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Ruscica M, Loh WJ, Sirtori CR, Watts GF. Phytosterols and phytostanols in context: From physiology and pathophysiology to food supplementation and clinical practice. Pharmacol Res 2025; 214:107681. [PMID: 40049428 DOI: 10.1016/j.phrs.2025.107681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2025] [Revised: 02/24/2025] [Accepted: 02/28/2025] [Indexed: 03/23/2025]
Abstract
Phytosterols and phytostanols are two classes of sterol derivatives naturally synthesised in plants, but not in humans. Structurally, phytosterols and phytostanols have a sterane ring in common, but phytostanols do not have a double bond between carbons 5 and 6. The therapeutic potential of phytosterols and phytostanols supplementation in cholesterol reduction is the main reason for its wide usage in an expansive food matrix, including milk, yoghurt, margarine, mayonnaise, chocolate, tartare, chips, esterification with omega-3, and recently, as a successful nutraceutical among athletes is its fortification with whey protein. The heterogeneous effect of phytosterols and phytostanols in cholesterol lowering appears to be related to whether the individuals' inherent physiologic tendencies to "hyper-synthesise" cholesterol in the liver or "hyperabsorb" cholesterol via the small intestine. Individuals who are 'hypersynthesizers" of cholesterol tend to have a good reduction in plasma low-density lipoprotein cholesterol (LDLc) in response to statin therapy. Conversely, "hyper-absorbers" of cholesterol show a greater LDLc lowering in response to phytosterols or phytostanols. The ratios of cholestanol to cholesterol and lathosterol to cholesterol are good biomarkers of intestinal absorption of cholesterol and hepatic cholesterol synthesis. Animal data and human observational data suggest that phytosterols and phytostanols may have anti-atherosclerotic activities, e.g. reduction of the formation of nitric oxide, antagonism to the formation of LDL aggregates and plaque formation. The absence of cardiovascular outcome trials using phytosterol or phytostanol supplementation, makes it difficult to confirm a wider use in clinical practice, especially with the rapidly expanding list of effective and safe lipid-lowering medications.
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Affiliation(s)
- Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università Degli Studi Di Milano, Milan, Italy; Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Wann Jia Loh
- School of Medicine, University of Western Australia, Australia; Department of Endocrinology, Changi General Hospital, Changi, Singapore; Duke-NUS Medical School, Singapore, Singapore.
| | - Cesare R Sirtori
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università Degli Studi Di Milano, Milan, Italy
| | - Gerald F Watts
- School of Medicine, University of Western Australia, Australia; Departments of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
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Yang Y, Xia J, Yu T, Wan S, Zhou Y, Sun G. Effects of phytosterols on cardiovascular risk factors: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2025; 39:3-24. [PMID: 39572895 DOI: 10.1002/ptr.8308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/20/2024] [Accepted: 07/20/2024] [Indexed: 01/21/2025]
Abstract
Cardiovascular diseases are the major cause of death globally. The primary risk factors are high blood lipid levels, hypertension, diabetes, and obesity. Phytosterols are naturally occurring plant bioactive substances. Short-term clinical trials have demonstrated phytosterols' cholesterol-lowering potential, but their effects on cardiovascular risk factors remain controversial, and relevant meta-analyses are limited and incomplete. We conducted a systematic and comprehensive search of PubMed, Web of Science, Embase and Cochrane Library up to December 22, 2023. A total of 109 randomized controlled trials (RCTS) of phytosterols (PS) intervention on cardiovascular risk factor outcomes were included in a preliminary screening of the retrieved literature by Endnote 20. We assessed the quality of all included randomized controlled trials using the Cochrane Collaboration's Risk of Bias tool. Cochrane data conversion tool was used for data conversion, and finally Stata was used for meta-analysis, egger test and sensitivity analysis of the included studies. The results indicated that dietary phytosterols intake could significantly decrease total cholesterol (TC) level (mean difference = -13.41; 95% confidence interval [CI]: -15.19, -11.63, p < 0.001), low density lipoprotein cholesterol (LDL-C) level (mean difference = -12.57; 95% CI: -13.87, -11.26, p < 0.001), triglycerides (TG) level (mean difference = -6.34; 95% CI: -9.43, -3.25, p < 0.001), C-reactive protein (CRP) level (mean difference = -0.05; 95% CI: -0.08, -0.01, p = 0.671), systolic blood pressure (SBP) level (mean difference = -2.10; 95% CI: -3.27, -0.9, p < 0.001), diastolic blood pressure (DBP) level (mean difference = -0.83; 95% CI: -0.58, -0.07, p = 0.032), increased high-density lipoprotein cholesterol (HDL-C) level (mean difference = 0.46; 95% CI: 0.13, 0.78, p = 0.005), but did not alter the levels of blood glucose (GLU) (mean difference = -0.44; 95% CI: -1.64, 0.76, p = 0.471), glycosylated hemoglobin, Type A1C (HbA1c) (mean difference = -0.28; 95% CI: -0.75, 0.20, p = 0.251), interleukin-6 (IL-6) (mean difference = 0.00; 95% CI: -0.02, 0.02, p = 0.980), tumor necrosis factor (TNF-α) (mean difference = 0.08; 95% CI: -0.08, 0.24, p = 0.335), oxidized low-density lipoprotein cholesterol (OXLDL-C) (standard mean difference = 0.16; 95% CI: -0.38, 0.06, p = 0.154), body mass index (BMI) (mean difference = 0.01; 95% CI: -0.07, 0.09, p = 0.886), waist circumference (WC) (mean difference = -0.10; 95% CI: -0.50, 0.30, p = 0.625) and body weight (mean difference = 0.03; 95% CI: -0.18, 0.24, p = 0.787). Our results suggest that phytosterols may be beneficial in reducing the levels of TC, LDL-C, TG, CRP, SBP, and DBP, but have no significant effect on GLU, HbA1c, TNF-α, IL-6, OXLDL-C, BMI, WC, and Weight. However, there were a small number of RCTS included in this study and their small population size may have reduced the quality of the study. And most of the included studies were short-term intervention trials. Therefore, higher quality studies need to be designed in future studies to establish more accurate conclusions.
