Cholesterol

A small published human study found that transdermal 7-oxo-DHEA increased HDL-cholesterol and apolipoprotein A-I levels in healthy men. This represents the primary human evidence linking 7-Keto-DHEA to lipid profiles. The study was very small (n=10) and short-term, so no definitive conclusions can be drawn.

Multiple clinical trials demonstrate acacia gum's ability to reduce total cholesterol and LDL cholesterol. A case-control trial in hyperlipidemia patients showed 30 g/day reduced total cholesterol by 25.9% and LDL by 30.8% when added to statin therapy. A type 2 diabetes RCT found total cholesterol reduced by 8.28% and LDL by 5.95% at 30 g/day.

A small human pilot study demonstrated statistically significant reduction in total cholesterol and borderline reductions in LDL-cholesterol after 30 days of acai pulp consumption in overweight adults. Preclinical data support hypolipidemic activity through cholesterol transporter upregulation. The human evidence base remains limited to uncontrolled or small trials.

Multiple clinical trials demonstrate that oral activated charcoal reduces total and LDL cholesterol in hypercholesterolemic patients in a dose-dependent manner. The mechanism is interruption of the enterohepatic bile acid cycle, forcing the liver to consume circulating cholesterol to replenish bile acids. Effects are comparable in magnitude to cholestyramine at equivalent doses.

The 8-week human RCT found adzuki bean polyphenol extract significantly raised HDL-C while the placebo group declined. Animal studies consistently show reductions in total cholesterol and LDL-C with adzuki bean supplementation. Resistant starch and dietary fiber are the primary cholesterol-modulating components.

The Maeda et al. (2005) RCT showed significantly greater total cholesterol reduction in the agar group (−7.6 mg/dL) versus conventional diet (+2.4 mg/dL, p=0.036) over 12 weeks. HbA1c and total cholesterol decreased significantly within the agar group specifically. The proposed mechanism involves soluble fiber binding bile acids and reducing cholesterol reabsorption in the small intestine.

Ajoene inhibits HMG-CoA reductase and downstream mevalonate pathway steps, reducing cholesterol biosynthesis in rat hepatocyte and HepG2 human liver cell models. It also inhibits arterial smooth muscle cell proliferation linked to cholesterol-associated plaque development. No clinical trials in hypercholesterolaemic patients have been performed for isolated ajoene.

Animal studies in rabbits and rats consistently document significant reductions in total cholesterol and LDL by ajwain seed powder, with effects comparable to pharmaceutical lipid-lowering drugs. Increases in protective HDL cholesterol were also documented. No human clinical trials exist.

In the pivotal human RCT, pasteurized A. muciniphila significantly reduced total plasma cholesterol by approximately 8.7% versus placebo (P=0.02) in overweight/obese insulin-resistant adults. The mechanism involves SCFA-mediated inhibition of cholesterol biosynthesis genes. Evidence for LDL-specific reductions in humans is directional but not yet statistically confirmed in completed trials.

ALA, the plant omega-3 found in flaxseed and walnuts, has a qualified FDA health claim for coronary heart disease risk reduction. Clinical trials show modest TC and LDL-C reductions. It is recognized alongside omega-3 fatty acids and fiber in nutraceutical dyslipidemia reviews.

The same 2019 meta-analysis of 10 RCTs found ALA significantly reduced total cholesterol (−10.7 mg/dL) and LDL-cholesterol (−12.9 mg/dL) versus placebo, while HDL was not significantly affected. An RCT in metabolic syndrome patients confirmed a significant total cholesterol reduction with 600 mg/day ALA over 12 weeks.

Alfalfa seeds and extracts have demonstrated cholesterol-lowering effects in both animal studies and limited human clinical trials. Saponins reduce intestinal cholesterol absorption and increase fecal steroid excretion. Two small human trials showed significant reductions in LDL-C and apolipoprotein B. Human data remain limited and heterogeneous.

Algal oil DHA specifically reduces serum triglycerides and modestly raises HDL-cholesterol, while also increasing LDL-cholesterol with a shift toward larger, less atherogenic LDL particles. A dedicated meta-analysis of 11 algal oil DHA RCTs (n=485) quantified these effects precisely. At 1–2 g/day, algal DHA lowers triglycerides by up to 26%.

Alginate inhibits pancreatic lipase activity and can bind bile acids and dietary cholesterol in the small intestine, potentially reducing cholesterol absorption. Evidence from a 2013 systematic review confirms some cholesterol-lowering activity in animal studies, while human evidence remains limited and mixed.

Allicin, the primary bioactive organosulfur compound in garlic, inhibits HMG-CoA reductase and reduces intestinal cholesterol absorption. Standardized allicin/ajoene extract at 600–900 mg/day showed 9–12% TC and LDL reductions in numerous placebo-controlled clinical trials.

Alliin is the precursor to allicin in garlic, converted by alliinase upon garlic preparation. As the source compound for all allicin-mediated cholesterol-lowering effects, alliin's presence is the prerequisite for garlic's HMG-CoA reductase inhibition. Standardized garlic supplements specify alliin content as a quality marker.

Almond consumption is one of the most robustly studied dietary interventions for LDL cholesterol reduction. Multiple RCTs and meta-analyses confirm dose-dependent decreases in total cholesterol and LDL-C. The effect is attributed to almonds' unsaturated fatty acid profile, phytosterol content, and dietary fiber. HDL cholesterol is generally maintained rather than significantly raised.

A systematic meta-analysis of five RCTs (n=415) found aloe vera supplementation significantly reduced total cholesterol and LDL-C, and increased HDL-C in pre-diabetic and early diabetic patients. A 12-week controlled trial in 60 hyperlipidemic patients using whole-leaf extract also showed significant decreases in total cholesterol and LDL.

Isoquercitrin (the direct precursor of AGIQ) is listed among flavonoids with hypolipidemic effects, including improvement in cholesterol and triglyceride levels, in published clinical and preclinical literature. A one-month clinical study of isoquercetin demonstrated improvements in cholesterol and triglyceride levels. AGIQ, which yields isoquercitrin and quercetin in vivo, shares this mechanistic basis.

Animal studies consistently show A. galanga extracts reduce total cholesterol, LDL-C, and triglycerides while increasing HDL-C in diabetic and hyperlipidaemic rodent models. Ethanolic extract in rats exerted significant hypolipidemic activity. Human clinical evidence is limited.

Amaranth grain and oil have been extensively studied for cholesterol-lowering effects. Animal models show robust reductions in total and LDL cholesterol, attributed to squalene, phytosterols, and unsaturated fatty acids. Human trials have yielded mixed results, with some pilot studies showing modest benefit while others found no significant lipid lowering beyond dietary changes alone. The mechanistic basis is well characterized even if clinical translation remains uncertain.

Niacin (88% RDA/100 g) and EPA from anchovies have clinical evidence for reducing LDL cholesterol and triglycerides. Omega-3s have variable effects on LDL depending on the EPA-to-DHA ratio — EPA tends to lower LDL while DHA can modestly raise it. Selenium contributes via antioxidant protection against LDL oxidation.

Clinical studies measuring lipid profiles in diabetic and hypertriglyceridemic patients have assessed total cholesterol, LDL, and HDL alongside andrographis treatment. Some trials report LDL reductions in animal models and preliminary human data, though results in human studies are inconsistent, with at least one trial showing no significant cholesterol change.

Anemarrhena polysaccharides and mangiferin have demonstrated lipid-lowering effects in preclinical studies, significantly reducing total cholesterol, LDL-C, and triglycerides while increasing HDL-C in diabetic animal models. Mangiferin activates PPAR-α, a key lipid metabolism regulator.

A clinical trial in 31 hypercholesterolemic adults found that 250 mg/day of annatto delta-tocotrienol reduced total cholesterol by 15% and LDL by 18% within 4 weeks. A 24-week RCT in T2DM patients (n=110) also saw total cholesterol fall 7.2% and LDL fall 8.5%. Annatto tocotrienol inhibits HMG-CoA reductase—the same rate-limiting enzyme targeted by statins.

Apple pectin and polyphenols reduce LDL and total cholesterol in multiple human RCTs. Meta-analyses confirm a significant cholesterol-lowering effect, particularly in hypercholesterolemic subjects. Whole apple consumption is more effective than juice due to the intact fiber-polyphenol matrix.

Pooled evidence from multiple meta-analyses shows ACV significantly reduces total cholesterol and LDL, with some studies also showing increased HDL. The 2021 BMC meta-analysis of 9 RCTs found a significant reduction of approximately 6 mg/dL in serum total cholesterol. Effects are modest and most consistent in people with diabetes or dyslipidemia.

Two human clinical studies on bitter apricot seeds showed significant reductions in total cholesterol and LDL-C in adults with elevated cholesterol. A 42-day controlled trial found that atherogenic LDL subfractions progressively decreased in the elevated-cholesterol group. The soluble fiber in apricot fruit also contributes to cholesterol lowering via bile acid sequestration. Evidence is strongest for the seed/kernel fraction.

A meta-analysis of 5 RCTs (n=292) found argan oil supplementation significantly reduced total cholesterol (−16.85 mg/dl) and LDL-C (−11.67 mg/dl) while raising HDL-C (+4.14 mg/dl). Individual trials in healthy subjects and diabetic/dyslipidaemic patients replicate these findings consistently.

Multiple controlled human trials and meta-analyses have demonstrated that Aronia melanocarpa supplementation reduces total cholesterol and LDL cholesterol. A 2024 RCT found daily Aronia juice prevented a rise in cholesterol levels (β=−0.50, p=0.03) and a meta-analysis confirmed significant reductions in total cholesterol, especially in adults over 50.

Artichoke leaf extract (ALE) reduces total cholesterol, LDL-C, and triglycerides in systematic reviews and RCTs. A 2024 double-blind RCT in 90 adults showed significant TC, LDL-C, and TG reductions versus placebo at 6 and 12 weeks. Typical doses are 500–1,800 mg/day standardized dry extract.

Ashitaba extract reduced plasma cholesterol in high-fat-diet mice via AMPK-mediated inhibition of hepatic lipogenesis. A rat type 2 diabetes study showed the flavonoid-rich extract reduced total cholesterol comparably to metformin. However, a rat dietary study found no cholesterol reduction at normal dietary doses.

Several clinical trials and a double-blind pilot RCT in overweight adults found ashwagandha reduces LDL, VLDL, and triglycerides while raising HDL. Mechanistic pathways include HMG-CoA reductase inhibition and increased bile acid secretion. A 2025 PMC RCT confirmed significant reductions in LDL/HDL ratio and triglycerides.

Multiple animal studies demonstrate that A. officinalis and A. racemosus significantly reduce total cholesterol and LDL-C while improving antioxidant status in hypercholesterolemic models. A small human open trial found total cholesterol reduction after 10 weeks of asparagus powder intake. The mechanism involves saponin-mediated bile acid synthesis promotion and flavonoid-driven hepatic antioxidant protection.

Multiple RCTs and meta-analyses demonstrate astaxanthin reduces total cholesterol and LDL-C while raising HDL-C. A 2023 RCT in prediabetic/dyslipidemic subjects found significant decreases in total cholesterol (−0.30 mM, p=0.027) and LDL (−0.33 mM, p=0.030) vs. placebo. Meta-analysis confirms these effects with small-to-moderate effect sizes.

An open-label fixed-dose study with B. coagulans SNZ 1969 in hyperlipidemia patients showed reduction in total serum cholesterol and LDL and increase in HDL. In-vitro studies with MTCC 5856 confirmed cholesterol-lowering activity. B. coagulans is noted to possess cholesterol-lowering effects through bile salt hydrolase activity.

Multiple animal studies show bamboo shoot polysaccharides, dietary fiber, and phytosterols reduce total cholesterol, LDL-cholesterol, and triglycerides. Bamboo shoot polysaccharides lowered total cholesterol by 26.5% in diabetic mice. TCM also records cholesterol-lowering use of bamboo shoots. No human RCTs have been completed.

Corosolic acid from banaba exhibits antihyperlipidemic activity including effects on total cholesterol and LDL in animal models, and banaba has been evaluated as part of multi-ingredient nutraceutical formulations in human cholesterol studies. Zebrafish models show banaba reduces total cholesterol and LDL-C under high-cholesterol diet conditions. Dedicated human monotherapy cholesterol RCTs are lacking.

Banana dietary fiber—particularly soluble pectin in ripe fruit and resistant starch in green fruit—has been linked to LDL cholesterol reduction through bile acid sequestration. Animal studies confirm banana's cholesterol-lowering effect via dietary fiber. Epidemiologic reviews show high-fiber diets are consistently associated with lower LDL and reduced cardiovascular risk.

In silico molecular docking studies (PMC10459191, King Saud University, 2023) demonstrated that baobab polyphenols—quercetin, epicatechin, rutin, and chlorogenic acid—bind to HMG-CoA reductase and pancreatic lipase with binding affinities competitive with simvastatin and orlistat respectively. Prior in vivo and in vitro studies referenced in this work showed baobab extract lowers cholesterol levels and improves dyslipidemia. Baobab's soluble fiber also reduces LDL-cholesterol through bile acid sequestration.

A PubMed-indexed meta-analysis of 5 RCTs (n=339) found barberry supplementation significantly decreased total cholesterol (−23.58 mg/dL), LDL cholesterol (−13.75 mg/dL), and triglycerides (−29.16 mg/dL), with no significant change in HDL. Berberine reduces LDL by decreasing PCSK9 expression and inhibiting cholesterol biosynthesis via AMPK. Multiple individual clinical trials corroborate these findings.

Barley β-glucan is among the most robustly evidenced dietary interventions for lowering LDL and total cholesterol. A meta-analysis of 8 RCTs found statistically significant reductions in total cholesterol, LDL, and triglycerides. Both the FDA and Health Canada have approved health claims. EFSA also substantiated a claim for barley β-glucan reducing LDL cholesterol.

Multiple lines of clinical and preclinical evidence show basil lowers LDL and total cholesterol while increasing HDL. A 2017 systematic review of 24 clinical trials found improvements in total cholesterol, LDL, VLDL, and HDL. Animal studies (Clinical Nutrition ESPEN, 2009; Metabolomics, 2026) showed marked cholesterol reductions.

Bee pollen polyphenol extracts significantly reduced total cholesterol and LDL in high-fat diet animal models. A human observational study in patients with dyslipidemia showed honey-plus-pollen reduced total cholesterol by 18.3% and LDL by 23.9%. Evidence is preliminary but multi-source.

Betalains from beetroot have demonstrated lipid-lowering activity in clinical studies, reducing total cholesterol, LDL, and triglycerides in populations with dyslipidemia and coronary artery disease. Evidence comes from small RCTs and controlled studies.

Animal studies demonstrate that T. bellirica extract reduces total cholesterol and LDL while increasing HDL in multiple hyperlipidemia models. In vitro, TBE inhibits LDL oxidation—a key step in atherogenesis. Gallic acid from the fruit also significantly reduces total cholesterol and LDL in animal studies. Traditional Ayurvedic use of Triphala (containing T. bellirica) for cholesterol management is documented. No robust human RCT on T. bellirica alone for cholesterol has been published.

Multiple meta-analyses of RCTs show berberine significantly reduces total cholesterol, LDL-C, and triglycerides in hyperlipidemic patients. A meta-analysis of 16 trials (2,147 patients) found reductions of 0.47 mmol/L total cholesterol and 0.38 mmol/L LDL-C. Its primary mechanism is upregulation of the hepatic LDL receptor. Typical studied doses range from 500–1,500 mg/day.

Bergamot fruit extract contains HMG-CoA reductase–inhibiting flavanones (brutieridin, melitidin) and other polyphenols. Multiple RCTs and a systematic review confirm significant reductions in TC, LDL-C, and triglycerides. Typical dose: 500–1,500 mg/day standardized polyphenolic extract.

Oat beta-glucan is one of the best-evidenced cholesterol-lowering dietary fibers. EFSA, FDA, and Health Canada have approved health claims for oat beta-glucan at ≥3 g/day for LDL-C reduction. Studies report 5–23% TC/LDL reductions depending on dose.

Beta-sitosterol, the most abundant plant sterol, inhibits intestinal cholesterol absorption and lowers LDL-C by 8–15% at therapeutic doses. Combined with soy protein it achieved a 22% LDL-C reduction in one investigation. EFSA endorses a health claim for plant sterols including beta-sitosterol.

Betaine supplementation at doses ≥4 g/day consistently raises total cholesterol and LDL cholesterol in human RCTs, while not significantly affecting HDL cholesterol. A meta-analysis of four placebo-controlled RCTs found betaine increased LDL cholesterol and triglycerides in healthy humans. This is considered an adverse effect relative to its cardiovascular benefits from homocysteine lowering, and the net effect on cardiovascular risk from betaine supplementation remains uncertain.

