Introduction: Dyslipidaemia is a major risk factor for atherosclerotic cardiovascular disease. Nutraceuticals have been investigated as lipid-lowering strategies, particularly for patients at low–moderate cardiovascular risk or with statin intolerance. Methods: We systematically reviewed randomized controlled trials (RCTs) and meta-analyses evaluating nutraceutical interventions for lipid management. A total of 27 studies were included, following PRISMA 2020 guidelines. Results: Evidence supports the beneficial effects of phytosterols, red yeast rice, polyphenols, prebiotics, and omega-3 fatty acids. Red yeast rice reduced LDL-C levels by 20–30%, comparable to low-dose statins; typical effective preparations contained 3–10 mg/day monacolin K. Phytosterols lowered LDL-C by ~10%, omega-3 fatty acids reduced triglycerides, and polyphenols and prebiotics demonstrated modest improvements across lipid parameters. Discussion: This meta-analysis provides a comprehensive synthesis of current evidence regarding the effectiveness of nutraceuticals in managing dyslipidemia, particularly in lowering LDLC levels. The results reinforce the clinical potential of many bioactive compounds as valid adjuncts or alternatives to pharmacologic therapy, especially in statin-intolerant patients with low to moderate cardiovascular risk. Conclusion: Nutraceuticals demonstrate clinically relevant lipid-lowering potential, though effects vary by compound and dosage. They may complement pharmacological therapy, especially in patients unable or unwilling to take statins. Large RCTs remain needed to clarify long-term efficacy and safety.
Muja et al. (Tue,) studied this question.