title: Isocaloric substitution of plant sterol-enriched fat spread for carbohydrate-rich foods in a low-fat, fibre-rich diet decreases plasma low-density lipoprotein cholesterol and increases high-density lipoprotein concentrations.
abstract: OBJECTIVE
  The aim of the study was to determine the effects on plasma cholesterol of replacing a plant sterol-enriched fat spread with carbohydrate-rich foods relative to a diet high in saturated fat.
  
  
  RESULTS
  Twenty-nine men and women, from the general community, with mean age (SD) 48 (14)y, body mass index 29.0 (6.2)kg/m(2), and plasma total cholesterol concentration 6.48 (0.97)mmol/L completed the randomised, crossover dietary intervention. There were three diets: New Zealand diet (NZ diet) high in total (34%kJ) and saturated (15%kJ) fat, a cholesterol-lowering fibre-rich diet reduced in total (30%kJ) and saturated fat (8%kJ) but including a plant sterol spread (PS diet), and the same cholesterol-lowering diet with the plant sterol spread isocalorically replaced with carbohydrate (CHO diet); total fat, 26%kJ; saturated fat 7%kJ. All foods were provided and each diet was followed for four weeks. Mean (SD) plasma low-density lipoprotein cholesterol concentration declined from 4.68 (0.91)mmol/L on the high saturated fat diet to 4.12 (0.83)mmol/L (P<0.001) on the carbohydrate diet and 3.76 (0.84)mmol/L (P<0.001) on the plant sterol diet. The 20% decrease on the plant sterol diet was significantly greater (P<0.001) than the 12% decrease on the carbohydrate diet. Relative to the NZ diet, mean (95% CI) plasma high-density lipoprotein cholesterol concentration changed by -0.11 (-0.16, -0.06)mmol/L on the CHO diet but was not different at the end of the PS diet, -0.03 (-0.09, 0.02).
  
  
  CONCLUSIONS
  Including a plant sterol-enriched fat spread in a cholesterol-lowering diet produces a more favourable plasma lipid profile than the same diet made lower in total and saturated fat by replacing the spread with carbohydrate-rich foods.
authors.affiliation: Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand. murray.skeaff@stonebow.otago.ac.nz
authors.forename: C Murray
authors.initials: CM
authors.lastname: Skeaff
authors.forename: Christian
authors.initials: C
authors.lastname: Thoma
authors.forename: Jim
authors.initials: J
authors.lastname: Mann
authors.forename: Alex
authors.initials: A
authors.lastname: Chisholm
authors.forename: Sheila
authors.initials: S
authors.lastname: Williams
authors.forename: Korina
authors.initials: K
authors.lastname: Richmond
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D018592:Cross-Over Studies; D018752:Diet, Fat-Restricted / Q000379:methods*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage*; D002149:Energy Intake; D005227:Fatty Acids / Q000097:blood; D005260:Female; D005527:Food, Fortified; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010840:Phytosterols / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D004043:Dietary Fiber; D005227:Fatty Acids; D010840:Phytosterols; D014280:Triglycerides; D002784:Cholesterol