Betel leaf extract and its active constituent eugenol demonstrated significant antihypercholesterolemic activity in rodent models, reducing total cholesterol, LDL, VLDL, and triglycerides while increasing HDL. A hypolipidemic effect was also observed in high-fat diet-fed rats.

B. bifidum strain PRL2010 has demonstrated cholesterol-lowering activity in vitro and in a murine model, with transcriptomic evidence of specific cholesterol assimilation mechanisms and conversion of cholesterol to coprostanol. Genus-level human data also link Bifidobacterium-containing probiotics to reductions in total cholesterol and LDL in metabolic disease patients.

B. breve supplementation has been associated with improvements in lipid profiles including LDL and HDL cholesterol in clinical trials. A 12-week RCT in type 2 diabetes patients showed significant reductions in LDL with B. breve compared to placebo. An RCT using B. breve BBr60 in overweight adults found significant upregulation of cholesterol metabolism pathways over 12 weeks.

B. lactis HN019 reduced total cholesterol and LDL-C in a randomized trial in metabolic syndrome patients. A meta-analysis of Bifidobacterium-containing probiotics in 24 RCTs found significant reductions in total cholesterol, LDL-C, and triglycerides. Results in normocholesterolemic individuals are less consistent.

B. longum CCFM1077 was tested in a 6-week double-blind RCT in 62 hyperlipidemic subjects for its lipid-lowering effects, with serum TC, LDL-C, TG, and HDL-C as endpoints. Bifidobacteria are proposed to reduce blood cholesterol by absorbing intestinal cholesterol for fecal excretion and by modulating bile acid metabolism.

Clinical studies show bilberry/blackcurrant anthocyanin supplementation can reduce total and LDL cholesterol and increase HDL in subjects with hypercholesterolemia, metabolic syndrome, or T2DM. Results are inconsistent across trials; a 52-participant RCT with isolated bilberry anthocyanins found no lipid effects at 28 days.

Bile acids are synthesized from cholesterol in the liver, making bile acid synthesis the primary route of cholesterol catabolism in humans. Bile acid sequestrants (cholestyramine, colestipol, colesevelam) interrupt enterohepatic circulation, forcing increased hepatic cholesterol conversion to bile acids, lowering LDL-cholesterol—this was the first drug class approved for LDL lowering. FXR signaling directly regulates hepatic cholesterol and VLDL metabolism.

A meta-analysis of 34 RCTs (2278 participants) found N. sativa significantly reduced total cholesterol (SMD: −1.78; p<0.001), LDL-C (SMD: −2.45; p<0.001), and TG while increasing HDL-C (SMD: +0.79; p<0.001). The 2025 meta-analysis of 82 RCTs confirmed these consistent lipid-lowering effects.

Piperine inhibits intestinal cholesterol transporter proteins NPC1L1 and SR-BI, reducing cholesterol uptake. A 2025 double-blind RCT in 170 NAFLD patients found piperine supplementation produced a 15% reduction in total cholesterol and a 22% reduction in LDL. A 2026 meta-analysis of RCTs confirmed significant total cholesterol and LDL reductions, particularly with turmeric-piperine combinations.

Multiple meta-analyses of RCTs show that black tea consumption significantly reduces LDL cholesterol, though the magnitude is modest and results on total and HDL cholesterol are inconsistent. Theaflavins inhibit LDL oxidation and fatty acid synthase. The 2013 Cochrane review and two subsequent meta-analyses provide the strongest clinical support.

Human dietary trials and meta-analyses demonstrate that walnut consumption significantly lowers total cholesterol and LDL cholesterol. The Fitschen (2008) randomized study specifically using black walnuts found total cholesterol reduced by 2.7% and LDL by 4.2%. Black walnuts contain phytosterols and ALA that mechanistically reduce cholesterol absorption and synthesis.

Anthocyanin-rich berry consumption, relevant to blackberries as a high-anthocyanin fruit, is associated with statistically significant reductions in total cholesterol in pooled RCT data. Blackberry phenolics also inhibit LDL oxidation in vitro. High soluble fiber contributes to cholesterol-lowering via bile acid binding.

A. scholaris extracts have demonstrated cholesterol-lowering effects in multiple preclinical rodent models, reducing total cholesterol and LDL/VLDL while elevating HDL. Effects have been replicated across diabetic, high-fat-diet, and high-cholesterol diet models in several independently published studies.

Fucoidan and alginic acid in bladderwrack reduce LDL and total cholesterol in animal studies and limited human trials. The 4-month human clinical study reported LDL normalization. The Gdue 505-patient study showed LDL reduction and HDL increase. Animal data are robust; human data are limited.

Several RCTs report significant reductions in total and LDL cholesterol with blueberry intake, though pooled meta-analytic evidence is heterogeneous. Effects appear more consistent in at-risk populations consuming blueberry for ≥6 weeks.

A 2021 clinical study in obese individuals found borage oil significantly increased HDL cholesterol, though no significant effect was observed on LDL or total cholesterol. GLA's modulation of lipid metabolism via DGLA and prostaglandin pathways provides mechanistic support. Evidence is limited.

Borage oil supplementation has been shown to lower total and LDL cholesterol in an 8-week RCT in early-type-2-diabetes/metabolic syndrome patients. GLA-containing oils are documented to elevate HDL-cholesterol and improve lipid profiles, including in RA patients with dyslipidemia.

Boxthorn extracts reduce total cholesterol and LDL-C while raising HDL-C, demonstrated in animal models and meta-analyzed human data. LBPs modulate hepatic lipid synthesis gene expression. A 16-week RCT in middle-aged adults consuming 15 g/day wolfberry showed characteristic plasma lipidomic alterations linked to cardiovascular protection.

Brassicasterol is a plant sterol abundant in canola oil and Brassica vegetables that inhibits intestinal cholesterol absorption as part of the phytosterol class. It shares the EFSA-recognized health claim for plant sterols and the same LDL-C-lowering mechanism.

Human clinical trials show that broccoli sprout supplementation reduces total cholesterol and LDL, and increases HDL in diabetic patients. A meta-analysis of 10 trials found marginally significant reductions in total cholesterol, LDL, and triglycerides. Sulforaphane reduces oxLDL and lipid peroxidation in human studies.

A 3-month human RCT (n=56 hyperlipidemic patients) found germinated brown rice significantly reduced LDL-C, total cholesterol, and ApoB while increasing HDL-C. A systematic review and meta-analysis found pre-germinated brown rice reduced total cholesterol by −24.22 mg/dL and LDL by −20.05 mg/dL. Animal studies show rice protein specifically reduces plasma total cholesterol by enhancing fecal excretion of cholesterol and bile acids.

Soluble fiber in Brussels sprouts binds bile acids in the intestine, reducing LDL cholesterol through decreased hepatic bile acid reabsorption. Brussels sprouts also supply plant-derived omega-3 fatty acids with lipid-modulating properties. Cleveland Clinic specifically identifies Brussels sprouts as containing nutrients that help lower LDL and maintain artery health.

A clinical trial in knee osteoarthritis patients (ScienceDirect, 2019) found that burdock root tea consumption for 42 days significantly reduced total cholesterol, LDL-C, TC/HDL-C ratio, and LDL-C/HDL-C ratio, while raising HDL-C. Animal studies using burdock inulin and seed ethanol extract also demonstrated cholesterol-lowering effects. The mechanism involves inulin-mediated changes to gut microbiota and bile acid excretion.

Cabbage contains phytosterols and soluble fiber, both of which reduce LDL cholesterol absorption. A clinical trial found that consumption of broccoli and cabbage for nine weeks produced significant LDL reductions. Red cabbage microgreens supplementation also significantly lowered LDL in a diet-induced hyperlipidemia model.

Human dietary intervention studies show that regular cabbage consumption reduces total cholesterol and LDL-cholesterol. In a 2014 study, 38 volunteers consuming 300 g/day of Brassica (black and red cabbage) for 2 weeks showed significantly decreased total cholesterol, LDL-cholesterol, and oxidized LDL. A clinical study (Suido et al. 2002) found that a green vegetable beverage containing broccoli and cabbage significantly reduced total and LDL-cholesterol in hypercholesterolemic patients. Glucosinolates and their metabolites are the proposed mediators.

C. crista seed extracts have shown hypolipidemic effects including cholesterol reduction in preclinical diabetic and high-fat diet models. Significant reduction of total cholesterol and LDL-C with increases in HDL-C have been reported in rodent studies.

Marine omega-3s have mixed effects on cholesterol fractions. Triglyceride reduction is well-established; however, effects on total cholesterol, LDL, and HDL are inconsistent. A 2025 systematic review found high-dose omega-3s produced substantial TG reductions but noted LDL may increase (especially at low doses), and HDL benefits are not consistent.

Campestanol is a plant stanol (saturated form of campesterol) that inhibits intestinal cholesterol absorption as part of the phytosterol/stanol class. EFSA endorses a health claim for plant stanols including campestanol for LDL-C reduction at 2–3 g/day.

Campesterol is a major plant sterol that inhibits intestinal cholesterol absorption. Meta-analyses of phytosterol RCTs confirm LDL-C reductions of 8–15% at 2–3 g/day. EFSA endorses a health claim for plant sterols including campesterol for LDL-C reduction.

Animal studies in obese/diabetic mice demonstrate that camu camu extract lowered non-HDL cholesterol and free fatty acids. A rat study also found reductions in total cholesterol and LDL. ACS Omega review notes antiobesity capacity includes cholesterol reduction in in vivo models. Human evidence is more limited but the 2024 RCT measured cholesterol parameters.

A 2015 meta-analysis of 13 RCTs found MCTs (C8/C10) did not significantly alter total cholesterol, LDL, or HDL overall versus LCTs. Animal data show caprylic acid may improve lipid metabolism via ABCA1 upregulation and reduced inflammatory lipid deposition. Human lipid effects of caprylic acid alone are small and inconsistent.

Capsaicinoids have been associated with cholesterol-lowering effects, inhibition of LDL oxidation, and improvement in lipid profiles in animal and human studies. A 2016 review specifically lists cholesterol-lowering among capsaicinoid cardiometabolic benefits. Effects are partly mediated via PPARα activation and increased fatty acid oxidation.

Capsanthin raises HDL-cholesterol in both rodent and a small human study, while reducing LDL-C and total cholesterol in HFD and atherosclerotic animal models. Hepatic upregulation of ApoA5 and LCAT is a documented molecular mechanism.

A 2022 meta-analysis of 9 RCTs in metabolic syndrome patients found capsaicin significantly reduced total cholesterol and LDL-C, and a 2025 meta-analysis in overweight/obese individuals confirmed reductions in total cholesterol. Effects on triglycerides and HDL-C are not consistently significant across analyses.

Evidence on cardamom's effect on total cholesterol is mixed across trials. A 2019 meta-analysis of 5 RCTs found no statistically significant change in total cholesterol, LDL-C, or HDL-C. However, a larger 2024 meta-analysis of 12 RCTs found a significant reduction in total cholesterol (WMD: −8.56 mg/dL). Some individual RCTs in prediabetic and diabetic populations report LDL-C reductions.

Carrot dietary fiber reduces intestinal cholesterol absorption by binding bile acids, increasing fecal sterol excretion. Human and rodent studies show measurable LDL and total cholesterol reduction. Black carrot bioactives additionally inhibit HMG-CoA reductase activity.

BCP lowers total cholesterol, LDL, and VLDL in animal models of hypercholesterolemia and high-fat diet-induced dyslipidemia by inhibiting hepatic HMG-CoA reductase and activating CB2/PPAR-γ receptors.

Casein has been studied against soy protein for effects on plasma lipoprotein profiles. Compared to soy protein, casein is associated with lower lipoprotein(a) concentrations but higher LDL cholesterol, suggesting casein may not be optimal for LDL-lowering versus plant proteins. Meta-analyses of milk protein more broadly show modest improvements in cholesterol with supplementation in metabolic disease populations.

One RCT demonstrated that cassia cinnamon lowered total cholesterol and LDL in T2DM patients; the effect was not replicated in two other RCTs from the same systematic review. Animal and in vitro studies consistently show lipid-lowering activity. Evidence in humans is present but inconsistent.

Tea catechins (primarily EGCG) inhibit intestinal cholesterol absorption and HMG-CoA reductase. A meta-analysis of 14 RCTs found catechin-rich tea reduced TC by 7.2 mg/dL and LDL-C by 2.19 mg/dL (p<0.001). Doses studied: 224–674 mg EGCG/day.

A human trial with moderate hypercholesterolemic subjects found that cowpea protein significantly reduced LDL-cholesterol and apolipoprotein B. Animal and in vitro studies show inhibition of HMG-CoA reductase and reduced cholesterol micellar solubilization. The high fiber and phytosterol content of catjang cowpea underpin these lipid-lowering effects.

Cauliflower's soluble fiber binds bile acids in the gut, reducing LDL cholesterol recycling. Sulforaphane has been shown to lower serum triglycerides and the oxLDL/LDL ratio in human supplementation studies. Steaming cauliflower enhances its bile acid-binding capacity.

A meta-analysis of RCTs in patients with metabolic syndrome found capsaicin significantly reduced total cholesterol and LDL-cholesterol. A separate RCT (n=42) found 4 mg/day capsaicin for 3 months raised HDL and lowered triglycerides. A 2026 meta-analysis of 13 RCTs also found a significant total cholesterol reduction, though rated as low-certainty evidence.

Multiple preclinical rodent studies demonstrate that A. aspera aqueous and seed saponin extracts significantly reduce total cholesterol, LDL, VLDL, and triglycerides, and increase HDL, in high-fat or high-cholesterol dietary models.

Multiple RCTs and meta-analyses demonstrate that hesperidin—Chen Pi's primary flavonoid—significantly reduces LDL and total cholesterol in humans. A clinical trial with Citrus peel pellet also showed significant cholesterol reductions. PMF compounds in CRP inhibit SREBP-mediated cholesterol synthesis.

Clinical trials show tart cherry juice can reduce LDL cholesterol and total cholesterol in some populations, particularly older adults and those with dyslipidemia. A meta-analysis found significant lipid improvements in unhealthy individuals via dose-response analysis, though pooled effects across all populations are not consistently significant.

Meta-analyses of RCTs demonstrate chia supplementation significantly reduces total cholesterol, LDL-C, and triglycerides. The 2024 14-RCT systematic review found WMD of −4.77 mg/dL for LDL-C and −8.69 to −13.11 mg/dL for triglycerides. HDL-C is not significantly affected in most analyses.

Chickpea dietary supplementation produces small but statistically significant reductions in total cholesterol and LDL-C in clinical trials. A 12-week RCT in prediabetic adults found LDL-C fell from 131.9 to 119.3 mg/dL versus baseline in the chickpea arm. A meta-analysis of 11 clinical trials confirmed that chickpea consumption significantly reduces LDL cholesterol.

Chicory inulin and root preparations have demonstrated cholesterol-lowering effects in clinical trials, particularly in patients with dyslipidemia, diabetes, or metabolic disease. A meta-analysis of 33 RCTs found significant total cholesterol reduction in diabetic subjects; a separate RCT in hypertensive patients with hypercholesterolemia found significant reductions in LDL and total cholesterol.

A 2024 meta-analysis of RCTs found that Salvia miltiorrhiza combined with statin therapy significantly reduced total cholesterol, LDL-C, and triglycerides while improving HDL-C, compared to statins alone. The mechanism involves inhibition of HMGCR, PI3K/Akt, and JAK/STAT pathways involved in lipid metabolism. Evidence specifically for Danshen monotherapy on cholesterol is more mixed.

A meta-analysis of 19 RCTs (797 subjects) found chlorella significantly reduced total cholesterol and LDL-C, with a 2025 GRADE review rating the evidence for TC and LDL-C reduction as high quality. HDL-C was also significantly increased. Triglyceride reductions were less consistent.

Human RCTs and a dedicated meta-analysis demonstrate that chokeberry supplementation can reduce total and LDL cholesterol, particularly at doses providing ≥150 mg anthocyanins and in people with elevated baseline lipids. A randomised controlled trial in former smokers showed significant reductions in total and LDL cholesterol. Effect sizes are modest and heterogeneity across trials is noted.

Several meta-analyses have examined chromium's effects on total cholesterol, LDL, and HDL with inconsistent results. A meta-analysis of 24 RCTs in T2DM found significant reductions in total cholesterol and increases in HDL. An umbrella meta-analysis of eight prior meta-analyses found no significant overall lipid effects. The early literature includes a specific study on chromium chloride supplementation and serum lipids in adult men.

Evidence for chromium's effect on lipid profiles is mixed and inconsistent. Some RCTs and meta-analyses in type 2 diabetes patients report modest reductions in total cholesterol and LDL; others, including an NIH ODS-cited 4-month RCT and the Merck Manual, report no significant effects on total cholesterol, HDL, LDL, or triglycerides. The Diabetes Care 2007 systematic review found the overall evidence for lipid effects inconclusive.

