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Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

  • Simone Eussen (a1) (a2), Olaf Klungel (a2), Johan Garssen (a2), Hans Verhagen (a1), Henk van Kranen (a1), Henk van Loveren (a1) and Cathy Rompelberg (a1)...


Functional foods and dietary supplements might have a role in supporting drug therapy. These products may (1) have an additive effect to the effect that a drug has in reducing risk factors associated with certain conditions, (2) contribute to improve risk factors associated with the condition, other than the risk factor that the drug is dealing with, or (3) reduce drug-associated side effects, for example, by restoring depleted compounds or by reducing the necessary dose of the drug. Possible advantages compared with a multidrug therapy are lower drug costs, fewer side effects and increased adherence. In the present review we have focused on the support of statin therapy using functional foods or dietary supplements containing plant sterols and/or stanols, soluble dietary fibre, n-3 PUFA or coenzyme Q10. We conclude that there is substantial evidence that adding plant sterols and/or stanols to statin therapy further reduces total and LDL-cholesterol by roughly 6 and 10 %, respectively. Adding n-3 PUFA to statin therapy leads to a significant reduction in plasma TAG of at least 15 %. Data are insufficient and not conclusive to recommend the use of soluble fibre or coenzyme Q10 in patients on statin therapy and more randomised controlled trials towards these combinations are warranted. Aside from the possible beneficial effects from functional foods or dietary supplements on drug therapy, it is important to examine possible (negative) effects from the combination in the long term, for example, in post-marketing surveillance studies. Moreover, it is important to monitor whether the functional foods and dietary supplements are taken in the recommended amounts to induce significant effects.

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Corresponding author

*Corresponding author: Dr O. H. Klungel, fax +31 30 253 9166, email


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1 Guinness Centre (2004) Global Market Review of Functional Foods – Forecasts to 2010. Dublin: Guinness Centre.
2 Crowley, R & FitzGerald, LH (2006) The impact of cGMP compliance on consumer confidence in dietary supplement products. Toxicology 221, 916.
3 de Jong, N, Klungel, OH, Verhagen, H, et al. (2007) Functional foods: the case for closer evaluation. BMJ 334, 10371039.
4 Mantel-Teeuwisse, AK, Verschuren, WM, Klungel, OH, et al. (2003) Undertreatment of hypercholesterolaemia: a population-based study. Br J Clin Pharmacol 55, 389397.
5 Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (2001) Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 285, 24862497.
6 Jones, PH, Davidson, MH, Stein, EA, et al. (2003) Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR* Trial). Am J Cardiol 92, 152160.
7 McKenney, JM, Jones, PH, Adamczyk, MA, et al. (2003) Comparison of the efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals: results from the STELLAR trial. Curr Med Res Opin 19, 689698.
8 Law, MR, Wald, NJ & Rudnicka, AR (2003) Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 326, 1423.
9 Kiortsis, DN, Filippatos, TD, Mikhailidis, DP, et al. (2007) Statin-associated adverse effects beyond muscle and liver toxicity. Atherosclerosis 195, 716.
10 Fincke, BG, Miller, DR & Spiro, A III (1998) The interaction of patient perception of overmedication with drug compliance and side effects. J Gen Intern Med 13, 182185.
11 Cannon, CP (2008) Combination therapy in the management of mixed dyslipidaemia. J Intern Med 263, 353365.
12 Jadad, AR, Moore, RA, Carroll, D, et al. (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17, 112.
13 Plat, J & Mensink, RP (2005) Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects. Am J Cardiol 96, 15D22D.
14 Marinangeli, CP, Varady, KA & Jones, PJ (2006) Plant sterols combined with exercise for the treatment of hypercholesterolemia: overview of independent and synergistic mechanisms of action. J Nutr Biochem 17, 217224.
15 Trautwein, EA (2003) Proposed mechanisms of cholesterol-lowering action of plant sterols. Eur J Lipid Sci Technol 105, 171185.
