Red yeast rice

Red yeast rice is also known as red fermented rice, red kojic rice or 'red koji rice from its Japanese name, and anka or angkak''' from Southern Min pronunciations of its Chinese name. In both the scientific and popular literature in English that draws principally on Japanese traditional use, red yeast rice is most often referred to as "red rice koji''". English language articles favoring Chinese literature sources prefer the translation "red yeast rice". ==Production==

Red yeast rice is produced by cultivating the mold species Monascus purpureus on rice for 3–6 days at room temperature. The rice grains turn bright red at the core and reddish purple on the outside. The fully cultured rice is then either sold as the dried grain, or cooked and pasteurized to be sold as a wet paste, or dried and pulverized to be sold as a fine powder. China is the world's largest producer of red yeast rice, but European companies have entered the market. ==Uses==

Culinary with misua noodles Red yeast rice is used to color a wide variety of food products, including fermented tofu, red rice vinegar, char siu, Peking duck, and Chinese pastries that require red food coloring. In China, documentation dates back to at least the first century AD. It was called a "koji" in Japanese, meaning "grain or bean overgrown with a mold culture". Red yeast rice (angkák in Filipino) is also used widely in the Philippines to traditionally color and preserve certain dishes like fermented shrimp (bagoóng alamáng), burong isdâ (fermented rice and fish), and balao-balao (fermented rice and shrimp). Traditional Chinese medicine In addition to its culinary use, red yeast rice is also used in Chinese herbology and traditional Chinese medicine. Medicinal use of red yeast rice is described in the Chinese pharmacopoeia Ben Cao Gang Mu compiled by Li Shizhen ca. 1590. One reference provided the Li Shizhen health claims as a quotation "...the effect of promoting the circulation of blood and releasing stasis, invigorating the spleen, and eliminating [in]digestion." Lovastatin became the patented, prescription drug Mevacor. Red yeast rice went on to become a non-prescription dietary supplement in the United States and other countries. Lovastatin and other prescription statin drugs inhibit cholesterol synthesis by blocking action of the enzyme HMG-CoA reductase. As a consequence, circulating total cholesterol and LDL-cholesterol are lowered by 24–49% depending on the statin and dose. Different strains of Monascus fungus will produce different amounts of monacolins. The 'Went' strain of Monascus purpureus (purpureus=dark red in Latin), when properly fermented and processed, will yield a dried red yeast rice powder that is approximately 0.4% monacolins, of which roughly half will be monacolin K (chemically identical to lovastatin). U.S. regulatory restrictions The US Food and Drug Administration (FDA) position is that red yeast rice products that contain monacolin K are identical to a prescription drug and, thus, subject to regulation as a drug. In 1998, the FDA initiated action to ban a product (Cholestin) containing red yeast rice extract. The U.S. District Court in Utah ruled in favor of allowing the product to be sold without restriction. This decision was reversed on appeal to the U.S. Court of Appeals in 2001. In 2007, the FDA sent warning letters to two dietary supplement companies. One was making a monacolin content claim about its RYR product and the other was not, but the FDA noted that both products contained monacolins. Both products were withdrawn. In a press release the FDA "...is warning consumers to not buy or eat red yeast rice products... may contain an unauthorized drug that could be harmful to health." The rationale for "harmful to health" was that consumers might not understand that the dangers of monacolin-containing red yeast rice are the same as those of prescription statin drugs. Many of these avoid FDA regulation by not having any appreciable monacolin content. Their labels and websites say no more than "fermented according to traditional Asian methods" or "similar to that used in culinary applications". The labeling on these products often says nothing about cholesterol lowering. If products do not contain lovastatin, do not claim to contain lovastatin, and do not make a claim to lower cholesterol, they are not subject to FDA action. Two reviews confirm that the monacolin content of red yeast rice dietary supplements can vary over a wide range, with some containing negligible monacolins. Clinical evidence The amount typically used in clinical trials is 1200–2400 mg/day of red yeast rice containing approximately 10 mg total monacolins, of which half are monacolin K. A meta-analysis reported LDL-cholesterol lowered by 1.02 mmol/L (39.4 mg/dL) compared to placebo. The incidence of reported adverse effects ranged from 0% to 5% and was not different from controls. A second meta-analysis incorporating more recent clinical trials also reported significant lowering of total cholesterol and LDL-cholesterol. Within the first review, These heart attack and cardiovascular death outcomes appear to be better than what has been reported for prescription statin drugs. A 2008 review pointed out that the cardioprotective effects of statins in Japanese populations occur at lower doses than are needed in Western populations, and theorized that the low amount of monacolins found in the xuezhikang product might have been more effectively athero-protective than expected in the Chinese population for the same reason. Safety The safety of red yeast rice (RYR) products has not been established. Some supplements have been found to contain high levels of citrinin, which can be toxic to the liver, kidneys, and cellular DNA. From a review: "The potential safety signals of myopathies and liver injury raise the hypothesis that the safety profile of RYR is similar to that of statins. Continuous monitoring of dietary supplements should be promoted to finally characterize their risk profile, thus supporting regulatory bodies for appropriate actions." The European Food Safety Authority (EFSA) Panel on Food Additives and Nutrient Sources added to Food concluded that when red yeast rice preparations contained monacolins, the Panel was unable to identify an intake that it could consider as safe. The reason given was case study reports of severe adverse reactions to products containing monacolins at amounts as low as 3 mg/day. Red yeast rice is not recommended during pregnancy or breast-feeding. In March 2024, the Japanese Ministry of Health ordered stores to remove three RYR dietary supplements (Benikoji ColesteHelp, NaishiHelp Plus Cholesterol and Natto-kinase Sarasara Tsubu) produced by Kobayashi Pharmaceutical after reports of thousands made ill. The suspect batch was manufactured in 2023. Some analysts have placed the blame on industry deregulation, intended to boost economic growth by facilitating the approval of health products. Benikoji products such as miso paste, crackers, food coloring, and a vinegar dressing made by other companies were also recalled. Kobayashi Pharmaceutical officially discontinued production of beni koji products on 8 August 2024. ==See also==