Chrysanthemum flavonoids demonstrate lipid-lowering effects in animal models, reducing total cholesterol and LDL-C while raising HDL-C. A PMC study showed chrysanthemum flavonoids (luteolin and luteoloside) performed comparably to simvastatin in cholesterol metabolism enzyme activity. A 2025 Scientific Reports study confirmed cholesterol-lowering effects in a fatty liver mouse model.

Chrysin reduces total cholesterol and LDL-C in preclinical models of hyperlipidemia and diabetes. In Triton WR-1339-induced hyperlipidemic mice, oral chrysin at 10 mg/kg prevented total cholesterol elevation. Chrysin-loaded phytosomes significantly reduced total cholesterol and LDL-C in db/db mice. Mechanisms include inhibition of intestinal cholesterol absorption and cholesterol biosynthesis.

Meta-analyses of RCTs consistently show cinnamon significantly reduces total cholesterol and triglycerides. A 2025 GRADE meta-analysis of 49 RCTs confirmed reductions in LDL-C, total cholesterol, and triglycerides. Cinnamon inhibits hepatic HMG-CoA reductase and intestinal cholesterol absorption via its polyphenol content.

Multiple human RCTs show CQR-300 (300 mg/day) significantly reduces total cholesterol and LDL-cholesterol while increasing HDL-cholesterol in overweight and obese participants after 8–10 weeks. The mechanism involves phytosterol-mediated cholesterol absorption inhibition and lipase inhibition limiting dietary fat uptake.

Multiple human clinical trials demonstrate that citrus pectin supplementation reduces total cholesterol and LDL cholesterol. A 16-week double-blind crossover trial in hypercholesterolemic adults found grapefruit pectin decreased plasma cholesterol by 7.6% and LDL by 10.8%. A 1999 meta-analysis in AJCN confirmed modest cholesterol-lowering at 6–24 g/day. The FDA permits a qualified health claim for soluble fiber, including pectin, in relation to heart disease and cholesterol.

A meta-analysis of 12 RCTs found hesperidin from C. sinensis significantly reduces LDL and total cholesterol in humans. Orange peel powder in human subjects and orange juice studies have also demonstrated cholesterol-lowering effects. The mechanism involves modulation of lipid metabolism pathways.

CLA's effects on cholesterol are inconsistent across meta-analyses. One 35-RCT meta-analysis shows modest total cholesterol reduction versus placebo. A 56-RCT meta-analysis found no significant net changes in TC, LDL, or TG. High-dose CLA may decrease HDL, which is an adverse finding.

Meta-analyses of RCTs show cocoa consumption reduces total cholesterol and LDL cholesterol, with one 2024 meta-analysis of 31 RCTs reporting reductions of −8.35 mg/dL and −9.47 mg/dL respectively. Effects on HDL are inconsistent across studies. Cocoa also reduces LDL oxidation susceptibility.

Multiple meta-analyses of clinical trials consistently demonstrate coconut oil raises both LDL-C and HDL-C versus unsaturated vegetable oils. A 16-trial meta-analysis (Neelakantan et al., Circulation 2020) found +10 mg/dL LDL-C and +4 mg/dL HDL-C. A 14-RCT VCO meta-analysis found VCO raised HDL-C and had variable LDL-C effects depending on the comparator fat.

A randomized trial of 60 healthy adults found 8 weeks of coconut milk porridge consumption significantly reduced LDL cholesterol and raised HDL cholesterol. A separate Cambridge RCT confirmed coconut oil did not raise LDL versus olive oil and significantly raised HDL. The American Heart Association notes concern that coconut-derived saturated fat can raise LDL in some contexts, indicating mixed but genuine clinical evidence.

Multiple RCTs and meta-analyses confirm coconut oil raises both LDL-C and HDL-C relative to nontropical vegetable oils. A 2020 meta-analysis published in Circulation (16 RCTs) found coconut oil significantly increased LDL-C by 10.47 mg/dL and HDL-C by 4.00 mg/dL versus nontropical oils. A separate 2022 meta-analysis confirmed the HDL-C increase (MD +3.28 mg/dL) but found no significant LDL-C reduction.

Cod liver oil modestly raises HDL cholesterol and has inconsistent effects on LDL and total cholesterol. A placebo-controlled RCT (600 patients) found CLO plus rosuvastatin lowered LDL and total cholesterol compared to statin alone. Fish oil meta-analyses show a small HDL increase but also a small LDL increase.

Multiple animal studies show coix seed extracts reduce total cholesterol and LDL-C while increasing HDL-C, acting via inhibition of liver cholesterol synthesis, PPAR signaling, and AMPK activation. Polyphenol extracts have specific hypocholesterolemic activity in vivo.

The soluble fiber in collard greens binds bile acids in the digestive tract, preventing their reabsorption and obligating the liver to synthesize new bile from circulating cholesterol, thereby lowering LDL. A study in spontaneously hypertensive rats confirmed reduced LDL cholesterol with collard green consumption. Glucosinolate-derived compounds additionally reduce hepatic cholesterol synthesis.

Multiple RCTs have tested C. mukul guggulipid for cholesterol lowering, with some Indian trials showing reductions of 11–12.5% in total cholesterol and LDL, while the best-designed US trial (JAMA 2003) found no benefit and a small LDL increase. Evidence is mixed but robust human trial data exists.

Copper deficiency is associated with elevated LDL, reduced HDL, and impaired cholesterol clearance via ceruloplasmin and HDL metabolism. However, a systematic review and meta-analysis of RCTs found that copper supplementation does not significantly alter total cholesterol, LDL, or HDL in adequately nourished populations.

Multiple RCTs and a meta-analysis demonstrate that berberine from Coptis chinensis significantly reduces total cholesterol, LDL-C, and raises HDL-C in dyslipidemic patients. The mechanism involves upregulation of hepatic LDL receptor expression via PCSK9 pathway modulation and AMPK-dependent lipid metabolism.

CoQ10 is primarily relevant to cholesterol management as an adjunct to statin therapy: statins deplete CoQ10 by up to 40%, and supplementation addresses this deficiency. CoQ10 inhibits LDL oxidation and is included in authoritative cholesterol supplement reviews.

Cordyceps sinensis and C. militaris consistently reduce plasma total cholesterol and LDL in dyslipidemic animal models, with effects comparable to simvastatin in some studies. C. militaris also significantly reduced total cholesterol in NASH mice at 150 mg/kg. Direct human evidence is limited, with one study in healthy adults showing no significant lipid changes at a low dose.

A 2019 systematic review and meta-analysis of four RCTs found corn silk decoction significantly improved HDL-C and reduced total cholesterol and LDL-C in angina patients. Animal studies confirm corn silk extract modulates cholesterol metabolism via HMG-CoA reductase and related pathways. Evidence in humans is promising but limited by methodological quality.

Animal studies consistently show corn silk extract significantly reduces total cholesterol and LDL-cholesterol while raising HDL. Reductions of 46–51% in total cholesterol and 57–67% in LDL have been reported in hyperlipidemia-induced rat models. The mechanism involves beta-sitosterol content, flavonoid inhibition of cholesterol synthesis, and gut microbiota modulation by polysaccharides.

Multiple randomized controlled trials show dietary cottonseed oil (CSO) significantly lowers total cholesterol and LDL-C compared to olive oil. A 2022 RCT in hypercholesterolemic adults found a 12.2% LDL-C reduction with 8 weeks of CSO enrichment. A 2018 crossover trial in healthy men demonstrated lower fasting total cholesterol, LDL-C, and triglycerides after just 5 days on a CSO-rich diet. A systematic review (Nutrition Reviews, 2023) confirmed these findings but noted the evidence base remains limited.

Multiple RCTs and a 2026 meta-analysis of 8 RCTs found creatine supplementation does not produce statistically significant changes in total cholesterol, LDL-cholesterol, or HDL-cholesterol. Evidence is low to very low certainty, and creatine does not appear to be a meaningful cholesterol-modifying agent.

Animal studies show cucumber and its extracts reduce LDL cholesterol and triglycerides in diabetic rodent models, and a small human RCT in diabetic women found cucumber juice significantly reduced LDL and triglycerides while raising HDL. Plant sterols in cucumber seeds also contribute to cholesterol lowering.

RCTs and meta-analyses show cumin supplementation reduces total cholesterol and LDL while raising HDL. A 2018 meta-analysis (6 RCTs, 376 participants) found significant reductions in total cholesterol (−10.90 mg/dl) and LDL (−6.94 mg/dl) and an increase in HDL (+3.35 mg/dl).

Curcumin modulates genes involved in cholesterol synthesis including LDL receptor mRNA and HMG-CoA reductase expression. A meta-analysis of RCTs confirmed significant TC, LDL-C, and TG reductions. One human study of 500 mg/day curcumin showed HDL increased 29% and TC fell 12%.

Limited human research and a large meta-analysis support blackcurrant and anthocyanin-rich berries lowering total cholesterol. A systematic review and meta-analysis of 44 RCTs found anthocyanin-rich berry administration significantly reduced total cholesterol. WebMD notes limited research suggesting blackcurrant may lower total cholesterol and increase HDL.

D-alpha tocopherol primarily targets LDL oxidation rather than lowering total cholesterol or LDL levels per se. It inhibits LDL oxidative modification, a key driver of atherogenic foam cell formation, but does not substantially alter circulating LDL or HDL concentrations in most clinical trials.

Preliminary human data show D-glucarate reduces total serum cholesterol by up to 12–15% and LDL cholesterol by up to 28–35%, attributed to bile acid excretion forced by beta-glucuronidase inhibition. Animal studies corroborate these findings. Larger controlled trials are needed to confirm clinical significance.

Daidzin and daidzein demonstrate anti-hyperlipidemic activity in animal models, reducing LDL cholesterol and elevating HDL. A 2024 systematic review confirmed that anti-hyperlipidemic effects are among the most consistently replicated findings in clinical settings for this isoflavone class.

Preclinical studies in cholesterol-fed rabbits and in vitro adipocyte models demonstrate that dandelion root and leaf extracts improve lipid profiles, reducing total cholesterol and improving antioxidant enzyme activity. In vivo rat NAFLD models also show reduced serum cholesterol following dandelion treatment. No human clinical trials have confirmed cholesterol-lowering effects.

Delta-tocopherol has been identified as the most potent vitamin E isoform for reducing cholesterol accumulation in cellular models of lysosomal storage disorders, showing 6–8x greater potency than α-, β-, and γ-tocopherols. A short-term clinical crossover study of delta-tocotrienol showed a trend toward increased HDL-C, though overall lipid profile changes did not reach statistical significance. The cholesterol-modulating activity differs mechanistically between δ-tocopherol (cholesterol trafficking) and δ-tocotrienol (HMG-CoA reductase inhibition).

DHA-containing omega-3 formulations are FDA-approved for treating severe hypertriglyceridemia and reliably reduce triglycerides by 20–30% at pharmacological doses (3.4–4 g/day). DHA-containing preparations may modestly raise LDL cholesterol, unlike EPA-only formulations, but do not increase non-HDL cholesterol. HDL cholesterol shows slight increases in some studies.

Diosgenin and sapogenin-rich Dioscorea preparations consistently reduce total and LDL cholesterol in multiple animal models via inhibition of intestinal cholesterol absorption and increased fecal excretion. A human study (Dioscorea alata substituted for dietary rice) also observed improvements in serum lipid fractions. No large randomized controlled trials in humans exist.

DHA reproducibly lowers triglycerides (with a greater effect than EPA), raises HDL-2 cholesterol, and raises LDL cholesterol concentration while shifting LDL to a larger, less atherogenic particle size. Total cholesterol is largely unchanged. These lipid effects have been confirmed in multiple systematic reviews and RCTs using algal and fish-oil DHA.

Clinical RCT evidence supports Rosa canina rosehip intake reducing LDL cholesterol in obese subjects. The Andersson et al. (2012) crossover RCT found significant reductions in LDL-C and LDL/HDL ratio, confirmed in a 2023 systematic review of 4 RCTs that found significant reductions in LDL cholesterol across studies.

DPA enhances reverse cholesterol transport through ABCA1/ABCG1 activation in macrophages, promoting efflux of cholesterol and reducing atherosclerotic lipid deposition. Animal data show DPA reduces non-HDL cholesterol significantly. DPA's effects on cholesterol appear distinct from EPA and DHA, with a focus on cholesterol efflux and lipoprotein clearance.

Dulse contains soluble fiber and bioactive compounds that may influence lipid metabolism. A human RCT (Allsopp et al. 2016) found consuming 5 g/day dulse-enriched bread increased serum triglycerides without significant changes to total cholesterol in healthy adults. WebMD notes dulse has been used for high cholesterol but acknowledges there is no strong clinical evidence to support this use.

EGCG, the most bioactive green tea catechin, inhibits micellar cholesterol absorption and HMG-CoA reductase, and upregulates hepatic LDL receptors. A meta-analysis of 14 RCTs confirmed significant TC and LDL-C reductions. Studied doses: 224–674 mg/day.

EPA significantly reduces plasma triglycerides and VLDL-cholesterol without raising LDL-cholesterol—a pharmacologically important distinction from DHA. Pure EPA formulations (icosapent ethyl) are FDA-approved for treating severe hypertriglyceridemia. A double-blind RCT with algal EPA found significant reductions in total cholesterol and VLDL-C versus placebo.

Animal research on LCMUFA-rich fish oils containing eicosenoic acid has demonstrated suppression of LDL-cholesterol rise without reducing HDL-cholesterol, with hepatic lipid synthesis gene downregulation as a proposed mechanism. Gondoic acid has been noted as a MUFA that may benefit lipid metabolism regulation and cholesterol reduction, though human clinical evidence for isolated eicosenoic acid is absent.

E. littorale and its isolated compound swertiamarin have demonstrated significant lipid-lowering effects in preclinical models, including reduction of total cholesterol, LDL, and VLDL with elevation of HDL in hypercholesterolaemic rats. Swertiamarin inhibits HMG-CoA reductase at a level comparable to atorvastatin in animal studies. The human clinical trial in 84 T2D patients also documented significant improvement in lipid profile.

EPA is the only omega-3 fatty acid with strong evidence for reducing cardiovascular events beyond triglyceride lowering. Purified EPA (as icosapent ethyl/Vascepa) robustly lowers triglycerides and, unlike DHA, does not raise LDL-C. The REDUCE-IT trial demonstrated a 25% reduction in composite cardiovascular events with 4 g/day EPA in statin-treated patients with elevated triglycerides.

Multiple preclinical studies show eucommia leaf extract lowers total cholesterol, LDL-C, and triglycerides in hyperlipidemic animal models, while raising HDL-C. Active compounds including quercetin, asperuloside, chlorogenic acid, and aucubin mediate these effects via PPAR activation and HMG-CoA reductase inhibition. Human clinical data for cholesterol specifically are lacking.

EPO's linoleic acid content is associated with total cholesterol reduction via the Keys equation, and GLA specifically raises HDL and lowers LDL and TG. RCT data in isotretinoin-treated patients and the 2024 systematic review both support modest cholesterol-improving effects, though EPO has not been studied as a primary lipid-lowering agent in dedicated trials.

Fava beans' soluble fiber, plant sterols, and bioactive compounds are associated with reduced LDL and total cholesterol in legume dietary trials. A systematic review found common beans reduced LDL by 19% and CVD risk by 11% in clinical trials. Some older fava bean-specific crossover trials showed mixed results depending on protein fraction studied.

Animal studies consistently show fennel seed extract reduces total cholesterol, LDL, triglycerides, and apolipoprotein-B while raising HDL in dyslipidemic rodent models. Bioactive constituents quercetin, anethole, and phenolic acids are implicated. Human clinical trial data are lacking.

Fenugreek seed demonstrates significant lipid-lowering effects across six meta-analyses of RCTs in adults with type 2 diabetes or hyperlipidemia, with pooled TC reductions of −9 to −33 mg/dL and LDL-C reductions of −7 to −29 mg/dL. Soluble galactomannans and saponins are the primary active components.

Preclinical studies in diabetic rat models show F. asafoetida extract significantly reduces total cholesterol and LDL-C while increasing HDL-C. Ferulic acid (a key asafoetida constituent) reduced total cholesterol by 8.1% and LDL-C by 9.3% in a human RCT in hyperlipidemic subjects.

A randomized, double-blind, placebo-controlled clinical trial in hyperlipidemic adults found that 1 g/day ferulic acid for six weeks significantly reduced total cholesterol by 8.1%, LDL-C by 9.3%, and triglycerides by 12.1%, while raising HDL-C by 4.3%. FA modulates lipid metabolism via SREBP1c, FAS, and ACC downregulation and upregulation of hepatic β-oxidation genes.

Fisetin is characterized as anti-hyperlipidemic in multiple preclinical studies, reducing dyslipidemia in HFD-fed mice and diabetic models by improving lipid profiles and reducing LDL-associated cardiovascular risk via AMPK and lipid metabolism gene regulation.