16 Plat, J & Mensink, RP (2002) Increased intestinal ABCA1 expression contributes to the decrease in cholesterol absorption after plant stanol consumption. FASEB J 16, 12481253.
17 de Jong, A, Plat, J & Mensink, RP (2003) Metabolic effects of plant sterols and stanols (review). J Nutr Biochem 14, 362369.
18 Hegele, RA & Robinson, JF (2005) ABC transporters and sterol absorption. Curr Drug Targets Cardiovasc Haematol Disord 5, 3137.
19 Calpe-Berdiel, L, Escolà-Gil, JC & Blanco-Vaca, F (2009) New insights into the molecular actions of plant sterols and stanols in cholesterol metabolism. Atherosclerosis 203, 1831.
20 Kidambi, S & Patel, SB (2008) Cholesterol and non-cholesterol sterol transporters: ABCG5, ABCG8 and NPC1L1: a review. Xenobiotica 38, 11191139.
21 Castro, IA, Barroso, LP & Sinnecker, P (2005) Functional foods for coronary heart disease risk reduction: a meta-analysis using a multivariate approach. Am J Clin Nutr 82, 3240.
22 de Graaf, J & Stalenhoef, AF (2000) Use of margarine fortified with phytosterols as a therapeutic food (article in Dutch). Ned Tijdschr Geneeskd 144, 918921.
23 Abumweis, SS, Barake, R & Jones, PJ (2008) Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials. Food Nutr Res 52, (epublication 18 August 2008).
24 Demonty, I, Ras, RT, van der Knaap, HC, et al. (2009) Continuous dose–response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr 139, 271284.
25 United States Food and Drug Administration (2003) FDA Letter Regarding Enforcement Discretion With Respect to Expanded Use of an Interim Health Claim Rule About Plant Sterol/Stanol Esters and Reduced Risk of Coronary Heart Disease. (accessed 17 April 2008).
26 United States Food and Drug Administration (2000) Interim Final Rule – Food Labeling: Health Claims; Plant Sterol/Stanol Esters and Coronary Heart Disease.
27 Hallikainen, MA, Sarkkinen, ES, Gylling, H, et al. (2000) Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on a low-fat diet. Eur J Clin Nutr 54, 715725.
28 European Parliament and the Council of the European Union (2006) Regulation (EC) No 1924/2006 of the European Parliament and the Council of 20 December 2006 on nutrition and health claims made on foods. = OJ:L:2007:012:0003:0018:EN:PDF.
29 European Food Safety Authority (2008) Plant Sterols and Blood Cholesterol – Scientific substantiation of a health claim related to plant sterols and lower/reduced blood cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/20061. (accessed 17 April 2008).
30 European Food Safety Authority (2008) Scientific substantiation of a health claim related to plant stanol esters and lower/reduced blood cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/20061. = true.
31 Verhagen, H (2008) The current status of nutrition and health claims in Europe. J Clin Biochem Nutr 43, Suppl. 1, 15.
32 European Parliament and the Council of the European Union (1997) Regulation (EC) No 258/97 of the European Parliament and of the Council of 27 January 1997 concerning novel foods and novel food ingredients. = CELEX:31997R0258:EN:HTML.
33 European Union Science Committee on Food (2000) Opinion of the Scientific Committee on Food on a Request for the Safety Assessment of the Use of Phytosterol Esters in Yellow Fat Spreads.
34 Verhagen, H, Te Boekhorst, J, Kamps, L, et al. (2009) Novel foods: an explorative study into their grey area. Br J Nutr 101, 12701277.
35 Vanhanen, H (1994) Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients. Eur J Clin Pharmacol 47, 169176.
36 Ketomaki, A, Gylling, H & Miettinen, TA (2005) Non-cholesterol sterols in serum, lipoproteins, and red cells in statin-treated FH subjects off and on plant stanol and sterol ester spreads. Clin Chim Acta 353, 7586.
