Time of ingestion relative to meal intake determines gastrointestinal responses to a plant sterol–containing yoghurt drink

Keszthelyi, Dániel; Knol, Diny; Troost, Freddy J.; Avesaat, Mark van; Foltz, Martin; Masclee, A.A.M.

doi:10.1007/s00394-012-0440-3

Cited by 16 publications

(20 citation statements)

References 13 publications

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“…Also, liquid foods (drinks) are not per definition consumed together with a meal; sufficient ingestion of food (i.e. fat) is required to trigger bile release for PS to optimally compete with cholesterol for micellar incorporation and subsequently to optimally inhibit cholesterol absorption ( 31 ) . Given the substantial number of studies included, we assume that publication bias had not affected the findings severely.…”

Section: Discussionmentioning

confidence: 99%

LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies

2014

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Phytosterols (PS, comprising plant sterols and plant stanols) have been proven to lower LDL-cholesterol concentrations. The dose–response relationship for this effect has been evaluated in several meta-analyses by calculating averages for different dose ranges or by applying continuous dose–response functions. Both approaches have advantages and disadvantages. So far, the calculation of averages for different dose ranges has not been done for plant sterols and stanols separately. The objective of the present meta-analysis was to investigate the combined and separate effects of plant sterols and stanols when classified into different dose ranges. Studies were searched and selected based on predefined criteria. Relevant data were extracted. Average LDL-cholesterol effects were calculated when studies were categorised by dose, according to random-effects models while using the variance as weighing factor. This was done for plant sterols and stanols combined and separately. In total, 124 studies (201 strata) were included. Plant sterols and stanols were administered in 129 and fifty-nine strata, respectively; the remaining used a mix of both. The average PS dose was 2·1 (range 0·2–9·0) g/d. PS intakes of 0·6–3·3 g/d were found to gradually reduce LDL-cholesterol concentrations by, on average, 6–12 %. When plant sterols and stanols were analysed separately, clear and comparable dose–response relationships were observed. Studies carried out with PS doses exceeding 4 g/d were not pooled, as these were scarce and scattered across a wide range of doses. In conclusion, the LDL-cholesterol-lowering effect of both plant sterols and stanols continues to increase up to intakes of approximately 3 g/d to an average effect of 12 %.

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Section: Discussionmentioning

confidence: 99%

LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies

2014

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“…Plant sterol addition to a meal displaces cholesterol from the intestinal aqueous phase and lowers chylomicron cholesterol occurrence in humans [ 39 ]. A plant sterol-containing yogurt drink, which was consumed before a meal, exhibited fast gastric emptying, with no triggering of gallbladder contraction, and in consequence did not inhibit cholesterol absorption [ 40 ]. In the present study, sub-analysis of the data found a higher efficacy in lowering LDL-c (decrease 8.9%) among hypercholesterolemic subjects who consumed stanol-fortified biscuits with a meal compared to only a 0.9% reduction in LDL-c when consuming stanol-fortified biscuits alone.…”

Section: Discussionmentioning

confidence: 99%

Serum Cholesterol Reduction Efficacy of Biscuits with Added Plant Stanol Ester

2015

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This study's aim was to test the low-density lipoprotein cholesterol- (LDL-c-) lowering efficacy of biscuits containing 2 g of plant stanols, which corresponded to 3.4 g of plant stanol esters. The biscuit is a new food format that can be consumed as a snack. In a double-blind, placebo-controlled parallel design study, 119 mildly to moderately hypercholesterolemic volunteers were randomized to plant stanol or control groups. Subjects were comparable in age, gender, lipid profiles, and body mass index. They consumed a control biscuit once a day for a two-week period, followed by a four-week intervention period that either had a plant stanol ester biscuit or a control. During the habitual diet, one biscuit per day was consumed at any time that subjects wished. Serum lipid profiles were measured at the first day of run-in, at baseline, and at the study's end. Compared to the control, the total cholesterol (TC), LDL-c, and the LDL-to-high-density lipoprotein (LDL/HDL) ratio had serum reductions of 4.9%, 6.1%, and 4.3%, respectively, and were observed after 4 weeks of biscuit consumption with added plant stanols (P < 0.05). A significantly higher reduction in LDL-c (8.9%) and LDL/HDL ratio (11.4%) was measured in those taking a plant stanol biscuit with a meal compared to those who consumed a plant stanol biscuit without other food. In conclusion, incorporating plant stanols into a biscuit is an attractive, convenient, and acceptable way to modestly lower elevated cholesterol concentrations. For optimal efficacy, biscuits should be consumed with a meal as part of a healthy diet.

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“…The higher dose used in this study did not provide an enhanced effect. The time of intake was reported to be ideal for inducing the physiological changes to allow plant stanols to compete over cholesterol absorption [ 29 ]. However, the subjects might not have consumed the yogurt drink immediately after a meal and thus the liquid nature of the food product might have influenced the cholesterol-lowering efficacy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of yogurt drink with added plant stanol esters (Benecol®, Colanta) in reducing total and LDL cholesterol in subjects with moderate hypercholesterolemia: a randomized placebo-controlled crossover trial NCT01461798

Vásquez-Trespalacios

Romero-Palacio

2014

Lipids Health Dis

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BackgroundCardiovascular diseases have become the leading cause of death from chronic diseases in the world. Main risk factors include hypercholesterolemia, which is caused in most cases by a high saturated fat diet. Plant stanol esters partly block cholesterol absorption in the digestive tract and thereby reduce total cholesterol and low-density lipoprotein (LDL) cholesterol serum levels. Based on epidemiological data, a 10 percent reduction of LDL cholesterol leads to a 20 percent decrease in the coronary heart disease risk throughout life. The aim of this study was to evaluate the efficacy of yogurt drink with added plant stanol esters (Benecol® yogurt drink) in higher doses than the typically used (2g/d stanols), in lowering blood lipids in moderately hypercholesterolemic subjects.MethodsA randomized double-blind crossover, placebo-controlled study in moderately hypercholesterolemic subjects (n = 40) aged between 20 and 50 years old.ResultsYogurt drink with added plant stanols (4 g) as esters (Benecol®, Colanta) consumption compared to regular yogurt drink caused a statistically significant decrease in total cholesterol and low density lipoprotein cholesterol by 7.2% and 10.3%. During the two periods and compared to controls, high-density lipoprotein cholesterol and triglycerides were not significantly different.ConclusionsYogurt drink with an active ingredient in Benecol®, plant stanol esters, reduced total cholesterol and LDL cholesterol in moderately hypercholesterolemic subjects.Trial registrationNCT01461798.

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Time of ingestion relative to meal intake determines gastrointestinal responses to a plant sterol–containing yoghurt drink

Cited by 16 publications

References 13 publications

LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies

LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies

Serum Cholesterol Reduction Efficacy of Biscuits with Added Plant Stanol Ester

Efficacy of yogurt drink with added plant stanol esters (Benecol®, Colanta) in reducing total and LDL cholesterol in subjects with moderate hypercholesterolemia: a randomized placebo-controlled crossover trial NCT01461798

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