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Wang Y, Liu B, Hu Y, Sampson L, Manson JE, Rimm EB, Sun Q. Phytosterol intake and risk of coronary artery disease: Results from 3 prospective cohort studies. Am J Clin Nutr 2024; 119:344-353. [PMID: 38042410 PMCID: PMC10884604 DOI: 10.1016/j.ajcnut.2023.11.020] [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: 07/06/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Phytosterols are structurally similar to cholesterol and partially inhibit intestinal absorption of cholesterol, although their impact on coronary artery disease (CAD) risk remains to be elucidated. OBJECTIVES This study aimed to prospectively assess the associations between total and individual phytosterol intake and CAD risk in United States health professionals. METHODS The analysis included 213,992 participants from 3 prospective cohorts-the Nurses' Health Study (NHS), NHSII, and Health Professionals Follow-Up Study-without cardiovascular disease or cancer at baseline. Diet was assessed using a validated food frequency questionnaire every 2-4 y since baseline. Associations between phytosterol intake and the risk of CAD, such as nonfatal myocardial infarction and fatal CAD, were evaluated using Cox proportional hazards regression models. RESULTS More than 5,517,993 person-years, 8725 cases with CAD were documented. Comparing extreme quintiles, pooled hazard ratios (95% CIs) of CAD were 0.93 (0.86, 1.01; P-trend = 0.16) for total phytosterols, 0.89 (0.82, 0.96; P-trend = 0.05) for campesterol, 0.95 (0.88, 1.02; P-trend = 0.10) for stigmasterol, and 0.92 (0.85, 1.00; P-trend = 0.09) for β-sitosterol. Nonlinear associations were observed for total phytosterols, campesterol, and β-sitosterol: the risk reduction plateaued at intakes above ∼180, 30, and 130 mg/d, respectively (P-nonlinearity < 0.001). In a subset of participants (N range between 11,983 and 22,039), phytosterol intake was inversely associated with plasma concentrations of total cholesterol, triglycerides, high-density lipoprotein cholesterol, and IL-6 and positively associated with adiponectin, whereas no significant associations were observed for low-density lipoprotein cholesterol or C-reactive protein concentrations. CONCLUSIONS Higher long-term intake of total and major subtypes of phytosterols may be associated with a modest reduction in CAD risk, displaying a nonlinear relationship that plateau at moderate intake levels. The role of phytosterols in preventing CAD warrants further investigation.
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Affiliation(s)
- Yeli Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Binkai Liu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Yang Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Laura Sampson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - JoAnn E Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
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2
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Fontané L, Pedro-Botet J, Garcia-Ribera S, Climent E, Muns MD, Ballesta S, Satorra P, Flores-Le Roux JA, Benaiges D. Use of phytosterol-fortified foods to improve LDL cholesterol levels: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2023; 33:1472-1480. [PMID: 37225641 DOI: 10.1016/j.numecd.2023.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/26/2023]
Abstract
AIMS The main objective was to assess if foods fortified with phytosterols (PS), including plant sterols and plant stanols, reduce low-density lipoprotein cholesterol (LDL-C) concentrations. The secondary objective was to determine the impact of different factors related to PS administration. DATA SYNTHESIS The search was carried out in MEDLINE, EMBASE, Web of Science, Scopus and The Cochrane Central Register of Controlled Trials (CENTRAL) databases up to March 2023. The meta-analysis was registered in the PROSPERO database (CRD42021236952). From a total of 223 studies, 125 were included. On average, PS lowered LDL-C 0.55 mmol/L [95% confidence interval (CI) = 10.82-12.67], and this decrease was significantly maintained for all analysed subgroups. A greater reduction in LDL-C levels was detected in relation to a higher daily PS dosage. The food format "Bread, biscuits, cereals", conditioned a lower decrease of 0.14 mmol/L (95%CI -8.71 to -2.16) in LDL-C levels, compared to the predominant food format group of "butter, margarine, spreads". No significant differences were detected with the other subgroups (treatment duration, intake pattern, number of daily intakes and concomitant statin treatment). CONCLUSION The present meta-analysis supported that the use of PS-fortified foods had a beneficial effect on LDL-C lowering. In addition, it was observed that the factors that influence a decline LDL-C levels were PS dose as well as the food format in which they were consumed.
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Affiliation(s)
- Laia Fontané
- Department of Endocrinology and Nutrition, Consorci Sanitari Alt Penedès-Garraf, Espirall, 61, E-08720 Vilafranca del Penedès, Spain; Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain.
| | - Juan Pedro-Botet
- Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Campus Universitari Mar. Dr. Aiguader, 80, E-08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, E-08003 Barcelona, Spain.
| | - Sonika Garcia-Ribera
- Department of Endocrinology and Nutrition, Consorci Sanitari Alt Penedès-Garraf, Espirall, 61, E-08720 Vilafranca del Penedès, Spain; Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, E-08003 Barcelona, Spain.
| | - Elisenda Climent
- Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, E-08003 Barcelona, Spain.
| | - Maria D Muns
- Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain.
| | - Silvia Ballesta
- Department of Endocrinology and Nutrition, Consorci Sanitari Alt Penedès-Garraf, Espirall, 61, E-08720 Vilafranca del Penedès, Spain; Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Campus Universitari Mar. Dr. Aiguader, 80, E-08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, E-08003 Barcelona, Spain.
| | - Pau Satorra
- Department of Biostatistics, Institut d'Investigació Biomèdica de Bellvitge, Gran Via de l'Hospitalet, 199, E-08908 Hospitalet de Llobregat, Spain.
| | - Juana A Flores-Le Roux
- Department of Endocrinology and Nutrition, Consorci Sanitari Alt Penedès-Garraf, Espirall, 61, E-08720 Vilafranca del Penedès, Spain; Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, E-08003 Barcelona, Spain; Department of Medicine, Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, E-08002 Barcelona, Spain.
| | - David Benaiges
- Department of Endocrinology and Nutrition, Consorci Sanitari Alt Penedès-Garraf, Espirall, 61, E-08720 Vilafranca del Penedès, Spain; Department of Endocrinology and Nutrition, Hospital del Mar, Passeig Marítim, 25-29, E-08003 Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80, E-08003 Barcelona, Spain; Department of Medicine, Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, E-08002 Barcelona, Spain.