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Affiliation(s)
- Yanhong Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, People's Republic of China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, People's Republic of China
| | - Jiayue Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, People's Republic of China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, People's Republic of China
| | - Tingqing Yu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, People's Republic of China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, People's Republic of China
| | - Shiyun Wan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, People's Republic of China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, People's Republic of China
| | - Yajie Zhou
- Nanjing Zhongke Pharmaceutical Co. Ltd, Nanjing, People's Republic of China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, People's Republic of China
- Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, People's Republic of China
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3
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Gao Y, Xun R, Xia J, Xia H, Sun G. Effects of phytosterol supplementation on lipid profiles in patients with hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials. Food Funct 2023; 14:2969-2997. [PMID: 36891733 DOI: 10.1039/d2fo03663k] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Phytosterols (PSs) have been reported to improve blood lipids in patients with hypercholesterolemia for many years. However, meta-analyses of the effects of phytosterols on lipid profiles are limited and incomplete. A systematic search of randomized controlled trials (RCTs) published in PubMed, Embase, Cochrane Library, and Web of Science from inception to March 2022 was conducted according to the 2020 preferred reporting items of the guidelines for systematic reviews and meta-analysis (PRISMA) statement. These included studies of people with hypercholesterolemia, comparing foods or preparations containing PSs with controls. Mean differences with 95% confidence intervals were used to estimate continuous outcomes for individual studies. The results showed that in patients with hypercholesterolemia, taking a diet containing a certain dose of plant sterol significantly reduced total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) (TC: Weight Mean Difference (WMD) [95% CI] = -0.37 [-0.41, -0.34], p < 0.001; LDL-C: WMD [95% CI] = -0.34 [-0.37, -0.30], p < 0.001). In contrast, PSs had no effect on high density lipoprotein cholesterol (HDL-C) or triglycerides (TGs) (HDL-C: WMD [95% CI] = 0.00 [-0.01, 0.02], p = 0.742; TG: WMD [95% CI] = -0.01 [-0.04, 0.01], p = 0.233). Also, a significant effect of supplemental dose on LDL-C levels was observed in a nonlinear dose-response analysis (p-nonlinearity = 0.024). Our findings suggest that dietary phytosterols can help reduce TC and LDL-C concentrations in hypercholesterolemia patients without affecting HDL-C and TG concentrations. And the effect may be affected by the food substrate, dose, esterification, intervention cycle and region. The dose of phytosterol is an important factor affecting the level of LDL-C.
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Affiliation(s)
- Yusi Gao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Ruilong Xun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Jiayue Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China. .,China-DRIs Expert Committee on Other Dietary Ingredients, Beijing 100052, China
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Turini E, Sarsale M, Petri D, Totaro M, Lucenteforte E, Tavoschi L, Baggiani A. Efficacy of Plant Sterol-Enriched Food for Primary Prevention and Treatment of Hypercholesterolemia: A Systematic Literature Review. Foods 2022; 11:foods11060839. [PMID: 35327262 PMCID: PMC8954273 DOI: 10.3390/foods11060839] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 01/27/2023] Open
Abstract
Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and exercise. A systematic review was performed to evaluate the efficacy of PS-enriched foods in the treatment of hypercholesterolemia. Randomized controlled clinical studies reporting the use of PS-enriched foods to reduce LDL-c among adult individuals were retrieved and assessed for risk of bias. Meta-analyses were performed to assess changes in LDL-c by treatment, food matrix, LDL-c range, sterols dosage and risk of bias (RoB). In the 13 studies analyzed, LDL-c in PS-treated participants decreased by an average of 12.14 (8.98; 15.29) mg/dL. PS administration was statistically more effective in patients with LDL-c ≥ 140 mg/dL and for PS dosages > 2 g/day. It can be concluded that PSs can be used as an important primary prevention measure for hypercholesterolemia and as tertiary prevention for cardiovascular events in patients who already have mild to moderate LDL-c. However, in severe hypercholesterolemia and in cases of familial hypercholesterolemia, it is necessary to combine dietary treatment with the use of statins.