Fish oil (EPA and DHA) is primarily established as a triglyceride-lowering agent, reducing TG by 20–50% at 2–4 g/day. It also modestly reduces total cholesterol and non-HDL-C. FDA-approved prescription omega-3 formulations are indicated for severe hypertriglyceridemia and are part of standard dyslipidemia management.

Flaxseed's soluble fiber, lignans, and ALA content collectively reduce total and LDL cholesterol in multiple clinical trials. The FDA has issued a qualified health claim for ALA (from flaxseed) and coronary heart disease risk reduction. Ground flaxseed at 30–40 g/day is the effective form.

C. speciosa powder supplementation in mice significantly reduced serum LDL cholesterol and total cholesterol, and reduced atherosclerotic plaque area. The antihyperlipidemic effect is attributed to polyphenols and triterpenoids. Evidence is limited to animal studies.

FOS has been hypothesized to lower cholesterol via SCFA-mediated inhibition of hepatic lipogenesis, primarily demonstrated in animal models. Human RCT data are inconsistent: a meta-analysis found significant total cholesterol reduction in diabetics only, and a well-controlled crossover RCT in mildly hypercholesterolemic adults found no significant effect. Some studies show small HDL-raising effects.

Poria cocos triterpenoids reduce total cholesterol and LDL while increasing HDL in dyslipidemic animal models. Polysaccharides promote reverse cholesterol transport and reduce hepatic lipid deposition. In a nephrotic syndrome rat model, P. cocos extract significantly reduced plasma total cholesterol and LDL-cholesterol.

Multiple clinical trials demonstrate that gamma oryzanol at 300 mg/day reduces total cholesterol and LDL-C in hypercholesterolemic patients. Mechanisms include inhibition of intestinal cholesterol absorption, increased bile acid conversion, and suppression of HMG-CoA reductase activity. HDL effects are mixed across studies. A randomized double-blind placebo-controlled study reported a 19.3% LDL-C reduction over three months.

Animal studies consistently show Ganoderma lucidum lowers total and LDL cholesterol and triglycerides. Earlier human trials reported positive effects but were methodologically weak; a well-designed 16-week RCT and 2025 meta-analysis found no significant overall effect on lipid profiles in humans.

Human clinical and epidemiological evidence consistently links chickpea consumption to reductions in total cholesterol and LDL cholesterol. A meta-analysis of 26 randomized controlled trials found that eating one daily serving of pulses including chickpeas lowered LDL by approximately 5%, translating to an estimated 5–6% reduction in cardiovascular disease risk. A 12-week ad libitum dietary trial in 45 adults showed serum total cholesterol and LDL cholesterol fell by approximately 7.7 mg/dL and 7.3 mg/dL respectively.

Gardenia jasminoides extract reduces total cholesterol and hepatic cholesterol in HFD rodent models. Crocin inhibits pancreatic lipase to reduce lipid absorption. Geniposide improves lipid profiles including LDL-C and HDL-C in T2DM models. Cholesterol reduction is a documented pharmacological property of gardenia in multiple reviews.

A glycoprotein isolated from Gardenia jasminoides reduced plasma total cholesterol, triglycerides, and LDL in mice (Clin Exp Pharmacol Physiol, 2006). Crocin inhibits pancreatic lipase activity in vitro to reduce lipid absorption. These hypolipidemic effects have been identified as relevant to TCM's traditional use of Fructus Gardeniae in metabolic conditions.

Garlic organosulfur compounds (allicin, ajoene) inhibit HMG-CoA reductase and reduce intestinal cholesterol absorption. A meta-analysis of 39 RCTs in 2,298 mild-to-moderate hypercholesterolemic subjects found a mean LDL-C reduction of −9 mg/dL with ≥2 months garlic extract use.

Multiple meta-analyses confirm garlic produces modest but statistically significant reductions in total cholesterol and triglycerides, with inconsistent effects on LDL and HDL. A 2024 meta-analysis of 21 RCTs in dyslipidemic patients found significant reductions in TC, TG, and LDL-C. Earlier analyses show approximately 9–12% reductions in total cholesterol versus placebo.

A 2016 meta-analysis of 8 RCTs confirmed that genistein significantly increases HDL-C and, specifically in women with metabolic syndrome, significantly decreases LDL-C, total cholesterol, and triglycerides. A 2025 meta-analysis of diverse RCTs further confirmed significant reductions in TC and LDL-C across broader populations.

Clinical trials and systematic reviews show that ginger supplementation can reduce total cholesterol, LDL, and triglycerides, with some evidence of HDL improvement. Effects appear dose- and duration-dependent. A 2025 umbrella review confirmed a significant positive influence on blood lipid profile across multiple RCTs.

Multiple systematic reviews and meta-analyses of RCTs have examined ginseng's effect on lipid profiles. A 2019 meta-analysis (18 RCTs) found 5 studies reported reductions in total cholesterol and 4 in LDL-cholesterol. However, a larger 2024 GRADE-assessed meta-analysis (29 RCTs) found no statistically significant overall influence on TG, TC, LDL-C, or HDL-C. Individual RCTs, particularly in metabolic syndrome populations, have shown reductions in total cholesterol, LDL, and triglycerides.

Clinical evidence shows GLA supplementation reduces total cholesterol and LDL-cholesterol while raising HDL-cholesterol in hyperlipidemic patients. Studies show significant cholesterol improvements alongside triglyceride reductions. Effects appear dose-dependent and more pronounced with longer supplementation periods.

Glucomannan has robust evidence from multiple meta-analyses for lowering total cholesterol, LDL cholesterol, and triglycerides. The Sood 2008 meta-analysis (14 RCTs, n=531) found WMDs of −19.28 mg/dL for total cholesterol and −15.99 mg/dL for LDL. A 2024 BMC Cardiovascular Disorders GRADE-assessed meta-analysis confirmed significant reductions. The mechanism involves bile acid sequestration in the intestine, forcing the liver to synthesize new bile acids from circulating cholesterol.

Hypolipidemic effects, including cholesterol lowering, are directly attributed to glycitin in systematic reviews. Soy isoflavone preparations have demonstrated statistically significant reductions in total cholesterol and LDL-C in type 2 diabetic patients across clinical RCTs and meta-analyses. Glycitein is specifically noted to enhance lipid profiles via PPAR-γ regulation.

Human RCTs and meta-analyses demonstrate that goji/LBP supplementation significantly reduces LDL cholesterol while increasing HDL cholesterol. A double-blind RCT in type-2 diabetics found significant HDL increase at 3 months; a 45-day human study in metabolic syndrome patients confirmed LDL reduction. A 2021 meta-analysis across multiple RCTs confirmed significant lipid-modulating effects.

Berberine from goldenseal has been studied in clinical trials for lipid-lowering effects, including reductions in LDL-C and total cholesterol. The Merck Manual states berberine has been shown to lower cholesterol, though evidence quality is mixed and the NCCIH cautions that poor bioavailability from whole goldenseal limits direct applicability.

Amla has strong clinical evidence for lowering LDL, total cholesterol, and VLDL while maintaining or raising HDL. A key RCT in 98 dyslipidemic patients using 500 mg extract twice daily for 12 weeks showed large, statistically significant reductions in all atherogenic lipid fractions. A pilot study over 6 months confirmed similar effects.

A 2020 review of 11 RCTs (536 participants), cited by NCCIH, found grape seed extract may reduce LDL cholesterol and triglycerides but not total or HDL cholesterol. An 8-week RCT in hypercholesterolemic subjects at 200 mg/day GSE found a 22% reduction in LDL and 15% in total cholesterol. GSE also significantly reduced oxidized LDL in hypercholesterolemic subjects in a human clinical trial.

A systematic review and dose-response meta-analysis of 11 RCTs (n=536) found GSE supplementation significantly decreased LDL-cholesterol (−0.17 mmol/L) and triglycerides (−0.11 mmol/L) versus control. Effects were seen in subjects with hypercholesterolemia, T2DM, or metabolic syndrome. However, Examine.com notes that evidence overall is inconsistent across studies.

Multiple clinical trials demonstrate that grapefruit and grapefruit pectin reduce total cholesterol and LDL cholesterol in hyperlipidemic adults. Red grapefruit produces larger reductions than blond. Grapefruit pectin supplementation reduced LDL by 10.8% in a double-blind crossover trial. Mechanistically, naringenin inhibits HMG-CoA reductase and activates hepatic fatty acid oxidation pathways.

Green tea and its catechins (primarily EGCG) inhibit intestinal cholesterol micellar absorption and HMG-CoA reductase, and upregulate LDL receptors. A meta-analysis of 14 RCTs found green tea reduced TC by 7.2 mg/dL and LDL-C by 2.19 mg/dL (p<0.001). Studied doses: 250–1,200 mg extract or 170–850 mg EGCG/day.

Guarana seed powder contains flavanols with cholesterol-lowering effects, demonstrated in vitro via inhibition of pancreatic lipase, bile acid binding, and reduced cholesterol micellar solubilization. A human epidemiological study found female guarana consumers had lower total and LDL cholesterol. In vitro studies show guarana inhibits LDL oxidation by 27% in regular consumers versus non-consumers.

Multiple human trials and a meta-analysis of 10 studies (419 participants) demonstrate GS significantly reduces total cholesterol, LDL, and triglycerides while improving HDL. A 2023 RCT in T2DM patients showed significant reductions in total cholesterol (p=0.01) and LDL (p=0.03). GS saponins reduce gut absorption of lipids.

Hawthorn extracts, particularly flavonoids and triterpenic acids, reduce total cholesterol and LDL-C in animal models and limited clinical observations. A 6-month clinical observation found 5.0 mg/kg hawthorn extract reduced serum lipid levels and promoted plaque stability. Mechanistically, hawthorn inhibits cholesterol absorption by downregulating intestinal acyl-CoA cholesterol acyltransferase (ACAT) and suppresses hepatic lipogenic gene expression via AMPK/SREBP pathways.

Hesperetin and its glycoside hesperidin reduce total cholesterol and LDL in human RCTs and animal models. The mechanism involves inhibition of hepatic HMG-CoA reductase and ACAT enzymes. A 2023 PMC meta-analysis of RCTs confirmed significant reductions in total cholesterol and LDL with hesperidin supplementation.

Multiple meta-analyses of RCTs support hesperidin's ability to reduce LDL and total cholesterol. A 2024 meta-analysis of nine RCTs (n=2,414) found significant reductions in LDL (p=0.005) and total cholesterol (p<0.00001). Effects are more pronounced with doses above 500 mg/day and treatment duration longer than six weeks. An earlier 2019 meta-analysis found no significant effect, illustrating that study quality and heterogeneity materially affect pooled conclusions.

Multiple RCTs and a 2022 meta-analysis of 17 studies found that Hibiscus sabdariffa at 500–1000 mg/day produced improvements in total cholesterol and LDL in some populations. Evidence is mixed—a 2013 PubMed meta-analysis concluded RCT evidence was insufficient—but more recent, larger analyses support modest beneficial effects particularly in hyperlipidemic individuals.

In a high-fat diet mouse model, HMRlignan (TEP preparation) reduced total cholesterol by 11% and LDL by 23%. Enterolactone, HMR's human metabolite, has been shown to inhibit cholesterol-7α-hydroxylase, the rate-limiting enzyme in bile acid synthesis from cholesterol. Observational data associate higher enterolactone with lower LDL in humans, though human RCT evidence with purified HMRlignan remains absent.

A preclinical study using obese Zucker rats showed that I. aquifolium saponin and terpenoid fractions reduced total cholesterol, LDL, and liver adiposity, and improved insulin sensitivity. Evidence is limited to animal models with no human clinical trials.

Clinical trials show honey reduces total cholesterol, LDL-C, and raises HDL-C when substituted for sucrose. The Al-Waili RCT (n=55) found honey reduced total cholesterol by 3–3.3% and LDL-C by 4.3–5.8% versus sucrose. GRADE-assessed meta-analyses confirm modest but statistically significant improvements in lipid profiles with regular honey intake.

Multiple preclinical studies demonstrate that L. japonica polysaccharides and flavonoid extracts significantly reduce total cholesterol, triglycerides, and LDL-C while increasing HDL-C in diabetic animal models. Pharmacological studies confirm blood fat-reducing activity as an established bioactivity of honeysuckle.

Xanthohumol and iso-alpha acids from hops reduce LDL cholesterol and triglycerides in animal models via PCSK9 suppression, SREBP inhibition, and PPAR-alpha activation. Isomerized hops extracts have been shown to raise HDL in animal studies. Human clinical evidence is limited to pilot and indirect data.

Animal studies show M. vulgare extracts significantly reduce total cholesterol, LDL, and triglycerides. An in vitro study demonstrated inhibition of human LDL oxidation and enhanced HDL-mediated cholesterol efflux in macrophages. A small human clinical study noted modest reductions in cholesterol. Evidence remains preliminary with limited clinical data.

Multiple RCTs using Vaccinium species anthocyanins have demonstrated significant reductions in LDL cholesterol and increases in HDL cholesterol. A 2021 meta-analysis of 44 RCTs confirmed these lipid effects. Huckleberry's matching anthocyanin profile makes this evidence highly transferable. A dedicated Vaccinium whortleberry (V. arctostaphylos) RCT showed significant cholesterol-lowering in hyperlipidemic patients.

Preclinical studies document hypolipidemic effects of L. purpureus extracts, including reductions in total cholesterol and triglycerides in diabetic and HFD-fed rodent models. Hypolipidemic activity is consistently listed among its pharmacological properties across multiple peer-reviewed pharmacology reviews.

ATP-citrate lyase inhibition by HCA also limits cholesterol biosynthesis by reducing the cytosolic acetyl-CoA pool. Multiple human trials and a 2024 meta-analysis of 14 RCTs report modest reductions in total cholesterol and LDL, though effects are smaller and less consistent than those on triglycerides.

Bael leaf and fruit extracts have been shown in multiple animal studies to reduce total cholesterol, LDL, VLDL, and free cholesterol while increasing HDL in hyperlipidemic and diabetic rat models. Antihyperlipidemic activity operates through regulation of lipid-metabolizing enzymes, HMG-CoA reductase inhibition, and antioxidant mechanisms.

Boswellia serrata extract has documented cholesterol-lowering activity demonstrated in animal studies and referenced in the early pharmacological literature (Zutshi et al., Indian J Pharmac, 1986). Clinical trials in type 2 diabetic patients have measured LDL, HDL, and total cholesterol as outcomes, with the Azadmehr et al. 2014 RCT documenting anti-hyperlipidaemic effects.

Human clinical trials demonstrate that gum arabic supplementation significantly lowers total cholesterol and LDL cholesterol. This effect is documented in diabetic patients and those with renal failure. The 2023 systematic review of 29 clinical trials confirmed altered lipid profiles as a primary outcome.

Preclinical studies and at least one small human clinical study support lipid-lowering effects. A pilot clinical study (n=24) in hypertriglyceridemic patients found T. cordifolia extract (3 g/day, 14 days) produced improvements in triglycerides, total cholesterol, and LDL comparable to metformin. In vitro and animal data additionally show reduction of serum and tissue cholesterol, phospholipids, and free fatty acids.

Inositol supplementation has demonstrated improvements in total cholesterol, LDL, and HDL in clinical trials predominantly in PCOS and metabolic syndrome populations. A 2016 clinical study found significant reductions in cholesterol and LDL after 3 months of myo-inositol. The MI + DCI combination showed the broadest lipid-profile improvements across LDL, HDL, and triglycerides.

Multiple clinical trials have examined inositol nicotinate (IHN) for hyperlipidemia, with results showing reductions in total cholesterol and LDL, though overall evidence is mixed. A 2019 abstract published in Circulation found significant reductions in total cholesterol and LDL in dyslipidemic patients after 12 weeks of IHN. Earlier controlled trials using 400 mg–2.4 g daily also demonstrated statistically significant cholesterol lowering. WebMD and RxList characterize effectiveness as unclear due to conflicting trial outcomes.

Root powder of I. racemosa has been reported as hypocholesterolemic in human subjects, as cited in multiple peer-reviewed literature reviews. Combined with guggulu, it demonstrated hypolipidemic effects in IHD patients. The root is known for antifungal, hypolipidemic, and antimicrobial properties in traditional Ayurvedic and Chinese medicine.

Meta-analyses of RCTs show inulin-type fructans reduce LDL-cholesterol and total cholesterol, predominantly in hyperlipidemic and diabetic populations. Effects in normolipidemic subjects are minimal. Proposed mechanisms include hepatic propionate inhibiting cholesterol synthesis and increased bile acid excretion via altered microbiota.

Clinical trials in constipated elderly subjects and hemodialysis patients show IMO supplementation significantly reduces total cholesterol and increases HDL-C. IMO-fortified cookie trials in hyperlipidemic subjects also demonstrated cholesterol reduction. The mechanism likely involves SCFA inhibition of hepatic cholesterol synthesis.