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3
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Althwab SA, Alamro SA, Al Abdulmonem W, Allemailem KS, Alarifi SA, Hamad EM. Fermented camel milk enriched with plant sterols improves lipid profile and atherogenic index in rats fed high -fat and -cholesterol diets. Heliyon 2022; 8:e10871. [PMID: 36237975 PMCID: PMC9552119 DOI: 10.1016/j.heliyon.2022.e10871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/27/2022] [Accepted: 09/28/2022] [Indexed: 11/30/2022] Open
Abstract
The current study was designed to explore the effect of fermented camel milk, plant sterols and their combination on the blood levels of sd-LDL and atherogenicity in rats fed on high-fat-cholesterol diets (HFC). Forty male Wistar rats were distributed into five groups: Normal control (NC), Positive control (PC, HFC), plant sterol (PS, HFC containing 1% (w/w) β-sitosterol:Stigmasterols; 9:1), FM (HFC containing 4% (w/w) lyophilized fermented camel milk), and PSFM (HFC containing 1% (w/w) plant sterols +4% (w/w) lyophilized fermented camel milk). Antioxidant activity showed that β-sitosterol had the highest radical scavenging activity, followed by fermented camel milk and stigmasterol (p < 0.05). Feeding rats on HFC for 8 weeks resulted in a significant (p < 0.05) increase in blood lipids of PC group compared with NC group. Administration of PS, FM, and PSFM resulted in a significant reduction in atherogenic index (50, 24.5, and 41.5 %, p < 0.05), and sd-LDL levels (73, 45, and 59%, p < 0.05), respectively. Only the FM group showed a significant reduction in triglycerides levels of rats. Administration of PS, FM and PSFM decreased serum MDA levels significantly by 58.7, 45.4, and 69% (p < 0.05), and increased total antioxidant capacity by 35.9, 84.8, and 38.3% (p < 0.05), respectively. This is the first report to the best of our knowledge that shows fermented camel milk enriched with plant sterol could reduce atherogenesis and cardiovascular diseases activity via inhibition of the status of small dense LDL and oxidative stress.
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Affiliation(s)
- Sami A. Althwab
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, 51452 Buraidah, Saudi Arabia
| | - Samar A. Alamro
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, 51452 Buraidah, Saudi Arabia
| | - Waleed Al Abdulmonem
- Department of Pathology, College of Medicine, Qassim University, P.O. Box 6655, Buraidah 51452, Saudi Arabia
| | - Khaled S. Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraidah 6699, Saudi Arabia
| | - Saud A. Alarifi
- Department of Zoology, College of Science, King Saud University, Riyadh 11461, Saudi Arabia
| | - Essam M. Hamad
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, 51452 Buraidah, Saudi Arabia
- Department of Dairy Science, Faculty of Agriculture, Cairo University, Egypt
- Corresponding author.
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4
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Nattagh-Eshtivani E, Barghchi H, Pahlavani N, Barati M, Amiri Y, Fadel A, Khosravi M, Talebi S, Arzhang P, Ziaei R, Ghavami A. Biological and pharmacological effects and nutritional impact of phytosterols: A comprehensive review. Phytother Res 2021; 36:299-322. [PMID: 34729825 DOI: 10.1002/ptr.7312] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/01/2021] [Accepted: 09/30/2021] [Indexed: 12/20/2022]
Abstract
Phytosterols (PSs), classified into plant sterols and stanols, are bioactive compounds found in foods of plant origin. PSs have been proposed to exert a wide number of pharmacological properties, including the potential to reduce total and low-density lipoprotein (LDL) cholesterol levels and thereby decreasing the risk of cardiovascular diseases. Other health-promoting effects of PSs include anti-obesity, anti-diabetic, anti-microbial, anti-inflammatory, and immunomodulatory effects. Also, anticancer effects have been strongly suggested, as phytosterol-rich diets may reduce the risk of cancer by 20%. The aim of this review is to provide a general overview of the available evidence regarding the beneficial physiological and pharmacological activities of PSs, with special emphasis on their therapeutic potential for human health and safety. Also, we will explore the factors that influence the physiologic response to PSs.
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Affiliation(s)
- Elyas Nattagh-Eshtivani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh Barghchi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naseh Pahlavani
- Nutrition and Biochemistry Department, School of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.,Department of Clinical Biochemistry and Nutrition, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mehdi Barati
- Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yasaman Amiri
- Medical School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdulmannan Fadel
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Maryam Khosravi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Talebi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pishva Arzhang
- Department of Biochemistry and Diet Therapy, Faculty of Nutritional Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abed Ghavami
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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5
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Gachumi G, Poudel A, Wasan KM, El-Aneed A. Analytical Strategies to Analyze the Oxidation Products of Phytosterols, and Formulation-Based Approaches to Reduce Their Generation. Pharmaceutics 2021; 13:pharmaceutics13020268. [PMID: 33669349 PMCID: PMC7920278 DOI: 10.3390/pharmaceutics13020268] [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: 01/08/2021] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022] Open
Abstract
Phytosterols are a class of lipid molecules present in plants that are structurally similar to cholesterol and have been widely utilized as cholesterol-lowering agents. However, the susceptibility of phytosterols to oxidation has led to concerns regarding their safety and tolerability. Phytosterol oxidation products (POPs) present in a variety of enriched and non-enriched foods can show pro-atherogenic and pro-inflammatory properties. Therefore, it is crucial to screen and analyze various phytosterol-containing products for the presence of POPs and ultimately design or modify phytosterols in such a way that prevents the generation of POPs and yet maintains their pharmacological activity. The main approaches for the analysis of POPs include the use of mass spectrometry (MS) linked to a suitable separation technique, notably gas chromatography (GC). However, liquid chromatography (LC)-MS has the potential to simplify the analysis due to the elimination of any derivatization step, usually required for GC-MS. To reduce the transformation of phytosterols to their oxidized counterparts, formulation strategies can theoretically be adopted, including the use of microemulsions, microcapsules, micelles, nanoparticles, and liposomes. In addition, co-formulation with antioxidants, such as tocopherols, may prove useful in substantially preventing POP generation. The main objectives of this review article are to evaluate the various analytical strategies that have been adopted for analyzing them. In addition, formulation approaches that can prevent the generation of these oxidation products are proposed.
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Affiliation(s)
- George Gachumi
- Drug Discovery and Development Research Group, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (G.G.); (A.P.)
| | - Asmita Poudel
- Drug Discovery and Development Research Group, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (G.G.); (A.P.)
| | - Kishor M. Wasan
- iCo Therapeutics Inc., Vancouver, BC V6Z 2T3, Canada;
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Skymount Medical Group Inc., Calgary, AB T3C 0J8, Canada
| | - Anas El-Aneed
- Drug Discovery and Development Research Group, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (G.G.); (A.P.)
- Correspondence: ; Tel.: +1-306-966-2013
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6
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Alhabeeb H, Sohouli MH, Lari A, Fatahi S, Shidfar F, Alomar O, Salem H, Al-Badawi IA, Abu-Zaid A. Impact of orange juice consumption on cardiovascular disease risk factors: a systematic review and meta-analysis of randomized-controlled trials. Crit Rev Food Sci Nutr 2020; 62:3389-3402. [PMID: 33350317 DOI: 10.1080/10408398.2020.1865263] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cardiovascular disease (CVD) is the greatest cause of premature death and disability globally. Numerous therapeutic strategies have been developed to improve and prevent the adverse cardiovascular events, including nutritional approaches. This systematic review and meta-analysis summarized the evidence on orange juice consumption on CVD risk factors. Four databases were searched up to September 2020. Ten randomized controlled trials were included in the final analysis. Pooled results demonstrated a significant effect of orange juice on glucose (WMD: -2.92 mg/dl, 95% CI: -5.327, -0.530, p = 0.017), insulin (WMD: -1.229 μU/ml, 95% CI: -2.083, -0.374, p = 0.005), HOMA-IR (WMD: -0.464, 95% CI: -0.747, -0.181, p = 0.001), total cholesterol (WMD: -9.84 mg/dl, 95% CI: -15.43, -4.24, p = 0.001), LDL-C (WMD: -9.14 mg/dl, 95% CI: -15.79, -2.49, p = 0.007), and CRP (WMD: -0.467 mg/l, 95% CI: -0.815, -0.120, p = 0.008) compared to control group. However, the effect of orange juice on body composition factors and other CVD risk factors was not significant compared to control group. These lowering effects of glucose, HOMA-IR, total cholesterol, and LDL-C were robust in subgroups with orange juice consumption ≥500 ml/day. This meta-analysis suggests that orange juice may be beneficial in improving several CVD risk factors.
