title: A review on the role of phytosterols: new insights into cardiovascular risk.
abstract: Phytosterols, which are structurally related to cholesterol, are found in all plant foods with highest concentration occurring in vegetable oils and nuts. Phytosterols are known to reduce serum low-density lipoprotein cholesterol level without changing high-density lipoprotein cholesterol or triglyceride levels. Daily consumption of phytosterols-enriched foods is widely used as a therapeutic option to lower plasma cholesterol and atherosclerotic disease risk. The cholesterol-lowering action of phytosterols is thought to occur, at least in part, through competitive replacement of dietary and biliary cholesterol in mixed micelles, which undermines the absorption of cholesterol. The aim of this review is to provide a general overview of available evidence regarding the effects of phytosterols on cholesterol metabolism and addressing issues related to efficacy as dose, length, frequency of consumption, type of phytosterol (sterols versus stanols) or food matrix. Furthermore, we will explore the factors that influence the response of individuals to phytosterol therapy and evaluate their safety and the possibility that elevated plasma phytosterol concentrations contribute to the development of premature coronary artery disease.
authors.affiliation: Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain. milagros.rocha@uv.es
authors.forename: Milagros
authors.initials: M
authors.lastname: Rocha
authors.forename: Celia
authors.initials: C
authors.lastname: Banuls
authors.forename: Lorena
authors.initials: L
authors.lastname: Bellod
authors.forename: Ana
authors.initials: A
authors.lastname: Jover
authors.forename: Victor M
authors.initials: VM
authors.lastname: Victor
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernandez-Mijares
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000097:blood / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control*; D002791:Cholesterol, Dietary / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D010840:Phytosterols / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D010938:Plant Oils / Q000737:chemistry / Q000494:pharmacology; D012307:Risk Factors
chemical_list: D002791:Cholesterol, Dietary; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D010840:Phytosterols; D010938:Plant Oils