A 2022 systematic review of 22 RCTs (2,407 participants) found G. pentaphyllum effective for normalizing serum cholesterol in dyslipidemia, lowering LDL and total cholesterol while raising HDL. The RxList monograph also notes evidence for decreased total cholesterol and improved HDL/total ratio.

The 12-week human RCT (n=48 T2D patients) reported significant reductions in total cholesterol (−7.46%) and LDL-C (−7.65%) with 30 g/day dried jujube. However, a 2025 systematic review and meta-analysis of RCTs concluded jujube was not effective in reducing cholesterol overall, and HDL did not improve consistently. Evidence is mixed.

Kale juice consumption has been shown in a clinical trial to significantly raise HDL-cholesterol and lower LDL-cholesterol in hypercholesterolemic men. Kale powder also reduced LDL in a prospective study of subjects with potential metabolic syndrome. Mechanisms include bile acid binding by kale fiber and the cholesterol-lowering activity of glucosinolate metabolites.

Human and clinical trial evidence documents kelp/fucoidan effects on LDL cholesterol reduction. A 3-month fucoidan intervention in overweight adults decreased LDL cholesterol. A 2022 Nutrients meta-analysis found seaweed intake reduced total cholesterol by up to 9% in dyslipidemic adults. Alginate also inhibits fat and cholesterol absorption in the gut.

Kidney beans contain soluble fiber, plant proteins, and fermentable carbohydrates that contribute to modest reductions in LDL cholesterol. WKBE supplementation in human and animal studies has also been shown to lower cholesterol and triglycerides while increasing HDL. Controlled trials and pooled analyses support a meaningful LDL-lowering effect with regular consumption.

Polydatin from PC demonstrated lipid-lowering effects in clinical trials, identified as a potential hypolipidemic agent. Resveratrol regulates cholesterol levels by interacting with estrogen receptors and inhibiting LDL oxidation. A 2021 PMC study validated PC extract's antihyperlipidemic effects via PI3K/AKT/FOXO3 signaling. Meta-analysis evidence for total cholesterol reduction by resveratrol is mixed.

Krill oil provides EPA and DHA in phospholipid form, which may enhance bioavailability versus fish oil triglycerides. It suppresses total cholesterol, LDL-C, and HMG-CoA reductase activity in animal studies, and is recognized in dyslipidemia supplement reviews for triglyceride and total cholesterol modulation.

Puerarin has demonstrated cholesterol-lowering effects in animal models, reducing total cholesterol and LDL-C while raising HDL-C. Postmenopausal women treated with kudzu showed improvements in cholesterol and lipid parameters in some studies. The mechanism involves effects on hepatic lipid metabolism. Clinical human data are limited.

Evidence for L-arginine's effect on cholesterol is mixed and dose-dependent. A 2019 meta-analysis of 12 RCTs found no significant effect on total cholesterol, LDL, or HDL. However, a 2025 meta-analysis of 17 RCTs found that at doses ≥8 g/day, L-arginine significantly reduced total cholesterol and LDL. Effects are more consistent at higher doses and in populations with dyslipidemia.

Multiple meta-analyses demonstrate L-carnitine supplementation significantly reduces total cholesterol and LDL-C in diabetic and dyslipidemic populations. A 2021 meta-analysis of RCTs in type 2 diabetes found WMD −8.17 mg/dL for total cholesterol and −5.22 mg/dL for LDL-C. Effects are most pronounced at higher baseline cholesterol levels.

LA significantly lowers LDL cholesterol compared with saturated fatty acids and carbohydrates, a finding confirmed by a meta-analysis of 40 RCTs comprising 2,175 participants. It also modestly reduces HDL cholesterol. Total cholesterol and triglycerides are not significantly changed by LA relative to other fatty acids in RCT-level evidence.

L. acidophilus has been the subject of dedicated cholesterol-lowering RCTs and meta-analyses. A meta-analysis of 15 human RCTs found Lactobacillus species significantly reduced total cholesterol and LDL-C. However, a specific RCT of L. acidophilus L-1 in yoghurt versus placebo found no significant effect on serum lipids in healthy adults with normal to borderline-high cholesterol. L. acidophilus K301 has been shown in preclinical work to promote reverse cholesterol transport via LXR agonist induction. The clinical evidence is mixed and appears strain- and population-dependent.

A pilot trial (n=23) using L. acidophilus and L. bulgaricus tablets at 3×10^7 CFU daily for 16 weeks found serum cholesterol decreased from 5.7 to 5.3 mmol/L at week 7 (P<0.05). In vitro studies at the University of Warsaw confirmed L. bulgaricus can uptake cholesterol from its environment.

L. casei and L. paracasei have documented bile salt hydrolase (BSH) activity in vitro providing a mechanistic basis for cholesterol reduction. Combination probiotic trials including L. casei have shown improved lipid profiles. L. casei Shirota has been studied in metabolic syndrome for effects including on cholesterol metabolism via improved gut permeability and reduced LPS-driven dyslipidemia.

Human and animal studies show L. gasseri can reduce total cholesterol and LDL cholesterol. L. gasseri CHO-220 combined with inulin reduced total cholesterol and LDL in hypercholesterolemic subjects via alteration of lipid transporters. Bile salt deconjugation is the primary proposed mechanism, with animal studies consistently showing cholesterol-lowering effects.

L. paracasei TISTR 2593 was tested in a randomized, double-blind, placebo-controlled clinical trial in hypercholesterolemic subjects measuring serum lipid profile, oxidative stress, and inflammation. L. paracasei DTA81 significantly reduced total cholesterol in mice on a high-fat diet. Multiple strains exhibit in vitro cholesterol assimilation capacity.

Multiple RCTs and meta-analyses consistently show L. plantarum strains reduce LDL-C and total cholesterol. A landmark 12-week RCT found 24.4 mg/dL LDL reduction vs. 9.8 mg/dL for placebo in hypercholesterolemic adults.

Clinical RCTs with L. rhamnosus strains have demonstrated improvements in LDL cholesterol and HDL-C levels. A randomized trial in elderly subjects showed significant LDL-C improvement in the probiotic group (p=0.045) at 8 weeks. L. rhamnosus LRa05 in a type 2 diabetes RCT produced a significant time-dependent cholesterol reduction (p=0.0164) and markedly improved HDL-C (p<0.0001).

A randomized controlled pilot trial of L. salivarius UBL S22 (with or without FOS) in 45 healthy young volunteers found significant reductions in total cholesterol, LDL cholesterol, and triglycerides, plus increased HDL cholesterol after 6 weeks versus placebo. These lipid-lowering effects were more pronounced in the synbiotic (probiotic + prebiotic) group.

Human clinical studies demonstrate that soy lecithin supplementation significantly reduces total and LDL cholesterol in hypercholesterolemic patients. A key mechanism involves lecithin-cholesterol acyltransferase (LCAT), which promotes reverse cholesterol transport and HDL formation. Evidence is present but effect sizes vary and some trials in healthy volunteers show no significant change.

Citrus flavonoids found in lemon (eriocitrin, hesperidin) have demonstrated cholesterol-lowering effects in human clinical trials. A meta-analysis of 13 RCTs found vitamin C supplementation (≥500 mg/day) significantly lowered LDL cholesterol and triglycerides. A systematic review and meta-analysis of 26 citrus studies confirmed reductions in total cholesterol and LDL in human subjects.

Meta-analyses of RCTs confirm that lemon balm supplementation significantly reduces total cholesterol and LDL. A 2020 meta-analysis (7 RCTs, n=305) found a significant total cholesterol reduction (SMD: −0.26). A 2024 meta-analysis (5 RCTs, n=302) confirmed reductions in total cholesterol, LDL, and triglycerides. Individual RCTs also report significant LDL reduction in borderline hyperlipidaemia.

Animal studies show lemongrass essential oil supplementation reduces total cholesterol (TC) and raises HDL cholesterol in diabetic models. A mouse study reported cholesterol reduction after 21 days of oral lemongrass essential oil intake with no observed genotoxicity. Human clinical evidence is limited but the lipid-modifying signal is consistent across multiple preclinical models.

L. edodes mycelia (LEM) contains eritadenine, an adenosine-analog alkaloid that modifies hepatic phospholipid metabolism to lower cholesterol. Preclinical studies in mice and rabbits demonstrate dose-dependent reductions in total cholesterol and LDL. A human RCT using a beta-glucan-enriched shiitake extract did not find significant lipid changes, indicating evidence is stronger in animal models than in humans.

Multiple intervention studies using flaxseed lignan supplements have shown reductions in total and LDL cholesterol. A meta-analysis of five such trials confirmed a cholesterol-lowering effect, and clinical trial data in patients with peripheral artery disease showed flaxseed independently lowered circulating cholesterol beyond that achieved by medication alone. Effects on HDL cholesterol are less consistent.

Lime's flavonoids and limonoids have been shown to inhibit LDL oxidation in human-derived samples. A meta-analysis of citrus clinical trials found Citrus species reduced total cholesterol by ~42 mg/dL and LDL by ~38 mg/dL on average. An RCT combining lime with cumin reported significant reductions in total cholesterol and LDL compared to placebo.

Animal studies consistently show D-limonene lowers LDL cholesterol, total cholesterol, and raises HDL in high-fat diet and diabetic obese rodent models. It functions as a cholesterol solvent and has been used clinically to dissolve cholesterol-rich gallstones. Preclinical lipid-lowering effects are well-replicated; controlled human trials on serum cholesterol are absent.

In vitro and animal studies show Lion's Mane extracts inhibit HMG-CoA reductase (the target of statin drugs), reduce LDL oxidation, and lower total cholesterol and LDL in hyperlipidemic models. A polysaccharide fraction lowered cholesterol by 32% and LDL by 45.4% in an animal study. No human RCTs specifically targeting cholesterol have been published.

Lotus plant extracts (including seed-related preparations) reduce total cholesterol and LDL-C while raising HDL-C in animal models of dyslipidemia. A clinical reference reports hyperlipidemia patients on lotus leaf water extracts showed significant TC and LDL-C reduction. Lotus seed-specific human cholesterol trials are absent.

Luteolin reduces LDL-C and total cholesterol in rat hyperlipidemia models and in a human combination nutraceutical RCT. Its mechanism includes SREBP-2 suppression, reduced HMGCR transcription, and inhibition of cholesterol biosynthesis.

Clinical trials and meta-analyses provide moderate evidence that lycopene supplementation reduces LDL cholesterol and may raise HDL, though findings are mixed. A 2010 meta-analysis found a borderline significant LDL reduction (−4.63 mg/dL; p=0.05) at doses ≥25 mg/day. A 2021 meta-analysis (12 trials, n=781) found a significant increase in HDL-c (SMD=0.33; p=0.002). HDL effects appear specific to higher-quality formulations.

Multiple clinical trials demonstrate that macadamia nut consumption reduces total and LDL cholesterol in hypercholesterolemic individuals. A randomized crossover feeding study in mildly hypercholesterolemic subjects showed significant reductions in TC and LDL-C compared to a typical American diet. The effect appears driven by the high monounsaturated fatty acid (MUFA) content displacing saturated fat. A 2023 RCT in overweight/obese adults found non-significant but directionally consistent LDL-C reductions of ~4%.

Preclinical studies show maitake supplementation reduces total and LDL cholesterol and maintains HDL in hyperlipidemic animal models, via suppression of hepatic cholesterol synthesis genes. Maitake polysaccharides modulate gut microbiota that regulate cholesterol transport genes. A human study reportedly showed LDL cholesterol reductions with 12-week maitake extract supplementation.

A 2025 UC Davis RCT in postmenopausal women showed that ~330 g of mango daily for 2 weeks reduced total cholesterol by ~13 mg/dL and LDL cholesterol by ~12.6 mg/dL. An 8-week RCT in adults with prediabetes also found a trend toward reduced total and LDL cholesterol with combined avocado and mango intake.

Clinical RCTs using a mangosteen/Sphaeranthus indicus combination found significant reductions in total cholesterol in obese subjects. A human prospective cohort study in cardiovascular-risk patients showed reduced LDL oxidation markers. Animal studies consistently demonstrate mangosteen extract lowers total cholesterol and LDL while tending to preserve or increase HDL.

A 3-month open clinical trial in 31 prediabetic adults showed Delphinol® 180 mg daily significantly reduced LDL (p=0.001), reduced VLDL at 1 month (p=0.019), and increased HDL throughout the treatment period. A double-blind RCT also demonstrated significant reduction in oxidized LDL, the atherogenic form of LDL. Total cholesterol and triglycerides were not significantly changed in the human trial.

In a high-fat diet rat model, hydroalcoholic marjoram extract (150 and 450 mg/kg/day) significantly reduced serum LDL cholesterol and total cholesterol compared to the high-fat diet group. The lower dose produced greater LDL reduction (P<0.01).

The CHIOS-MASTIHA RCT (n=179) found 1 g/day crude mastic significantly reduced total cholesterol by 11.5 mg/dL after 8 weeks (p<0.05), with stronger effects in overweight/obese individuals. An earlier human study with 5 g/day for 18 months reduced total cholesterol, LDL, TC/HDL ratio, and apolipoprotein B. Polymer-free or powdered mastic formulations showed no significant cholesterol reduction in the RCT.

A human clinical study in 26 patients with hypercholesterolemia found that L-MMSC at 1500 mg/day for 8 weeks produced a statistically significant 9.7% reduction in serum total cholesterol (p<0.001) and significant increases in HDL-cholesterol and favorable HDL ratios. Multiple preclinical studies in rat models confirmed hypolipidemic effects via enhanced fecal bile acid and neutral sterol excretion.

Meta-analyses of RCTs consistently show silymarin reduces total cholesterol, LDL cholesterol, and fasting glucose in diabetic and metabolic syndrome populations. A Merck Manual-cited meta-analysis of 16 RCTs (1,358 patients) confirmed reductions in total cholesterol and LDL. A 2021 ScienceDirect meta-analysis found LDL-C reduction with silymarin but no significant effect on total cholesterol or triglycerides in all studies.

A systematic review and meta-analysis of 19 studies found millet consumption reduced total cholesterol by 8%, LDL-C by 10%, VLDL-C by 9%, and raised HDL-C by 6%, all statistically significant. These lipid improvements moved values from above-normal to normal range. Soluble fiber in millet reduces bile acid reabsorption, lowering hepatic cholesterol.

Momordica charantia has been examined for effects on total cholesterol, LDL, and HDL in both animal studies and human RCTs. Animal evidence consistently shows cholesterol reduction; a meta-analysis of nine human RCTs found no statistically significant effect on any cholesterol fractions versus placebo.

Animal studies show that mogroside fractions from monk fruit lower serum total cholesterol and triglycerides while improving HDL cholesterol in diabetic and obese models. The PRISMA systematic review of RCTs identified lipid profiles as a target outcome for MFE investigation. Human clinical trial evidence on lipid parameters specifically is limited and has not established effect sizes in humans.

A randomised double-blind placebo-controlled clinical trial of 132 heavy smokers found M. citrifolia noni juice (29.5–188 mL/day) significantly reduced total cholesterol, LDL, triglycerides, and hs-CRP while increasing HDL. Animal studies with M. citrifolia fruit, leaf, and root extracts confirmed significant reductions in total cholesterol, LDL-C, and triglycerides in high-fat-diet models.

Multiple human studies and a meta-analysis show that Morus alba leaf or fruit preparations reduce total cholesterol and LDL-cholesterol. A 2025 meta-analysis of 15 RCTs confirmed significant pooled reductions in total cholesterol and LDL. Effects on HDL are less consistent.

A. vulgaris extracts have demonstrated hypolipidemic effects in rodent models of diet-induced hypercholesterolemia, normalizing total cholesterol, LDL, VLDL, triglycerides, and HDL. The mechanism is proposed to involve inhibition of hepatic HMG-CoA reductase. These findings are preclinical only; no human trials have been conducted.

Several RCTs and a 2025 meta-analysis of 15 trials show mulberry supplementation reduces total cholesterol and LDL. Mulberry leaf powder was effective in patients with mild dyslipidaemia. The mechanism involves hepatic AMPK activation, upregulation of bile acid synthesis genes, and increased faecal cholesterol excretion.

Mustard seed extracts and whole mustard have shown cholesterol-lowering potential in animal and preliminary human studies. Plant sterols in mustard compete with cholesterol absorption; omega-3 fatty acids reduce hepatic VLDL synthesis. A human pilot in pre-diabetic patients reported reductions in cholesterol with nightly wholegrain mustard consumption.

Multiple preclinical studies show TC aqueous extract significantly reduces total cholesterol and LDL-C in diabetic animal models. A human RCT using a TC-containing combination formula demonstrated significant reductions in total cholesterol and LDL-C in diabetic women versus placebo after 3 months.

