Influence of phytosterol and phytostanol food supplementation on plasma liposoluble vitamins and provitamin A carotenoid levels in humans: An updated review of the evidence

• Published in: Critical reviews in food science and nutrition Vol. 57; no. 9; pp. 1906 - 1921
• Main Authors: Fardet, Anthony, Morise, Anne, Kalonji, Esther, Margaritis, Irène, Mariotti, François
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 13.06.2017; Taylor & Francis Ltd
• Subjects: Absorption; alpha-tocopherol; beta-carotene; Bioavailability; Cardiovascular disease; cardiovascular disease risk; Carotenoids; Carotenoids - blood; Cholesterol; Dietary Supplements; Enriched foods; Food Analysis; Food and Nutrition; foods; fruits; Health risks; Humans; intervention studies; intestinal absorption; Life Sciences; liposoluble vitamins; low density lipoprotein cholesterol; Phytosterol and phytostanol-enriched foods; phytosterols; Phytosterols - chemistry; Phytosterols - pharmacology; Plasma; provitamin A carotenoids; risk; Risk factors; Sterols; vegetable consumption; Vitamin A; Vitamins; Vitamins - blood; Phytosterol and phytostanol-enriched foods; cardiovascular disease risk; intervention studies; liposoluble vitamins; provitamin A carotenoids; cardiovascular disease; vitamine liposoluble; provitamine; phytostérol; aliment enrichi; carotenoid; phytosterol and phytostanol-enriched foods; maladie cardiovasculaire; carotenoide
• ISSN: 1040-8398; 1549-7852; 1549-7852
• DOI: 10.1080/10408398.2015.1033611

Phytosterols and phytostanols (PAP) compete with cholesterol absorption in the intestine, resulting in a 5-15%-reduction in plasma total and LDL cholesterol. An important issue is the PAP potential to reduce the plasma concentrations of fat-soluble vitamins and provitamin A carotenoids. Here, an update of the scientific evidence is reviewed to evaluate plant PAP-enriched foods impact on plasma fat-soluble vitamins and carotenoid levels, and to discuss potential implications in terms of cardiovascular risk. Based on 49 human interventional and 3 bioavailability studies, results showed that regular consumption, particularly over the long term, of foods fortified with PAP as recommended in labeling does not significantly impact plasma vitamins A, D, and K concentration. A 10% significant median reduction was observed for α-tocopherol. Concerning carotenoids, while 13 studies did not demonstrate statistically significant plasma β-carotene reduction, 20 studies showed significant reductions, with median effect size of −24%. This decline can be mitigated or offset by increased fruits and vegetables consumption. Furthermore, higher cardiovascular risk was observed for differences in plasma β-carotene concentration of the same magnitude as the estimated average decrease by PAP consumption. These results are supported by the only study of β-carotene bioavailability showing decrease in absorption by phytosterols daily intake.