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Affiliation(s)
- Habeeb Alhabeeb
- Clinical Research, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammad Hassan Sohouli
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran Iran.,Student Research Committee, Faculty of public health branch, Iran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Lari
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran Iran.,Student Research Committee, Faculty of public health branch, Iran University of Medical Sciences, Tehran, Iran
| | - Somaye Fatahi
- Student Research Committee, Faculty of public health branch, Iran University of Medical Sciences, Tehran, Iran.,Pediatric Gastroenterology, Hepatology, and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Student Research Committee, Faculty of public health branch, Iran University of Medical Sciences, Tehran, Iran
| | - Osama Alomar
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hany Salem
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ismail A Al-Badawi
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Abu-Zaid
- Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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7
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Kopeć A, Zawistowski J, Kitts DD. Benefits of Anthocyanin-Rich Black Rice Fraction and Wood Sterols to Control Plasma and Tissue Lipid Concentrations in Wistar Kyoto Rats Fed an Atherogenic Diet. Molecules 2020; 25:E5363. [PMID: 33212852 PMCID: PMC7698440 DOI: 10.3390/molecules25225363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 01/27/2023] Open
Abstract
Background: This study reports on the relative effects of administrating a cyanidin-3-O-glucoside-rich black rice fraction (BRF), a standardized wood sterol mixture (WS), and a combination of both to lower plasma and target tissue lipid concentrations in Wistar Kyoto (WKY) rats fed atherogenic diets. Methods: Male WKY (n = 40) rats were randomly divided into five groups, which included a nonatherogenic control diet and atherogenic diets that included a positive control and atherogenic diets supplemented with BRF or WS, respectively, and a combination of both BRF + WS. Plasma and target tissue liver, heart and aorta cholesterol, and triacylglycerides (TAG) content were also measured. Results: Rats fed atherogenic diets exhibited elevated hyperlipidemia compared to counterparts fed nonatherogenic diets (p < 0.001); this effect was mitigated by supplementing the atherogenic diets with BRF and WS, respectively (p < 0.05). Combining BRF with WS to enrich the supplement lowered cholesterol similar to the WS effect (p < 0.05) and lowered TAG characteristic to the BRF effect (p < 0.05). Conclusions: Rats fed diets containing BRF or WS effectively mitigate the hypercholesterolemia and elevated TAG induced by feeding an atherogenic diet. The benefit of adding BRF + WS together is relevant to the lipid parameter measured and is target tissue-specific.
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Affiliation(s)
- Aneta Kopeć
- Department of Human Nutrition and Dietetics, Faculty of Food Technology, University of Agriculture in Krakow, Balicka 122, 31-149 Kraków, Poland;
| | - Jerzy Zawistowski
- Faculty of Land and Food Systems, University of British Columbia 209-2205 East Mall, Vancouver, BC V6T 1Z4, Canada;
| | - David D. Kitts
- Faculty of Land and Food Systems, University of British Columbia 209-2205 East Mall, Vancouver, BC V6T 1Z4, Canada;
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8
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Kaur R, Myrie SB. Association of Dietary Phytosterols with Cardiovascular Disease Biomarkers in Humans. Lipids 2020; 55:569-584. [PMID: 32557606 DOI: 10.1002/lipd.12262] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 12/27/2022]
Abstract
Cardiovascular disease (CVD) is a leading cause of death worldwide. Elevated concentrations of serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) are major lipid biomarkers that contribute to the risk of CVD. Phytosterols well known for their cholesterol-lowering ability, are non-nutritive compounds that are naturally found in plant-based foods and can be classified into plant sterols and plant stanols. Numerous clinical trials demonstrated that 2 g phytosterols per day have LDL-C lowering efficacy ranges of 8-10%. Some observational studies also showed an inverse association between phytosterols and LDL-C reduction. Beyond the cholesterol-lowering beneficial effects of phytosterols, the association of phytosterols with CVD risk events such as coronary artery disease and premature atherosclerosis in sitosterolemia patients have also been reported. Furthermore, there is an increasing demand to determine the association of circulating phytosterols with vascular health biomarkers such as arterial stiffness biomarkers. Therefore, this review aims to examine the ability of phytosterols for CVD risk prevention by reviewing the current data that looks at the association between dietary phytosterols intake and serum lipid biomarkers, and the impact of circulating phytosterols level on vascular health biomarkers. The clinical studies in which the impact of phytosterols on vascular function is investigated show minor but beneficial phytosterols effects over vascular health. The aforementioned vascular health biomarkers are pulse wave velocity, augmentation index, and arterial blood pressure. The current review will serve to begin to address the research gap that exists between the association of dietary phytosterols with CVD risk biomarkers.
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Affiliation(s)
- Ramandeep Kaur
- Department of Food and Human Nutritional Sciences, Richardson Centre for Functional Food and Nutraceuticals, University of Manitoba, R3T 2N2, 196 Innovation Drive, Winnipeg, MB, Canada
| | - Semone B Myrie
- Department of Food and Human Nutritional Sciences, Richardson Centre for Functional Food and Nutraceuticals, University of Manitoba, R3T 2N2, 196 Innovation Drive, Winnipeg, MB, Canada
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9
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Gylling H, Simonen P, Kaipiainen L, Wester I. Methodological Aspects of Phytosterol Measurements in Biological Samples. Curr Med Chem 2020; 26:6776-6785. [PMID: 30009697 DOI: 10.2174/0929867325666180713160330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/09/2018] [Accepted: 06/28/2018] [Indexed: 01/21/2023]
Abstract
Phytosterol measurement has gained a lot of interest during the last two decades after foods and supplements with added 4-desmethyl phytosterols were recognized and used as effective and safe non-pharmacologic hypocholesterolemic agents, and also after the mechanisms of intestinal absorption and hepatic excretion of sterols were unraveled. In addition, the wide use of serum phytosterols as biomarkers of cholesterol absorption has increased the interest in their measurement. In this review, the basic methods are discussed without going into details of the practical operations. The analysis includes first lipid extraction and saponification from various biologic matrices such as serum/plasma, feces, or tissues, after which the individual sterols are separated by adsorption chromatography (gas-liquid or liquid or high performance liquid chromatography) based on the polarity of the various sterols. We also deal with some specific aspects of phytosterol measurements in biological samples such as the need of harmonization of their analysis in biological samples, the discrepancies in the results of sitosterol and campesterol concentrations between different studies, and what is known about their biological day-to-day fluctuation. Phytosterols have a remarkable role in human health, so that their complicated and time consuming measurements call attention to routine ways of standardization between the sterol research laboratories.
