title: Cholesterol-lowering efficacy of plant sterols/stanols provided in capsule and tablet formats: results of a systematic review and meta-analysis.
abstract: Plant sterols/stanols-enriched foods possess well-documented low-density lipoprotein (LDL)-cholesterol-lowering effect. However, the relative efficacy of plant sterols/stanols as supplements (tablets/capsules) compared with other dietary forms still needs to be determined. Our aim was to precisely identify and quantify the LDL-cholesterol-lowering effect of plant sterols/stanols as supplements in contrast to food-based approaches. Eight eligible clinical trials published from January 1992 to April 2013 were identified from five databases. A random effect model was used to calculate weighted mean effect sizes for net differences in LDL-cholesterol concentrations. Among the included trials with the duration between 4 and 6 weeks, plant sterol/stanol dose ranged from 1.0 to 3.0 g/day administrated mainly with the main meals (2 or 3 times/day). Intake of plant sterol/stanol supplements decreased LDL-cholesterol concentrations by 12 mg/dL (0.31 mmol/L) (95% CI -0.39 to -0.23; P<0.000) compared with placebo. The test of heterogeneity was not significant (χ(2) , P=0.50, I(2)=0%). Further analysis showed no significant difference between the LDL-cholesterol-lowering action of plant sterols/stanols supplements (-12 mg/dL [-0.31 mmol/L]; 95% CI -0.39 to -0.24; P<0.0001) vs foods enriched with plant sterols/stanols (-12 mg/dL [-0.31 mmol/L]; 95% CI -0.35 to -0.27; P<0.0001). Plant sterol/stanol supplements as part of a healthy diet represent an effective means of delivering LDL-cholesterol-lowering similar to plant sterols/stanols delivered in various food formats.
authors.forename: Mandana
authors.initials: M
authors.lastname: Amir Shaghaghi
authors.forename: Suhad S
authors.initials: SS
authors.lastname: Abumweis
authors.forename: Peter J H
authors.initials: PJH
authors.lastname: Jones
mesh_terms: D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D019587:Dietary Supplements; D006801:Humans; D016239:MEDLINE; D010840:Phytosterols / Q000008:administration & dosage*; D015203:Reproducibility of Results
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D010840:Phytosterols
keywords: Capsule; Cholesterol reduction; Meta-analysis; Plant sterols; Tablet