Dose-response effects of different plant sterol sources in fat spreads on serum lipids and C-reactive protein and on the kinetic behavior of serum plant sterols

Abstract

Objective: To test the dose-response effect on low-density lipoprotein cholesterol (LDL-c) of plant sterols (PS) from different sources in a low-fat spread. Methods: Dose responses of soybean oil (BO), tall oil (TO) and a mix of tall oil and rapeseed oil (TO/RP) as fatty acid esters were tested in a parallel design in free-living subjects recruited from the general community who had elevated cholesterol concentrations. Subjects received either control for 6 weeks or 1.6 g PS per day for 3 weeks, then 3.0 g/day for 3 weeks. Results: LDL-c was lowered significantly by consumption of 1.6 g/day of PS (À10.4%, range À7.3 to À11.4%). Increasing the dose to 3.0 g/day modestly reduced LDL-c concentrations further to À14.7%. TO, containing 78% sitosterol, produced an increase in serum sitosterol of 6.5 nmol/ml, while BO, containing only 27% campesterol, produced an increase in serum campesterol of 9.5 nmol/ml in 6 weeks. After PS withdrawal, serum sterols declined by 50% within 2 weeks. Conclusion: Different PS sources were equally effective in lowering serum LDL-c concentrations. The decrease in absolute concentrations of LDL-c was dependent on the baseline concentrations. IntroductionA large number of human intervention studies have been performed using plant sterols (PS) or stanols incorporated into different food matrices to study their cholesterollowering effects. These studies are based on unesterified (free) or esterified PS or stanols, where the esterification is mostly based on vegetable-oil-derived fatty acids. Since the first publications of Mattson et al. in 1977 and1982, in which the efficacy of the ester format was shown, the interest in enriching foods with PS or stanol esters as an effective means of lowering total cholesterol (TC) and lowdensity lipoprotein-cholesterol (LDL-c) has increased. Quite a number of different food formats are now available, such as spreads, yogurts or milks, which can be taken on a daily basis. These foods formats typically provide between 1.5 and 2.5 g/day of PS or stanols from one or more servings, which have been proven to result in a 10-15% LDL-c lowering.From these studies considered collectively, the effective dose range can be established. It was stated in a recent metaanalysis of 41 studies that increasing the dose of PS or stanols to above 2.5 g/day results in little additional effects on lowering cholesterol (Katan et al., 2003). A few studies using specific PS sources and formats have also shown a dose response in smaller groups (Weststrate and Meijer, 1998;Hendriks et al., 1999). However, these studies were based on parallel groups or random assignment to the order of PS dose. One study has examined using PS the effect of four Correspondence: Dr PM Clifton, CSIRO Human Nutrition, Gate 13 Kintore Ave, Adelaide, SA 5000, Australia. E-mail: peter.clifton@csiro.au Guarantor: PM Clifton. Contributors: PMC and GSMJED designed the study; the intervention part was organized and monitored by PMC. PMC and MM coordinated the serum analysis. HCMvdK performed the data analysis ...

Consumption of plant sterols reduces plasma and hepatic triglycerides and modulates the expression of lipid regulatory genes and de novo lipogenesis in C57BL/6J mice

“…Multiple clinical trials have reported variable reductions in circulating TAG concentrations following PS consumption in the range of 6-27% [4][5][6][7][8][9]. Furthermore, although a recent meta-analysis reports reductions in plasma TAG in response to PS consumption [9], previous meta-analyses have failed to establish this relationship [2,10].…”

“…Recent meta-analyses suggest that consumption of PS lowers circulating cholesterol concentrations by 10% and may reduce heart disease risk [2,3]. Although PS are not generally recognized as effective triglyceride (TAG)-lowering agents, assessment of previously published clinical PS interventions reveals a variable, yet often-overlooked response of plasma TAG concentrations [4][5][6][7][8]. Furthermore, a recent meta-analysis supports this potentially significant and emerging TAG-lowering response to PS therapy [9], although previously meta-analyses have failed to establish this relationship [2,10].…”

Tangible Health Benefits of Phytosterol Functional Foods

“…However, the decrease was not significant, most likely due to the large variability in CRP at baseline (Hansel et al 2007). Clifton et al (2008) also reported a tendency for a modest, but statistically non-significant, decrease of CRP on consumption of 3 g of phytosterols in the cohort study.…”

Stability of Sterols in Phytosterol-Enriched Milk under Different Heating Conditions

“…Some studies have shown that a daily intake of 2 g of sterols or stanols could lead to a 25% reduction of the cardiovascular risk (3). Although most of the studies are made with spreads (4,5), it has been also proved that plant sterol esters, when provided in low-fat phytosterol-enriched milk, are effective in lowering total and LDL-cholesterol (6).…”