title: Effectiveness of customary use of phytosterol/-stanol enriched margarines on blood cholesterol lowering.
abstract: Postlaunch monitoring of functional foods can encompass monitoring of effectiveness under conditions of customary use. To this end, the effectiveness of phytosterol/-stanol enriched margarine consumption in free-living conditions was investigated with data from the Dutch "Doetinchem cohort study". In total, 4,505 subjects (aged 26-70 years) were examined in 1994-1998 and re-examined during 1999-2003. A general and a food frequency questionnaire and non-fasting blood samples for total and HDL cholesterol determination were obtained. Subjects were stratified into phytosterol/-stanol enriched margarine users (n = 84) and non-users (n = 4,421) based on the re-examination data, as these margarines were available on the Dutch market from 1999 onwards. Mean spontaneous daily use (g +/- SD) of phytosterol-containing margarine (n = 71) was 15 +/- 8 and of phytostanol-containing margarine (n = 13) 9+/-6. After five years, total blood cholesterol had increased with 0.26 mmol/l in non-users while it had not significantly changed in users. The difference in total blood cholesterol change in users versus non-users was -0.30 mmol/l (p < 0.001). The beneficial effect of the phytosterol/-stanol enriched margarine, used under customary conditions can be characterized as a stabilization of cholesterol levels. This is the first report finding a modest beneficial effect on blood cholesterol level under customary conditions thereby partly confirming findings from clinical trials.
authors.affiliation: National Institute for Public Health and the Environment, RIVM, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
authors.forename: Marion
authors.initials: M
authors.lastname: Wolfs
authors.forename: Nynke
authors.initials: N
authors.lastname: de Jong
authors.forename: Marga C
authors.initials: MC
authors.lastname: Ocké
authors.forename: Hans
authors.initials: H
authors.lastname: Verhagen
authors.forename: W M
authors.initials: WM
authors.lastname: Monique Verschuren
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D004041:Dietary Fats; D005260:Female; D006801:Humans; D008297:Male; D008383:Margarine; D008875:Middle Aged; D010840:Phytosterols; D012855:Sitosterols
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D004041:Dietary Fats; D010840:Phytosterols; D012855:Sitosterols; C407042:plant stanol ester; D008383:Margarine; D002784:Cholesterol