Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations--a meta-analysis of randomized controlled studies.
OBJECTIVE
Intake of plant sterol (PS)-enriched foods effectively lowers plasma total- and LDL-cholesterol concentrations while increasing plasma PS concentrations. The magnitude of this increase has not been systematically assessed. This study aimed to investigate the effect of PS-enriched foods on plasma PS concentrations by performing a meta-analysis of randomized controlled studies.


METHODS
Published PS intervention studies reporting plasma PS concentrations were searched through June 2012. Studies were selected that fulfilled pre-defined in- and exclusion criteria. Data were extracted, particularly on campesterol, sitosterol, total- and LDL-cholesterol. Random-effects models were used to calculate net effects while weighing each study by the inverse of its variance. Potential sources of heterogeneity were investigated.


RESULTS
The meta-analysis included data from 41 studies (55 strata) with in total 2084 subjects. The average dose of PS from enriched foods was 1.6 g/d (range: 0.3-3.2 g/d). Plasma sitosterol and campesterol concentrations were increased by on average 2.24 μmol/L (31%) and 5.00 μmol/L (37%), respectively, compared to control. Total- and LDL-cholesterol were reduced by on average 0.36 mmol/L (5.9%) and 0.33 mmol/L (8.5%), respectively. The increase in sitosterol and campesterol was impacted by the dose of PS, the baseline PS concentration and the PS composition of the test products. In the highest PS dose category (2.0-3.2 g/d), increases in sitosterol and campesterol were on average 3.56 and 7.64 μmol/L, respectively.


CONCLUSIONS
Intake of PS-enriched foods increases plasma sitosterol and campesterol concentrations. However, total PS remain below 1% of total sterols circulating in the blood.
Unilever R&D Vlaardingen, Olivier van Noortlaan 120, 3133 AT Vlaardingen, The Netherlands. Electronic address: Rouyanne.Ras@unilever.com.
Rouyanne T
RT
Ras
Harry
H
Hiemstra
Yuguang
Y
Lin
Mario A
MA
Vermeer
Guus S M J E
GS
Duchateau
Elke A
EA
Trautwein
D002784:Cholesterol / Q000031:analogs & derivatives / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D005527:Food, Fortified; D006801:Humans; D010840:Phytosterols / Q000097:blood / Q000737:chemistry*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012855:Sitosterols / Q000097:blood
D008078:Cholesterol, LDL; D010840:Phytosterols; D012855:Sitosterols; C021273:campesterol; C025473:gamma-sitosterol; D002784:Cholesterol
Cholesterol; Dietary intervention; Meta-analysis; Plant sterols; Plasma/serum