EPA and DHA increase SAC and tend to reduce pulse pressure and total vascular resistance, effects that may reduce the risk of adverse cardiovascular events.

Objective: To measure the relative effects of each of four phytosterol ester-enriched low-fat foods (bread, breakfast cereal, milk and yoghurt) on serum lipids, plasma phytosterols and carotenoids. Design: Three research centres undertook a randomised, incomplete crossover, single-blind study consisting of four treatment periods of 3 weeks each, one of which was a control period. Each sterol-enriched test food provided 1.6 g/day of phytosterols as sterol esters. Setting: General Community. Subjects: In all 58, free-living men and women with mean age (s.d.) 54 (8) y, moderately elevated plasma total cholesterol 6.2 (0.7) mmol/l and body mass index 26.2 (3.0) kg/m 2 . Main outcome measures: Serum lipids, plasma phytosterols and carotenoids. Results: Serum total and LDL cholesterol levels were significantly lowered by consumption of phytosterol-enriched foods: milk (8.7 and 15.9%) and yoghurt (5.6 and 8.6%). Serum LDL cholesterol levels fell significantly by 6.5% with bread and 5.4% with cereal. They were both significantly less efficacious than sterol-enriched milk (Po0.001). Plasma sitosterol increased by 17-23% and campesterol by 48-52% with phytosterol-enriched milk and bread. Lipid-adjusted b-carotene was lowered by 5-10% by sterols in bread and milk, respectively. Conclusions: This is the first study to demonstrate that cholesterol-lowering effects of plant sterol esters may differ according to the food matrix. Plant sterols in low-fat milk was almost three times more effective than in bread and cereal. Despite phytosterolenriched cereal products resulting in lower serum cholesterol reductions compared to sterol-enriched milk, the detection of similar changes in plasma phytosterols demonstrated that such products still delivered and released phytosterols to the gut.

Objectives: To determine the efficacy on plasma cholesterol-lowering of plant sterol esters or non-esterified stanols eaten within low-fat foods as well as margarine. Design: Randomised, controlled, single-blind study with sterol esters and non-esterified plant stanols provided in breakfast cereal, bread and spreads. Study 1 comprised 12 weeks during which sterol esters (2.4 g) and stanol (2.4 g) -containing foods were eaten during 4 week test periods of cross-over design following a 4 week control food period. In Study 2, in a random order cross-over design, a 50% dairy fat spread with or without 2.4 g sterol esters daily was tested. Subjects: Hypercholesterolaemic subjects; 22 in study 1 and 15 in study 2. Main outcome measures: Plasma lipids, plasma sterols, plasma carotenoids and tocopherols. Results: Study 1 -median LDL cholesterol was reduced by the sterol esters (713.6%; P < 0.001 by ANOVA on ranks; P < 0.05 by pairwise comparison) and by stanols (78.3%; P ¼ 0.003, ANOVA and < 0.05 pairwise comparison). With sterol esters plasma plant sterol levels rose (35% for sitosterol, 51% for campesterol; P < 0.001); plasma lathosterol rose 20% (P ¼ 0.03), indicating compensatory increased cholesterol synthesis. With stanols, plasma sitosterol fell 22% (P ¼ 0.004), indicating less cholesterol absorption. None of the four carotenoids measured in plasma changed significantly. In study 2, median LDL cholesterol rose 6.5% with dairy spread and fell 12.2% with the sitosterol ester fortified spread (P ¼ 0.03 ANOVA and < 5% pairwise comparison). Conclusion: 1. Plant sterol esters and non-esterified stanols, two-thirds of which were incorporated into low-fat foods, contributed effectively to LDL cholesterol lowering, extending the range of potential foods. 2. The LDL cholesterol-raising effect of butter fat could be countered by including sterol esters. 3. Plasma carotenoids and tocopherols were not reduced in this study. Sponsorship: Meadow Lea Foods, Australia. Descriptors: sterolesters; sitostanol; low-fat foods; cholesterol European Journal of Clinical Nutrition (2001Nutrition ( ) 55, 1084Nutrition ( -1090 Introduction Plant stanol and sterol esters incorporated within spreads have been shown to augment the low density lipoprotein cholesterol lowering effect of other strategies. Alone, in dosages of around 2 g daily, stanol or unhydrogenated sterol esters lower LDL cholesterol by about 10% or more (Miettinen et al, 1995;Westrate & Meijer, 1998;Gylling & Miettinen, 1994). When added to a cholesterollowering diet, sitostanol ester-containing margarine reduces LDL cholesterol by at least a further 5% Andersson et al, 1999). Each of these studies had provided sterols in the form of esters and within margarine.Non-esterified or free sterols have also been shown to be effective by a 17% reduction in LDL cholesterol during treatment with a high dose of a soy sterol suspension, although lesser amounts (3 g tall oil sterols, mainly sitosterol) were also effective (Lees et al, 1977). The effect of non-esterified sitostanol is les...

Objective: To determine whether dairy fat in cheese raises low-density lipoprotein (LDL) cholesterol as much as in butter, since epidemiology suggests a different impact on cardiovascular disease. Design: A randomised crossover trial testing the daily consumption of 40 g dairy fat as butter or as matured cheddar cheese, each of 4 weeks duration, was preceded by and separated by 2-week periods when dietary fat was less saturated. Setting: Free-living volunteers.

Compared with a wheat-based meal, a single chickpea-based meal led to a lesser response in plasma glucose and insulin concentrations, but this was not translated into long-term improvement in insulin sensitivity over 6 wk, at least in healthy subjects.