Red yeast rice hits Japan. Four people could have died by resorting to this natural remedy against cholesterol, in its version marketed by Kobayashi laboratories. One hundred and six other Japanese have had to be hospitalized and authorities are investigating the possible link to the colored pills.

This week, the Osaka firm withdrew 300,000 sachets of “Beni Koji Choleste Help”, one of its star products advertised on television, along with two other food supplements. He said he did so on his own initiative, after receiving an email on Saturday from the relatives of a deceased person (due to kidney failure) who had been consuming his pills practically since their launch, three years ago.

The company’s warning generated a flood of emails, more than three thousand, in a few hours. And to the hospitals, an avalanche of income. A visit by the Ministries of Health and Consumer Affairs, with data comparison, would have brought to light that three other recent deaths could be directly related to red yeast rice from the same company.

It claims to have contacted more than fifty food industries to which it served as a supplier, since the aforementioned yeast acts as a coloring or flavor enhancer. All of them are in Japan, except two based in Taiwan. Among the products from several brands that are also being recalled are everything from candy to pink sake with bubbles, to squid appetizers, miso paste, fermented tofu or rice crackers.

The Japanese government has already notified embassies and the World Health Organization of the alert. The Osaka company has apologized and claims to be investigating what happened. According to their analysis, citrinin, a mycotoxin occasionally present in fungi of the same family, has not been detected in the presumably affected consignment. However, they do not rule out that some foreign ingredient may have slipped into them.

Red yeast rice is part of the wide range of products in Japanese and Asian cuisine that depend on natural fermentation. Specifically, a type of harmless mold that provides the characteristic red color to rice grains. Red yeast (beni koji in Japanese) is used much less than black or white yeast and much less than yellow yeast. The latter is essential for the production of miso, soy sauce and certain sakes, shochus, tofus and rice vinegars. Without it, Japan would not be Japan. The red, on the other hand, gives the characteristic color to the Peking duck.

This mold with healthy effects has been with Asians for millennia – also in Korea – and has been described in Chinese medical literature for more than seven hundred years, as promoting blood circulation.

In any case, Kagoshima University professor Yumiko Yoshizaki, who specializes in the study of fermented foods, calls for serenity. “We have been eating red yeast rice for centuries and there is no reason not to continue doing so, in moderation, except for the brand now in question,” he told the Mainichi Shimbun newspaper.

It is no less true that, for at least fifteen years, the damage that its enzyme, called Monacolin K, can cause in patients with liver problems has been described. In a way not very different from the side effects that its twin sister the statin, the active ingredient of drugs against cholesterol, can produce in patients with kidney or liver problems.

According to some studies, the natural remedy of Asian origin would be half as effective as prescription medications from pharmaceutical multinationals. However, it can be much lower or even harmless, depending on the concentration, which varies enormously in the dozens of Western brands of “diet” products that have joined the bandwagon.

All of these Western brands of red yeast rice continue to be sold without any problems in stores and online. Kobayashi, on the other hand, has asked its many customers in China to stop shopping.

“The Ministry of Health and relevant agencies are working together to ensure food safety, which includes identifying the harmful substance and the cause of its inclusion in products,” Japanese government spokesman Yoshimasa Hayashi said on Thursday. A statement that does not seem to exonerate, for the moment, the company, but it does exonerate red yeast rice. Although so far, no one has talked about sabotage.

In a parliamentary appearance, the Japanese Prime Minister, Fumio Kishida, assured that the health authorities “will take the necessary measures to prevent something similar from happening again,” according to the NHK network.

The statements by Kishida and Hayashi came shortly after the pharmaceutical company Kobayashi today reported the suspicion of a causal link between the consumption of its product and two hitherto uncounted deaths, raising the number to four.

Another 106 people have been hospitalized with swelling or kidney problems after ingesting the company’s products, although their condition is unknown. Meanwhile, Kobayashi shares have plummeted 20%.