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Affiliation(s)
- Helena Gylling
- University of Helsinki and Helsinki University Hospital, Internal Medicine, Helsinki, Finland
| | - Piia Simonen
- University of Helsinki and Helsinki University Hospital, Heart and Lung Center, Cardiology, Helsinki, Finland
| | - Leena Kaipiainen
- University of Helsinki and Helsinki University Hospital, Abdominal Center, Gastroenterology, Helsinki, Finland
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10
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Vilahur G, Ben-Aicha S, Diaz-Riera E, Badimon L, Padró T. Phytosterols and Inflammation. Curr Med Chem 2020; 26:6724-6734. [PMID: 29932029 DOI: 10.2174/0929867325666180622151438] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 01/27/2018] [Accepted: 01/31/2018] [Indexed: 02/08/2023]
Abstract
Besides the well-characterized effect of foods and supplements enriched with plant sterols/stanols on serum LDL-C concentrations, evidence is now emerging that phytosterols exert beneficial effects on non-lipid variables such as inflammatory and oxidative stress markers, coagulation parameters and endothelial function. This makes sterols and stanols an attractive alternative for dietary interventions in cardiovascular disease prevention, particularly in populations at low or medium risk. This review aims to summarize the current knowledge derived from experimental studies and human data on the anti-inflammatory effects of phytosterols/stanols and their relevance in promoting atheroprotection and preventing cardiovascular disease. The anti-inflammatory effects induced by plant sterols/stanols have been demonstrated in in vitro studies and in experimental animal models. However, not all the beneficial effects seen at an experimental level have translated into clinical benefit. Indeed, clinical studies that evaluate the association between phytosterols consumption and inflammatory variables (CRP and cytokines) are inconsistent and have not yet provided a solid answer. Plant sterols have been proposed as useful adjuncts to statin therapy to further reduce the risk of cardiovascular disease. However, there is limited available data and more research needs to be done.
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Affiliation(s)
- Gemma Vilahur
- Cardiovascular Program ICCC, Research Institute - Hospital Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,CIBERCV Instituto de Salud Carlos III, Barcelona, Spain
| | - Soumaya Ben-Aicha
- Cardiovascular Program ICCC, Research Institute - Hospital Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Elisa Diaz-Riera
- Cardiovascular Program ICCC, Research Institute - Hospital Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Lina Badimon
- Cardiovascular Program ICCC, Research Institute - Hospital Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,CIBERCV Instituto de Salud Carlos III, Barcelona, Spain.,Cardiovascular Research Chair, UAB, Barcelona, Spain
| | - Teresa Padró
- Cardiovascular Program ICCC, Research Institute - Hospital Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,CIBERCV Instituto de Salud Carlos III, Barcelona, Spain
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11
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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: 1.8] [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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12
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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: 2.6] [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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13
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Ferguson JJA, Wolska A, Remaley AT, Stojanovski E, MacDonald-Wicks L, Garg ML. Bread enriched with phytosterols with or without curcumin modulates lipoprotein profiles in hypercholesterolaemic individuals. A randomised controlled trial. Food Funct 2019; 10:2515-2527. [DOI: 10.1039/c8fo02512f] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A novel functional food containing phytosterols and curcumin significantly lowers blood cholesterol concentrations in hypercholesterolaemic individuals.
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Affiliation(s)
- Jessica J. A. Ferguson
- Nutraceuticals Research Program
- School of Biomedical Sciences & Pharmacy
- 305C Medical Science Building
- University of Newcastle
- Callaghan
| | - Anna Wolska
- Lipoprotein Metabolism Section
- National Heart
- Lung and Blood Institute
- NIH
- Bethesda
| | - Alan T. Remaley
- Lipoprotein Metabolism Section
- National Heart
- Lung and Blood Institute
- NIH
- Bethesda
| | - Elizabeth Stojanovski
- School of Mathematical and Physical Sciences
- University of Newcastle
- Callaghan
- Australia
| | - Lesley MacDonald-Wicks
- School of Health Sciences
- Faculty of Health & Medicine
- University of Newcastle
- Callaghan
- Australia
| | - Manohar L. Garg
- Nutraceuticals Research Program
- School of Biomedical Sciences & Pharmacy
- 305C Medical Science Building
- University of Newcastle
- Callaghan
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14
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Attanzio A, Tesoriere L, Vasto S, Pintaudi AM, Livrea MA, Allegra M. Short-term cactus pear [ Opuntia ficus-indica (L.) Mill] fruit supplementation ameliorates the inflammatory profile and is associated with improved antioxidant status among healthy humans. Food Nutr Res 2018; 62:1262. [PMID: 30150921 PMCID: PMC6104507 DOI: 10.29219/fnr.v62.1262] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 12/13/2022] Open
Abstract
Background Dietary ingredients and food components are major modifiable factors protecting immune system and preventing the progression of a low-grade chronic inflammation responsible for age-related diseases. Objective Our study explored whether cactus pear (Opuntia ficus-indica, Surfarina cultivar) fruit supplementation modulates plasma inflammatory biomarkers in healthy adults. Correlations between inflammatory parameters and antioxidant status were also assessed in parallel. Design In a randomised, 2-period (2 weeks/period), crossover, controlled-feeding study, conducted in 28 healthy volunteers [mean age 39.96 (±9.15) years, BMI 23.1 (±1.5) kg/m2], the effects of a diet supplemented with cactus pear fruit pulp (200 g, twice a day) were compared with those of an equivalent diet with isocaloric fresh fruit substitution. Results With respect to control, cactus pear diet decreased ( p < 0.05) the pro-inflammatory markers such as tumour necrosis factor-α (TNF-α), interleukin (IL)-1β, interferon-γ (INF)-γ, IL-8, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), whereas it increased ( p < 0.05) the anti-inflammatory marker IL-10. Moreover, the diet decreased ratios between pro-inflammatory biomarkers (CRP, IL-6, IL-8, TNF-α) and anti-inflammatory biomarker (IL-10) ( p < 0.05). Cactus pear supplementation caused an increase ( p < 0.05) in dermal carotenoids (skin carotenoid score, SCS), a biomarker of the body antioxidant status, with correlations between SCS and CRP (r = −0.905, p < 0.0001), IL-8 (r = −0.835, p < 0.0001) and IL-10 (r = 0.889, p < 0.0001). Conclusions The presently observed modulation of both inflammatory markers and antioxidant balance suggests cactus pear fruit as a novel and beneficial component to be incorporated into current healthy dietary habits.
