title: Plant sterol enriched functional food and atherosclerosis.
abstract: Hypercholesterolaemia is a major cardiovascular risk factor. A healthy diet and a healthy lifestyle reduces cardiovascular risk. 'Functional foods' supplemented with phytosterols are recommended for the management of hypercholesterolaemia and have become a widely used non-prescription approach to lower plasma cholesterol levels. Two billion euros are spent world-wide each year on various functional foods, which have regulator-approved health claims for the management of elevated cholesterol levels. While international societies, such as the European Atherosclerosis Society or the National Heart Foundation in Australia, still advise phytosterols as an additional dietary option in the management of hypercholesterolaemia, recently released guidelines such as those from the National Institute of Health and Clinical Excellence in the United Kingdom are more critical of food supplementation with phytosterols and draw attention to significant safety issues. This review challenges whether an intervention with phytosterol supplements is beneficial. We summarize the current evidence from genetic diseases, genetic association studies, clinical trial data and data from animal studies.
  
  
  
  This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc.
authors.affiliation: Clinic for Thorax-, Vascular and Endovascular Surgery, Pius-Hospital Oldenburg, Carl von Ossietzky Universität, Oldenburg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Köhler
authors.affiliation: Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Teupser
authors.affiliation: Department of Cardiology, Klinikum Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University, Oldenburg, Germany.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Elsässer
authors.affiliation: Department of Cardiology, Klinikum Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University, Oldenburg, Germany.
authors.forename: Oliver
authors.identifier: 0000-0002-0236-206X
authors.initials: O
authors.lastname: Weingärtner
mesh_terms: D000818:Animals; D050197:Atherosclerosis / Q000209:etiology / Q000235:genetics / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000209:etiology / Q000235:genetics / Q000517:prevention & control; D019587:Dietary Supplements; D055951:Functional Food; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000178:diet therapy* / Q000235:genetics; D010840:Phytosterols / Q000494:pharmacology*; D017410:Practice Guidelines as Topic; D012307:Risk Factors
chemical_list: D010840:Phytosterols