Cholesterol-lowering effects of plant sterol esters and non-esterified stanols in margarine, butter and low-fat foods.
OBJECTIVE
To determine the efficacy on plasma cholesterol-lowering of plant sterol esters or non-esterified stanols eaten within low-fat foods as well as margarine.


METHODS
Randomised, controlled, single-blind study with sterol esters and non-esterified plant stanols provided in breakfast cereal, bread and spreads. Study 1 comprised 12 weeks during which sterol esters (2.4 g) and stanol (2.4 g)-containing foods were eaten during 4 week test periods of cross-over design following a 4 week control food period. In Study 2, in a random order cross-over design, a 50% dairy fat spread with or without 2.4 g sterol esters daily was tested.


METHODS
Hypercholesterolaemic subjects; 22 in study 1 and 15 in study 2.


METHODS
Plasma lipids, plasma sterols, plasma carotenoids and tocopherols.


RESULTS
Study 1-median LDL cholesterol was reduced by the sterol esters (-13.6%; P<0.001 by ANOVA on ranks; P<0.05 by pairwise comparison) and by stanols (-8.3%; P=0.003, ANOVA and <0.05 pairwise comparison). With sterol esters plasma plant sterol levels rose (35% for sitosterol, 51% for campesterol; P<0.001); plasma lathosterol rose 20% (P=0.03), indicating compensatory increased cholesterol synthesis. With stanols, plasma sitosterol fell 22% (P=0.004), indicating less cholesterol absorption. None of the four carotenoids measured in plasma changed significantly. In study 2, median LDL cholesterol rose 6.5% with dairy spread and fell 12.2% with the sitosterol ester fortified spread (P=0.03 ANOVA and <5% pairwise comparison).


CONCLUSIONS
1. Plant sterol esters and non-esterified stanols, two-thirds of which were incorporated into low-fat foods, contributed effectively to LDL cholesterol lowering, extending the range of potential foods. 2. The LDL cholesterol-raising effect of butter fat could be countered by including sterol esters. 3. Plasma carotenoids and tocopherols were not reduced in this study.


BACKGROUND
Meadow Lea Foods, Australia.
Nestel
P
P
Baker Medical Research Institute, Melbourne, Australia.
Cehun
M
M
Pomeroy
S
S
Abbey
M
M
Weldon
G
G
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D000975:Antioxidants / Q000378:metabolism; D002079:Butter / Q000032:analysis; D002338:Carotenoids / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D018592:Cross-Over Studies; D018752:Diet, Fat-Restricted; D004952:Esters; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008297:Male; D008383:Margarine / Q000032:analysis; D008875:Middle Aged; D010840:Phytosterols / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D008517:Phytotherapy; D016037:Single-Blind Method; D016896:Treatment Outcome; D014810:Vitamin E / Q000097:blood
D000924:Anticholesteremic Agents; D000975:Antioxidants; D004952:Esters; D010840:Phytosterols; D014810:Vitamin E; D002338:Carotenoids; D002079:Butter; D008383:Margarine; D002784:Cholesterol