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Affiliation(s)
- Alessandro Attanzio
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Palermo, Italy
| | - Luisa Tesoriere
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Palermo, Italy
| | - Sonya Vasto
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Palermo, Italy
| | - Anna Maria Pintaudi
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Palermo, Italy
| | - Maria A Livrea
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Palermo, Italy
| | - Mario Allegra
- Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università degli Studi di Palermo, Palermo, Italy
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15
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Javanmardi MA, Mohammad Shahi M, Seyedian SS, Haghighizadeh MH. Effects of Phytosterol Supplementation on Serum Levels of Lipid Profiles, Liver Enzymes, Inflammatory Markers, Adiponectin, and Leptin in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial. J Am Coll Nutr 2018; 37:1-8. [PMID: 29768109 DOI: 10.1080/07315724.2018.1466739] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 04/15/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Considering the high prevalence of nonalcoholic fatty liver disease and based on the evidence about the role of dietary cholesterol in liver inflammation, and also with regard to the effect of phytosterols on the metabolism of cholesterol, we aimed at exploring the therapeutic potential of phytosterol supplementation against nonalcoholic fatty liver disease. METHOD Thirty-eight patients with nonalcoholic fatty liver disease were randomly divided into two groups: The phytosterol group (n = 19) received a 1.6-g phytosterol supplement daily and the control group (n = 19) received 1.6 g starch daily as placebo for an 8-week period. Blood samples of all patients were taken at baseline (week 0) and at the end of the study (week 8) for measurement of lipid profiles, liver enzymes, inflammatory markers, adiponectin, and leptin. RESULTS Phytosterol supplementation significantly improved the levels of low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha compared to the placebo group. On the other hand, there were no significant differences between the two groups in total cholesterol, triglycerides, high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, ratios of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol, gamma-glutamyl transferase, interleukin 6, high-sensitivity C-reactive protein, adiponectin, and leptin. CONCLUSIONS The present study suggested that daily consumption of 1.6 g phytosterols efficiently lowers low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha in patients with nonalcoholic fatty liver disease.
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Affiliation(s)
- Mohammad Ali Javanmardi
- a Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Majid Mohammad Shahi
- b Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Seyed Saeed Seyedian
- c Research Institute for Infectious Diseases of the Digestive System, School of Medicine, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Mohammad Hossein Haghighizadeh
- d Department of Health Statistics, School of Public Health , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
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16
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Ribeiro C, Dourado G, Cesar T. Orange juice allied to a reduced-calorie diet results in weight loss and ameliorates obesity-related biomarkers: A randomized controlled trial. Nutrition 2017; 38:13-19. [DOI: 10.1016/j.nut.2016.12.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/08/2016] [Accepted: 12/24/2016] [Indexed: 01/08/2023]
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17
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Orem A, Alasalvar C, Vanizor Kural B, Yaman S, Orem C, Karadag A, Pelvan E, Zawistowski J. Cardio-protective effects of phytosterol-enriched functional black tea in mild hypercholesterolemia subjects. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.01.048] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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18
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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: 0.9] [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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19
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Gonçalves D, Lima C, Ferreira P, Costa P, Costa A, Figueiredo W, Cesar T. Orange juice as dietary source of antioxidants for patients with hepatitis C under antiviral therapy. Food Nutr Res 2017; 61:1296675. [PMID: 28469541 PMCID: PMC5404424 DOI: 10.1080/16546628.2017.1296675] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 01/30/2017] [Indexed: 02/08/2023] Open
Abstract
Background: HCV causes alterations in liver metabolism, resulting in biochemical and nutritional disorders. Supplementation with antioxidants has been suggested to minimize the diseases effects. Objective: This study assessed whether orange juice, a source of citrus flavonoids and vitamin C, may contribute to the treatment of patients with chronic hepatitis C. Design: Anthropometric, hemodynamic, dietary, and biochemical parameters, CRP and liver enzymes were measured in 43 adult patients of both genders who were diagnosed with chronic hepatitis C and were under antiviral therapy. Twenty-three patients were supplemented with orange juice for eight consecutive weeks, while 20 were enrolled as control group. Results: Following regular use of orange juice, no alterations were found in body mass, fat, and waist circumference. The serum levels of total cholesterol, LDL-cholesterol, CRP and parameters of oxidative stress decreased in the orange juice group. Furthermore, the levels of the liver enzyme AST decreased in those who had high levels before the intervention. Conclusion: The orange juice was a convenient food in the diet of patients due to the increase in antioxidant capacity and decreased inflammation and cholesterol in blood serum, in addition to maintaining body mass, which protect against the harmful effects caused by the chronic hepatitis C virus.
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Affiliation(s)
- Danielle Gonçalves
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Claudia Lima
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Paula Ferreira
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Paulo Costa
- Clinical Analysis Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Angela Costa
- Special Health Service of Araraquara (SESA), Faculty of Public Health, Universidade de Sao Paulo (USP), Araraquara, Brazil
| | - Walter Figueiredo
- Special Health Service of Araraquara (SESA), Faculty of Public Health, Universidade de Sao Paulo (USP), Araraquara, Brazil
| | - Thais Cesar
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
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de Barra M. Reporting bias inflates the reputation of medical treatments: A comparison of outcomes in clinical trials and online product reviews. Soc Sci Med 2017; 177:248-255. [DOI: 10.1016/j.socscimed.2017.01.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 01/10/2017] [Accepted: 01/20/2017] [Indexed: 01/03/2023]
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21
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Effect of a plant sterol-enriched spread on biomarkers of endothelial dysfunction and low-grade inflammation in hypercholesterolaemic subjects. J Nutr Sci 2016; 5:e44. [PMID: 28620471 PMCID: PMC5465806 DOI: 10.1017/jns.2016.40] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/11/2016] [Indexed: 01/08/2023] Open
Abstract
Plant sterols (PS) lower LDL-cholesterol, an established risk factor for CHD. Endothelial dysfunction and low-grade inflammation are two important features in the development of atherosclerosis. Whether PS affect biomarkers of endothelial function and low-grade inflammation is not well studied. The aim of the present study was to investigate the effect of regular intake of PS on biomarkers of endothelial dysfunction and low-grade inflammation. In a double-blind, randomised, placebo-controlled, parallel-group study, which was primarily designed to investigate the effect of PS intake on vascular function (clinicaltrials.gov: NCT01803178), 240 hypercholesterolaemic but otherwise healthy men and women consumed a low-fat spread with added PS (3 g/d) or a placebo spread for 12 weeks. Endothelial dysfunction biomarkers (both vascular and intracellular adhesion molecules 1 and soluble endothelial-selectin) and low-grade inflammation biomarkers (C-reactive protein, serum amyloid A, IL-6, IL-8, TNF-α and soluble intercellular adhesion molecule-1) were measured using a multi-array detection system based on electrochemiluminescence technology. Biomarkers were combined using z-scores. Differences in changes from baseline between the PS and the placebo groups were assessed. The intake of PS did not significantly change the individual biomarkers of endothelial dysfunction and low-grade inflammation. The z-scores for endothelial dysfunction (−0·02; 95 % CI −0·15, 0·11) and low-grade inflammation (−0·04; 95 % CI −0·16, 0·07) were also not significantly changed after PS intake compared with placebo. In conclusion, biomarkers of endothelial dysfunction and low-grade inflammation were not affected by regular intake of 3 g/d PS for 12 weeks in hypercholesterolaemic men and women.
