{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:00:29Z","timestamp":1792803629686,"version":"4.5.0"},"reference-count":84,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Hyperlipidemia is associated with a higher rate of cardiovascular, cerebrovascular, and peripheral vascular disease. Conventional drugs such as statins are effective in controlling hyperlipidemia; however, they are associated with various side effects, especially myalgia. Nutraceutical lipid-lowering interventions are becoming increasingly popular, particularly among patients who are intolerant or refractory to statins. Substantial preclinical and clinical evidence suggests that extracts of amla, walnut, and olive, and red yeast rice (RYR) powder possess significant antihyperlipidemic effects.<\/jats:p><jats:p><jats:bold>Aims:<\/jats:bold> This study aimed to evaluate the efficacy, safety, and patient satisfaction of a combined supplementation of standardized dry extracts of amla fruit (500\u00a0mg), walnut leaves (50\u00a0mg), olive fruit (25\u00a0mg), and RYR powder (33.6\u00a0mg) (Cholesfytol NG\u00ae) in hypercholesterolemic patients.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This was a <jats:italic>real-life setting<\/jats:italic>, retrospective, observational, single-arm, non-randomized study in hypercholesterolemic patients (total cholesterol (TC) \u2265 200\u00a0mg\/dL or low-density lipoprotein-cholesterol (LDL-C) \u2265 130\u00a0mg\/dL), enrolled at 57 general practitioner (GP) surgeries in Belgium from March 2020 to January 2022. These patients received a GP-prescribed daily single dosage of two oral tablets of Cholesfytol NG\u00ae supplementation for 2 months to overcome their hypercholesterolemia in the absence of a conventional lipid-lowering drug (n = 208) or with a lipid-lowering drug (n = 13). At 2-month follow-up, the lipid profile was re-evaluated, alongside a patient\u2019s questionnaire on treatment general satisfaction and willingness to pursue supplementation.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> After supplementation, TC decreased by 15%, LDL-C by 19%, non-high-density lipoprotein-cholesterol (non-HDL-C) by 20% (all <jats:italic>p<\/jats:italic> &amp;lt; 0.0001), triglycerides (TG) by 9% (<jats:italic>p<\/jats:italic> = 0.0028) (\u221218.4%, <jats:italic>p<\/jats:italic> = 0.0042, in patients with baseline TG &amp;gt; 180\u00a0mg\/dL, n = 58), and remnant cholesterol (RC) by 12% (<jats:italic>p<\/jats:italic> = 0.0001). These changes were unaffected by statin intolerance status in patients who received Cholesfytol NG\u00ae alongside statin. The supplement was well tolerated by all patients, and no serious adverse events or supplement-emergent effects were reported. Most patients were satisfied with the supplementation and wanted to pursue the nutraceutical.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> According to the results of this study, a combined supplementation of amla, walnut, and olive extracts, and RYR powder exerts a significant antihyperlipidemic effect, leading to a decrease in circulatory LDL-C and RC levels in patients with hypercholesterolemia. The supplementation bears excellent safety and tolerability, and is rated as satisfactory and pursuable, even among patients with statin intolerance.<\/jats:p><jats:p>Clinical Trial Registration: <jats:ext-link>clinicaltrials.gov<\/jats:ext-link>; identifier number: <jats:ext-link>NCT06002893<\/jats:ext-link><\/jats:p>","DOI":"10.3389\/fphar.2023.1280234","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T14:42:11Z","timestamp":1701096131000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["The antihyperlipidemic effect of a combined supplement of standardized dry extracts of amla (Emblica officinalis), walnut (Juglans regia), olive (Olea europaea) and red yeast rice (Monascus purpureus) powder: Reduction in circulatory low-density lipoprotein-cholesterol (LDL-C) and remnant cholesterol (RC) levels in patients with hypercholesterolemia"],"prefix":"10.3389","volume":"14","author":[{"given":"Michel P.","family":"Hermans","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvan","family":"Dierckxsens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Janssens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Seidel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelin","family":"Albert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie A.","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel F.","family":"Rousseau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"609","DOI":"10.3109\/09637486.2011.560565","article-title":"Effect of Amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patients","volume":"62","author":"Akhtar","year":"2011","journal-title":"Int. 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