The Lipid-Lowering Effects of Phytosterols and (n-3) Polyunsaturated Fatty Acids Are Synergistic and Complementary in Hyperlipidemic Men and Women

Abstract

Fish oils rich in (n-3) long-chain PUFA (LCPUFA) can reduce circulating triglycerides and raise HDL-cholesterol. Phytosterols have been shown to reduce total cholesterol and LDL-cholesterol in normocholesterolemic and hyperlipidemic populations. We investigated the combined effects of phytosterols and (n-3) LCPUFA on plasma lipid profile in hyperlipidemic individuals. This study was a 3-wk randomized, double-blind, placebo-controlled, 2 x 2 factorial trial in 4 parallel groups of 60 hyperlipidemic individuals. Subjects were randomized to receive either sunola oil or 1.4 g/d (n-3) LCPUFA capsules with or without 2 g phytosterols per day while maintaining their habitual diet. The combination of phytosterols and (n-3) LCPUFA reduced plasma total cholesterol by 13.3% (P = 0.001), which differed from (n-3) LCPUFA alone (P < 0.001). LDL-cholesterol concentrations followed the same pattern as that of plasma cholesterol with a 12.5% decrease (P = 0.002) in the combination group. The HDL-cholesterol concentration was increased by (n-3) LCPUFA (7.1%; P = 0.01) alone and in combination with phytosterols (8.6%; P = 0.04), whereas phytosterol treatment alone had no effect. Plasma triglyceride concentration was lowered by (n-3) LCPUFA (22.3%; P = 0.004) alone and in combination with phytosterols (25.9%; P = 0.005), whereas phytosterol treatment alone had no effect. In conclusion, the combined supplementation with phytosterols and (n-3) LCPUFA has both synergistic and complementary lipid-lowering effects in hyperlipidemic men and women.

Phytosterol stearate esters elicit similar responses on plasma lipids and cholesterol absorption but different responses on fecal neutral sterol excretion and hepatic free cholesterol in male Syrian hamsters

“…3 Phytosterol treatment indicates quantification of the specific treatment phytosterol only. 4 Free treatment phytosterol to total treatment phytosterol ratio is referred to as net hydrolysis. tions), whereas the current study indicated that a maximum of 4.68% of sitosterol stearate ester is hydrolyzed.…”

“…Both free and fatty acid-esterified phytosterols decrease serum studies. Fish oil phytosterol esters have demonstrated equal effectiveness as sunflower oil phytosterol esters in lowering LDL cholesterol but have the added benefit of reducing plasma triglycerides [3], indicating that the fish oil phytosterol esters maintain the favorable therapeutic effects of both the fatty acid and the phytosterol [4]. Phytosterols esterified to stearate-enriched fatty acid mixtures have demonstrated an ability to decrease LDL cholesterol in humans [5] and a superior plasma nonhigh-density lipoprotein (non-HDL) cholesterol-lowering efficacy compared with linoleate-enriched esters in hamsters [6].…”

Cholesterol-lowering phytosterols: factors affecting their use and efficacy

“…124 Combining phytosterols with diets rich in fish oil or high-oleic sunflower oil significantly lowered LDL cholesterol, but the fish oil and phytosterol combination also lowered serum triglycerides. 125 In addition, the combination of fish oil and phytosterol significantly reduced serum markers of inflammation. 126 Using a different approach, Jones and coworkers 127,128 used phytosterols that were esterified to fatty acids derived from fish oil (high in 22:6n−3 and 20:5n−3) vs sunflower oil (high in 18:2n−6) or olive oil (high in 18:1n−9).…”

Functional foods for dyslipidaemia and cardiovascular risk prevention

“…more effectively than long-chain n-3 fatty acid alone (95) . Both in the USA and in Europe phytosterols are officially functional ingredients.…”