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Affiliation(s)
- Elisa Turini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
- Correspondence:
| | - Miriana Sarsale
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
- Department of Pharmacy, University of Pisa, 56123 Pisa, Italy
| | - Davide Petri
- Department of Clinical and Experimental Medicine, University of Pisa, 56123 Pisa, Italy; (D.P.); (E.L.)
| | - Michele Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
| | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine, University of Pisa, 56123 Pisa, Italy; (D.P.); (E.L.)
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
| | - Angelo Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
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Salehi B, Quispe C, Sharifi-Rad J, Cruz-Martins N, Nigam M, Mishra AP, Konovalov DA, Orobinskaya V, Abu-Reidah IM, Zam W, Sharopov F, Venneri T, Capasso R, Kukula-Koch W, Wawruszak A, Koch W. Phytosterols: From Preclinical Evidence to Potential Clinical Applications. Front Pharmacol 2021; 11:599959. [PMID: 33519459 PMCID: PMC7841260 DOI: 10.3389/fphar.2020.599959] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/14/2020] [Indexed: 12/30/2022] Open
Abstract
Phytosterols (PSs) are plant-originated steroids. Over 250 PSs have been isolated, and each plant species contains a characteristic phytosterol composition. A wide number of studies have reported remarkable pharmacological effects of PSs, acting as chemopreventive, anti-inflammatory, antioxidant, antidiabetic, and antiatherosclerotic agents. However, PS bioavailability is a key issue, as it can be influenced by several factors (type, source, processing, preparation, delivery method, food matrix, dose, time of administration into the body, and genetic factors), and the existence of a close relationship between their chemical structures (e.g., saturation degree and side-chain length) and low absorption rates has been stated. In this sense, the present review intends to provide in-depth data on PS therapeutic potential for human health, also emphasizing their preclinical effects and bioavailability-related issues.
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Affiliation(s)
- Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cristina Quispe
- Facultad de Ciencias de la Salud, Universidad Arturo Prat, Iquique, Chile
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Manisha Nigam
- Department of Biochemistry, H. N. B. Garhwal (A Central) University, Srinagar Garhwal, India
| | - Abhay Prakash Mishra
- Adarsh Vijendra Institute of Pharmaceutical Sciences, School of Pharmacy, Shobhit University, Gangoh, India
| | - Dmitryi Alexeevich Konovalov
- Department of Pharmacognosy, Botany and Technology of Phytopreparations, Pyatigorsk Medical-Pharmaceutical Institute, Branch of Volgograd State Medical University, Ministry of Health of Russia, Pyatigorsk, Russia
| | - Valeriya Orobinskaya
- Institute of Service, Tourism and Design (Branch) of North-Caucasus Federal University in Pyatigorsk, Pyatigorsk, Russia
| | - Ibrahim M. Abu-Reidah
- Department of Environmental Science/Boreal Ecosystem Research Initiative, Memorial University of Newfoundland, Corner Brook, NL, Canada
| | - Wissam Zam
- Department of Analytical and Food Chemistry, Faculty of Pharmacy, Al-Andalus University for Medical Sciences, Tartous, Syria
| | - Farukh Sharopov
- “Chinese-Tajik Innovation Center for Natural Products”, Academy of Sciences of the Republic of Tajikistan, Dushanbe, Tajikistan
| | - Tommaso Venneri
- Department of Pharmacy, University of Napoli Federico II, Napoli, Italy
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
| | | | - Anna Wawruszak
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin, Poland
| | - Wojciech Koch
- Chair and Department of Food and Nutrition, Medical University of Lublin, Lublin, Poland
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Kodahl N. Sacha inchi (Plukenetia volubilis L.)-from lost crop of the Incas to part of the solution to global challenges? PLANTA 2020; 251:80. [PMID: 32185506 DOI: 10.1007/s00425-020-03377-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/11/2020] [Indexed: 05/19/2023]
Abstract
The underutilized, oleaginous crop Plukenetia volubilis L. has a remarkable lipid composition and a large potential for further domestication, alleviation of malnutrition, and integration into sustainable food production systems. Current global challenges include climate change, increasing population size, lack of food security, malnutrition, and degradation of arable lands. In this context, a reformation of our food production systems is imperative. Underutilized crops, or orphan crops, can provide valuable traits for this purpose, e.g., climate change resilience, nutritional benefits, cultivability on marginal lands, and improvement of income opportunities for smallholders. Plukenetia volubilis L. (Euphorbiaceae)-sacha inchi-is a 'lost crop' of the Incas native to the Amazon basin. Its oleaginous seeds are large, with a high content of ω-3, and -6 fatty acids (ca. 50.5, and 34.1%, of the lipid fraction, respectively), protein, and antioxidants. Culinarily, the seeds are nut-like and the crop has been associated with humans since Incan times. Research has particularly been undertaken in seed biochemistry, and to some extent in phylogeny, genetics, and cultivation ecology, but attention has been unevenly distributed, causing knowledge gaps in areas such as ethnobotany, allergenicity, and sustainable cultivation practices. Recently, seed size evolution and molecular drivers of the fatty acid synthesis and composition have been studied, however, further research into the lipid biosynthesis is desirable. Targeted breeding has not been undertaken but might be especially relevant for yield, sensory qualities, and cultivation with low environmental impact. Similarly, studies of integration into sustainable management systems are of highest importance. Here, present knowledge on P. volubilis is reviewed and a general framework for conducting research on underutilized crops with the aim of integration into sustainable food production systems is presented.
