Effects of 2 low-fat stanol ester–containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects
01 Mar 1999-The American Journal of Clinical Nutrition (American Society for Nutrition)-Vol. 69, Iss: 3, pp 403-410
TL;DR: It is concluded that the low-fat, plant stanol ester-containing margarines are effective cholesterol-lowering products in hypercholesterolemic subjects when used as part of a low-Fat, low-cholesterol diet.
About: This article is published in The American Journal of Clinical Nutrition.The article was published on 1999-03-01 and is currently open access. It has received 240 citations till now. The article focuses on the topics: Stanol ester & Plant stanol ester.
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TL;DR: Esterification of stanols with long-chain fatty acids increases fat solubility by 10-fold and enables the incorporation of plant stanol into different food products, even low-fat foods, and provides an adequate daily amount of stanol for optimal reduction of cholesterol absorption, while maintaining a high-quality food product.
Abstract: Clinical trials have shown that an intake of 2 to 3 g/day of esterified plant stanol—when incorporated in margarines or spreads—significantly reduces serum total and low-density lipoprotein (LDL) cholesterol concentrations without affecting serum high-density lipoprotein cholesterol or triglyceride levels. There is also a growing interest in incorporating cholesterol-lowering ingredients into low-fat foods. Esterification of stanols with long-chain fatty acids increases fat solubility by 10-fold and enables the incorporation of plant stanols into different food products, even low-fat foods. It provides a means of introducing an adequate daily amount of stanol for optimal reduction of cholesterol absorption, while maintaining a high-quality food product. Recent clinical trials show that esterified plant stanols effectively reduce serum total and LDL cholesterol levels, even when used in food vehicles with a low-fat content.
40 citations
TL;DR: The efficacy of PS in relation to lipoprotein profile is not influenced by saturated fat or dietary cholesterol intake, which confirms the positive effect of healthy diet therapy in improving the negative effects that PS exert on carotenoid levels.
Abstract: Phytosterols (PS) are recommended to reduce LDL-cholesterol. However, the influence of cholesterol and fat intake on the lipid-lowering effect of PS in mildly hypercholesterolaemia is unclear. Thus, the aim of the present study was to evaluate whether the efficacy of PS is related to the composition of saturated fat and dietary cholesterol intake. Additionally, serum carotenoid content was analysed to evaluate to what extent it was undermined by PS. This was a 3-month randomised, parallel trial with a three-arm design. Patients were divided into three groups: healthy diet (n 24), healthy diet þ PS (n 31) and free diet þ PS (n 29), receiving 2 g/d of PS. Healthy and free diets were characterised by a daily ingestion of 6·8 % of saturated fat and 194·4 mg of cholesterol and 12·7 % of saturated fat and 268·1 mg of cholesterol, respectively. After PS therapy, patients receiving the healthy diet þ PS or a free diet þ PS exhibited a similar reduction in total cholesterol (6·7 and 5·5 %), LDL-cholesterol (9·6 and 7·0 %), non-HDL-cholesterol (12·2 and 8·9 %) and apo B-100/apo A-I ratio (11·5 and 11·6 %), respectively. In patients following the healthy diet, (b-carotene concentration rose by 26·9 %, whereas the b-carotene and lycopene levels dropped by 21·0 and 22·8 % in the group receiving the free diet þ PS, respectively. No change was observed in carotenoid levels in healthy diet þ PS group. In conclusion, the efficacy of PS in relation to lipoprotein profile is not influenced by saturated fat or dietary cholesterol intake, which confirms the positive effect of healthy diet therapy in improving the negative effects that PS exert on carotenoid levels.
38 citations
Cites background from "Effects of 2 low-fat stanol ester–c..."
...While some investigators have reported that low levels of dietary cholesterol intake attenuate the effectiveness of PS((18,19)), others have shown that PS lower cholesterol concentration, even in subjects with a strict restriction of cholesterol intake((20,21))....
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TL;DR: It is demonstrated that BBR and PS, when combined, synergistically lower plasma cholesterol levels and significantly reduce liver cholesterol, without the observation of any toxic effects.
37 citations
References
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TL;DR: Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
Abstract: THE SECOND report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II, or ATP II) presents the National Cholesterol Education Program's updated recommendations for cholesterol management. It is similar to the first in general outline, and the fundamental approach to treatment of high blood cholesterol is comparable. This report continues to identify low-density lipoproteins (LDL) as the primary target of cholesterol-lowering therapy. As in the first report, the second report emphasizes the role of the clinical approach in primary prevention of coronary heart disease (CHD). Dietary therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD. However, the second report contains new features that distinguish it from the first. These include the following: Increased emphasis on See also pp 3002 and 3009.
28,495 citations
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TL;DR: In this paper, the authors tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia.
Abstract: Background Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia. Methods We conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day). Results The margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -...
752 citations