title: Unesterified plant sterols and stanols lower LDL-cholesterol concentrations equivalently in hypercholesterolemic persons.
abstract: BACKGROUND
  Plant sterols, in various forms, have been shown to reduce total and LDL-cholesterol concentrations. Particularly controversial at present is the effect of the degree of hydrogenation of the plant sterols on cholesterol-lowering efficacy and the responsible mechanisms.
  
  
  OBJECTIVE
  Our goal was to examine the effect of supplementation with unesterified plant sterols and stanols on plasma lipid and phytosterol concentrations and cholesterol absorption, synthesis, and turnover.
  
  
  METHODS
  Fifteen otherwise healthy hypercholesterolemic subjects consumed each of 4 dietary treatments in a randomized crossover design. Unesterified sterols and stanols were blended into the butter component of the diet at a dosage of 1.8 g/d. The diets contained plant sterols (NS), plant stanols (SS), a 50:50 mixture of sterols and stanols (NSS), or cornstarch (control).
  
  
  RESULTS
  Plasma total cholesterol concentrations were 7.8%, 11.9%, and 13.1% lower (P < 0.01) in the NS, SS, and NSS groups, respectively, than in the control group. LDL-cholesterol concentrations were 11.3%, 13.4%, and 16.0% lower (P < 0.03) in the NS, SS, and NSS groups, respectively, than in the control group. Plasma triacylglycerols and HDL-cholesterol concentrations did not differ significantly across diets. Cholesterol absorption efficiency was 56.0%, 34.4%, and 48.9% lower (P < 0.001) in the NS, SS, and NSS groups, respectively, than in the control group. The fractional synthesis rate was higher by 45.5% (P < 0.003) in the NSS group than in the control group. Plasma campesterol and sitosterol concentrations were higher (P < 0.01) in the NS group and sitosterol concentrations were lower (P < 0.01) in the SS group than in the control group.
  
  
  CONCLUSIONS
  These data indicate that, in their free unesterified form, sterols and stanols lower plasma LDL cholesterol equivalently in hypercholesterolemic persons by suppressing cholesterol absorption.
authors.affiliation: School of Dietetics and Human Nutrition, McGill University, Ste Anne-de-Bellevue, Quebec, Canada.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Vanstone
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Raeini-Sarjaz
authors.forename: William E
authors.initials: WE
authors.lastname: Parsons
authors.forename: Peter J H
authors.initials: PJ
authors.lastname: Jones
mesh_terms: D000328:Adult; D002079:Butter; D002784:Cholesterol / Q000031:analogs & derivatives* / Q000096:biosynthesis / Q000097:blood / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood*; D018592:Cross-Over Studies; D004032:Diet; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D007700:Kinetics; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010840:Phytosterols / Q000008:administration & dosage* / Q000097:blood; D008517:Phytotherapy; D012855:Sitosterols / Q000097:blood
chemical_list: D008078:Cholesterol, LDL; D008055:Lipids; D010840:Phytosterols; D012855:Sitosterols; C021273:campesterol; C025473:gamma-sitosterol; D002079:Butter; D002784:Cholesterol