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Affiliation(s)
- Nete Kodahl
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, 1871, Frederiksberg C, Denmark.
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7
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Phytosterol compositions of enriched products influence their cholesterol-lowering efficacy: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 2019; 73:1579-1593. [DOI: 10.1038/s41430-019-0504-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 09/07/2019] [Accepted: 09/11/2019] [Indexed: 11/08/2022]
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Gandola AE, Dainelli L, Zimmermann D, Dahlui M, Detzel P. Milk Powder Fortified with Potassium and Phytosterols to Decrease the Risk of Cardiovascular Events among the Adult Population in Malaysia: A Cost-Effectiveness Analysis. Nutrients 2019; 11:E1235. [PMID: 31151244 PMCID: PMC6627836 DOI: 10.3390/nu11061235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/17/2019] [Accepted: 05/27/2019] [Indexed: 11/17/2022] Open
Abstract
This study evaluated the cost-effectiveness of the consumption of a milk powder product fortified with potassium (+1050.28 mg/day) and phytosterols (+1200 mg/day) to lower systolic blood pressure and low-density lipoprotein cholesterol, respectively, and, therefore, the risk of myocardial infarction (MI) and stroke among the 35-75-year-old population in Malaysia. A Markov model was created against a do-nothing option, from a governmental perspective, and with a time horizon of 40 years. Different data sources, encompassing clinical studies, practice guidelines, grey literature, and statistical yearbooks, were used. Sensitivity analyses were performed to evaluate the impact of uncertainty on the base case estimates. With an incremental cost-effectiveness ratio equal to international dollars (int$) 22,518.03 per quality-adjusted life-years gained, the intervention can be classified as very cost-effective. If adopted nationwide, it would help prevent at least 13,400 MIs, 30,500 strokes, and more than 10,600 and 17,100 MI- and stroke-related deaths. The discounted cost savings generated for the health care system by those who consume the fortified milk powder would amount to int$8.1 per person, corresponding to 0.7% of the total yearly health expenditure per capita. Sensitivity analyses confirmed the robustness of the results. Together with other preventive interventions, the consumption of milk powder fortified with potassium and phytosterols represents a cost-effective strategy to attenuate the rapid increase in cardiovascular burden in Malaysia.
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Affiliation(s)
- Anita E Gandola
- Nestlé Research Center, 1000 Lausanne, Switzerland.
- Università della Svizzera Italiana, 6900 Lugano, Switzerland.
| | | | | | - Maznah Dahlui
- Centre of Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
- Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia.