37 Blair, SN, Capuzzi, DM, Gottlieb, SO, et al. (2000) Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am J Cardiol 86, 4652.
38 Goldberg, AC, Ostlund, RE Jr, Bateman, JH, et al. (2006) Effect of plant stanol tablets on low-density lipoprotein cholesterol lowering in patients on statin drugs. Am J Cardiol 97, 376379.
39 Richter, WO (1996) Treatment of severe hypercholesterolemia with a combination of β-sitosterol and lovastatin. Curr Ther Res 57, 497505.
40 Simons, LA (2002) Additive effect of plant sterol-ester margarine and cerivastatin in lowering low-density lipoprotein cholesterol in primary hypercholesterolemia. Am J Cardiol 90, 737740.
41 De Jong, A, Plat, J, Bast, A, et al. (2007) Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment. Eur J Clin Nutr 62, 263273.
42 Castro Cabezas, M, de Vries, JH, Van Oostrom, AJ, et al. (2006) Effects of a stanol-enriched diet on plasma cholesterol and triglycerides in patients treated with statins. J Am Diet Assoc 106, 15641569.
43 Gylling, H, Radhakrishnan, R & Miettinen, TA (1997) Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine: women and dietary sitostanol. Circulation 96, 42264231.
44 Vuorio, AF, Gylling, H, Turtola, H, et al. (2000) Stanol ester margarine alone and with simvastatin lowers serum cholesterol in families with familial hypercholesterolemia caused by the FH-North Karelia mutation. Arterioscler Thromb Vasc Biol 20, 500506.
45 de Jong, N, Zuur, A, Wolfs, MC, et al. (2007) Exposure and effectiveness of phytosterol/-stanol-enriched margarines. Eur J Clin Nutr 61, 14071415.
46 Wolfs, M, de Jong, N, Ocke, MC, et al. (2006) Effectiveness of customary use of phytosterol/-stanol enriched margarines on blood cholesterol lowering. Food Chem Toxicol 44, 16821688.
47 Amundsen, AL, Ntanios, F, Put, N, et al. (2004) Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread. Eur J Clin Nutr 58, 16121620.
48 Neil, HA, Meijer, GW & Roe, LS (2001) Randomised controlled trial of use by hypercholesterolaemic patients of a vegetable oil sterol-enriched fat spread. Atherosclerosis 156, 329337.
49 O'Neill, FH, Brynes, A, Mandeno, R, et al. (2004) Comparison of the effects of dietary plant sterol and stanol esters on lipid metabolism. Nutr Metab Cardiovasc Dis 14, 133142.
50 Gylling, H & Miettinen, TA (2002) Baseline intestinal absorption and synthesis of cholesterol regulate its response to hypolipidaemic treatments in coronary patients. Atherosclerosis 160, 477481.
51 Katan, MB, Grundy, SM, Jones, P, et al. (2003) Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 78, 965978.
52 Patel, MD & Thompson, PD (2006) Phytosterols and vascular disease. Atherosclerosis 186, 1219.
53 Heinemann, T, Axtmann, G & von Bergmann, K (1993) Comparison of intestinal absorption of cholesterol with different plant sterols in man. Eur J Clin Invest 23, 827831.
54 Goldstein, MR, Mascitelli, L & Pezzetta, F (2008) Statins, plant sterol absorption, and coronary risk. J Clin Lipidol 2, 304305.
55 John, S, Sorokin, AV & Thompson, PD (2007) Phytosterols and vascular disease. Curr Opin Lipidol 18, 3540.
56 Lea, LJ & Hepburn, PA (2006) Safety evaluation of phytosterol-esters. Part 9: Results of a European post-launch monitoring programme. Food Chem Toxicol 44, 12131222.
57 Van Horn, L, McCoin, M, Kris-Etherton, PM, et al. (2008) The evidence for dietary prevention and treatment of cardiovascular disease. J Am Diet Assoc 108, 287331.