Naringin-containing bergamot extracts significantly reduce total cholesterol and LDL in human clinical trials. A 6-month open-label trial in 80 hypercholesterolemic subjects found decreases in total cholesterol from 255 to 224 mg/dL and LDL from 159 to 132 mg/dL. However, a 4-week RCT with 500 mg isolated naringin found no significant effect on cholesterol, suggesting dose and duration dependence.

Multiple RCTs and a 2023 meta-analysis (6 RCTs, n=546) have examined nattokinase's effects on blood lipids. Evidence shows dose-dependent effects on total cholesterol (TC) and LDL-C, particularly at higher doses. A 12-month clinical study in 1,062 participants at 10,800 FU/day found 15.9% reduction in TC and 18.1% reduction in LDL-C. Low-dose supplementation (2,000 FU/day) does not appear to produce significant lipid-lowering effects based on a 3-year RCT.

Nattokinase's effect on cholesterol is dose-dependent and contested. Higher doses (10,800 FU/day) have shown significant lipid profile improvements in clinical studies, while a 2023 meta-analysis of lower-dose RCTs found no significant LDL or triglyceride benefit at standard 2,000 FU/day doses. Results from combination NK plus red yeast rice trials are more consistently positive.

The 2020 RCT in T2DM patients measured a full lipid profile including total cholesterol (TC), LDL-C, HDL-C, TG, and VLDL-C; neem supplementation at 125–500 mg twice daily for 12 weeks produced improvements in lipid parameters on background metformin. Preclinical studies consistently show neem extract reduces TC, LDL, and triglycerides while increasing HDL in diabetic and cholesterol-fed animal models.

Several human RCTs and a systematic review/meta-analysis support nopal's ability to reduce LDL cholesterol and total cholesterol, and raise HDL, particularly in individuals with dyslipidemia or metabolic syndrome. A 6-week RCT (N=68) using NeOpuntia 1.6 g/meal significantly increased HDL and decreased LDL in women with metabolic syndrome. Effects are attributed primarily to soluble fiber content. Overall evidence is modest and results vary by formulation.

C. rotundus extract has demonstrated lipid-lowering effects in both animal models and human RCTs. In the 2022 pilot RCT (n=30), the serum lipid profile showed significant improvement in CRE-treated obese individuals. The 2025 RCT (n=96) included serum lipid parameters as secondary outcomes. Animal models also confirm hypolipidemic effects.

Oat β-glucan is one of the most robustly evidenced dietary components for lowering LDL and total cholesterol. Multiple meta-analyses of RCTs confirm that ≥3 g/day of oat β-glucan reduces LDL cholesterol by approximately 0.19–0.25 mmol/L and total cholesterol by ~0.30 mmol/L. Health agencies including the FDA, EFSA, and Health Canada have issued approved health claims on this basis.

Clinical meta-analyses demonstrate okra significantly reduces total cholesterol and LDL-C. A 2024 Frontiers in Nutrition meta-analysis of nine RCTs found TC reduced by −14.40 mg/dL and LDL by −7.90 mg/dL. A separate 2024 dyslipidemia meta-analysis (PMC) confirmed TC reduction (SMD=−0.53). Evidence quality for TC and LDL is rated high.

OA lowers total cholesterol and LDL-cholesterol and raises HDL-cholesterol in multiple animal models of hyperlipidemia and atherosclerosis, with effects comparable to atorvastatin in some atherosclerosis models. These lipid-modulating effects are mediated partly through PPARγ, AdipoR1/R2 pathways.

Dietary oleic acid reliably lowers LDL cholesterol and maintains or raises HDL when substituted for saturated or trans fats, supported by multiple RCTs and systematic reviews. An RCT of 61 healthy adults showed significantly lower LDL after an oleic acid diet versus industrial trans fat diet (2.68 vs 3.00 mmol/L, p<0.001). The FDA's qualified health claim for oleic acid in edible oils is based in part on this cholesterol-modifying evidence.

Oligomeric proanthocyanidins (OPCs) from grape seed and pine bark reduce LDL oxidation and demonstrate modest LDL-C-lowering effects in some clinical trials. Evidence is more limited compared to phytosterols or berberine but is present in peer-reviewed lipid literature.

Multiple RCTs and a 2022 meta-analysis confirm that OLE supplementation reduces total cholesterol, LDL cholesterol, and triglycerides while sparing HDL cholesterol. The EFSA health claim for olive polyphenols protecting blood lipids from oxidative damage is the most formally endorsed lipid-related claim. Effects are most consistent in hypertensive and overweight individuals.

Human RCTs and meta-analyses confirm that EVOO and its phenolic compounds improve lipid profiles, particularly by reducing LDL cholesterol and increasing HDL function. High-phenolic EVOO shows more pronounced effects than low-phenolic refined olive oil. EFSA reviewed RCTs supporting olive oil polyphenols' effect on LDL-cholesterol reduction.

Omega-3 fatty acids are among the most evidence-backed supplements for lowering elevated triglycerides, with dose-dependent reductions of 9–51% depending on baseline levels and dose. Effects on LDL-C are complex (modest increases possible), HDL-C shows small increases, and total cholesterol effects are limited. A prescription EPA-only formulation reduced major CV events by 25% in the REDUCE-IT trial.

High-quality Cochrane evidence (10 RCTs, 4,280 participants) demonstrates that increasing omega-6 fat intake reduces total serum cholesterol by a modest but significant amount (MD −0.33 mmol/L). Replacing dietary saturated fat with omega-6 PUFA (primarily linoleic acid) reliably lowers LDL cholesterol, triglycerides, and apolipoprotein B in controlled feeding trials. Effects on HDL and LDL independently are small or negligible.

Human interventional studies, including a randomized controlled trial with purified palmitoleic acid, have reported reductions in LDL cholesterol and increases in HDL cholesterol. A placebo-controlled study found approximately 8% LDL reduction and 5% HDL increase with 210 mg/day omega-7 over 30 days. Epidemiological data from the Cardiovascular Health Study also linked higher plasma palmitoleate to more favorable lipid profiles.

Diets enriched with oleic acid (omega-9) are associated with favorable changes in lipid profiles, including lower LDL cholesterol and improved HDL/LDL ratio compared to saturated-fat-rich diets. Research supports that replacing saturated fats with MUFA reduces LDL while preserving or modestly raising HDL. Effects are primarily observed as dietary substitution rather than isolated supplement effects.

Multiple RCTs and meta-analyses confirm that onion supplementation significantly reduces LDL and total cholesterol while raising HDL. A 2021 meta-analysis of 10 RCTs (446 participants) found LDL reduction of 6.64 mg/dL and total cholesterol reduction of 5.39 mg/dL. Onion's diallyl disulfide and quercetin inhibit hepatic cholesterol synthesis.

A 2024 meta-analysis of 12 RCTs (589 participants) found that hesperidin from citrus/orange significantly reduced LDL cholesterol (WMD −0.22 mmol/L) and total cholesterol (WMD −0.20 mmol/L). An earlier 2019 meta-analysis found no significant effect, highlighting ongoing trial heterogeneity. Orange peel powder also showed antihyperlipidaemic effects in a human clinical study.

A small human clinical study found that oregano extract taken after each meal for 3 months significantly reduced LDL cholesterol and raised HDL cholesterol in 48 people with mildly elevated cholesterol, compared to lifestyle changes alone. Preclinical evidence confirms carvacrol alters lipid profiles and inhibits LDL oxidation. Larger controlled trials are needed to confirm these findings.

Berberine from Oregon grape is among the best-studied plant-derived cholesterol-lowering agents, with a unique mechanism involving upregulation of LDL receptor expression. Multiple meta-analyses of RCTs confirm significant reductions in LDL-C, total cholesterol, and triglycerides. Evidence is for isolated berberine; Oregon grape whole-herb lipid trials are not separately published.

Gamma-oryzanol from Oryza sativa rice bran and rice bran oil have demonstrated cholesterol-lowering effects in human clinical trials and multiple animal studies, reducing LDL and total cholesterol. Red yeast rice (a fermented Oryza sativa product) also regulates hypercholesterolemia via monacolins.

Bile acid synthesis is the primary catabolic pathway for cholesterol, accounting for approximately 50% of daily cholesterol turnover in the liver. Endogenous bile acids carry cholesterol out of the body via fecal excretion. Ox bile supplements contain pre-formed bile acids; while they do not increase hepatic synthesis, they re-enter the enterohepatic circulation and can influence luminal cholesterol solubilization and absorption.

Human intervention trials consistently demonstrate reductions in total cholesterol and LDL-cholesterol following oyster mushroom intake. The 2020 systematic review of 8 trials reported decreases in total cholesterol, LDL-C, and triglycerides. Animal data support lovastatin-like compounds and β-glucan-mediated bile acid binding as key mechanisms.

P. foetida exhibits antihyperlipidemic activity in preclinical models, reducing elevated lipid profiles. Animal studies with streptozotocin-induced diabetic rats report normalization of lipid parameters. The mechanism is proposed to involve antioxidant effects and reduction of lipid peroxidation.

Multiple meta-analyses of clinical trials show that palm oil raises LDL and HDL cholesterol compared to unsaturated vegetable oils, but has a neutral or favorable effect compared to trans fats. Its tocotrienol-rich fraction (TRF) has been shown in some controlled trials to reduce LDL and total cholesterol in hypercholesterolemic subjects. The net effect on the TC:HDL ratio—a key cardiovascular risk marker—appears largely neutral relative to other vegetable oils. Evidence is mixed and context-dependent.

Multiple RCTs and meta-analyses confirm that dietary palmitic acid raises LDL-cholesterol. Replacing it isoenergetically with unsaturated fatty acids reduces LDL-C by approximately 0.36 mmol/L across 18 RCTs, with similar reductions in total cholesterol and apolipoprotein B. This LDL-raising effect is the primary basis for dietary recommendations to limit saturated fat.

Human dietary interventions with POA-rich foods and supplements consistently show reductions in LDL-C and increases in HDL-C. A small purified POA RCT found significant LDL reduction and HDL increase at 30 days; macadamia-based diet trials show similar directional effects.

Pantethine, a vitamin B5 derivative, reduces total cholesterol, LDL-C, and triglycerides in multiple RCTs. A triple-blind RCT found an 11% LDL-C decrease at 600–900 mg/day over 16 weeks. It has been used as a hypolipidemic medicine in Japan for over 40 years.

Multiple preclinical studies show that papaya extracts (seeds, leaves, juice) consistently reduce total cholesterol, LDL-cholesterol, and triglycerides while raising HDL-cholesterol in hyperlipidemic animal models. Human clinical trial data specific to cholesterol endpoints are limited, but the American Heart Association recognizes fiber from papaya as supporting cholesterol reduction.

Parsley seed methanol extract significantly reduces total cholesterol, triglycerides, LDL, and VLDL while raising HDL in hypercholesterolaemic animal models. These hypolipidaemic effects are attributed to apigenin, kaempferol, and associated flavonoids. Human lipid trials for parsley are absent.

Animal studies and in vitro evidence show pea protein and bioactive pulse peptides reduce total cholesterol, LDL, and VLDL while increasing HDL and fecal bile acid excretion. A 2025 comprehensive review confirmed these hypolipidemic effects, though robust human RCT data remain limited.

Peach leaf extract significantly reduced total cholesterol in high-fructose-diet rats. Polyphenol-rich peach by-products also demonstrated cholesterol-lowering effects in obese animal models. This is attributed to phenolic modulation of hepatic cholesterol metabolism. Human trials are lacking.

Multiple RCTs and meta-analyses confirm peanuts lower total cholesterol, LDL-C, and the LDL:HDL ratio while increasing HDL-C. Plant sterols in peanuts block intestinal cholesterol absorption. A crossover RCT in 54 hypercholesterolaemic men found significant reductions in TC/HDL and LDL/HDL ratios with ~77 g/day peanuts.

Pear's soluble fiber (pectin) binds bile acids in the gut, reducing LDL cholesterol reabsorption. Animal studies directly with pears show lowered plasma lipid levels. Epidemiological data link regular apple/pear intake to improved cardiometabolic lipid profiles. Pear peel has a greater lipid-lowering effect than pulp due to higher polyphenol and fiber concentration.

Pectin is one of the best-evidenced dietary fibers for LDL and total cholesterol reduction. Multiple RCTs in hypercholesterolaemic humans confirm significant reductions with pectin supplementation. The mechanism is primarily bile acid sequestration in the gut lumen, upregulating hepatic LDL receptors.

Perilla leaf and seed oil have demonstrated cholesterol-lowering effects in animal models and some human data. A 6-month human RCT found Perilla leaf powder significantly decreased serum oxidized LDL, a highly atherogenic form. Luteolin-7-O-diglucuronide from perilla leaves shows cholesterol-lowering potential in cell models.

Berberine from P. amurense significantly reduces LDL-cholesterol and total cholesterol in clinical trials of diabetic, dyslipidemic, and osteoarthritic subjects. A 2025 meta-analysis of RCTs found berberine reduced LDL-C by a weighted mean difference of −0.495 mmol/L. An 8-week pilot RCT combining P. amurense extract with citrus peel also demonstrated significant LDL-C reductions in osteoarthritis patients.

PC is required for VLDL assembly and biliary cholesterol secretion. PC-derived choline metabolized to betaine can lower homocysteine, while PC itself has modest, context-dependent effects on blood lipids. LCAT uses PC to esterify cholesterol on HDL, central to reverse cholesterol transport.

Phytosterols inhibit intestinal cholesterol absorption and consistently lower LDL-C by 8–15% at 2–3 g/day in numerous RCTs and meta-analyses. EFSA and major cardiovascular guidelines endorse their use for LDL-C management.

A pilot clinical study in dyslipidemia patients showed P. kurroa significantly reduced total cholesterol (max 25.36%) and LDL-C (max 28.79%) over 106 days. Preclinical NAFLD studies also show hepatic and serum cholesterol reduction. Evidence is preliminary-clinical in quality.

Clinical studies show Pycnogenol (pine bark extract) lowers LDL cholesterol and total cholesterol in patients with dyslipidemia. In one 3-month study, LDL decreased by 16% and total cholesterol by 9.4% in mildly hypercholesterolemic men. A meta-analysis also found significant reductions in plasma lipids.

Meta-analyses and RCTs show Pycnogenol significantly reduces LDL-cholesterol and raises HDL-cholesterol. A 200-woman peri-menopausal RCT found 9.9% LDL reduction and 4.6% HDL increase after 6 months of 200 mg/day. The meta-analysis confirmed LDL reduction of WMD −7.12 mg/dl and HDL increase of +3.27 mg/dl.

Plant sterols competitively inhibit intestinal cholesterol absorption and consistently lower LDL-C by 8–15% at 2–3 g/day. EFSA and major dyslipidemia guidelines recognize their LDL-lowering health claim.

A 2024 systematic review and meta-analysis of 29 RCTs found Plantago consumption significantly reduced total cholesterol by 0.28 mmol/L and LDL-C by 0.35 mmol/L. The FDA has approved a health claim for psyllium fiber's cholesterol-lowering effect. Soluble fiber from psyllium husks traps bile acids in the gut, reducing hepatic cholesterol recycling.

A 2024 systematic review and meta-analysis of 29 RCTs (n=2769) found Plantago consumption significantly reduced total cholesterol by 0.28 mmol/L and LDL-C by 0.35 mmol/L versus control. Effects were attributable primarily to psyllium/Plantago husk and soluble fiber. A single RCT (n=125, double-blind, placebo-controlled) also confirmed cholesterol lowering with psyllium in type 2 diabetes patients.

Platycodon saponins, fermented extracts, and polysaccharides consistently reduce total cholesterol and LDL while increasing HDL in high-fat-diet and diabetic animal models. Platycodin D inhibits lipase and intestinal fat absorption genes. A human clinical trial (NCT04023864) reported blood lipid-lowering effects in obese patients.

Multiple animal studies demonstrate platycodon root saponins and dietary powder reduce total cholesterol, LDL-C, and increase HDL-C. A 1996 rat study found 5% dietary platycodon significantly decreased serum and liver cholesterol. Platycodin D enhances LDL receptor (LDLR) expression and LDL uptake in hepatic cells, providing a direct molecular mechanism.

Policosanol (long-chain aliphatic alcohols from sugarcane wax) has been studied for LDL-C lowering. Original Cuban RCTs reported significant LDL reductions, but most independent European and North American trials failed to replicate these results. Evidence is classified as modest and inconsistent by authoritative sources.

A 2025 cardiometabolic meta-analysis found pomegranate supplementation significantly reduced total cholesterol (SMD: −0.12, p=0.04) and elevated HDL-c. A 2023 ScienceDirect systematic review and meta-analysis specifically on lipid profiles confirms reductions in total cholesterol and LDL, with some studies also showing TG and VLDL improvements. Evidence for LDL-oxidation protection is particularly strong.