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Ghaedi E, Kord-Varkaneh H, Mohammadi H, Askarpour M, Miraghajani M. Phytosterol Supplementation Could Improve Atherogenic and Anti-Atherogenic Apolipoproteins: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials. J Am Coll Nutr 2019; 39:82-92. [PMID: 31074692 DOI: 10.1080/07315724.2019.1605313] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Phytosterol and phytostanol (PS) supplementation is reported to improve atherogenic and anti-atherogenic apolipoproteins (Apo). The purpose of the present study is to critically investigate the effectiveness of PS supplementation on Apo in adults.A comprehensive search was conducted of all randomized controlled trials (RCTs) conducted up to September 2018 in the following databases: PubMed, Web of Science, Cochrane Library, and Scopus. Mean difference with 95% confidence intervals (CIs) were pooled using a random-effects model (DerSimonian-Laird method).Fifty-one arms from 37 RCTs were included in the present meta-analysis. Findings showed that PS supplementation and fortification increased Apo-AI (weighted mean difference [WMD]: 0.014 mg/dl, 95% CI: 0.001, 0.028, p = 0.042) and Apo-CII (WMD: 0.303 mg/dl, 95% CI: 0.084, 0.523, p = 0.007) and lowered Apo-B (WMD: -0.063 mg/dl, 95% CI: -0.075, -0.051, p < 0.001), Apo-B/Apo-A-I ratio (WMD: -0.044 mg/dl, 95% CI: -0.062, -0.025, p < 0.001), and Apo-E (WMD: -0.255 mg/dl, 95% CI: -0.474, -0.036, p = 0.023). However, PS supplementation did not have significant effects on Apo-AII and Apo-CIII. PS supplementation or fortification significantly changes Apo-E (r = -0.137, p nonlinearity = 0.006) and Apo-CIII (r = 1.26, p nonlinearity = 0.028) based on PS dosage (mg/d) and Apo-CIII (r = 3.34, p nonlinearity = 0.013) and Apo-CII (r = 1.09, p nonlinearity = 0.017) based on trial duration (weeks) in a nonlinear fashion.Based on our findings, supplements or fortified foods containing PS might have a considerable favorite effect in achieving Apo profile target; however, due to high heterogeneity among included studies, results must be interpreted with caution.KEY TEACHING POINTSCardiovascular diseases (CVDs) recognized as main public health concern worldwide with considerable mortality of all global deaths.Apo-lipoproteins are amphipathic molecules involved in the lipoprotein metabolism which introduced as biomarkers in the evaluation of CVD risk.Phytosterols bioactive components of plants have important biological functions in cholesterol metabolism in humans.Here we showed that phytosterols and phytostanols improve apo-lipoproteins profile of humans; finding from meta-analysis of randomized controlled trials.Phytosterols supplementation lowered atherogenic apo-lipoproteins (Apo-B and Apo-E) and increased anti-atherogenic apo-lipoproteins (Apo-AI, Apo-CII).
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Affiliation(s)
- Ehsan Ghaedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Kord-Varkaneh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Moein Askarpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Miraghajani
- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,The Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
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Soto-Méndez MJ, Rangel-Huerta OD, Ruiz-López MD, Martínez de Victoria E, Anguita-Ruiz A, Gil A. Role of Functional Fortified Dairy Products in Cardiometabolic Health: A Systematic Review and Meta-analyses of Randomized Clinical Trials. Adv Nutr 2019; 10:S251-S271. [PMID: 31089744 PMCID: PMC6518140 DOI: 10.1093/advances/nmz001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/26/2018] [Indexed: 12/11/2022] Open
Abstract
There is insufficient evidence on the role of functional fortified dairy products in improving health and in preventing risk factors associated with noncommunicable chronic diseases. This systematic review was conducted to summarize effects of the consumption of fortified dairy products on biomarkers of cardiometabolic risk. MEDLINE and SCOPUS databases were used to perform searches to include studies published up to 30 April 2018. Randomized clinical trials with human subjects consuming dairy products fortified with phytosterols, FAs, vitamins or minerals and relating this consumption with cardiometabolic health were included in this review. Risk of bias assessment according to Cochrane guidelines was performed to determine the quality of the trials. Forty-one studies were finally selected for this synthesis; the selected studies tested dairy products fortified with the following nutrients and bioactive components: phytosterols (n = 31), FAs (n = 8), and vitamin D (n = 2). We found that the consumption of phytosterol-fortified dairy, led to an overall LDL cholesterol reduction of -0.36 (-0.41, -0.31) mmol/L, P < 0.001; this decrease was mainly related to the dosage. Likewise, consumption of ω-3 FA-fortified dairy products resulted in a plasma LDL cholesterol reduction of -0.18 (-0.27, -0.09) mmol/L as well as a decrease of -0.18 (-0.32, -0.05) mmol/L in triacylglycerols (TG). Performing meta-analyses of the consumption of dairy products fortified with vitamin D or FAs other than ω-3 FAs and biomarkers of cardiometabolic risk was not possible because of the few available publications. Our results indicate that consumption of dairy products fortified with phytosterols and ω-3 FAs can lead to a reduction of LDL cholesterol and consumption of fortified dairy products fortified with ω-3 FAs can reduce TG concentration. However, more studies with homogeneous designs are needed to determine the advantages of using dairy products as fortification vehicles to prevent cardiometabolic risk.