58 Anderson, JW, Allgood, LD, Lawrence, A, et al. (2000) Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. Am J Clin Nutr 71, 472479.
59 Bell, LP, Hectorn, KJ, Reynolds, H, et al. (1990) Cholesterol-lowering effects of soluble-fiber cereals as part of a prudent diet for patients with mild to moderate hypercholesterolemia. Am J Clin Nutr 52, 10201026.
60 Chen, J, He, J, Wildman, RP, et al. (2006) A randomized controlled trial of dietary fiber intake on serum lipids. Eur J Clin Nutr 60, 6268.
61 Davidson, MH, Dugan, LD, Burns, JH, et al. (1991) The hypocholesterolemic effects of β-glucan in oatmeal and oat bran. A dose-controlled study. JAMA 265, 18331839.
62 Naumann, E, van Rees, AB, Onning, G, et al. (2006) β-Glucan incorporated into a fruit drink effectively lowers serum LDL-cholesterol concentrations. Am J Clin Nutr 83, 601605.
63 Van Horn, L, Emidy, LA, Liu, KA, et al. (1988) Serum lipid response to a fat-modified, oatmeal-enhanced diet. Prev Med 17, 377386.
64 Butt, MS, Shahzadi, N, Sharif, MK, et al. (2007) Guar gum: a miracle therapy for hypercholesterolemia, hyperglycemia and obesity. Crit Rev Food Sci Nutr 47, 389396.
65 Todd, PA, Benfield, P & Goa, KL (1990) Guar gum. A review of its pharmacological properties, and use as a dietary adjunct in hypercholesterolaemia. Drugs 39, 917928.
66 Brown, L, Rosner, B, Willett, WW, et al. (1999) Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 69, 3042.
67 Vergara-Jimenez, M, Furr, H & Fernandez, ML (1999) Pectin and psyllium decrease the susceptibility of LDL to oxidation in guinea pigs. J Nutr Biochem 10, 118124.
68 Theuwissen, E & Mensink, RP (2008) Water-soluble dietary fibers and cardiovascular disease. Physiol Behav 94, 285292.
69 United States Food and Drug Administration (1997) Food Labeling: Health Claims; Oats and Coronary Heart Disease; Final Rule. (accessed 25 June 2008).
70 United States Food and Drug Administration (1998) Federal Register 63 FR 8103, February 18, 1998 – Food Labeling: Health Claims; Soluble Fiber From Certain Foods and Coronary Heart Disease, Final Rule. (accessed 25 June 2008).
71 Joint Health Claims Initiative (2006) Generic health claim for oats and blood cholesterol 06-05-04.
72 Swedish Nutrition Foundation (2004) Swedish Nutrition Foundation, Health Claims. In the Labelling and Marketing of Food Products. The Food Sector's Code of Practice.
74 Richter, WO, Jacob, BG & Schwandt, P (1991) Interaction between fibre and lovastatin. Lancet 338, 706.
75 Uusitupa, M, Ebeling, T, Happonen, P, et al. (1991) Combination therapy with lovastatin and guar gum versus lovastatin and cholestyramine in treatment of hypercholesterolemia. J Cardiovasc Pharmacol 18, 496503.
76 Uusitupa, MI, Miettinen, TA, Happonen, P, et al. (1992) Lathosterol and other noncholesterol sterols during treatment of hypercholesterolemia with lovastatin alone and with cholestyramine or guar gum. Arterioscler Thromb 12, 807813.
77 Moreyra, AE, Wilson, AC & Koraym, A (2005) Effect of combining psyllium fiber with simvastatin in lowering cholesterol. Arch Intern Med 165, 11611166.
78 Jayaram, S, Prasad, HB, Sovani, VB, et al. (2007) Randomised study to compare the efficacy and safety of isapgol plus atorvastatin v. atorvastatin alone in subjects with hypercholesterolaemia. J Indian Med Assoc 105, 142145, 150.
