British Journal of Nutrition

Cambridge Journals Online - CUP Full-Text Page
British Journal of Nutrition (2010), 103:1260-1277 Cambridge University Press
Copyright © The Authors 2010

Review Article

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

Simone Eussena1a2, Olaf Klungela2 c1, Johan Garssena2, Hans Verhagena1, Henk van Kranena1, Henk van Loverena1 and Cathy Rompelberga1

a1 National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
a2 Utrecht Institute for Pharmaceutical Sciences, PO Box 80082, 3508 TB Utrecht, The Netherlands
Article author query
eussen s [PubMed]  [Google Scholar]
klungel o [PubMed]  [Google Scholar]
garssen j [PubMed]  [Google Scholar]
verhagen h [PubMed]  [Google Scholar]
van kranen h [PubMed]  [Google Scholar]
van loveren h [PubMed]  [Google Scholar]
rompelberg c [PubMed]  [Google Scholar]


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.

(Received March 26 2009)

(Revised September 15 2009)

(Accepted November 05 2009)

(Online publication March 03 2010)

Key Words:Combination therapy; Dyslipidaemia; Statins; Functional foods


c1 Corresponding author: Dr O. H. Klungel, fax +31 30 253 9166, email


Abbreviations: ABC, ATP-binding cassette; CoQ10, coenzyme Q10; DS, dietary supplements; EFSA, European Food Safety Authority; FDA, Food and Drug Administration; FF, functional foods; FH, familial hypercholesterolaemia; HC, hypercholesterolaemic; HMG-CoA, hydroxymethylglutaryl CoA; IDL, intermediate-density lipoprotein