Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet

• Published in: The American journal of clinical nutrition Vol. 74; no. 1; pp. 33 - 43
• Main Authors: MAKI, Kevin C, DAVIDSON, Michael H, PERRONE, Gayle, ROBINS, Sander J, FRANKE, William C, UMPOROWICZ, Denise M, SCHAEFER, Ernst J, DICKLIN, Mary R, INGRAM, Kate A, CHEN, Shirley, MCNAMARA, Judith R, GEBHART, Brian W, RIBAYA-MERCADO, Judy D
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01.07.2001; American Society for Clinical Nutrition, Inc
• Subjects: Adult; Aged; Biological and medical sciences; Carotenoids; Cholesterol; Cholesterol - blood; Cholesterol, Dietary - administration & dosage; Cholesterol, Dietary - pharmacokinetics; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Diet; Diet, Fat-Restricted - standards; Disorders of blood lipids. Hyperlipoproteinemia; Double-Blind Method; Esters; Female; Flowers & plants; Food products; Humans; Hypercholesterolemia - diet therapy; Hypercholesterolemia - metabolism; Intestinal Absorption - drug effects; Intestinal Absorption - physiology; Lipids; Male; Margarine; Medical sciences; Metabolic diseases; Middle Aged; Patient Compliance; Phytosterols - pharmacology; Vitamins; Human; Metabolic diseases; Lipids; Hyperlipoproteinemia; Fortified product; Feeding; Low fat product; Clinical management; Hypercholesterolemia; Lipemia; Diet therapy; Diet; Phytosterol; Plant origin; Dyslipemia
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/74.1.33

Plant sterol esters reduce cholesterol absorption and lower circulating blood cholesterol concentrations when incorporated into the habitual diet. This randomized, double-blind, 3-group parallel, controlled study evaluated the influence of esterified plant sterols on serum lipid concentrations in adults with mild-to-moderate primary hypercholesterolemia. Subjects incorporated a conventional 50%-fat spread into a National Cholesterol Education Program Step I diet for a 4-wk lead-in period, followed by a 5-wk intervention period of the diet plus either a control reduced-fat spread (40% fat; n = 92) or a reduced-fat spread enriched with plant sterol esters to achieve intakes of 1.1 g/d (n = 92; low-sterol group) or 2.2 g/d (n = 40; high-sterol group). Subjects in the low- and high-sterol groups who consumed > or = 80% of the scheduled servings (per-protocol analyses) had total cholesterol values that were 5.2% and 6.6% lower, LDL-cholesterol values that were 7.6% and 8.1% lower, apolipoprotein B values that were 6.2% and 8.4% lower, and ratios of total to HDL cholesterol that were 5.9% and 8.1% lower, respectively, than values for the control group (P < 0.001 for all). Additionally, triacylglycerol concentrations decreased by 10.4% in the high-sterol group. Serum concentrations of fat-soluble vitamins and carotenoids were generally within reference ranges at baseline and postintervention. Serum plant sterol concentrations increased from baseline (0.48% of total sterol by wt) to 0.64% and 0.71% by wt for the low- and high-sterol groups, respectively (P < 0.05 compared with control). A reduced-fat spread containing plant sterol esters incorporated into a low-fat diet is a beneficial adjunct in the dietary management of hypercholesterolemia.