79 Agrawal, AR, Tandon, M & Sharma, PL (2007) Effect of combining viscous fibre with lovastatin on serum lipids in normal human subjects. Int J Clin Pract 61, 18121818.
80 Borel, P (2003) Factors affecting intestinal absorption of highly lipophilic food microconstituents (fat-soluble vitamins, carotenoids and phytosterols). Clin Chem Lab Med 41, 979994.
81 Riedl, J, Linseisen, J, Hoffmann, J, et al. (1999) Some dietary fibers reduce the absorption of carotenoids in women. J Nutr 129, 21702176.
82 Garcia, JJ, Fernandez, N, Diez, MJ, et al. (2000) Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 62, 253257.
83 Hokanson, JE & Austin, MA (1996) Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies. J Cardiovasc Risk 3, 213219.
84 Harris, WS, Miller, M, Tighe, AP, et al. (2007) Omega-3 fatty acids and coronary heart disease risk: clinical and mechanistic perspectives. Atherosclerosis 197, 1224.
85 Davidson, MH (2006) Mechanisms for the hypotriglyceridemic effect of marine omega-3 fatty acids. Am J Cardiol 98, 27i33i.
86 Harris, WS & Bulchandani, D (2006) Why do omega-3 fatty acids lower serum triglycerides? Curr Opin Lipidol 17, 387393.
87 Connor, SL & Connor, WE (1997) Are fish oils beneficial in the prevention and treatment of coronary artery disease? Am J Clin Nutr 66, Suppl. 4, 1020S1031S.
88 Demaison, L & Moreau, D (2002) Dietary n-3 polyunsaturated fatty acids and coronary heart disease-related mortality: a possible mechanism of action. Cell Mol Life Sci 59, 463477.
89 Balk, EM, Lichtenstein, AH, Chung, M, et al. (2006) Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review. Atherosclerosis 189, 1930.
90 Harris, WS (1989) Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review. J Lipid Res 30, 785807.
91 McKenney, JM & Sica, D (2007) Prescription omega-3 fatty acids for the treatment of hypertriglyceridemia. Am J Health Syst Pharm 64, 595605.
92 United States Food and Drug Administration (2004) FDA Announces Qualified Health Claims for Omega-3 Fatty Acids. (accessed 15 July 2008).
93 Contacos, C, Barter, PJ & Sullivan, DR (1993) Effect of pravastatin and omega-3 fatty acids on plasma lipids and lipoproteins in patients with combined hyperlipidemia. Arterioscler Thromb 13, 17551762.
94 Chan, DC, Watts, GF, Barrett, PH, et al. (2002) Regulatory effects of HMG CoA reductase inhibitor and fish oils on apolipoprotein B-100 kinetics in insulin-resistant obese male subjects with dyslipidemia. Diabetes 51, 23772386.
95 Chan, DC, Watts, GF, Mori, TA, et al. (2002) Factorial study of the effects of atorvastatin and fish oil on dyslipidaemia in visceral obesity. Eur J Clin Invest 32, 429436.
96 Davidson, MH, Macariola-Coad, JR, McDonald, AM, et al. (1997) Separate and joint effects of marine oil and simvastatin in patients with combined hyperlipidemia. Am J Cardiol 80, 797798.
97 Davidson, MH, Stein, EA, Bays, HE, et al. (2007) Efficacy and tolerability of adding prescription omega-3 fatty acids 4 g/d to simvastatin 40 mg/d in hypertriglyceridemic patients: an 8-week, randomized, double-blind, placebo-controlled study. Clin Ther 29, 13541367.
98 Durrington, PN, Bhatnagar, D, Mackness, MI, et al. (2001) An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia. Heart 85, 544548.
99 Grekas, D, Kassimatis, E, Makedou, A, et al. (2001) Combined treatment with low-dose pravastatin and fish oil in post-renal transplantation dislipidemia. Nephron 88, 329333.
