cast Doubt on High Cholesterol Treatment

Healthnotes Newswire (June 15, 2006)—New research suggests that policosanol might not be as helpful for treating high cholesterol as previous studies have found.

Policosanol is a substance that is usually extracted from sugar cane wax, but it can also be extracted from beeswax, wheat germ, and rice bran. Based on the positive findings from a number of controlled trials, policosanol has been promoted as a safe and effective cholesterol-lowering agent, and is now sold in more than 40 countries.

In more than 80 studies, people taking policosanol had significant reductions in total cholesterol and LDL (“bad”) cholesterol levels, while their HDL (“good”) cholesterol levels rose. Even the results from studies comparing policosanol to statins, a family of common cholesterol-lowering medications, were favorable.

However, almost all of the previous policosanol studies have been conducted by one research group. They have also all used the same sugar cane–derived policosanol product, and the subjects have all been Cuban. A recent trial conducted in the Netherlands that used wheat germ–derived policosanol put the claims for policosanol into question as it did not find the same benefits.

Two recent studies done outside of Cuba looked at the effect sugar cane–derived policosanol on cholesterol levels. The first was performed in South Africa and was published in the British Journal of Nutrition. The 19 people in this study were randomly assigned to either a policosanol group, receiving 20 mg of policosanol per day from a product similar to the one used in the earlier studies, or a placebo group for 12 weeks; then, after a 4-week period with no treatment, the groups were switched for another 12 weeks. The policosanol used in this study was no more effective than placebo at lowering total cholesterol and LDL cholesterol levels.

The second of these studies was performed in Germany and was published in the Journal of the American Medical Association. The 143 people in this study were randomly assigned to receive either 10, 20, 40, or 80 mg per day of the same policosanol product used in most of the previous studies or placebo for 12 weeks. None of these policosanol doses had any more effect than placebo at lowering total cholesterol and LDL cholesterol levels, nor at raising HDL cholesterol levels.

“In general, it has been clearly demonstrated that cholesterol-lowering therapy reduces the risk of coronary heart disease and diminishes cardiovascular [disease],” the authors of the German study noted. “Our results suggest that [policosanol] is devoid of lipoprotein-lowering effects in white patients,” they added, stressing that people who might take policosanol to improve their cardiac risk profile should be made aware of the conflicting information.

The conflicting results of policosanol studies point out the importance of reading research with a critical eye. Independent studies (not sponsored by product manufacturers) that look at the effects of similar preparations on various populations are needed to make good decisions about when specific therapies are most likely to be beneficial.

With the conflicting evidence on policosanol’s cholesterol-lowering effects, healthcare providers would be wise to continue to emphasize the importance of a high-fiber, low-saturated-fat diet that includes nuts and seeds and an extra teaspoon of fish oil. “I’ve been using policosanol with my patients who have high cholesterol based on the research I was aware of,” said Katina Martin, ND, a naturopathic doctor. “Now I will have to think again and be sure to consider other treatment options if it isn’t working for people.”

(JAMA 2006;295:2262–9; Br J Nutr 95;968–75)

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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