The present review provides an up-to-date summary of the findings on the lipid-lowering effects of the most important nutraceuticals and functional foods. Based on current knowledge, nutraceuticals might exert significant lipid-lowering, and their use has several advantages:
•They have natural origins and are mainly extracted from natural products.
•They are mostly safe and very well tolerated.
•Their use is supported by the findings from randomized controlled trials and meta-analyses.
•The lipid-lowering effect of most nutraceuticals is multimechanistic, which makes them potential candidates for improving the effects of current lipid-lowering drugs when used in combination.
A number of important questions remain to be addressed, including whether longer durations of therapy would result in a better response and the exact safety profile of nutraceuticals, especially at doses higher than those consumed in an average diet. Additionally, data regarding the effects of nutraceutical supplementation on the incidence of cardiovascular outcomes are lacking, and it is not clear whether additional lipid lowering by nutraceuticals can modify the residual cardiovascular risk that remains after statin therapy.