Safety of long-term consumption of plant sterol esters-enriched spread

Hendriks, H.; Brink, Elizabeth J.; Meijer, G.W.; Princen, H.M.G.; Ntanios, Fady

doi:10.1038/sj.ejcn.1601598

Cited by 149 publications

(107 citation statements)

References 29 publications

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“…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). In our study, however, the slight increase in campesterol levels in the red blood cells did not reach statistical significance.…”

Section: Discussioncontrasting

confidence: 93%

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: Discussioncontrasting

confidence: 93%

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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“…It is also possible that the maximal effect of PSE is already reached after about 3 weeks and is then maintained at that level with no further decrease. A 1-y PSE intake study by Hendriks et al (2003) supports this. Thus, a subsequent increased cholesterol synthesis is not sufficient to compensate for the reduction of intestinal cholesterol absorption.…”

Section: Discussionmentioning

confidence: 72%

“…Thus, we can not ignore that some of the lipid changes observed here might be due to this natural variation. In earlier papers, no effect of plant sterol ester-enriched spread intake on HDL cholesterol and TG has been reported in short-term and long-term studies (Weststrate & Meijer, 1998;Hendriks et al, 1999Hendriks et al, , 2003Nestel et al, 2001;Geelen et al, 2002). However, if an HDL-cholesterol decrease would be a long-term consequence of plant sterol ester intake, it would be an undesirable effect.…”

Section: Discussionmentioning

confidence: 97%

“…Doses of about 1.5-3 g/day of plant sterols or stanols may reduce total cholesterol by 8-17% and LDL cholesterol by 9-19%. Gylling et al, 1995Gylling et al, , 1997Weststrate & Meijer 1998;Hallikainen & Uusitupa 1999;Hendriks et al, 1999Hendriks et al, , 2003Moghadasian & Frohlich 1999;Hallikainen et al, 2000a;Law, 2000;Jones et al, 2000;Nestel et al, 2001;Geelen et al, 2002). An intake of 20-25 g of spread per day is necessary to get about 2 g of plant sterols, which is considered an optimal dose for lowering blood total and LDL cholesterol (Hendriks et al, 1999;Law, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread

et al. 2004

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Objective: To study the compliance and changes in plasma lipids, plant sterols, fat-soluble vitamins and carotenoids in children and parents with familial hypercholesterolemia (FH) consuming a plant sterol ester-enriched (PSE) spread. Design: A 26-week open-label follow-up of children who had previously been studied in a controlled cross-over design. The parents were also included in the open-label arm of the study. Setting: Outpatient clinic for treatment of hyperlipidemia. Subjects: A total of 37 children (7-13 y) and 20 parents (32-51 y) diagnosed with 'definite' or 'possible' heterozygous FH. In all, 19 of the parents, but no children, used statins. All were patients at the Lipid Clinic, National Hospital in Oslo. Interventions: Subjects were recommended to eat 20 g/day of PSE spread as part of their lipid-lowering diet. Results: The mean intake of PSE spread was 13.7 and 16.5 g/days in the children and parents, respectively, corresponding to 1.2 and 1.5 g of plant sterols. Plasma total cholesterol decreased by 9.1% in both children (Po0.001) and parents (P ¼ 0.002). The corresponding decreases in LDL cholesterol were 11.4% (Po0.001) and 11.0% (P ¼ 0.012). Increases in serum lathosterol, campesterol and sitosterol, adjusted for total cholesterol, were observed in the children (31, 96, 48%, respectively, Po0.001) at the end of the controlled cross-over period. In the parents, serum campesterol and sitosterol, adjusted for total cholesterol, increased by 92 and 39%, respectively (Po 0.001). Lipid-adjusted serum a-and b-carotene decreased by 17.4% (P ¼ 0.008) and 10.9% (P ¼ 0.018), respectively, in the children at the end of the controlled PSE period, but increased again during the followup. In the parents, serum a-and b-carotene concentrations were unchanged, while serum lutein and lycopene decreased by 7.3% (P ¼ 0.037) and 14.6% (P ¼ 0.044), respectively. Conclusions: Sustained efficacy of cholesterol reduction and long-term compliance of PSE intake were demonstrated in this study.

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“…Phytosterols are structurally related to cholesterol, and they inhibit the absorption of dietary cholesterol and the reabsorption of biliary cholesterol from the intestine due to their higher affinity for mixed micelles compared with cholesterol (Ling and Jones, 1995). Earlier studies suggest that the use of PS could enhance the effect of statins (Neil et al, 2001;Hendrinks et al, 2003;Noakes et al, 2004;O'Neill et al, 2005;Patch et al, 2005). Although still unevaluated in patients with FH, genetic variation and other associated factors have been found to determine the response of plasma cholesterol to dietary fat composition (Hill et al, 1991;Jansen et al, 1998;Pérez-Martínez et al, 2001;Marks et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Basal plasma concentrations of plant sterols can predict LDL-C response to sitosterol in patients with familial hypercholesterolemia

et al. 2007

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Background: Familial hypercholesterolemia (FH) is associated with a high risk of coronary heart disease. Pharmacological treatment and diet are both essential for the management of FH. Foods rich in plant sterols (PS) may play an important role in the treatment of patients with these disorders. Objective: To test the effect of the intake of PS on low-density lipoprotein (LDL) concentration, endothelial function (EF) and LDL particle size in 30 patients with FH. Design: Randomized and crossover dietary intervention study. Setting: Tertiary outpatient care. Subjects: Thirty-eight were recruited, but only 30 were subjected to four low-fat dietary intervention periods, each of 4 weeks. Methods: Each intervention had a different content of cholesterol (o150 or 300 mg/day) and sitosterol (o1 or 2 g/day). Lipid response, EF and LDL particle size were analysed after the intervention. Results: Plasma sitosterol/cholesterol ratio was higher during both plant sterol-rich periods than during the low plant sterols periods. Basal sitosterol concentrations predicted the LDL-cholesterol response during the intake of plant sterol-enriched diets. The change in LDL-cholesterol was significantly greater in subjects in the upper and intermediate tertiles of basal plasma sitosterol concentrations (À2178 mg/dl, P ¼ 0.03; À1977 mg/dl, P ¼ 0.04, respectively) than in subjects in the lower tertile (875 mg/dl) when they changed from a low cholesterol diet to a low cholesterol plus plant sterol diet. Conclusion: Our study demonstrates that basal sitosterol values can predict hypolipidemic response in patients with FH.

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Safety of long-term consumption of plant sterol esters-enriched spread

Cited by 149 publications

References 29 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

Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread

Basal plasma concentrations of plant sterols can predict LDL-C response to sitosterol in patients with familial hypercholesterolemia

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