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22
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Ho XL, Liu JJH, Loke WM. Plant sterol-enriched soy milk consumption modulates 5-lipoxygenase, 12-lipoxygenase, and myeloperoxidase activities in healthy adults - a randomized-controlled trial. Free Radic Res 2016; 50:1396-1407. [PMID: 27776459 DOI: 10.1080/10715762.2016.1252839] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A randomized, double blind, placebo-controlled and crossover study was conducted to simultaneously measure the effects, after 3-h and 4-week daily exposure to plant sterols-enriched food product, on inflammation, oxidative status, 5-lipoxygenase, 12-lipoxygenase, and myeloperoxidase activities in healthy adults. Eighteen healthy participants (67% female, 35.3 (mean) ± 9.5 (SD) years, mean body mass index 22.8 kg m-2) received two soy milk (20g) treatments daily: placebo and one containing 2.0 g free plant sterols equivalent of their palmitates (β-sitosterol, 55%; campesterol, 29%; stigmasterol, 23%). F2-isoprostanes, leukotriene B4, sitosterol, campesterol, and stigmasterol concentrations were measured in the blood plasma and urine, using stable isotope-labeled gas chromatography-mass spectrometry. High-sensitivity c-reactive protein, tumor necrosis factor-α, and lipoxin A4 concentrations in blood serum were measured using commercially available enzyme immunoassays. Myeloperoxidase activity, serum lipid hydroperoxides, plasma and urinary F2-isoprostanes, plasma and urinary leukotriene B4, and plasma high-sensitivity c-reactive protein concentrations were significantly reduced, while circulating lipoxin A4 concentrations were significantly elevated after 4-week plant sterols treatment. Plant sterols treatment decreased plasma leukotriene B4 and increased plasma lipoxin A4 concentrations acutely. Total plant sterols, β-sitosterol, campesterol, and stigmasterol concentrations were significantly elevated after 4-week treatments compared with the pre-treatment concentrations. Our results suggest that dietary plant sterols, in the combination used, can alleviate lipid peroxidation and inflammatory events in vivo. These effects are possibly exerted via the modulation of myeloperoxidase, 5-lipoxygenase, and 12-lipoxygenase activities.
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Affiliation(s)
- Xing Lin Ho
- a Centre for Functional Foods & Human Nutrition, School of Chemical & Life Sciences , Nanyang Polytechnic , Singapore, Singapore.,b Food Science & Nutrition Group, School of Chemical & Life Sciences , Nanyang Polytechnic , Singapore, Singapore
| | - Jonathan Jia He Liu
- b Food Science & Nutrition Group, School of Chemical & Life Sciences , Nanyang Polytechnic , Singapore, Singapore
| | - Wai Mun Loke
- a Centre for Functional Foods & Human Nutrition, School of Chemical & Life Sciences , Nanyang Polytechnic , Singapore, Singapore.,b Food Science & Nutrition Group, School of Chemical & Life Sciences , Nanyang Polytechnic , Singapore, Singapore
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23
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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: 2.9] [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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Kehili HE, Zerizer S, Beladjila KA, Kabouche Z. Anti-inflammatory effect of Algerian date fruit (Phoenix dactylifera). FOOD AGR IMMUNOL 2016. [DOI: 10.1080/09540105.2016.1183597] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Rocha VZ, Ras RT, Gagliardi AC, Mangili LC, Trautwein EA, Santos RD. Effects of phytosterols on markers of inflammation: A systematic review and meta-analysis. Atherosclerosis 2016; 248:76-83. [DOI: 10.1016/j.atherosclerosis.2016.01.035] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/21/2015] [Accepted: 01/21/2016] [Indexed: 12/29/2022]
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Brüll F, De Smet E, Mensink RP, Vreugdenhil A, Kerksiek A, Lütjohann D, Wesseling G, Plat J. Dietary plant stanol ester consumption improves immune function in asthma patients: results of a randomized, double-blind clinical trial. Am J Clin Nutr 2016; 103:444-53. [PMID: 26762374 DOI: 10.3945/ajcn.115.117531] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 11/30/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In vitro and ex vivo studies have suggested that plant sterols and stanols can shift the T helper (Th) 1/Th2 balance toward a Th1-type immune response, which may be beneficial in Th2-dominant conditions such as asthma and allergies. OBJECTIVE We evaluated in vivo whether plant stanol esters affect the immune response in asthma patients. DESIGN Fifty-eight asthma patients participated in a randomized, double-blind, placebo-controlled intervention study. All subjects started with a 2-wk run-in period in which they consumed 150 mL control soy-based yogurt without added plant stanol esters/d. Next, an 8-wk experimental period was started in which one-half of the participants received plant stanol enriched soy-based yogurts (4.0 g plant stanols/d), whereas the other one-half of subjects continued the consumption of control yogurts. After 4 wk of daily plant stanol consumption, all participants were vaccinated against hepatitis A virus (HAV), and the increase of antibody titres was monitored weekly until 4 wk after vaccination. RESULTS Asthma patients in the plant stanol ester group showed higher antibody titres against HAV 3 and 4 wk after vaccination [19% (P = 0.037) and 22% (P = 0.030), respectively]. Also, substantial reductions in plasma total immunoglobulin E, interleukin (IL)-1β, and tumor necrosis factor-α were shown in the plant stanol ester group. The increase in serum plant stanol concentrations was correlated significantly with the decrease in IL-13 concentrations and the Th1 switch in the Th1/Th2 balance. However, no absolute differences in cytokine production between the plant stanol ester group and the control group were shown. CONCLUSION To the best of our knowledge, we are among the first authors to show that plant stanol ester consumption improves the immune function in vivo in asthma patients. This trial was registered at clinicaltrials.gov as NCT01715675.
