title: Influence of phytosterol and phytostanol food supplementation on plasma liposoluble vitamins and provitamin A carotenoid levels in humans: An updated review of the evidence.
abstract: Phytosterols and phytostanols (PAP) compete with cholesterol absorption in the intestine, resulting in a 5-15%-reduction in plasma total and LDL cholesterol. An important issue is the PAP potential to reduce the plasma concentrations of fat-soluble vitamins and provitamin A carotenoids. Here, an update of the scientific evidence is reviewed to evaluate plant PAP-enriched foods impact on plasma fat-soluble vitamins and carotenoid levels, and to discuss potential implications in terms of cardiovascular risk. Based on 49 human interventional and 3 bioavailability studies, results showed that regular consumption, particularly over the long term, of foods fortified with PAP as recommended in labeling does not significantly impact plasma vitamins A, D, and K concentration. A 10% significant median reduction was observed for α-tocopherol. Concerning carotenoids, while 13 studies did not demonstrate statistically significant plasma β-carotene reduction, 20 studies showed significant reductions, with median effect size of -24%. This decline can be mitigated or offset by increased fruits and vegetables consumption. Furthermore, higher cardiovascular risk was observed for differences in plasma β-carotene concentration of the same magnitude as the estimated average decrease by PAP consumption. These results are supported by the only study of β-carotene bioavailability showing decrease in absorption by phytosterols daily intake.
authors.affiliation: a INRA, JRU 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand & Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine , Clermont - Ferrand , France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Fardet
authors.affiliation: b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France.
authors.forename: Anne
authors.initials: A
authors.lastname: Morise
authors.affiliation: b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France.
authors.forename: Esther
authors.initials: E
authors.lastname: Kalonji
authors.affiliation: b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France.
authors.forename: Irène
authors.initials: I
authors.lastname: Margaritis
authors.affiliation: c AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior , Paris , France.|d INRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior , Paris , France.
authors.forename: François
authors.initials: F
authors.lastname: Mariotti
mesh_terms: D002338:Carotenoids / Q000097:blood*; D019587:Dietary Supplements; D005504:Food Analysis; D006801:Humans; D010840:Phytosterols / Q000737:chemistry / Q000494:pharmacology*; D014815:Vitamins / Q000097:blood*
chemical_list: D010840:Phytosterols; D014815:Vitamins; D002338:Carotenoids
keywords: Phytosterol and phytostanol-enriched foods; cardiovascular disease risk; intervention studies; liposoluble vitamins; provitamin A carotenoids