A dietary portfolio approach to cholesterol reduction: Combined effects of plant sterols, vegetable proteins, and viscous fibers in hypercholesterolemia

Jenkins, David; Kendall, Cyril W.C.; Faulkner, Dorothea; Vidgen, Edward; Trautwein, Elke A.; Parker, Tina; Marchie, Augustine; Koumbridis, George; Lapsley, Karen G.; Josse, Robert G.; Leiter, Lawrence A.; Connelly, Philip W.

doi:10.1053/meta.2002.35578

Cited by 161 publications

(147 citation statements)

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“…Animal studies (Naito et al, 2000;Ratnayake et al, 2003), as well as clinical features of sitosterolaemic patients, who are characterized by high plasma plant sterol concentrations (Bjorkhem and Boberg, 1994), have however suggested unfavourable effects of increased plant sterol concentrations on erythrocyte properties. In agreement with our results, however, Jenkins et al (2002) found no effect on osmotic fragility in hyperlipidaemic subjects of a combined intake of plant sterols, viscous fibres and vegetable proteins. Also, consumption of plant sterol-enriched margarine for 52 weeks did not decrease red blood cell deformability in healthy subjects, despite significant increases in red blood cell campesterol and b-sitosterol levels (Hendriks et al, 2003).…”

Section: Discussionsupporting

confidence: 92%

Plant sterol or stanol consumption does not affect erythrocyte osmotic fragility in patients on statin treatment

Jong

Mensink

2006

Eur J Clin Nutr

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Objective: To assess the effects of plant sterol or stanol ester consumption on their incorporation into erythrocytes and their effects on osmotic fragility of red blood cells. Design: Double-blind, randomized, placebo-controlled intervention trial. Subjects and intervention: Forty-one subjects on stable statin treatment -who already have increased serum plant sterol and stanol concentrations -first received for 4 weeks a control margarine. For the next 16 weeks, subjects were randomly assigned to one of three possible interventions. Eleven subjects continued with control margarine, 15 subjects with plant sterol ester enriched and 15 subjects with plant stanol ester-enriched margarine. Daily plant sterol or stanol intake was 2.5 g. Erythrocyte haemolysis was measured spectrophotometrically at five different saline concentrations. Results: Despite significant (P ¼ 0.004) increases of, respectively, 42 and 59% in cholesterol-standardized serum sitosterol and campesterol concentrations in the plant sterol group as compared to the control group, campesterol levels in the red blood cells did not change (P ¼ 0.196). Osmotic fragility did not change significantly (P ¼ 0.757) in the plant sterol and plant stanol groups as compared to the control group. Conclusion: We conclude that plant sterol and stanol ester consumption for 16 weeks does not change osmotic fragility of erythrocytes in statin-treated patients.

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Section: Discussionsupporting

confidence: 92%

Plant sterol or stanol consumption does not affect erythrocyte osmotic fragility in patients on statin treatment

Jong

Mensink

2006

Eur J Clin Nutr

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“…Dietary modification remains the preferred initial treatment option for improving major lipid risk factors rather than instigating drug therapy (NCEP, 2001;Anderson, 2003). Jenkins and coworkers recently proposed the 'Portfolio diet' as a new approach to lipid management: the diet utilizes a combination of hypocholesterolaemic agents such as psyllium, oats, nuts, plant sterols and soy protein to provide an additive effect in reducing total and low-density lipoprotein cholesterol (LDL-C), equivalent to first-line drug therapy (Jenkins et al, 2002a(Jenkins et al, , 2003. Dietary intervention studies have shown that numerous legumes (eg, soy beans, navy beans, field beans, lentils, chickpeas and pinto beans) beneficially modify serum lipids (Jenkins et al, 1983;Anderson et al, 1984Anderson et al, , 1990Anderson et al, , 1995Duane, 1997;Fruhbeck et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