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Affiliation(s)
| | - Oscar D Rangel-Huerta
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - María D Ruiz-López
- Iberoamerican Nutrition Foundation –FINUT–, Granada, Spain
- Department of Nutrition and Food Sciences, School of Pharmacy
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
| | - Emilio Martínez de Victoria
- Iberoamerican Nutrition Foundation –FINUT–, Granada, Spain
- Department of Physiology, School of Sciences
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
| | - Augusto Anguita-Ruiz
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
- Biomedical Research Institute ibs GRANADA, University Hospital Complex in Granada, Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
| | - Angel Gil
- Iberoamerican Nutrition Foundation –FINUT–, Granada, Spain
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
- Biomedical Research Institute ibs GRANADA, University Hospital Complex in Granada, Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
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Smolders L, Plat J, Mensink RP. Dietary Strategies and Novel Pharmaceutical Approaches Targeting Serum ApoA-I Metabolism: A Systematic Overview. J Nutr Metab 2017; 2017:5415921. [PMID: 28695008 PMCID: PMC5485365 DOI: 10.1155/2017/5415921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/16/2017] [Indexed: 12/19/2022] Open
Abstract
The incidence of CHD is still increasing, which underscores the need for new preventive and therapeutic approaches to decrease CHD risk. In this respect, increasing apoA-I concentrations may be a promising approach, especially through increasing apoA-I synthesis. This review first provides insight into current knowledge on apoA-I production, clearance, and degradation, followed by a systematic review of dietary and novel pharmacological approaches to target apoA-I metabolism. For this, a systematic search was performed to identify randomized controlled intervention studies that examined effects of whole foods and (non)nutrients on apoA-I metabolism. In addition, novel pharmacological approaches were searched for, which were specifically developed to target apoA-I metabolism. We conclude that both dietary components and pharmacological approaches can be used to increase apoA-I concentrations or functionality. For the dietary components in particular, more knowledge about the underlying mechanisms is necessary, as increasing apoA-I per se does not necessarily translate into a reduced CHD risk.
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Affiliation(s)
- Lotte Smolders
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
| | - Jogchum Plat
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
| | - Ronald P. Mensink
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
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Fardet A, Morise A, Kalonji E, Margaritis I, Mariotti F. Influence of phytosterol and phytostanol food supplementation on plasma liposoluble vitamins and provitamin A carotenoid levels in humans: An updated review of the evidence. Crit Rev Food Sci Nutr 2017; 57:1906-1921. [PMID: 26193046 DOI: 10.1080/10408398.2015.1033611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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.
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Affiliation(s)
- Anthony Fardet
- a INRA, JRU 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand & Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine , Clermont - Ferrand , France
| | - Anne Morise
- b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France
| | - Esther Kalonji
- b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France
| | - Irène Margaritis
- b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France
| | - François Mariotti
- c AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior , Paris , France.,d INRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior , Paris , France
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Randomized controlled trial of the effect of phytosterols-enriched low-fat milk on lipid profile in Chinese. Sci Rep 2017; 7:41084. [PMID: 28117400 PMCID: PMC5259797 DOI: 10.1038/srep41084] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 12/13/2016] [Indexed: 11/21/2022] Open
Abstract
Phytosterols found naturally in plants are known to reduce cholesterol absorption in the gut. The traditional southern Chinese diet typically contains many vegetables and not much meat, and there is high prevalence of lactose intolerance in Chinese; we therefore aimed to test if phytosterols-enriched milk is effective in lowering serum LDL-cholesterol in Chinese. Two hundred and twenty-one participants (41 men and 180 women; age 24–79) without cholesterol-lowering drugs or diabetes mellitus were randomized to daily intake of phytosterols-enriched low-fat milk which contained 1.5 g phytosterols per day (N = 110) or a conventional low-fat milk (N = 111) for three weeks. Fasting bloods were taken before and at the end of the study for the measurement of lipid and glucose profile. Physical examination was also performed. Comparing treatment with control, treatment group had significant decrease in serum LDL-cholesterol level (9.5 ± 2.0%; p < 0.0001). Phytosterols intake also decreased total cholesterol (P < 0.0001) and diastolic blood pressure (P = 0.01). Consumption of a phytosterols-enriched low-fat milk led to a significant fall in LDL-cholesterol, total cholesterol, and diastolic blood pressure in Chinese. This can be recommended as part of a healthy diet for people. (ClinicalTrials.gov identifier: NCT02541201; Date of registration: 26 Aug 2015).
