Non-cholesterol sterols in serum, lipoproteins, and red cells in statin-treated FH subjects off and on plant stanol and sterol ester spreads

Ketomäki, Anna; Gylling, Helena; Miettinen, Tatu A.

doi:10.1016/j.cccn.2004.10.008

Cited by 31 publications

(50 citation statements)

References 27 publications

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“…Finally, in normo-and mildly hypercholesterolemic subjects, plant sterols (3.2 g/day) and stanols (2.7 g/day) lowered LDL cholesterol by 13.1 and 11.9%, respectively (Weststrate and Meijer, 1998). However, only two small studies have compared side-by-side the effects of plant sterol and stanol esters in subjects on statin therapy (Ketomaki et al, 2004(Ketomaki et al, , 2005. In five subjects with familial hypercholesterolemia (FH), plant stanol ester consumption (2 g/day) lowered LDL cholesterol by 14.6%.…”

Section: )mentioning

confidence: 99%

Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment

et al. 2007

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Objective: The present study was designed to examine for the first time, side-by-side, the effects of plant sterol and stanol consumption on lipid metabolism and markers of antioxidant status, oxidative stress, endothelial dysfunction and low-grade inflammation in subjects on stable statin-treatment. Design: Double-blind, randomized, placebo-controlled, intervention trial. Setting: University. Subjects: Forty-five patients on current statin treatment were recruited via newspaper advertisements. Data of 41 patients were used in statistical analysis. Intervention: Subjects consumed margarine with no added plant sterols or stanols for 4 weeks and were then divided into three groups of 15 subjects. For the next 16 weeks, one group continued with the control margarine and the other two groups with either a plant sterol-or stanol (2.5 g/day)-enriched margarine. Blood was sampled at the end of the run-in and intervention periods. Results: Plant sterol and stanol consumption significantly (P ¼ 0.026) reduced low-density lipoprotein (LDL) cholesterol by 0.34 mmol/l (95% confidence interval (CI), À0.67 to À0.04 mmol/l). No effects were shown on enzymatic and non-enzymatic antioxidants and markers of oxidative modification of lipids and DNA. In addition, no effect was found on soluble adhesion molecules, C-reactive protein and monocyte chemotactic protein-1 concentrations. Conclusions: We conclude that 16 weeks of plant sterol or stanol consumption did not affect markers of antioxidant status, oxidative stress, endothelial dysfunction and low-grade inflammation in patients on stable statin treatment, despite a significant reduction of LDL cholesterol.

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Section: )mentioning

confidence: 99%

Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment

et al. 2007

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“…Absolute reductions in total and LDLcholesterol ranged from 0·31 to 0·62 mmol/l and from 0·30 to 0·67 mmol/l, respectively. The largest reductions were found in a cross-over trial conducted in patients with FH (36) , although these reductions are probably partly caused by the low-fat spread as the results were not corrected for changes in a placebo-controlled group and no run-in period on placebo spread was used.…”

Section: Mechanism Of Supporting Statin Therapymentioning

confidence: 95%

“…The majority of the studies did not find any significant effects of plant sterols or stanols on HDL-cholesterol or TAG, nor were the effects of plant sterols different compared with the effects of plant stanols. However, Ketomaki et al found in a study consisting of two consecutive 4-week intervention periods with either a plant stanol ester or a plant sterol ester that only during the sterol ester period HDL-cholesterol increased and TAG levels decreased significantly (36) . This study achieved a Jadad score of 3; no placebo-controlled group was included in this study, possibly leading to flawed results.…”

Section: Mechanism Of Supporting Statin Therapymentioning

confidence: 98%

“…† Borderline significant. ‡ The net change in lipid levels was calculated by subtracting the mean change from baseline after control intervention from the mean change from baseline after plant sterol or stanol intervention, except for the study of Ketomaki et al (36) where the net change is the mean change from baseline after plant sterol and stanol intervention. § The study of Simons (40) is a 2 £ 2 factorial design study with four parallel arms.…”

Section: Mechanism Of Supporting Statin Therapymentioning

confidence: 99%

“…Differences in cholesterol-lowering effects of plant sterols or stanols between the different studies might be explained by baseline cholesterol levels, because it has been hypothesised that patients with high baseline cholesterol levels experience a larger reduction in cholesterol levels after sterol or stanol ester consumption (36) . Moreover, it is suggested that patients with high ratios of serum cholestanol and plant sterols to cholesterol (markers for cholesterol absorption) may benefit the most from plant stanol or sterol intake (50) .…”

Section: Mechanism Of Supporting Statin Therapymentioning

confidence: 99%

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Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

et al. 2010

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Functional foods and dietary supplements might have a role in supporting drug therapy. These products may (1) have an additive effect to the effect that a drug has in reducing risk factors associated with certain conditions, (2) contribute to improve risk factors associated with the condition, other than the risk factor that the drug is dealing with, or (3) reduce drug-associated side effects, for example, by restoring depleted compounds or by reducing the necessary dose of the drug. Possible advantages compared with a multidrug therapy are lower drug costs, fewer side effects and increased adherence. In the present review we have focused on the support of statin therapy using functional foods or dietary supplements containing plant sterols and/or stanols, soluble dietary fibre, n-3 PUFA or coenzyme Q 10 . We conclude that there is substantial evidence that adding plant sterols and/or stanols to statin therapy further reduces total and LDL-cholesterol by roughly 6 and 10 %, respectively. Adding n-3 PUFA to statin therapy leads to a significant reduction in plasma TAG of at least 15 %. Data are insufficient and not conclusive to recommend the use of soluble fibre or coenzyme Q 10 in patients on statin therapy and more randomised controlled trials towards these combinations are warranted. Aside from the possible beneficial effects from functional foods or dietary supplements on drug therapy, it is important to examine possible (negative) effects from the combination in the long term, for example, in post-marketing surveillance studies. Moreover, it is important to monitor whether the functional foods and dietary supplements are taken in the recommended amounts to induce significant effects. Combination therapy: Dyslipidaemia: Statins: Functional foodsThe world market for functional foods (FF) and dietary supplements (DS) is expanding rapidly. In 2010 FF are expected to represent 5 % of the total global food market (1) and the market for DS is estimated at more than $60 billion worldwide (2) . In general, the target population of FF or DS is healthy individuals with slightly elevated risk factors or some physical discomfort. However, due to the fast growing market of FF or DS and the accompanying strong advertising and marketing, also patients on medication may be stimulated to use FF or DS. This may have several consequences for the quality of drug treatment as stated by de Jong et al. with the example of the combined intake of plant sterols and/or stanols and statins (3) . Whereas they addressed the additive effect of plant sterols and/or stanols on reducing LDL-cholesterol values in patients on statin treatment, their main focus was the possible negative aspects of the combination, such as unfavourable effects on patient adherence with drug treatment and increasing the potential for food-drug interactions.In the present review we will focus on the possible beneficial effects that FF or DS may have on drug therapy. Because of the large number of subjects treated suboptimally with statins (hydroxymethylglutaryl Co...

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Dietary treatment for familial hypercholesterolaemia

Shafiq¹,

Singh

Kaur

et al. 2010

Cochrane Database of Systematic Reviews

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Non-cholesterol sterols in serum, lipoproteins, and red cells in statin-treated FH subjects off and on plant stanol and sterol ester spreads

Cited by 31 publications

References 27 publications

Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment

Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment

Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

Dietary treatment for familial hypercholesterolaemia

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