Naringin extracted from pomelo peel significantly reduces total cholesterol and LDL-C while raising HDL-C in hyperlipidemic animal models. Pomelo extract reduced LDL cholesterol by up to 41% and raised HDL by 8.87% in rat studies. A human clinical trial with naringin (400 mg/day for 8 weeks) in hypercholesterolemic subjects demonstrated reduced plasma total cholesterol and LDL.

Multiple human clinical trials and a systematic review of RCTs demonstrate that Opuntia ficus-indica consumption, particularly cladodes, can significantly reduce total cholesterol and LDL cholesterol. Effects appear within 14 days and are largely attributed to high pectin/fiber content.

Animal studies, including in laying hens, show FLL supplementation reduces total cholesterol, LDL cholesterol, and triglycerides while elevating HDL cholesterol. ScienceDirect also documents hypolipidemic activity among FLL's pharmacological effects. Human data are absent.

Propionate inhibits cholesterol biosynthesis from acetate in hepatocytes and has been shown in human trials to alter lipid profiles, including increasing HDL-C by 9.5% in a 7-week RCT. Long-term colonic propionate delivery reduced hepatic cholesterol synthesis and intrahepatocellular lipid in overweight humans. Human hepatocyte studies have found species-specific differences, with rat but not human hepatocytes showing robust direct propionate-mediated cholesterol synthesis inhibition.

A systematic review and meta-analysis of RCTs (PMC, 2023) found plum/prune supplementation significantly reduces LDL-cholesterol in pooled samples (WMD = −11.52 mg/dL, p=0.03), particularly in unhealthy subjects and when dried prune is consumed for >8 weeks. A study in moderately hypercholesterolaemic patients on 100 g/day for 6 weeks showed significant reductions in total cholesterol, LDL, and the LDL/HDL atherogenicity index. Results across trials are mixed, with one large RCT in healthy postmenopausal women showing no significant lipid effects.

Prunus domestica prune consumption has been shown in clinical trials to reduce total cholesterol (TC) and LDL cholesterol and improve the LDL/HDL ratio. A placebo-controlled RCT of 48 hypercholesterolemic subjects found 100 g/day prune juice for 6 weeks significantly reduced TC, LDL-c, and LDL/HDL ratio. A meta-analysis by Askarpour et al. confirmed significant improvement in TC and LDL-c.

Psyllium soluble fiber consistently reduces total and LDL cholesterol. A clinical study found 10.2 g/day reduced LDL-C by 7% and TC by 4% (p<0.0001) over 8 weeks. The FDA has approved a health claim for psyllium and heart disease risk reduction.

P. marsupium flavonoids significantly reduce total cholesterol, LDL, and VLDL in hyperlipidemic animal models. Pterostilbene from P. marsupium has also been evaluated in a clinical trial on individuals with elevated cholesterol.

Pumpkin seed oil and whole seeds have demonstrated LDL-C lowering and HDL-C improvements in animal atherogenesis models, and modest lipid improvements in human studies. The primary mechanism is competitive inhibition of intestinal cholesterol absorption by plant sterols. Human RCT evidence exists but is limited to small samples.

Aqueous B. diffusa leaf extract has been shown in animal studies to reduce serum and tissue cholesterol significantly in diabetic rats. This was observed alongside triglyceride and free fatty acid reductions. Evidence remains preclinical only.

Meta-analyses of RCTs demonstrate purslane significantly reduces total cholesterol and raises HDL-C. The 2023 13-RCT meta-analysis found total cholesterol decreased by −9.97 mg/dL (p=0.048) and HDL-C increased by +4.09 mg/dL (p=0.001). LDL-C was not significantly affected. Phytosterols, omega-3 fatty acids, and flavonoids are proposed active agents.

Pycnogenol (French maritime pine bark extract, rich in OPCs) has been shown in RCTs to modestly reduce total cholesterol and LDL-C while improving endothelial function. Its primary relevant mechanism is reduction of LDL oxidation and anti-inflammatory effects on the arterial wall.

A double-blind, placebo-controlled RCT (n=29, 20 mg/day, 12 weeks) in healthy adults with elevated LDL examined PQQ's effects on LDL-cholesterol and total cholesterol. Preclinical data and a rodent study on PCSK9 inhibition also support a cholesterol-modulating effect.

Multiple human RCTs and meta-analyses have examined quercetin's effect on lipid profiles, with results that are mixed but documented. One meta-analysis found significant reductions in HDL-C and triglycerides after 8 or more weeks of supplementation in parallel-design trials. An earlier meta-analysis found only a significant reduction in triglycerides at doses above 50 mg/day, with no clinically relevant effect on total cholesterol or LDL. Mechanistically, quercetin suppresses lipid aggregation and reduces LDL oxidation.

A human clinical study found that a blend of Quillaja saponaria and Yucca schidigera extracts reduced total and LDL cholesterol in hypercholesterolemic patients over four weeks. Mechanistic in vitro studies confirm that Quillaja dry saponin extract reduces cholesterol bioaccessibility by precipitating cholesterol and displacing it from dietary mixed micelles.

A systematic review and meta-analysis of eight human intervention studies found quinoa consumption significantly reduced total cholesterol (WMD −0.27 mmol/L) and LDL-cholesterol (WMD −0.21 mmol/L). Clinical trials with quinoa cereal bars and biscuits showed reductions in total and LDL-C in healthy older adults and overweight women. Mechanistically, quinoa's unsaturated fatty acids, dietary fiber, and bile acid-binding capacity are implicated.

Animal studies demonstrate that radish extracts—particularly purple radish—significantly reduce LDL-cholesterol and total cholesterol in hyperlipidemic models, while also attenuating atherosclerotic plaque formation. Radish seed glucosinolate extract similarly reduced total cholesterol in obese mice. Evidence is entirely preclinical.

Multiple RCTs and two meta-analyses have examined red clover isoflavones and serum lipids. A 2020 meta-analysis (10 RCTs, n=910) found significant total cholesterol reduction; a 2022 meta-analysis added significant HDL increases. Results are mixed for LDL, with some individual trials showing significant LDL reductions and others showing no effect. Effects appear most consistent in postmenopausal women with dyslipidemia.

Red yeast rice contains monacolin K, structurally identical to lovastatin, which inhibits HMG-CoA reductase and lowers LDL-C by 15–25% within 6–8 weeks. A 5,000-patient Chinese RCT over 4.5 years showed a 17.6% LDL reduction and 30% reduction in cardiovascular mortality. It is considered the most effective cholesterol-lowering nutraceutical.

R. glutinosa extracts and catalpol reduce total cholesterol and LDL-C while increasing HDL-C in multiple diabetic animal models. Water extracts of dried Rehmanniae Radix significantly decreased serum cholesterol in STZ-induced hyperglycemic rats. The polysaccharide fraction also lowers TC in diabetic mice.

Reishi contains ganoderic acids that inhibit HMG-CoA reductase (the same enzyme targeted by statins), providing a mechanistic basis for cholesterol lowering. Animal studies confirm LDL reduction and HDL elevation. However, the Cochrane systematic review (2015) found no significant total cholesterol or LDL reduction in five pooled RCTs. RxList notes reishi does not appear to lower cholesterol in diabetic or hypertensive patients.

Resveratrol reduces TC, LDL-C, and triglycerides through inhibition of cholesterol ester formation, increased bile acid excretion, and oxidized LDL reduction. A meta-analysis of 17 RCTs (968 participants) found significant TC (−0.27 mmol/L), TG (−0.10 mmol/L), and LDL-C (−0.147 mmol/L) reductions with a dose-dependent response.

Both preclinical reviews and human clinical data link rhubarb root to reductions in total cholesterol, LDL, and triglycerides. A 2025 randomized human trial found that green tea with rhubarb root reduced plasma lipid levels over 21 days. Rhubarb anthraquinones regulate lipid metabolism via PPAR-α, AMPK, and C/EBP-α signaling pathways.

Robusta coffee intake in a 10-week rat model raised plasma total cholesterol and HDL in the robusta group versus arabica and control, attributed to robusta's distinct bioactive profile. Green coffee CGA supplementation in a human RCT significantly reduced serum cholesterol in PCOS patients. Robusta coffee diterpenes (cafestol, kahweol) can raise LDL when unfiltered coffee is consumed, while CGA reduces LDL oxidation.

Rosehip supplementation has shown significant reductions in total cholesterol and LDL cholesterol in multiple RCTs. A 6-week RCT (n=31) with 40 g rosehip powder daily demonstrated reductions in total cholesterol and LDL. A 2023 systematic review of RCTs found significant LDL reductions as a primary outcome, though results are mixed across studies.

A double-blind crossover RCT found that 40 g/day rose hip powder for 6 weeks significantly reduced total plasma cholesterol by 4.9% and LDL cholesterol by 6.0% in obese subjects, with even greater reductions (8.6% LDL) in those not on statins. HDL cholesterol was unaffected. The high dietary fiber content of rose hip and its polyphenolic antioxidants are proposed as mechanisms.

Rosmarinic acid demonstrated significant total cholesterol and LDL-related lipid-lowering effects in high-fat-diet-fed mouse models, mediated by upregulation of hepatic SR-B1 and LDL receptor expression via the reverse cholesterol transport pathway. In vitro, RA also countered oleic-acid-induced cholesterol accumulation in hepatocytes.

Multiple meta-analyses of RCTs confirm RJ significantly lowers total cholesterol and LDL. A 2023 GRADE meta-analysis of 8 RCTs found significant TC reduction, especially at doses ≥3,000 mg/day for ≥8 weeks. Effects on HDL are inconsistent. Triglycerides and HDL changes are less reliably demonstrated.

A randomized, double-blind, placebo-controlled trial found monoglucosyl rutin reduced LDL-cholesterol in Japanese adults with mild hypercholesterolemia. A separate RCT in type 2 diabetes patients also showed reductions in LDL and total cholesterol after 500 mg/day rutin. Preclinical evidence supports lipid-lowering mechanisms.

Multiple clinical studies link whole-grain rye to LDL-cholesterol reduction. The SYSDIET secondary analysis found the rye biomarker ratio inversely associated with LDL, non-HDL cholesterol, and apolipoprotein B. A 2020 crossover RCT in metabolic syndrome directly showed WG rye caused transient LDL-cholesterol reduction versus WG wheat.

Safflower oil is one of the richest dietary sources of linoleic acid (≈75%), a polyunsaturated fatty acid that reduces LDL and total cholesterol. A network meta-analysis of 54 randomized trials ranked safflower oil highest for LDL-C reduction (SUCRA 82%) and total cholesterol reduction (SUCRA 90%) among common cooking oils. A separate clinical trial (n=37 healthy adults, 24 g/day) showed significant reductions in total cholesterol and LDL.

Multiple meta-analyses of RCTs demonstrate that saffron significantly reduces total cholesterol and triglycerides, with some evidence for LDL reduction and HDL elevation. A 2022 meta-analysis of 32 RCTs (n=1,674) found significant decreases in TG (−8.81 mg/dl), TC (−6.87 mg/dl), and LDL (−6.71 mg/dl). A 2019 meta-analysis found no significant LDL effect but confirmed TC and TG reductions.

Multiple RCTs and a meta-analysis demonstrate that sage leaf extract significantly lowers total cholesterol and LDL while raising HDL in hyperlipidemic patients. A meta-analysis of 4 RCTs showed reductions in total cholesterol of approximately 52 mg/dL. Mechanisms include PPARγ agonism and pancreatic lipase inhibition.

Sterols isolated from Smilax glabra (beta-sitosterol, stigmasterol) are documented in a PMC review to have cholesterol-lowering pharmacological activity. Smilax aristolochiifolia reduced hypertriglyceridemia by ~60% in obese mice. Evidence is preclinical; no human lipid trials for sarsaparilla have been conducted.

In mice with high cholesterol, oral schisandra significantly reduced triglycerides and LDL cholesterol while increasing HDL. A human RCT with Omija (schisandra) extract mixture found significantly decreased LDL cholesterol in hyperglycemic subjects after 12 weeks versus placebo.

Poria cocos sclerotium extract exhibits hypolipidemic effects in preclinical models, reducing aberrant lipid accumulation and modulating lipid metabolism pathways. Pharmacological reviews classify hypolipidemic activity as a confirmed pharmacological effect of Poria cocos.

A 2024 randomized, parallel, double-blind, placebo-controlled human clinical trial (n=72 adults with borderline LDL-C) demonstrated that SDG at 60 mg/day for 12 weeks significantly reduced LDL-C and total cholesterol in male participants. SDG enterolignans upregulate LDL receptor activity in hepatocytes and reduce hepatic cholesterol synthesis. Animal models consistently show decreased LDL-C, VLDL-C, and total cholesterol with SDG treatment.

Clinical evidence on sesame and cholesterol is mixed but leans positive, particularly for LDL and total cholesterol in metabolic disease populations. A meta-analysis of 13 RCTs in type 2 diabetes showed significant reductions in LDL-C (WMD −29.72 mg/dL) and total cholesterol (WMD −32.76 mg/dL). An earlier meta-analysis (2016) found no significant effect in general populations but did find triglyceride reduction. Sesame lignans and phytosterols are the primary proposed mechanisms.

Shiitake contains eritadenine and beta-glucans that modulate cholesterol metabolism. Animal studies robustly show LDL reduction; human RCT data are limited but supportive. A double-blind RCT in borderline-high-cholesterol adults reported improvements in lipid markers over 66 days. Systematic reviewers note the overall quality of human evidence remains preliminary.

Clinical evidence indicates silymarin modestly but significantly reduces total cholesterol, LDL, and triglycerides. A 2024 dose-response meta-analysis of 33 RCTs (1,943 participants) found TC reduced by ~14 mg/dL, LDL by ~17 mg/dL, and TG by ~26 mg/dL vs. placebo. Proposed mechanisms include partial HMG-CoA reductase inhibition, reduced cholesterol absorption, and improved LDL receptor expression. HDL effects are inconsistent.

Sitostanol (the saturated derivative of beta-sitosterol) inhibits intestinal cholesterol absorption and lowers LDL-C by 8–15% at 2–3 g/day. EFSA endorses a health claim for plant stanols including sitostanol for LDL-C reduction.

Smilax saponins bind cholesterol in the intestinal tract, potentially reducing absorption, and this mechanism has been proposed since the 1980s. Early clinical observations described steroidal saponins reducing blood cholesterol. Pre-clinical data on S. china show lipid accumulation inhibition. Evidence remains largely mechanistic and animal-based.

Animal studies demonstrate that S. japonica extract reduces total cholesterol, raises HDL-cholesterol, and lowers LDL-cholesterol in high-fat diet models. Rutin at 500 mg/day reduced plasma LDL in diabetic hypertensive patients in a human study. Quercetin glycosides also show lipid-lowering potential by inhibiting LDL oxidation.

A. muricata extracts reduce total cholesterol, triglycerides, LDL, and VLDL in rodent models of hypertension and diabetes. The hypolipidemic effect is linked to antioxidant activity and phenolic content and is noted in multiple pharmacological reviews.

Soy protein modestly reduces LDL-C through hepatic SREBP modulation and increased bile salt excretion. The FDA approved a qualified health claim for soy protein (25 g/day) for coronary heart disease risk reduction. Meta-analyses of RCTs confirm approximately 4–6% LDL-C reductions.

Soy isoflavones (genistein, daidzein) modulate lipid metabolism through estrogen receptor pathways and hepatic LDL receptor upregulation. Meta-analyses report modest TC and LDL-C reductions; evidence is more variable than for soy protein as a whole.

Soy protein at 25 g/day has an FDA qualified heart health claim for coronary heart disease risk reduction. Meta-analyses of RCTs confirm consistent modest LDL-C reductions via SREBP modulation and increased LDL receptor clearance.

Soy protein has well-documented LDL-cholesterol-lowering effects, leading to FDA and Health Canada regulatory approval of a cardiovascular health claim. A meta-analysis of 46 trials confirmed soy protein significantly reduces LDL and total cholesterol in adults. The average effect across randomized trials is modest (approximately 3–5% reduction in LDL), with larger effects in hypercholesterolemic individuals. Soy isoflavones alone show minimal independent lipid-lowering effect.

Antihyperlipidemic activity is among the scientifically evidenced properties of S. indicus, supported by preclinical studies in diabetic rat models and the Meratrim blend meta-analysis in obese humans, which showed improvements in lipid profiles.

Spinach phytochemicals including glycolipids, thylakoids, and fiber exhibit hypolipidemic properties in preclinical and early clinical evidence. The 2025 comprehensive ScienceDirect review identifies hypolipidemic activity among spinach's evidence-based biological activities, and thylakoid supplementation trials report effects on lipid profiles.

A meta-analysis of 7 RCTs found spirulina supplementation significantly reduced total cholesterol (MD: −11.83 mg/dL) and triglycerides (MD: −15.34 mg/dL) in adults with obesity, diabetes, or dyslipidemia. Human studies also consistently report increases in HDL-cholesterol. Proposed mechanisms include HMG-CoA reductase inhibition, decreased intestinal cholesterol absorption, and phycocyanin-mediated decreases in serum total cholesterol and atherogenic index.