100 Hong, H, Xu, ZM, Pang, BS, et al. (2004) Effects of simvastain combined with omega-3 fatty acids on high sensitive C-reactive protein, lipidemia, and fibrinolysis in patients with mixed dyslipidemia. Chin Med Sci J 19, 145149.
101 Meyer, BJ, Hammervold, T, Rustan, AC, et al. (2007) Dose-dependent effects of docosahexaenoic acid supplementation on blood lipids in statin-treated hyperlipidaemic subjects. Lipids 42, 109115.
102 Nakamura, N, Hamazaki, T, Ohta, M, et al. (1999) Joint effects of HMG-CoA reductase inhibitors and eicosapentaenoic acids on serum lipid profile and plasma fatty acid concentrations in patients with hyperlipidemia. Int J Clin Lab Res 29, 2225.
103 Nordøy, A, Bønaa, KH, Nilsen, H, et al. (1998) Effects of simvastatin and omega-3 fatty acids on plasma lipoproteins and lipid peroxidation in patients with combined hyperlipidaemia. J Intern Med 243, 163170.
104 Yokoyama, M, Origasa, H, Matsuzaki, M, et al. (2007) Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 369, 10901098.
105 Nordøy, A, Hansen, JB, Brox, J, et al. (2001) Effects of atorvastatin and omega-3 fatty acids on LDL subfractions and postprandial hyperlipemia in patients with combined hyperlipemia. Nutr Metab Cardiovasc Dis 11, 716.
106 Aligeti, VR, Gandhi, M, Braden, R, et al. (2007) Effect of combination lipid-modifying therapy on the triglyceride lowering effect of fish oil. Am J Med Sci 333, 168172.
107 Sandset, PM, Lund, H, Norseth, J, et al. (1991) Treatment with hydroxymethylglutaryl-coenzyme A reductase inhibitors in hypercholesterolemia induces changes in the components of the extrinsic coagulation system. Arterioscler Thromb 11, 138145.
108 Balestrieri, GP, Maffi, V, Sleiman, I, et al. (1996) Fish oil supplementation in patients with heterozygous familial hypercholesterolemia. Recenti Prog Med 87, 102105.
109 Bays, H (2006) Clinical overview of Omacor: a concentrated formulation of omega-3 polyunsaturated fatty acids. Am J Cardiol 98, 71i76i.
110 Bays, HE (2007) Safety considerations with omega-3 fatty acid therapy. Am J Cardiol 99, 35C43C.
111 Yang, H & Kenny, A (2007) The role of fish oil in hypertension. Conn Med 71, 533538.
112 Littarru, GP & Langsjoen, P (2007) Coenzyme Q10 and statins: biochemical and clinical implications. Mitochondrion 7, Suppl., S168S174.
113 Nawarskas, JJ (2005) HMG-CoA reductase inhibitors and coenzyme Q10. Cardiol Rev 13, 7679.
114 Caso, G, Kelly, P, McNurlan, MA, et al. (2007) Effect of coenzyme Q10 on myopathic symptoms in patients treated with statins. Am J Cardiol 99, 14091412.
115 Levy, HB & Kohlhaas, HK (2006) Considerations for supplementing with coenzyme Q10 during statin therapy. Ann Pharmacother 40, 290294.
116 Marcoff, L & Thompson, PD (2007) The role of coenzyme Q10 in statin-associated myopathy: a systematic review. J Am Coll Cardiol 49, 22312237.
117 Pepe, S, Marasco, SF, Haas, SJ, et al. (2007) Coenzyme Q10 in cardiovascular disease. Mitochondrion 7, Suppl., S154S167.
118 Bargossi, AM, Grossi, G, Fiorella, PL, et al. (1994) Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med 15, Suppl., s187s193.
119 Young, JM, Florkowski, CM, Molyneux, SL, et al. (2007) Effect of coenzyme Q(10) supplementation on simvastatin-induced myalgia. Am J Cardiol 100, 14001403.
120 Langsjoen, PH, Langsjoen, JO, Langsjoen, AM, et al. (2005) Treatment of statin adverse effects with supplemental coenzyme Q10 and statin drug discontinuation. Biofactors 25, 147152.
