title: Implementing phytosterols into medical practice as a cholesterol-lowering strategy: overview of efficacy, effectiveness, and safety.
abstract: More than 200 clinical trial reports and several meta-analyses have demonstrated that phytosterols (PSs), natural components of plants, induce clinically relevant reductions in blood low-density lipoprotein cholesterol levels. Here we review data regarding the biochemical effects and potential cardiovascular benefit of PSs as part of the dietary management of dyslipidemia. In addition to discussing the efficacy, effectiveness, and safety of PSs as hypocholesterolemic agents, this review provides an overview of PSs as an adjunctive therapy to cholesterol-lowering pharmaceuticals. Given this lack of evidence regarding the benefits of PSs for reducing cardiovascular end points, this review also discusses the present knowledge that exists about the ability for therapeutic dosages of PSs to confer protection from cardiovascular-related mortality and morbidity. Finally, this review summarizes the factors that affect PS efficacy and the Canadian regulations that govern the use of PSs as cholesterol-lowering agents in foods and supplements.
authors.affiliation: Department of Clinical Nutrition and Dietetics, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan.
authors.forename: Suhad S
authors.initials: SS
authors.lastname: AbuMweis
authors.affiliation: Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Christopher P F
authors.initials: CP
authors.lastname: Marinangeli
authors.affiliation: Pathology and Laboratory Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Jiri
authors.initials: J
authors.lastname: Frohlich
authors.affiliation: Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: peter_jones@umanitoba.ca.
authors.forename: Peter J H
authors.initials: PJ
authors.lastname: Jones
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use; D019587:Dietary Supplements; D050171:Dyslipidemias / Q000188:drug therapy*; D000069438:Ezetimibe; D006801:Humans; D010840:Phytosterols / Q000378:metabolism / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D010840:Phytosterols; D000069438:Ezetimibe