title: Effect of a plant sterol, fish oil and B vitamin combination on cardiovascular risk factors in hypercholesterolemic children and adolescents: a pilot study.
abstract: BACKGROUND
  Assessment of cardiovascular disease (CVD) risk factors can predict clinical manifestations of atherosclerosis in adulthood. In this pilot study with hypercholesterolemic children and adolescents, we investigated the effects of a combination of plant sterols, fish oil and B vitamins on the levels of four independent risk factors for CVD; LDL-cholesterol, triacylglycerols, C-reactive protein and homocysteine.
  
  
  METHODS
  Twenty five participants (mean age 16 y, BMI 23 kg/m2) received daily for a period of 16 weeks an emulsified preparation comprising plant sterols esters (1300 mg), fish oil (providing 1000 mg eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA)) and vitamins B12 (50 μg), B6 (2.5 mg), folic acid (800 μg) and coenzyme Q10 (3 mg). Atherogenic and inflammatory risk factors, plasma lipophilic vitamins, provitamins and fatty acids were measured at baseline, week 8 and 16.
  
  
  RESULTS
  The serum total cholesterol, LDL- cholesterol, VLDL-cholesterol, subfractions LDL-2, IDL-1, IDL-2 and plasma homocysteine levels were significantly reduced at the end of the intervention period (p<0.05). The triacylglycerols levels decreased by 17.6%, but did not reach significance. No significant changes in high sensitivity C-reactive protein, HDL-cholesterol and apolipoprotein A-1 were observed during the study period. After standardisation for LDL cholesterol, there were no significant changes in the levels of plasma γ-tocopherol, β-carotene and retinol, except for reduction in α-tocopherol levels. The plasma levels of n-3 fatty acids increased significantly with the dietary supplementation (p<0.05).
  
  
  CONCLUSIONS
  Daily intake of a combination of plant sterols, fish oil and B vitamins may modulate the lipid profile of hypercholesterolemic children and adolescents.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN89549017.
authors.affiliation: Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, 813 72, Slovakia.
authors.forename: Iveta
authors.initials: I
authors.lastname: Garaiova
authors.forename: Jana
authors.initials: J
authors.lastname: Muchová
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Nagyová
authors.forename: Csilla
authors.initials: C
authors.lastname: Mišľanová
authors.forename: Stanislav
authors.initials: S
authors.lastname: Oravec
authors.forename: Andrej
authors.initials: A
authors.lastname: Dukát
authors.forename: Duolao
authors.initials: D
authors.lastname: Wang
authors.forename: Sue F
authors.initials: SF
authors.lastname: Plummer
authors.forename: Zdeňka
authors.initials: Z
authors.lastname: Ďuračková
mesh_terms: D000293:Adolescent; D016632:Apolipoprotein A-I / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D006937:Hypercholesterolemia / Q000517:prevention & control*; D008297:Male; D010840:Phytosterols / Q000008:administration & dosage*; D010865:Pilot Projects; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014803:Vitamin B Complex / Q000008:administration & dosage*; D055815:Young Adult; D019207:beta Carotene / Q000097:blood; D024504:gamma-Tocopherol / Q000097:blood
chemical_list: D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D010840:Phytosterols; D014280:Triglycerides; D019207:beta Carotene; D014803:Vitamin B Complex; D024504:gamma-Tocopherol; D002097:C-Reactive Protein