121 Thompson, PD, Clarkson, P & Karas, RH (2003) Statin-associated myopathy. JAMA 289, 16811690.
122 Ucar, M, Mjorndal, T & Dahlqvist, R (2000) HMG-CoA reductase inhibitors and myotoxicity. Drug Saf 22, 441457.
123 Hidaka, T, Fujii, K, Funahashi, I, et al. (2008) Safety assessment of coenzyme Q10 (CoQ10). Biofactors 32, 199208.
124 Mabuchi, H, Nohara, A, Kobayashi, J, et al. (2007) Effects of CoQ10 supplementation on plasma lipoprotein lipid, CoQ10 and liver and muscle enzyme levels in hypercholesterolemic patients treated with atorvastatin: a randomized double-blind study. Atherosclerosis 195, e182e189.
125 Kromer, A & Moosmann, B (2009) Statin-induced liver injury involves cross-talk between cholesterol and selenoprotein biosynthetic pathways. Mol Pharmacol 75, 14211429.
126 Moosmann, B & Behl, C (2004) Selenoprotein synthesis and side-effects of statins. Lancet 363, 892894.
127 Arduini, A, Peschechera, A, Giannessi, F, et al. (2004) Improvement of statin-associated myotoxicity by l-carnitine. J Thromb Haemost 2, 22702271.
128 Link, E, Parish, S, Armitage, J, et al. (2008) SLCO1B1 variants and statin-induced myopathy – a genomewide study. N Engl J Med 359, 789799.
129 Schaeffer, L, Gohlke, H, Muller, M, et al. (2006) Common genetic variants of the FADS1 FADS2 gene cluster and their reconstructed haplotypes are associated with the fatty acid composition in phospholipids. Hum Mol Genet 15, 17451756.
130 Tanaka, T, Shen, J, Abecasis, GR, et al. (2009) Genome-wide association study of plasma polyunsaturated fatty acids in the InCHIANTI Study. PLoS Genet 5, e1000338.
131 Xie, L & Innis, SM (2008) Genetic variants of the FADS1 FADS2 gene cluster are associated with altered (n-6) and (n-3) essential fatty acids in plasma and erythrocyte phospholipids in women during pregnancy and in breast milk during lactation. J Nutr 138, 22222228.
132 Manolio, TA (2009) Cohort studies and the genetics of complex disease. Nat Genet 41, 56.
133 Herings, RMC, Leufkens, HGM, Heerdink, ER, et al. (2002) Chronic Pharmacotherapy Forever. Utrecht, The Netherlands: PHARMO.
134 Mantel-Teeuwisse, AK, Goettsch, WG, Klungel, OH, et al. (2004) Long term persistence with statin treatment in daily medical practice. Heart 90, 10651066.
135 De Jong, N, Ros, MM, Ocke, MC, et al. (2008) A general postlaunch monitoring framework for functional foods tested with the phytosterol/-stanol case. Trends Food Sci Tech 19, 535545.
136 Commission of the European Communities (2009) Commission Regulation (EC) No 983/2009 of 21 October 2009 on the authorisation and refusal of authorisation of certain health claims made on food and referring to the reduction of disease risk and to children's development and health.
137 European Food Safety Authority (2009) Scientific Opinion on the substantiation of health claims related to beta-glucans and maintenance of normal blood cholesterol concentrations (ID 754, 755, 757, 801, 1465, 2934) and maintenance or achievement of a normal body weight (ID 820, 823) pursuant to Article 13(1) of Regulation (EC) No 1924/20061,0.pdf%3Fssbinary%3Dtrue.


Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

  • Simone Eussen (a1) (a2), Olaf Klungel (a2), Johan Garssen (a2), Hans Verhagen (a1), Henk van Kranen (a1), Henk van Loveren (a1) and Cathy Rompelberg (a1)...


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