title: Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet.
abstract: BACKGROUND
  Plant sterol esters reduce cholesterol absorption and lower circulating blood cholesterol concentrations when incorporated into the habitual diet.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  A reduced-fat spread containing plant sterol esters incorporated into a low-fat diet is a beneficial adjunct in the dietary management of hypercholesterolemia.
authors.affiliation: Chicago Center for Clinical Research, IL 60610, USA. kmaki@protocare.com
authors.forename: K C
authors.initials: KC
authors.lastname: Maki
authors.forename: M H
authors.initials: MH
authors.lastname: Davidson
authors.forename: D M
authors.initials: DM
authors.lastname: Umporowicz
authors.forename: E J
authors.initials: EJ
authors.lastname: Schaefer
authors.forename: M R
authors.initials: MR
authors.lastname: Dicklin
authors.forename: K A
authors.initials: KA
authors.lastname: Ingram
authors.forename: S
authors.initials: S
authors.lastname: Chen
authors.forename: J R
authors.initials: JR
authors.lastname: McNamara
authors.forename: B W
authors.initials: BW
authors.lastname: Gebhart
authors.forename: J D
authors.initials: JD
authors.lastname: Ribaya-Mercado
authors.forename: G
authors.initials: G
authors.lastname: Perrone
authors.forename: S J
authors.initials: SJ
authors.lastname: Robins
authors.forename: W C
authors.initials: WC
authors.lastname: Franke
mesh_terms: D000328:Adult; D000368:Aged; D002338:Carotenoids; D002784:Cholesterol / Q000097:blood*; D002791:Cholesterol, Dietary / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018752:Diet, Fat-Restricted / Q000592:standards; D004311:Double-Blind Method; D004952:Esters; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy* / Q000378:metabolism; D007408:Intestinal Absorption / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008383:Margarine; D008875:Middle Aged; D010349:Patient Compliance; D010840:Phytosterols / Q000494:pharmacology*; D014815:Vitamins
chemical_list: D002791:Cholesterol, Dietary; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004952:Esters; D010840:Phytosterols; D014815:Vitamins; D002338:Carotenoids; D008383:Margarine; D002784:Cholesterol