title: Dose-dependent cholesterol-lowering effects of phytosterol/phytostanol-enriched margarine in statin users and statin non-users under free-living conditions.
abstract: OBJECTIVE
  To assess the effectiveness (extent to which an intervention works in daily medical practice) of the use of phytosterol/phytostanol-enriched margarines to lower total and non-HDL cholesterol levels in users and non-users of statins.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Data were obtained from questionnaires on health and food intake from a population-based longitudinal cohort linked to pharmacy-dispensing records.
  
  
  METHODS
  The analysis included 3829 men and women (aged 31-71 years) who were examined during 1998-2002 and re-examined at 5-year follow-up during 2003-2007.
  
  
  RESULTS
  Recommended doses of margarines were consumed by only 9 % of the subjects. Serum total cholesterol decreased by respectively -0·16 (95 % CI -0·26, -0·05) mmol/l, -1·40 (95 % CI -1·51, -1·30) mmol/l and -1·64 (95 % CI -1·91, -1·37) mmol/l in subjects who started to use phytosterols/phytostanols only, statins only or a combination of both compounds at some point in time between examination and re-examination, compared with subjects who did not start using phytosterols/phytostanols or statins. Cholesterol-lowering effects of the phytosterols/phytostanols were similar in statin users and statin non-users and increased with increasing intake of enriched margarine (no intake, 0; low intake, -0·017 (95 % CI -0·16, 0·13) mmol/l; medium intake, -0·089 (95 % CI -0·22, 0·038) mmol/l; high intake, -0·32 (95 % CI -0·50, -0·14) mmol/l).
  
  
  CONCLUSIONS
  Although recommended intake levels of the enriched margarines were not reached by all persons, these data show that under customary conditions of use phytosterols/phytostanols are effective in lowering cholesterol levels in both statin users and non-users.
authors.affiliation: Utrecht Institute for Pharmaceutical Sciences, PO Box 80082, 3508 TB Utrecht, The Netherlands.
authors.forename: Simone R B M
authors.initials: SR
authors.lastname: Eussen
authors.forename: Nynke
authors.initials: N
authors.lastname: de Jong
authors.forename: Cathy J M
authors.initials: CJ
authors.lastname: Rompelberg
authors.forename: Johan
authors.initials: J
authors.lastname: Garssen
authors.forename: W M Monique
authors.initials: WM
authors.lastname: Verschuren
authors.forename: Olaf H
authors.initials: OH
authors.lastname: Klungel
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D002784:Cholesterol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005527:Food, Fortified; D018565:Food-Drug Interactions; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D006937:Hypercholesterolemia / Q000188:drug therapy; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008383:Margarine / Q000032:analysis*; D008875:Middle Aged; D015999:Multivariate Analysis; D010840:Phytosterols / Q000008:administration & dosage*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010840:Phytosterols; D008383:Margarine; D002784:Cholesterol