et al. 2004

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Objective: To examine the effect of a diet containing a novel legume food ingredient, Australian sweet lupin (Lupinus angustifolius) kernel fibre (LKFibre), compared to a control diet without the addition of LKFibre, on serum lipids in men. Design: Randomized crossover dietary intervention study. Setting: Melbourne, Australia -Free-living men. Subjects: A total of 38 healthy males between the ages of 24 and 64 y completed the intervention. Intervention: Subjects consumed an LKFibre and a control diet for 1 month each. Both diets had the same background menus with seven additional experimental foods that either contained LKFibre or did not. Depending on energy intake, the LKFibre diet was designed to contain an additional 17 to 30 g/day fibre beyond that of the control diet. Results: Compared to the control diet, the LKFibre diet reduced total cholesterol (TC) (mean7s.e.m.; 4.571.7%; P ¼ 0.001), low-density lipoprotein cholesterol (LDL-C) (5.472.2%; P ¼ 0.001), TC: high-density lipoprotein cholesterol (HDL-C) (3.072.0%; P ¼ 0.006) and LDL-C:HDL-C (3.872.6%; P ¼ 0.003). No effects on HDL-C, triacylglycerols, glucose or insulin were observed. Conclusions: Addition of LKFibre to the diet provided favourable changes to some serum lipid measures in men, which, combined with its high palatability, suggest this novel ingredient may be useful in the dietary reduction of coronary heart disease risk.

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“…6 (SE 0 . 9) kg/m 2 ), three of whom had blood lipids in the normal range (32) . At the end of the 4-week intervention total cholesterol (TC; -22 .…”

Section: The Dietary Portfolio: Metabolic Trialsmentioning

confidence: 94%

“…0% total energy and <50 mg dietary cholesterol/4 . 2 MJ (1000 kcal) was present (32)(33)(34) . Furthermore, the diet provided 30 .…”

Section: The Dietary Portfoliomentioning

confidence: 99%

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Session 4: CVD, diabetes and cancer A dietary portfolio for management and prevention of heart disease

2009

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CHD is the leading cause of worldwide mortality. The prevalence of heart disease has been linked to the adoption of a sedentary lifestyle and the increased dietary dependence on saturated fats from animal sources and the intake of refined foods. Elevated blood cholesterol level is one of the major risk factors for CHD. While cholesterol-lowering drug therapy (statins) has been effective in reducing the risk of heart disease, there are those individuals who are unwilling or because of muscle pains or raised levels of liver or muscle enzymes are unable to take cholesterol-lowering medication. Fortunately, there is evidence linking a number of dietary components to CHD risk reduction. The strength of this evidence has prompted various regulatory bodies to advocate diet as the first line of defence for primary prevention of heart disease. It was therefore decided to combine four dietary components that have been shown to lower blood cholesterol concentrations (nuts, plant sterols, viscous fibre and vegetable protein) in a dietary portfolio in order to determine whether the combined effect is additive. In a metabolically-controlled setting this dietary portfolio has proved to be as effective as a starting dose of a first-generation statin cholesterol-lowering medication in reducing the risk of CHD. The dietary portfolio has also been shown to be effective in sustaining a clinically-significant effect in the long term under a 'real-world' scenario. However, success of the diet depends on compliance and despite the accessibility of the foods adherence has been found to vary greatly. Overall, the evidence supports the beneficial role of the dietary portfolio in reducing blood cholesterol levels and CHD risk.

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A dietary portfolio approach to cholesterol reduction: Combined effects of plant sterols, vegetable proteins, and viscous fibers in hypercholesterolemia

Cited by 161 publications

References 0 publications

Plant sterol or stanol consumption does not affect erythrocyte osmotic fragility in patients on statin treatment

Plant sterol or stanol consumption does not affect erythrocyte osmotic fragility in patients on statin treatment

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

Session 4: CVD, diabetes and cancer A dietary portfolio for management and prevention of heart disease

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