Magnitude of the Hypocholesterolemic Effect of Dietary Sitosterol in Man

Abstract:The purpose of this study was to determine the effects of phytosterol esterenriched vegetable oil on the serum concentration of cholesterol and to assess its safety in healthy subjects with normocholesterolemics. Twenty-two healthy subjects completed this study in a double blind, parallel arm design. The subjects were randomly divided into 2 groups: control group (n = 11) and phytosterol ester-enriched group (n = 11), and fed either 42 g of phytosterol ester-enriched vegetable oil or control vegetable oil, containing about 1.336 g and 0.117 g of phytosterol (as the major free sterol) respectively, daily for 4 weeks. Serum lipids, apolipoproteins, serum fat-soluble vitamins, serum phytosterols and biochemical parameters were measured. The subjects were asked to report any side effect. Phytosterol ester-enriched vegetable oil significantly reduced the concentrations of serum total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B, by 3.3%, 4.4% and 3.2% respectively, compared with control oil. No significant changes were found in the concentrations of triacylglycerol, high-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, remnant-like lipoprotein cholesterol and other kinds of apolipoproteins. Neither vegetable oil affected the concentrations of fat-soluble vitamins (retinol and a-tocopherol) or b-carotene. Serum bsitosterol and campesterol were significantly higher in the phytosterol ester-enriched vegetable oil group compared with the control oil group. The concentrations of biochemical parameters did not change in either group. There were no side effects or serious adverse events in either group during the administration. In conclusion, the results showed that a daily 1.336 g intake of phytosterol (as the major free sterol) is effective in lowering serum total-and LDL-cholesterol in healthy men and has no negative physiologic action.

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“…459.5 ± 9.6 14.4 ± 1.0 2.4 ± 0.3 1048.9 ± 107. 7 17.2 ± 0.5 1) There was no significant difference between the 2 groups.…”

Section: Diet Recordsmentioning

confidence: 84%

Effects of Phytosterol Ester-Enriched Vegetable Oil on Serum Cholesterol and Assessment of Safety in Healthy Men.

et al. 2003

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“…In addition to the difference in fatty acid composition of the two experimental diets, there was also a greater amount of plant sterols in the safflower oil-containing diet, amounting to 300 mg digitonin-precipitable material per day. If this were entirely /8-sitosterol we would expect to see no significant effect on the serum cholesterol concentration in view of the quantity of dietary 8-sitosterol required to affect blood cholesterol levels (100). With the total plant sterol content of these two diets (420 and 720 mg/ day) we would expect to see no more than minimal effects (1 to 5 mg/100 ml changes) on the serum cholesterol levels of these subjects as a result of the plant sterols (101).…”

Section: Discussionmentioning

confidence: 99%

Effect of dietary fat on the fecal excretion of cholesterol and its degradation products in man

Moore¹,

Anderson²,

Taylor³

et al. 1968

J. Clin. Invest.

134

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Fecal bile acid and neutral sterol excretion rates were determined in five healthy young men when serum cholesterol changes were induced by isocaloric substitution of an unsaturated (safflower oil) for a saturated fat (butter). The isotope balance method was used after the intravenous injection of cholesterol-4-14C. A feces extraction method is presented which permits essentially complete separation of fecal neutral sterols and bile acids.There was a significant increase in the total excretion of the fecal end products of cholesterol metabolism from 966 + 42 mg/day on saturated fat to 1147 + 45 mg/day on unsaturated fat, and the increase was equally distributed between the neutral sterol and bile acid fractions. With the substitution of dietary fats, regardless of the sequence of their feeding, there was a 28% reduction in serum cholesterol concentration during ingestion of the unsaturated fat. There were reciprocal changes in serum cholesterol levels and fecal steroid excretion with the substitution of one type of fat for the other. The changes in plasma cholesterol content were more than adequately balanced by the reciprocal changes in fecal cholesterol end product excretion.The findings in this study agree with several previous reports in supporting the hypothesis that the hypocholesteremic action of dietary unsaturated fatty acids is associated with an increase in the fecal loss of bile acids and neutral sterols.