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Affiliation(s)
- Florence Brüll
- Department of Human Biology, School for Nutrition, Toxicology and Metabolism, and
| | - Els De Smet
- Department of Human Biology, School for Nutrition, Toxicology and Metabolism, and
| | - Ronald P Mensink
- Department of Human Biology, School for Nutrition, Toxicology and Metabolism, and
| | | | - Anja Kerksiek
- Institute of Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Dieter Lütjohann
- Institute of Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Geertjan Wesseling
- Respiratory Medicine, Maastricht University Medical Centre+, Maastricht, Netherlands; and
| | - Jogchum Plat
- Department of Human Biology, School for Nutrition, Toxicology and Metabolism, and
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Dourado GKZS, Cesar TB. Investigation of cytokines, oxidative stress, metabolic, and inflammatory biomarkers after orange juice consumption by normal and overweight subjects. Food Nutr Res 2015; 59:28147. [PMID: 26490535 PMCID: PMC4613901 DOI: 10.3402/fnr.v59.28147] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 09/06/2015] [Accepted: 09/07/2015] [Indexed: 01/17/2023] Open
Abstract
Background Abdominal adiposity has been linked to metabolic abnormalities, including dyslipidemia, oxidative stress, and low-grade inflammation. Objective To test the hypothesis that consumption of 100% orange juice (OJ) would improve metabolic, oxidative, and inflammatory biomarkers and cytokine levels in normal and overweight subjects with increased waist circumference. Design Subjects were divided into two groups in accordance with their body mass index: normal and overweight. Both groups of individuals consumed 750 mL of OJ daily for 8 weeks. Body composition (weight, height, percentage of fat mass, and waist circumference); metabolic biomarkers (total cholesterol, low-density lipoprotein-cholesterol [LDL-C], high-density lipoprotein-cholesterol [HDL-C], triglycerides, glucose, insulin, HOMA-IR, and glycated hemoglobin); oxidative biomarkers (malondialdehyde and DPPH•); inflammatory biomarkers (high-sensitivity C-reactive protein [hsCRP]); cytokines (IL-4, IL-10, IL-12, TNF-α, and IFN-γ); and diet were evaluated before and after consumption of OJ for 8 weeks. Results The major findings of this study were: 1) no alteration in body composition in either group; 2) improvement of the lipid profile, evidenced by a reduction in total cholesterol and LDL-C; 3) a potential stimulation of the immune response due to increase in IL-12; 4) anti-inflammatory effect as a result of a marked reduction in hsCRP; and 5) antioxidant action by the enhancement of total antioxidant capacity and the reduction of lipid peroxidation, in both normal and overweight subjects. Conclusions OJ consumption has a positive effect on important biomarkers of health status in normal and overweight subjects, thereby supporting evidence that OJ acts as functional food and could be consumed as part of a healthy diet to prevent metabolic and chronic diseases.
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Affiliation(s)
- Grace K Z S Dourado
- Department of Food and Nutrition, Faculty of Pharmaceutical Sciences, UNESP - Univ Estadual Paulista, Araraquara, Brazil (Faculdade de Ciências Farmacêuticas, UNESP - Univ Estadual Paulista, Departamento de Alimentos e Nutrição, Araraquara, SP 14801-902, Brazil)
| | - Thais B Cesar
- Department of Food and Nutrition, Faculty of Pharmaceutical Sciences, UNESP - Univ Estadual Paulista, Araraquara, Brazil (Faculdade de Ciências Farmacêuticas, UNESP - Univ Estadual Paulista, Departamento de Alimentos e Nutrição, Araraquara, SP 14801-902, Brazil);
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Borrell‐Pages M, Carolina Romero J, Badimon L. LRP5 and plasma cholesterol levels modulate the canonical Wnt pathway in peripheral blood leukocytes. Immunol Cell Biol 2015; 93:653-61. [DOI: 10.1038/icb.2015.41] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 01/05/2015] [Accepted: 01/28/2015] [Indexed: 02/02/2023]
Affiliation(s)
- Maria Borrell‐Pages
- Cardiovascular Research Center, CSIC‐ICCC, Hospital de la Santa Creu i Sant Pau, IIB‐Sant Pau Barcelona Spain
- Cardiovascular Research Chair, UAB Barcelona Spain
| | - July Carolina Romero
- Cardiovascular Research Center, CSIC‐ICCC, Hospital de la Santa Creu i Sant Pau, IIB‐Sant Pau Barcelona Spain
- Cardiovascular Research Chair, UAB Barcelona Spain
| | - Lina Badimon
- Cardiovascular Research Center, CSIC‐ICCC, Hospital de la Santa Creu i Sant Pau, IIB‐Sant Pau Barcelona Spain
- Cardiovascular Research Chair, UAB Barcelona Spain
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Bard JM, Paillard F, Lecerf JM. Effect of phytosterols/stanols on LDL concentration and other surrogate markers of cardiovascular risk. DIABETES & METABOLISM 2015; 41:69-75. [DOI: 10.1016/j.diabet.2014.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/06/2014] [Accepted: 11/07/2014] [Indexed: 11/16/2022]
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Ulbricht C. An Evidence-Based Systematic Review of Lutein by the Natural Standard Research Collaboration. J Diet Suppl 2015; 12:383-480. [PMID: 25616151 DOI: 10.3109/19390211.2014.988577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
An evidence-based systematic review of lutein by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
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Borrell-Pages M, Romero JC, Badimon L. Cholesterol modulates LRP5 expression in the vessel wall. Atherosclerosis 2014; 235:363-70. [PMID: 24929284 DOI: 10.1016/j.atherosclerosis.2014.05.922] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/07/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Macrophages are key players in atherosclerotic lesion formation and progression. We have recently demonstrated that lipid-loaded macrophages show activation of the canonical Wnt signaling pathway. METHODS To test the in vivo role of the canonical Wnt pathway in atherosclerosis we used mice deficient in the Wnt signaling receptor LRP5 (LRP5(-/-)) fed a hypercholesterolemic diet (HC) to induce atherosclerosis. These dietary groups were further subdivided into two subgroups receiving their respective diets supplemented with 2% plant sterol esters (PSE). All mice remained on their assigned diets until age 18 weeks. RESULTS HC WT mice had mildly increased non-HDL cholesterol levels, developed aortic atherosclerotic lesions and showed upregulated expression levels of aortic Lrp5. HC LRP5(-/-) mice develop larger aortic atherosclerotic lesions than WT mice indicating that LRP5 has a protective function in atherosclerosis progression. The oral administration of PSE, a dietary cholesterol-lowering agent, had an effect in the expression levels of the Wnt signaling receptor and in atherosclerosis progression. We found that PSE reduced serum total cholesterol levels, abolished HC-induced LRP5 overexpression and reduced aortic atherosclerotic plaques. CONCLUSION The proatherogenic effects of the excess of plasma lipids are in part mediated by modulation of LRP5 in the aorta. LRP5 and canonical Wnt signaling exert a protective defense mechanism against hyperlipidemia and atherosclerosis lesion progression.
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Affiliation(s)
- M Borrell-Pages
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - J C Romero
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - L Badimon
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain; Cardiovascular Research Chair, UAB, Barcelona, Spain.
