Very high plant stanol intake and serum plant stanols and non-cholesterol sterols.
BACKGROUND
Today, consumers meet abundant supply of functional foods with plant stanol increments for serum cholesterol lowering purposes. However, efficacy and safety of plant stanols intake beyond 4 g/day have remained unexplored.


OBJECTIVE
We evaluated the effects of very high daily intake of plant stanols (8.8 g/day) as esters on cholesterol metabolism, and serum levels of plant sterols and stanols.


METHODS
In a randomized, double-blind, parallel study of 49 hypercholesterolemic subjects (mean age 62 years, range 41-73) consumed a test diet without (control, n = 24), and with added plant stanol esters (staest, n = 25) over 10 weeks followed by 4 weeks on home diet. Serum lipids, lipoprotein lipids, and non-cholesterol sterols were determined at baseline, during intervention, and 4 weeks afterwards. Cholesterol precursor sterol lathosterol reflected cholesterol synthesis, and serum plant sterols and cholestanol mirrored cholesterol absorption.


RESULTS
When compared with controls, 8.8 g/day of plant stanols reduced serum and LDL cholesterol by 12 and 17% (P < 0.01 for both). Synthesis marker lathosterol was increased by 30%, while absorption markers decreased up to 62% when compared with controls (P < 0.001 for both). Serum plant stanols increased slightly, but significantly compared with controls (serum sitostanol during intervention, controls: 16 +/- 1 microg/dL, staest: 37 +/- 2 microg/dL, serum campestanol during intervention, controls: 0.5 +/- 0 microg/dL, staest: 9 +/- 1 microg/dL, P < 0.001 for both). Changes in serum cholesterol, non-cholesterol sterols, and plant stanols were normalized during post-treatment weeks.


CONCLUSIONS
Serum plant stanol levels remained at comparable low levels as in studies with daily intake of 2-3 g, and were normalized in 4 weeks suggesting that daily intake of 8.8 g of plant stanols might not increase systemic availability of plant stanols, but reduces effectively serum cholesterol and plant sterol levels.
Gylling
Helena
H
Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland. helena.gylling@uku.fi
Hallikainen
Maarit
M
Nissinen
Markku J
MJ
Simonen
Piia
P
Miettinen
Tatu A
TA
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood / Q000378:metabolism; D004311:Double-Blind Method; D004952:Esters / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005526:Food, Formulated; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D007408:Intestinal Absorption; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D010840:Phytosterols / Q000097:blood*; D008517:Phytotherapy; D012855:Sitosterols / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use*; D013997:Time Factors
D000924:Anticholesteremic Agents; D015415:Biomarkers; D004952:Esters; D008055:Lipids; D008074:Lipoproteins; D010840:Phytosterols; D012855:Sitosterols; C407042:plant stanol ester; C001521:lathosterol; D002784:Cholesterol