Effect of a polyphenol-rich extract on LDL cholesterol in mild to moderate hypercholesterolemia: a randomized, double-blind, placebo-controlled trial

Eur J Clin Nutr. 2026 Mar;80(3):285-292. doi: 10.1038/s41430-025-01691-1. Epub 2025 Dec 24.

Abstract

Background/objective: Hypercholesterolemia is a well-known risk factor for cardiovascular disease. This clinical trial evaluated the effects of TOTUM-070, a polyphenol-rich blend of plant extracts, on lipid metabolism in individuals with moderate hypercholesterolemia.

Subjects/methods: This was a 6-month, multicenter, randomized, double-blind, placebo-controlled trial. Individuals not receiving lipid-lowering treatment and with fasting low-density lipoprotein cholesterol (LDL-C) between 1.3 and 1.9 g/L received TOTUM-070 (5 g/day) or placebo. The primary outcome was the change in fasting LDL-C. Secondary endpoints included safety, changes in the lipid profile, anthropometric measurements, and gut microbiome composition.

Results: A total of 120 subjects (mean age:53.1 ± 10.3 years; BMI: 25.9 ± 3.7 kg.m2; 69.2% women; baseline LDL-C: 1.44 ± 0.23 g/L) were included and randomized. TOTUM-070 was well tolerated. After 6 months, fasting LDL-C was reduced in the TOTUM-070 group compared with the placebo group (Mean estimate: 1.31 ± 0.03 [1.25 ; 1.37] vs 1.41 ± 0.03 [1.35 ; 1.47], p = 0.0041). Compared with placebo, TOTUM-070 also reduced total cholesterol (p < 0.01), non-high-density lipoprotein cholesterol (non-HDL-C) (p < 0.001), triglycerides (p < 0.05), apolipoprotein (apo)B100 (p < 0.01), the apoB100/apoA1 ratio (p < 0.01), oxidized LDL (p < 0.05), and body weight (-1.4 kg; p < 0.001). Furthermore, a decrease in the abundance of Dorea in fecal samples was observed in the TOTUM-070 group.

Conclusions: This clinical trial showed that supplementation with TOTUM-070 significantly lowers LDL-C and improves other lipid parameters in subjects with moderate hypercholesterolemia. As a polyphenol-rich plant-based blend, TOTUM-070 represents a promising non-pharmacological strategy that could complement lifestyle modifications for the management of early-stage hypercholesterolemia.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cholesterol, LDL* / blood
  • Double-Blind Method
  • Female
  • Gastrointestinal Microbiome / drug effects
  • Humans
  • Hypercholesterolemia* / blood
  • Hypercholesterolemia* / drug therapy
  • Male
  • Middle Aged
  • Plant Extracts* / administration & dosage
  • Plant Extracts* / pharmacology
  • Plant Extracts* / therapeutic use
  • Polyphenols* / administration & dosage
  • Polyphenols* / pharmacology

Substances

  • Polyphenols
  • Cholesterol, LDL
  • Plant Extracts