Department of Nutrition, University of Tennessee at Knoxville, Knoxville 37916, USA
College of Food Science and Technology, College of Biomedicine and Health, Huazhong Agricultural University, Wuhan 430070, China
School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan 430065, China
Department of Public Health, University of Tennessee at Knoxville, Knoxville 37916, USA
†These authors contributed equally to this work.
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Highlights
(1) Red Yeast Rice and Treatment Options Lifestyle changes can lower LDL cholesterol levels without increasing the side effects caused by statins.
(2) Future modified red yeast products could be hydrophilic or hydrophobic, thus creating simple daily functional foods that can be adapted to lower blood lipids for a broader range of people.
(3) Contaminants caused by process defects and human error can lead to the mixing of impurities into the product. Which leads to additional risks, even fatal, in the use of red yeast rice, emphasizing the need for upgraded processes and strict quality control.
Abstract
Hypercholesterolemia is closely associated with the risk of cardiovascular diseases. Medicinal and dietary approaches are both used to combat it. Red yeast rice (RYR) is a traditional ingredient that has been used for a long time in food preparation. Interestingly, it shows activity to alleviate hypercholesterolemia as a food supplement due to the high content of lovastatin (also known as monacolin K), a statin drug. To gain a comprehensive understanding of RYR and its functions, we have reviewed the current literature from PubMed. This review summarizes the RYR historical use in traditional Chinese medicine and compares it with statins for controlling hypercholesterolemia. In addition, we have also included the side effects of RYR, its impacts on the heart, liver, and muscle, and the limitations of current research. The needs to reduce side effects while providing the same bioavailability and efficacy of RYR for the alleviation of hypercholesterolemia are important for its benefits in health. We believe that more research is needed to thoroughly investigate RYR and find novel compounds with activities to control hypercholesterolemia and help subjects who are sensitive to statin-mediated side effects.
Graphical Abstract
The graphical abstract illustrates how red yeast rice (RYR), containing Monacolin K (natural Lovastatin), competitively inhibits HMG-CoA reductase in the liver, blocking cholesterol synthesis and reducing hyperlipidemia. Future modified red yeast rice products could be hydrophilic or hydrophobic, affecting their audience and bioavailability. This product modification aims to create simple daily functional foods that lower blood lipids, reduce side effects like muscle pain, and enhance active ingredient bioavailability for superior effectiveness while minimizing unintended toxic side effects. The image shows RYR in various forms, from raw rice to supplements, emphasizing its potential as a natural cholesterol-lowering agent.
Ma G-D, Hu X-G, Xu J-H, et al. Future of red yeast rice: a promising and safer natural approach for daily management of hypercholesterolemia. Food & Medicine Homology, 2026, 3(1): 9420092. https://doi.org/10.26599/FMH.2026.9420092
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