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Plasma fat-soluble vitamin and carotenoid concentrations after plant sterol and plant stanol consumption: a meta-analysis of randomized controlled trials. Eur J Nutr 2016; 56:909-923. [PMID: 27591863 PMCID: PMC5346416 DOI: 10.1007/s00394-016-1289-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/29/2016] [Indexed: 12/13/2022]
Abstract
Purpose Plant sterols and stanols interfere with intestinal cholesterol absorption, and it has been questioned whether absorption and plasma concentrations of fat-soluble vitamins and carotenoids are also affected. We conducted a meta-analysis to assess the effects of plant sterol and stanol consumption on plasma fat-soluble vitamin and carotenoid concentrations. Methods Forty-one randomized controlled trials involving 3306 subjects were included. Weighted absolute and relative changes of non-standardized and total cholesterol (TC)-standardized values (expressed as summary estimates and 95 % CIs) were calculated for three fat-soluble vitamins (α- and γ-tocopherol, retinol and vitamin D) and six carotenoids (β-carotene, α-carotene, lycopene, lutein, zeaxanthin and β-cryptoxanthin) using a random effects model. Heterogeneity was assessed using predefined subject and treatment characteristics. Results Average plant sterol or stanol intake was 2.5 g/d. Relative non-standardized and TC-standardized concentrations of β-carotene decreased by, respectively, −16.3 % (95 % CI −18.3; −14.3) and −10.1 % (−12.3; −8.0), α-carotene by −14.4 % (−17.5; 11.3) and −7.8 % (−11.3; −4.3), and lycopene by −12.3 % (−14.6; −10.1) and −6.3 % (−8.6; −4.0). Lutein concentrations decreased by −7.4 % (−10.1; −4.8), while TC-standardized concentrations were not changed. For zeaxanthin, these values were −12.9 % (−18.9; −6.8) and −7.7 % (−13.8; −1.7) and for β-cryptoxanthin −10.6 % (−14.3; −6.9) and −4.8 % (−8.7; −0.9). Non-standardized α-tocopherol concentrations decreased by −7.1 % (−8.0; −6.2) and γ-tocopherol by −6.9 % (−9.8; −3.9), while TC-standardized tocopherol concentrations were not changed. Non-standardized retinol and vitamin D concentrations were not affected. Results were not affected by baseline concentrations, dose, duration and type of plant sterols/stanols, except for significant effects of duration (≤4 vs. >4 weeks) on TC-standardized lutein concentrations (1.0 vs. −5.6 %) and type of plant sterol/stanol on TC-standardized β-carotene concentrations (−8.9 vs. −14.2 %). Conclusions Plant sterol and stanol intake lowers TC-standardized hydrocarbon carotenoid concentrations, differently affects TC-standardized oxygenated carotenoid concentrations, but does not affect TC-standardized tocopherol concentrations or absolute retinol and vitamin D concentrations. Observed concentrations remained within normal ranges. Electronic supplementary material The online version of this article (doi:10.1007/s00394-016-1289-7) contains supplementary material, which is available to authorized users.
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Leal-Castañeda EJ, Inchingolo R, Cardenia V, Hernandez-Becerra JA, Romani S, Rodriguez-Estrada MT, Galindo HSG. Effect of Microwave Heating on Phytosterol Oxidation. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2015; 63:5539-5547. [PMID: 25973984 DOI: 10.1021/acs.jafc.5b00961] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The oxidative stability of phytosterols during microwave heating was evaluated. Two different model systems (a solid film made with a phytosterol mixture (PSF) and a liquid mixture of phytosterols and triolein (1:100, PS + TAG (triacylglycerol))) were heated for 1.5, 3, 6, 12, 20, and 30 min at 1000 W. PS degraded faster when they were microwaved alone than in the presence of TAG, following a first-order kinetic model. Up to 6 min, no phytosterol oxidation products (POPs) were generated in both systems. At 12 min of heating, the POP content reached a higher level in PSF (90.96 μg/mg of phytosterols) than in PS + TAG (22.66 μg/mg of phytosterols), but after 30 min of treatment, the opposite trend was observed. 7-Keto derivates were the most abundant POPs in both systems. The extent of phytosterol degradation depends on both the heating time and the surrounding medium, which can impact the quality and safety of the food product destined to microwave heating/cooking.
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Affiliation(s)
- Everth Jimena Leal-Castañeda
- †Unidad de Investigación y Desarrollo de Alimentos, Instituto Tecnológico de Veracruz, M.A. de Quevedo 2779, Colonia Formando Hogar, Veracruz 91897, México
| | - Raffaella Inchingolo
- ‡Department of Agricultural and Food Sciences, Alma Mater Studiorum-Università di Bologna, Viale G. Fanin 40, 40127 Bologna, Italy
| | | | - Josafat Alberto Hernandez-Becerra
- ⊥División de Tecnología de Alimentos, Universidad Tecnológica de Tabasco, Kilómetro 14.6 Carretera Villahermosa-Teapa, Villahermosa, Tabasco 86280, México
| | | | - María Teresa Rodriguez-Estrada
- ‡Department of Agricultural and Food Sciences, Alma Mater Studiorum-Università di Bologna, Viale G. Fanin 40, 40127 Bologna, Italy
| | - Hugo Sergio García Galindo
- †Unidad de Investigación y Desarrollo de Alimentos, Instituto Tecnológico de Veracruz, M.A. de Quevedo 2779, Colonia Formando Hogar, Veracruz 91897, México
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Garcia-Llatas G, Cilla A, Alegría A, Lagarda MJ. Bioavailability of plant sterol-enriched milk-based fruit beverages: In vivo and in vitro studies. J Funct Foods 2015. [DOI: 10.1016/j.jff.2015.01.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Cusack LK, Fernandez ML, Volek JS. The food matrix and sterol characteristics affect the plasma cholesterol lowering of phytosterol/phytostanol. Adv Nutr 2013; 4:633-43. [PMID: 24228192 PMCID: PMC3823509 DOI: 10.3945/an.113.004507] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Foods with added phytosterols/phytostanols (PS) are recommended to lower LDL cholesterol (LDL-c) concentrations. Manufacturers have incorporated PS into a variety of common foods. Understanding the cholesterol-lowering impact of the food matrix and the PS characteristics would maximize their success and increase the benefit to consumers. This review systematically examines whether the PS characteristics and the fatty acid composition of foods with added PS affects serum LDL-c. A total of 33 studies published between the years 1998 and 2011 inclusive of 66 individual primary variables (strata) were evaluated. The functional food matrices included margarine, mayonnaise, yogurt, milk, cheese, meat, grain, juice, and chocolate. Consistently, ≥10% reductions in LDL-c were reported when the characteristics of the food matrix included poly- and monounsaturated fatty acids known to lower LDL-c. Also, >10% mean reductions in LDL-c were reported when β-sitostanol and campestanol as well as stanol esters were used. These characteristics allow both low-fat and high-fat foods to successfully incorporate PS and significantly lower LDL-c.