Squalene is an intermediate in the cholesterol biosynthesis pathway, positioned between farnesyl pyrophosphate and lanosterol, bypassing HMG-CoA reductase. Human clinical evidence is mixed: one RCT reported significant reductions in total cholesterol and LDL-C with 860 mg/day supplementation, while other human studies found no change or increased cholesterol synthesis. Animal evidence is similarly contradictory.

Human evidence on stevia's effects on cholesterol is mixed. One study in 20 women with hypercholesterolemia found stevia leaf extract reduced total cholesterol and LDL while raising HDL. A 24-week controlled trial in diabetic patients similarly showed lipid profile improvement. However, meta-analyses of multiple RCTs found no significant overall effects of stevia-based sweeteners on total cholesterol, LDL, or HDL.

Multiple human RCTs have measured cholesterol parameters as endpoints for SG supplementation. Meta-analyses show non-significant trends toward reduced total cholesterol and HDL-C, with non-significant trends toward increased LDL-C. No statistically significant effects on any cholesterol fraction have been confirmed in human trials.

Stigmasterol is a plant sterol with an extra double bond at C-22 that inhibits intestinal cholesterol absorption as part of the phytosterol class. EFSA endorses a health claim for plant sterols including stigmasterol for LDL-C reduction at 2–3 g/day.

Strawberry interventions show significant LDL-cholesterol reduction in people with elevated baseline LDL, and improve atherogenic small-dense LDL particle concentrations. A meta-analysis of 11 RCTs found a significant reduction in LDL-C in those with LDL >3 mmol/L at baseline. A broader berry meta-analysis (22 RCTs, n=1,251) found significant pooled LDL reduction of 0.21 mmol/L.

In vitro studies show S. thermophilus strains can assimilate cholesterol, with one strain (MCC0200) demonstrating 43% cholesterol assimilation in simulated intestinal fluid. Animal data (heat-killed S. thermophilus in diabetic ZDF rats) showed reductions in total cholesterol alongside blood glucose improvements. Human clinical data for cholesterol-lowering specifically from S. thermophilus remain limited.

In HFD-induced obese mice, succinic acid supplementation decreased serum TG, TC, and LDL-C while increasing HDL-C. Menopausal RCTs also assessed apolipoprotein A1 and B levels and reported favorable changes. Evidence is currently limited to animal and perimenopausal studies.

Sulforaphane reduces oxidized LDL/LDL ratio and triglycerides in human RCTs, and inhibits endothelial lipase (protecting HDL) via NF-κB suppression. Broccoli sprout powder improved lipid profiles in type 2 diabetic patients in published clinical trials.

Multiple human clinical trials demonstrate that sunflower seed oil and seeds reduce LDL cholesterol when substituted for saturated fats. High-oleic-acid sunflower oil specifically lowers LDL and triglycerides. Sunflower seeds in dyslipidemia patients produced significant cholesterol reductions in a controlled trial. The American Heart Association has reviewed linoleic acid (the dominant PUFA in sunflower) and concluded it lowers coronary heart disease risk.

Multiple RCTs and a dyslipidemia intervention trial show that sunflower oil consumption significantly reduces total cholesterol, LDL-C, and triglycerides, while increasing HDL-C, compared to baseline in people with dyslipidemia. High-oleic varieties specifically show favorable effects on LDL and HDL. Some studies show HDL may also decrease with linoleic-acid-rich sunflower oil compared to other oils.

Preclinical studies consistently show A. calamus reduces total cholesterol and LDL in diabetic and normal animal models. A small clinical study in ischemic heart disease patients reported decreased serum cholesterol. The 2013 pharmacological review lists 'hypolipidemic' among validated A. calamus activities.

Taurine reduces total cholesterol and LDL cholesterol in meta-analyses of RCTs. Mechanistically, it decreases HMG-CoA reductase activity, enhances LDL receptor expression, and increases 7α-hydroxylase activity to accelerate cholesterol conversion to bile acids.

Terminalia arjuna and T. chebula both show clinically documented lipid-lowering activity. A randomized controlled trial in 105 coronary heart disease patients found T. arjuna bark significantly reduced total and LDL cholesterol with antioxidant effects comparable to vitamin E. A clinical trial in dyslipidemic patients with T. chebula also showed significant decreases in total and LDL cholesterol.

Animal studies demonstrate that thyme essential oil significantly decreases total cholesterol, LDL, and triglycerides while increasing HDL, effects attributed to antioxidant modulation of lipid metabolism. Thymol's antihyperlipidemic mechanism involves membrane stabilization and modulation of lipoprotein circulating levels. Human clinical data are absent; evidence is preclinical.

Clinical and animal studies show T. cordifolia reduces total cholesterol and beta-lipoprotein levels, stimulates plasma LCAT activity, and partially recovers alpha-lipoprotein levels. The 14-day clinical trial in type 2 diabetic patients showed significant decreases in cholesterol alongside triglycerides.

Multiple RCTs and meta-analyses show tocotrienols lower total cholesterol, LDL-cholesterol, and raise HDL in hypercholesterolemic subjects. The mechanism involves suppression of the hepatic mevalonate/HMG-CoA reductase pathway, distinct from statins. Effect sizes are modest and results across trials are not entirely consistent.

Tomato consumption is associated with modest but significant reductions in LDL-cholesterol in clinical meta-analyses. A meta-analysis of 21 intervention trials found tomato supplementation reduced LDL by −0.22 mmol/L. The mechanism involves lycopene inhibiting an enzyme in the cholesterol synthesis pathway. Effects on triglycerides and HDL remain inconsistent.

GGOH is a downstream intermediate of the same mevalonate pathway that produces cholesterol, and it acts at a branch point after the cholesterol-production step. GGOH supplementation has been shown in vitro to prevent statin cytotoxicity in human cells without reducing the cholesterol-lowering efficacy of statins. This distinguishes GGOH from other mevalonate intermediates and makes it relevant in the context of statin-managed hypercholesterolemia.

Human RCT evidence shows pterostilbene monotherapy increases LDL cholesterol (by ~17 mg/dL, p=0.001) in hypercholesterolemic adults, an effect attenuated by concurrent cholesterol medication. HDL and triglycerides were not significantly changed. PTE also modulates PCSK9/LDLR pathways in cardiomyocytes.

Human RCT data show that tribulus extract (1000 mg/day) significantly reduced total cholesterol and LDL in diabetic women over 3 months, with no significant change in triglycerides or HDL. Animal data also support a lipid-lowering effect via saponins.

T. kirilowii seed oil with flavonoids and peel polysaccharide both significantly reduced total cholesterol and LDL-cholesterol in hyperlipidemic mice. T. dioica aqueous fruit extract showed cholesterol-lowering activity in STZ diabetic rats. All evidence is preclinical.

A 2021 systematic review of 12 RCTs (749 patients) found Triphala significantly reduced LDL-cholesterol, total cholesterol, and triglycerides in 6 studies. A safety trial also showed improved HDL-C. Mechanisms include HMG-CoA reductase inhibition, reduced cholesterol absorption, and downregulation of adipogenic genes.

Meta-analyses of RCTs confirm turmeric/curcumin significantly reduces LDL-C and triglycerides while showing trends for HDL-C improvement in patients with cardiovascular risk factors. A 2017 Nutrition Journal meta-analysis of 7 RCTs (649 patients) found significant LDL-C reduction (SMD = −0.340). A 2025 RCT additionally confirmed LDL-C reduction and HDL-C increase.

CoQ10 does not substantially lower total LDL cholesterol in clinical trials, but ubiquinol specifically protects LDL particles from oxidative modification, which is more relevant to cardiovascular risk than cholesterol quantity alone. In PCOS women, CoQ10 reduced total cholesterol and LDL while increasing HDL. A 2024 umbrella review confirmed modest effects on the overall lipid profile.

Several human clinical trials in diabetic patients have documented reductions in total cholesterol and LDL-cholesterol following vanadium supplementation. A long-term (30-month) study in type 1 diabetics showed decreased plasma total cholesterol with vanadyl sulfate. Animal studies consistently show cholesterol-lowering effects; human data are supportive but based on small, short trials.

Human clinical trials show that vanadyl sulfate at higher doses (300 mg/day) can reduce total cholesterol in type 2 diabetic patients, though this is accompanied by a concurrent decrease in HDL cholesterol. Animal data broadly support hypolipidemic effects including LDL and VLDL reduction.

Niacin (nicotinic acid) raises HDL-C, reduces triglycerides, and modestly lowers LDL-C. It inhibits diacylglycerol acyltransferase-2 and increases hepatic apoB degradation. Despite the AIM-HIGH trial showing no added cardiovascular benefit when combined with statins, niacin remains used in dyslipidemia management for statin-intolerant patients.

The vitamin B5 derivative pantethine has demonstrated clinically significant reductions in LDL and total cholesterol in multiple RCTs and a systematic review. The NIH ODS reports that a 2005 review of 28 trials found total cholesterol declines of 8.7–15.1% with pantethine supplementation. Pantothenic acid itself does not appear to produce equivalent effects.

A meta-analysis of 13 RCTs found that at least 500 mg/day of vitamin C for a minimum of four weeks significantly reduced serum LDL cholesterol and triglycerides, with a non-significant elevation in HDL. Effects are more pronounced in individuals with higher baseline cholesterol. Clinical results are inconsistent at lower doses or shorter durations.

Vitamin E consistently and significantly inhibits the oxidation of LDL cholesterol—a key mechanistic step in atherosclerosis—as confirmed by a 2025 meta-analysis of 21 clinical trials. Effects on total cholesterol or LDL particle levels are generally neutral, but reduction of oxidized LDL is robust.

In rat models, wasabi supplementation decreased total plasma cholesterol in both normal-diet and high-fat diet animals. Allyl isothiocyanate from wasabi also reduced total cholesterol in diabetic rodents. The mechanism likely involves AMPK activation and PPARγ/PPARα modulation affecting lipid metabolism. Human evidence is absent.

Human RCT data show watercress supplementation can reduce LDL cholesterol and modestly reduce total cholesterol. Clemente et al. (2021) found a significant post-intervention difference in LDL versus placebo. The 2025 systematic review of 7 RCTs reported mean decreases in total cholesterol and noted LDL improvement in at least one trial.

Clinical evidence from RCTs and meta-analyses indicates that watermelon consumption and lycopene supplementation can reduce LDL cholesterol and improve HDL levels, particularly in overweight and cardiovascular-risk individuals. Effects in healthy normolipidemic individuals are less consistent.

Whole-grain wheat consumption has been associated with modest reductions in LDL cholesterol and total cholesterol in several RCTs, though effect sizes are smaller than for oat-based whole grains. Meta-analyses of whole-grain diets show LDL reductions compared to refined grain controls; wheat-specific effects are less consistent than oats due to lower soluble fiber content.

Wheat germ contains phytosterols and fiber that mechanistically inhibit intestinal cholesterol absorption. One RCT in T2DM patients found significant total cholesterol reduction at 20 g/day over 12 weeks. A meta-analysis of five RCTs, however, showed non-significant pooled effects. Phytosterol-replete wheat germ has also been specifically shown to reduce cholesterol absorption in a human clinical study.

A human RCT demonstrated that 3.5 g/day of freeze-dried wheatgrass powder for 10 weeks reduced total cholesterol by 5.4%, LDL by 4.4%, and triglycerides by 9.5% in hyperlipidemic women. Animal studies consistently show lipid-lowering and HDL-raising effects. This is among the strongest areas of human clinical evidence for wheatgrass.

A 2025 meta-analysis of 21 RCTs found whey protein reduced LDL-cholesterol in adults under 50 and when combined with exercise, and lowered total cholesterol in overweight individuals and when combined with exercise. HDL-cholesterol was not significantly affected. A separate meta-analysis in metabolic syndrome patients found significant reductions in total cholesterol, LDL-cholesterol, and TC/HDL ratio.

Diosgenin from wild yam has been shown in animal studies to reduce total and LDL cholesterol and raise HDL, by inhibiting cholesterol absorption. A small human clinical trial by Araghiniknam et al. (1996) found raised HDL in elderly adults. The Komesaroff et al. (2001) crossover RCT found no significant lipid changes after 3 months of topical wild yam cream. Human evidence is mixed and limited.

Human clinical data in T2DM patients show XOS (4 g/day, 8 weeks) significantly reduced total cholesterol, LDL cholesterol, oxidized LDL, and apolipoprotein B. Animal studies confirm XOS reduces total cholesterol and LDL while increasing HDL in high-fat-diet models, partly through AMPK pathway activation and increased bile acid conversion.

In a 2020 PMC study in STZ-diabetic rats, yarrow hydroalcoholic extract significantly reduced total cholesterol and LDL-cholesterol while increasing HDL-cholesterol, with effects comparable to metformin. The anti-hyperlipidemic effect is corroborated by earlier Achillea species pharmacological reviews.

Multiple human studies—from small RCTs and semi-experimental trials—report significant reductions in total cholesterol and LDL-C and increases in HDL-C with brewer's yeast supplementation. Effects are attributed primarily to chromium-GTF activity and potentially to beta-glucan and yeast cell wall fractions. Results are mixed across studies, with some showing no lipid changes.

Human trials show yerba mate can reduce LDL-cholesterol and increase HDL-cholesterol, particularly in dyslipidemic individuals or those on statin therapy. A 2022 systematic review and meta-analysis found mixed results across pooled studies, with the strongest individual trial signals in hypercholesterolemic populations.

A human study (Kim et al. 2003, Arch Pharm Res) administered a blend of Yucca schidigera and Quillaja saponaria extracts to hypercholesterolemic patients for four weeks, observing decreases in total and LDL cholesterol. Saponins bind cholesterol in the gut by forming insoluble complexes, reducing reabsorption. Earlier human reports by Bingham (1978) also noted cholesterol reduction alongside blood pressure effects.

Multiple preclinical studies demonstrate cholesterol-lowering effects of Zanthoxylum extracts. Z. heitzii extract prevented elevation of hepatic LDL, VLDL, and total cholesterol in hypercholesterolemic rats; Z. armatum extracts significantly reduced serum cholesterol in diabetic mice; and Z. bungeanum fractions inhibited HMG-CoA reductase more effectively than simvastatin in cell studies.

Animal studies consistently show caraway extracts reduce total cholesterol and LDL while raising HDL. One human RCT found no significant change in lipid profiles, though the evidence base for cholesterol effects in humans is limited. Preclinical evidence is consistent, but clinical evidence in humans is insufficient to confirm a cholesterol-lowering effect.

Animal and in vitro studies show that Agaricus bisporus extracts and ergosterol-rich fractions can reduce total cholesterol, raise HDL, and modulate cholesterol-related gene expression (LDLR, SREBP). No controlled human clinical trials have demonstrated cholesterol-lowering in humans. Evidence is preclinical only.

Elderberry polyphenols are associated with improved lipid profiles in animal models, with elderberry feeding shown to produce more favorable serum lipid profiles in hypertensive rats. Traditional use as a 'blood purifier' encompassed lipid-related concepts. No direct human clinical trials exist.

Guggul resin is used in Ayurvedic medicine as a traditional lipid-lowering agent classified as medohar (fat-reducing). However, controlled human clinical trials have not confirmed cholesterol lowering; one well-controlled RCT of 103 patients found guggulsterones increased LDL by 4–5% with no benefit on TC, HDL, or TG.

Guggulsterones (E and Z isomers from Commiphora mukul) are Ayurvedic cholesterol-lowering agents with FXR antagonist activity. Clinical trials have failed to confirm LDL-lowering; one well-controlled RCT showed a 4–5% LDL increase. They are included due to traditional use and presence in authoritative supplement reviews.

The Restorative Medicine clinical monograph lists hyperlipidemia (high cholesterol) as a documented traditional indication for Rehmannia. Preclinical evidence shows catalpol reduces hepatic lipid accumulation via AMPK/TFEB autophagy pathway activation, which has indirect relevance to cholesterol metabolism.

Thymol and carvacrol have been shown to inhibit HMG-CoA reductase activity—the key enzyme in endogenous cholesterol biosynthesis—in preclinical studies. Animal studies and a pig model study demonstrated reduction in blood triglycerides and cholesterol with thyme supplementation. No human clinical trials for cholesterol management with T. vulgaris have been published.

Hypolipidemic activity is attributed to Tylophora indica in multiple phytopharmacological review papers, listing it among the plant's diverse pharmacological properties. The plant contains phytosterols and saponins — constituents known to interfere with cholesterol absorption. No human clinical trial evaluating Tylophora's effect on serum lipids has been published.

Preclinical animal studies show MP seed extract at 200–400 mg/kg reduces serum total cholesterol, triglycerides, VLDL, and LDL, while increasing HDL in hypercholesterolemic rats. Free radical scavenging antioxidants in MP may prevent LDL oxidation. No human clinical trial data exist for cholesterol outcomes.