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“…The chemical structure of phytosterols, including β-sitosterol, campesterol and stigmasterol, closely resembles that of cholesterol, with the exception that these lipophilic substances contain substitutions at the C24 position on the sterol side chain. Recent studies (6)(7)(8)(9) showed that 1.5 to 3.0 g/day of sitosterol and sitostanol were as effective as higher amounts to reduce LDL-C levels (10)(11)(12)(13). Recent studies (6)(7)(8)(9) showed that 1.5 to 3.0 g/day of sitosterol and sitostanol were as effective as higher amounts to reduce LDL-C levels (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

“…Dietary intake of phytosterols, which is well tolerated (2), inhibits cholesterol absorption in the gastrointestinal tract and as a result leads to reduction in serum total cholesterol and low density lipoprotein-cholesterol (LDL-C) levels (5). As dietary fat represents the major transport vehicle for phytosterols in the diet and as esterification is required for solubilisation of plant sterols in the lipid phase, spreads enriched in plant sterol esters have been developed recently and added as supplements to the diet for the treatment of hypercholesterolemia (12)(13)(14)(15). As dietary fat represents the major transport vehicle for phytosterols in the diet and as esterification is required for solubilisation of plant sterols in the lipid phase, spreads enriched in plant sterol esters have been developed recently and added as supplements to the diet for the treatment of hypercholesterolemia (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Plant Sterol-Enriched Margarine Lowers Plasma LDL in Hyperlipidemic Subjects with low Cholesterol Intake: Effect of Fibrate Treatment

Nigon

Serfaty-Lacrosnière²,

Beucler³

et al. 2001

Clinical Chemistry and Laboratory Medicine

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Phytosterols, found in fat-soluble fractions of plants, chemically resemble cholesterol and inhibit cholesterol absorption in the small intestine. Phytosterol consumption in human subjects reduces plasma total and low density lipoprotein-cholesterol (LDL-C) levels. The primary aim of this study was to determine the efficacy of a low-fat spread enriched with plant sterols in reducing total and LDL-C concentrations in primary hypercholesterolemia. The secondary objective was to evaluate whether patients receiving a lipid-lowering drug (fibrate) might differ in their response to plant sterols. The study was a randomized, double-blind, placebo-controlled two-period cross-over trial with two treatments and three periods. Both treatment periods lasted 2 months, with a washout period (2 months) between them. Spread enriched with plant sterols was compared to non-enriched control spread. Fortified fat spread provided 1.6 g/day of plant sterols derived from edible vegetable oils and fatty acids from sunflower seed oil. The plant sterol content consisted of sitosterol esters (50%), campesterol esters (25%), stigmasterol esters (20%) and 10% of other esters. Data in 53 hypercholesterolemic patients (31 females and 22 males) who completed the study were as follows: patients were 58+/-12 years of age with mean body mass index 23.5+/-2.8 kg/m2 (mean+/-SD). No adverse side-effects of the diet were reported. Plasma total cholesterol and LDL-C concentrations were significantly reduced by 6.4% and 8.8%, respectively, after using the spread enriched in plant sterols, as compared to controls (0.0% and 1.3%, respectively). No effect on high density lipoprotein-cholesterol (HDL-C) and lipoprotein(a) concentrations was detected. When subjects were divided in two subgroups according to fibrate treatment, supplementation with phytosterols decreased plasma cholesterol and LDL-C by 8.5% and 11.1%, respectively in the subgroup of patients treated with fibrates. In the group of patients who did not receive fibrates, consumption of plant sterol margarine reduced plasma cholesterol and LDL-C by 5.5% and 7.7%, respectively. Spread enriched with plant sterol esters significantly lowers blood total and LDL-C levels without affecting HDL-C concentrations, in a hypercholesterolemic population following a strict low cholesterol diet (NCEP step1). In addition, a combination of fibrate treatment and plant sterol ester-supplemented spread offers a safe and effective measure to significantly decrease abnormally high cholesterol levels. We conclude that phytosterol-enriched spread is a useful adjunctive therapy for hypercholesterolemic patients.

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Magnitude of the Hypocholesterolemic Effect of Dietary Sitosterol in Man

Cited by 32 publications

References 16 publications

Effects of Phytosterol Ester-Enriched Vegetable Oil on Serum Cholesterol and Assessment of Safety in Healthy Men.

Effects of Phytosterol Ester-Enriched Vegetable Oil on Serum Cholesterol and Assessment of Safety in Healthy Men.

Effect of dietary fat on the fecal excretion of cholesterol and its degradation products in man

Plant Sterol-Enriched Margarine Lowers Plasma LDL in Hyperlipidemic Subjects with low Cholesterol Intake: Effect of Fibrate Treatment

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