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Affiliation(s)
| | | | - Jeff S. Volek
- Departments of Kinesiology and,To whom correspondence should be addressed. E-mail:
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Ras RT, Hiemstra H, Lin Y, Vermeer MA, Duchateau GSMJE, Trautwein EA. Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations--a meta-analysis of randomized controlled studies. Atherosclerosis 2013; 230:336-46. [PMID: 24075766 DOI: 10.1016/j.atherosclerosis.2013.08.012] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 08/08/2013] [Accepted: 08/12/2013] [Indexed: 12/26/2022]
Abstract
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. CONCLUSION Intake of PS-enriched foods increases plasma sitosterol and campesterol concentrations. However, total PS remain below 1% of total sterols circulating in the blood.
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Affiliation(s)
- Rouyanne T Ras
- Unilever R&D Vlaardingen, Olivier van Noortlaan 120, 3133 AT Vlaardingen, The Netherlands.
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García-Llatas G, Vidal C, Cilla A, Barberá R, Lagarda MJ. Simultaneous quantification of serum phytosterols and cholesterol precursors using a simple gas chromatographic method. EUR J LIPID SCI TECH 2012. [DOI: 10.1002/ejlt.201100331] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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MacKay DS, Jones PJH. Phytosterols in human nutrition: Type, formulation, delivery, and physiological function. EUR J LIPID SCI TECH 2011. [DOI: 10.1002/ejlt.201100100] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hernández-Mijares A, Bañuls C, Jover A, Solá E, Bellod L, Martínez-Triguero ML, Lagarda MJ, Víctor VM, Rocha M. Low intestinal cholesterol absorption is associated with a reduced efficacy of phytosterol esters as hypolipemic agents in patients with metabolic syndrome. Clin Nutr 2011; 30:604-9. [DOI: 10.1016/j.clnu.2011.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 02/18/2011] [Accepted: 03/10/2011] [Indexed: 11/26/2022]
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Musa-Veloso K, Poon TH, Elliot JA, Chung C. A comparison of the LDL-cholesterol lowering efficacy of plant stanols and plant sterols over a continuous dose range: results of a meta-analysis of randomized, placebo-controlled trials. Prostaglandins Leukot Essent Fatty Acids 2011; 85:9-28. [PMID: 21345662 DOI: 10.1016/j.plefa.2011.02.001] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine if plant stanols and plant sterols differ with respect to their low-density lipoprotein cholesterol (LDL-CH) lowering efficacies across a continuous dose range. METHODS Dose-response relationships were evaluated separately for plant stanols and plant sterols and reductions in LDL-CH, using a first-order elimination function. RESULTS Altogether, 113 publications and 1 unpublished study report (representing 182 strata) complied with the pre-defined inclusion and exclusion criteria and were included in the assessment. The maximal LDL-CH reductions for plant stanols (16.4%) and plant stanol ester (17.1%) were significantly greater than the maximal LDL-CH reductions for plant sterols (8.3%) and plant sterol ester (8.4%). These findings persisted in several additional analyses. DISCUSSION AND CONCLUSIONS Intakes of plant stanols in excess of the recommended 2g/day dose are associated with additional and dose-dependent reductions in LDL-CH, possibly resulting in further reductions in the risk of coronary heart disease (CHD).
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Serum lipid responses to phytosterol-enriched milk in a moderate hypercholesterolemic population is not affected by apolipoprotein E polymorphism or diameter of low-density lipoprotein particles. Eur J Clin Nutr 2010; 65:255-61. [DOI: 10.1038/ejcn.2010.241] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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