Cholesterol efflux is a critical step in the reverse cholesterol pathway, in which high-density lipoprotein (HDL) removes excess cholesterol from tissues and cells and delivers it to the liver for excretion or recycling.
CEC has therefore emerged as a predictor of cardiovascular risk, showing an inverse association with coronary events, independant from HDL levels.
“These findings suggest that ginger may promote reverse cholesterol transport and enhance resistance to oxidative stress, two mechanisms that are critically involved in the prevention of atherosclerotic cardiovascular disease,” wrote researchers at Shahid Beheshti University of Medical Sciences in Iran in the journal Complementary Therapies in Clinical Practice.
The phytochemicals in ginger are widely known to exert anti-inflammatory and antioxidant effects. Research investigating the effects of ginger on lipids and lipoproteins has been inconsistent, although animal studies have suggested potential modulation of cholesterol efflux. The researchers claim that the current study is the first randomized controlled trial to examine the effects of ginger on CEC in humans.
Study details
The study was a randomized, double-blind, placebo-controlled crossover trial involving 35 healthy adult participants. They were assigned either three daily capsules containing 500 mg of dried ginger powder (Zingiber officinale Roscoe), standardized to 25 mg gingerols, or placebo capsules. The researchers selected the 1500mg dose based on prior research demonstrating its efficacy and safety.
Participants received each intervention for six weeks, with a four-week washout period between interventions. The researchers conducted anthropometric measurements, biochemical analyses of blood samples, and interviews on health and lifestyle factors at the start and end of the study, and analyzed the data using statistical methods.
The primary finding was that the ginger increased the plasma cholesterol efflux capacity (CEC).
“During the placebo period, the mean change in CEC was − 1.2% [− 2.7 to 0.2], while during the ginger period, it increased by 2.8% [1.0 to 4.5],” the researchers wrote.
They noted that although the increase was modest, there is accumulating evidence that CEC is linked to cardiovascular outcomes.
“Prospective cohort studies have reported that a one–standard deviation increase in CEC is associated with a 3-5% reduction in incident cardiovascular events,” they wrote, noting that a recent study found that each 0.1 unit increase in CEC is associated with an approximately 5% reduction in cardiovascular event risk.
Plasma malondialdehyde (MDA) levels, a marker of oxidative stress, decreased following incubation with an oxidizing agent during the ginger intervention compared with placebo. No significant effects were observed for lipid and lipoprotein levels, body weight or blood pressure.
“Given the established roles of impaired CEC and oxidative stress in the pathogenesis of atherosclerosis, the observed improvements suggest that regular ginger consumption may represent a promising dietary approach for cardiovascular disease prevention,” the researchers concluded.
They noted that the results should be interpreted with caution and require confirmation in larger-scale studies.
Source: Complementary Therapies in Clinical Practice; doi: 10.1016/j.ctcp.2026.102074. “Daily ginger supplementation improves plasma cholesterol efflux capacity and reduces oxidative stress in healthy adults: A randomized, double-blind, placebo-controlled crossover trial.” Authors: F. Ansarifard et al.
