This story describes a potential cholesterol-lowering herbal supplement derived from the bitter citrus fruit, bergamot, found in Italy. It explains that four human studies have been published on the subject, and that all of these studies involved a cardiologist who is a paid scientific consultant to a company that sells the supplement extract. The story does a very nice job of describing the problem (that some people have muscle aches or side effects from statins), and that this extract appears to result in cholesterol reductions without those same side effects. The story could have done a better job explaining what the observed reductions in cholesterol might mean for someone’s overall cardiovascular risk, and describing the potential harms of taking unregulated supplements. That being said, the shortcomings of the supplement research are appropriately highlighted in a quote from a Cleveland Clinic cardiologist. He reminds us that we have data that statins improve health outcomes beyond simply lowering cholesterol, and that we do not have such evidence from bergamot studies.
With the introduction of new cholesterol guidelines last year, a large proportion of the public will be recommended to take a statin for primary prevention of heart disease. Many patients experience side effects from statins or prefer herbal/natural products. Research on foods or supplements that lower cholesterol is helpful for people who want or need alternatives. However, it is important to understand the limitations of this research versus large, well-conducted studies of pharmaceuticals.
There are bergamot supplements on the market, but the price was not discussed. The cost of statins is also excluded.
This story meets our standard by explaining that 1,000 milligrams daily of bergamot extract lowered cholesterol from an average of 278 milligrams per deciliter of blood to 191 in the study. But while many readers with high cholesterol likely understand the significance of these numbers, readers without them (but who are nonetheless interested in the story) would benefit from a clear example or description of the risks posed by high cholesterol. The story would also have been stronger had it told us how this reduction in cholesterol would affect one’s overall risk of a heart attack or stroke.
The story noted that mild heartburn was the only side effect seen in the study, and that larger long-term studies are needed to establish safety. “I would tell a patient the caveat is, ‘If you want to try it, you need to be aware that we don’t really know its side effects,'” a researcher says.
We’d also add that the herbal supplement industry is not regulated or controlled in the same way as the pharmaceutical industry, i.e. there are fewer restrictions and enforcement, so relying on supplements to treat a condition can pose additional risks from potentially poor-quality or contaminated products.
We aren’t told much about how the study was conducted. For example, was it randomized and blinded? Was there a placebo control group?
Those deficiencies aside, the story did an admirable job of explaining the limitations of existing research and putting the current study in context. Examples:
On balance, we’ll rate this satisfactory.
This story does not hype the problem of high cholesterol or the association with heart disease, which is obviously among the most important causes of death in developed countries. But we do wish the story had made the link between cholesterol and heart disease more explicit.
Dr. David Frid, a cardiologist from the Cleveland Clinic, reminds us that the studies need to be reproduced in other populations, and that statins have been show to reduce heart attacks (not just cholesterol).
Because of the included quote about statins, we’ll award a satisfactory rating. The story could have mentioned how bergamot compares to other supplements that claim to lower cholesterol, and provided general information about a diet low in saturated fats and high in plant sources of foods.
The supplements are already on the market and the story makes that clear.
The story shares that several prior reports from the same research group have shown cholesterol reductions with the product.
The story shows evidence of data gathering including speaking to experts and reviewing the literature. We can be sure that this story wasn’t based mainly on a news release.