title: Consumption of tall oil-derived phytosterols in a chocolate matrix significantly decreases plasma total and low-density lipoprotein-cholesterol levels.
abstract: In a randomized, double-blind, placebo-controlled trial we evaluated the effect of dietary chocolates enriched with a wood-based phytosterol-phytostanol mixture, containing 18 % (w/w) sitostanol, compared with placebo dietary chocolates in seventy subjects with primary hypercholesterolaemia (total cholesterol levels below 8 mmol/l). For 4 weeks, participants consumed three servings of the phytosterol-enriched chocolate/d that provided 1.8 g unesterified phytosterols/d or a placebo chocolate in conjunction with a low-fat, low-cholesterol diet. Plasma total and LDL-cholesterol levels were statistically significantly reduced by 6.4 % (-0.44 mmol/l) and 10.3 % (-0.49 mmol/l), respectively, after 4 weeks of phytosterol-enriched-chocolate treatment. Plasma HDL-cholesterol and triacylglycerol levels were not affected. Consumption of phytosterol-enriched chocolates significantly increased plasma lathosterol concentration (+20.7 %), reflecting an increased endogenous cholesterol synthesis in response to phytosterol-induced decreased intestinal cholesterol absorption. Furthermore, the chocolates enriched with phytosterols significantly increased both plasma sitosterol (+95.8 %) and campesterol (+64.1 %) levels, compared with the placebo chocolate group. However, the absolute values of plasma sitosterol and campesterol remained within the normal range, that is, below 10 mg/l. The chocolates with phytosterols were palatable and induced no clinical or biochemical side effects. These findings indicate that dietary chocolate enriched with tall oil-derived phytosterols (1.8 g/d) is effective in lowering blood total and LDL-cholesterol levels in subjects with mild hypercholesterolaemia and thus may be helpful in reducing the risk of CHD in these individuals.
authors.affiliation: Department of General Internal Medicine, University Medical Centre Nijmegen, The Netherlands. J.deGraaf@aig.azn.nl
authors.forename: Jacqueline
authors.initials: J
authors.lastname: De Graaf
authors.forename: Pernette R W
authors.initials: PR
authors.lastname: De Sauvage Nolting
authors.forename: Marjel
authors.initials: M
authors.lastname: Van Dam
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Belsey
authors.forename: John J P
authors.initials: JJ
authors.lastname: Kastelein
authors.forename: P
authors.initials: P
authors.lastname: Haydn Pritchard
authors.forename: Anton F H
authors.initials: AF
authors.lastname: Stalenhoef
mesh_terms: D000328:Adult; D001055:Apolipoproteins B / Q000032:analysis; D002099:Cacao; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000031:analogs & derivatives* / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010840:Phytosterols / Q000008:administration & dosage* / Q000097:blood; D010938:Plant Oils; D012855:Sitosterols / Q000008:administration & dosage / Q000097:blood; D018709:Statistics, Nonparametric
chemical_list: D001055:Apolipoproteins B; D008078:Cholesterol, LDL; D008055:Lipids; D010840:Phytosterols; D010938:Plant Oils; D012855:Sitosterols; C482568:tall oil; C003535:campestanol; C021273:campesterol; C025473:gamma-sitosterol; C001521:lathosterol; D002784:Cholesterol; C021255:stigmastanol