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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: 38] [Impact Index Per Article: 3.5] [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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Amir Shaghaghi M, Abumweis SS, Jones PJ. Cholesterol-Lowering Efficacy of Plant Sterols/Stanols Provided in Capsule and Tablet Formats: Results of a Systematic Review and Meta-Analysis. J Acad Nutr Diet 2013; 113:1494-1503. [DOI: 10.1016/j.jand.2013.07.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 06/18/2013] [Indexed: 11/29/2022]
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Napoleone E, Cutrone A, Zurlo F, Di Castelnuovo A, D’Imperio M, Giordano L, De Curtis A, Iacoviello L, Rotilio D, Cerletti C, de Gaetano G, Donati MB, Lorenzet R. Both red and blond orange juice intake decreases the procoagulant activity of whole blood in healthy volunteers. Thromb Res 2013; 132:288-92. [DOI: 10.1016/j.thromres.2013.06.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 06/16/2013] [Accepted: 06/24/2013] [Indexed: 02/05/2023]
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Alemany L, Cilla A, Garcia-Llatas G, Rodriguez-Estrada MT, Cardenia V, Alegría A. Effect of simulated gastrointestinal digestion on plant sterols and their oxides in enriched beverages. Food Res Int 2013. [DOI: 10.1016/j.foodres.2013.02.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Coelho RCLA, Hermsdorff HHM, Bressan J. Anti-inflammatory properties of orange juice: possible favorable molecular and metabolic effects. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2013; 68:1-10. [PMID: 23417730 DOI: 10.1007/s11130-013-0343-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The low-grade inflammation has been recognized as the link between adiposity and the risk of chronic metabolic disorders. Thus, increased concentrations of inflammatory markers, such as interleukins and tumor necrosis factor alpha have been found in obese individuals. In turn, diet can positively or negatively influence on the risk of chronic metabolic diseases by modulating the inflammatory status. In this context, orange juice consumption can play a role in modulation of inflammatory markers through bioactive compounds, such as the flavonoids (hesperidin, naringenin). According to this review, orange juice appears to mediate the inflammatory response in plasma level and gene expression, and in postprandial and chronic (≥7 consecutive days) periods. The current findings suggest that orange juice could be a dietary feature for prevention and treatment of chronic diseases, although more studies are necessary to evaluate the physiological and molecular mechanisms involved.
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Affiliation(s)
- Raquel Cristina Lopes Assis Coelho
- Department of Nutrition and Healthy, Federal University of Viçosa, Avenida PH Rolfs s/n, Campus Universitário, 36571-000, Viçosa, Minas Gerais, Brazil.
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A highly sensitive quantification of phytosterols through an inexpensive derivatization. Chem Phys Lipids 2013; 166:18-25. [DOI: 10.1016/j.chemphyslip.2012.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 11/29/2012] [Accepted: 12/07/2012] [Indexed: 11/21/2022]
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Turpeinen AM, Ikonen M, Kivimäki AS, Kautiainen H, Vapaatalo H, Korpela R. A spread containing bioactive milk peptides Ile-Pro-Pro and Val-Pro-Pro, and plant sterols has antihypertensive and cholesterol-lowering effects. Food Funct 2012; 3:621-7. [PMID: 22398753 DOI: 10.1039/c2fo10286b] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Lifestyle intervention is recommended as the primary treatment for mild hypertension and hypercholesterolemia. We studied the effects of a spread containing bioactive milk peptides IPP and VPP, as well as plant sterols, on cardiovascular risk factors in 104 hypertensive, hypercholesterolemic subjects in a randomised, placebo-controlled double-blind intervention. Middle-aged subjects consumed 20 g day⁻¹ of a spread containing 4.2 mg of IPP and VPP as well as 2 g of plant sterols for 10 weeks after a 2 week run-in period. Blood pressure was measured at home 3 times a week. Office blood pressure and 24 h ambulatory blood pressure measurements were performed at the end of the run-in and intervention periods. Blood samples were analysed for serum lipids, plasma glucose and inflammation markers. A significant decrease (-4.1 mmHg vs. -0.5 mmHg, p = 0.007) in systolic blood pressure was seen in the active group, compared to placebo at home measurements. Office blood pressure and 24 h nighttime or daytime ambulatory systolic or diastolic pressure did not differ between the groups. Total (-0.16 vs. 0.25 mmol l⁻¹, p = 0.005) and LDL cholesterol (-0.16 vs. 0.18 mmol l⁻¹, p = 0.006) decreased significantly in the active group compared to the placebo. No significant differences between groups were seen for plasma glucose or inflammation markers. The results thus suggest that milk peptides IPP and VPP and plant sterols, in a low-fat spread matrix, produce a clinically significant reduction in systolic blood pressure as well as serum total and LDL cholesterol without adverse effects. Functional foods that affect 2 major risk factors offer a safe and convenient way to reduce the risk of cardiovascular disease by supporting lifestyle intervention.
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González-Larena M, Cilla A, García-Llatas G, Barberá R, Lagarda MJ. Plant sterols and antioxidant parameters in enriched beverages: storage stability. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2012; 60:4725-4734. [PMID: 22509888 DOI: 10.1021/jf3002679] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Plant sterols (PS) stability, antioxidant parameters, and color were studied during 6 months of storage at 4, 24, and 37 °C in three PS-enriched functional beverages. Beverages were skimmed milk with fruit juice and PS (MFJPS), fruit juice and PS (FJPS), and skimmed milk with PS (MPS). No loss in total PS content occurred during storage observing the same values at any given storage time point. Total carotenoids decreased 36% with storage at two months and then remained stable. Total polyphenols showed fluctuations throughout the storage, remaining stable at 6 months and reaching initial values. The antioxidant capacity (TEAC method) increased 18% at 6 months, and there was an increase in color over time and temperature, probably due to Maillard reaction compound formation. The increase in total antioxidant capacity might have helped PS maintenance throughout storage, these beverages being a good PS source even after 6 months of storage.
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Affiliation(s)
- Marina González-Larena
- Nutrition and Food Science Area, Faculty of Pharmacy, University of Valencia, Avda. Vicente Andrés Estellés s/n, 46100-Burjassot, Valencia, Spain
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Haidari F, Rashidi MR, Mohammad-Shahi M. Effects of orange juice and hesperetin on serum paraoxonase activity and lipid profile in hyperuricemic rats. BIOIMPACTS : BI 2012; 2:39-45. [PMID: 23678440 DOI: 10.5681/bi.2012.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 02/24/2012] [Accepted: 02/29/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Hypouricemic, antioxidant and xanthine oxidase inhibitory effects of orange juice and hesperetin have been already indicated. The objective of this study was to investigate the effects of orange juice and hesperetin on paraoxonase and arylesterase activity and lipid profile of hyperuricemic rats. METHODS Forty eight male Wistar rats were divided into 8 equal groups of healthy control, healthy+orange juice, healthy+hesperetin, healthy+allopurinol, hyperuricemic control, hyperuricemic+orange juice, hyperurice-mic+hesperetin and hyperuricemic+allopurinol. Hyperuricemia was induced using potassi-um oxonate (250 mg/kg ip). The treatments were carried out by daily gavage of 5 ml/kg orange juice, 5 mg/kg hesperetin and 5 mg/kg allopurinol for 2 weeks. Paraoxonase activi-ty in serum was measured spectrophotometrically using paraoxon and phenylacetate as substrates. Serum lipids levels were determined using enzymatic colorimetric methods. RESULTS Hyperuricemia-induced reduction of paraoxonase and arylesterase activity was restored after treatment with orange juice and hesperetin (p<0.05). The effect of both treatments on lipid profile was marginal and only orange juice could significantly increase the levels of HDL-C. CONCLUSION Supplementation of orange juice and hesperetin could restore paraoxonase and arylesterase activity in hyperuricemic rats. Orange juice could also partially improve the lipid profile. These effects could have major implications with respect to the prevention of cardiovascular disease in hyperuricemic patients. However, more studies are needed in future investigations.
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Affiliation(s)
- Fatemeh Haidari
- Nutrition Research Center, Faculty of Para-medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Rosa FT, Zulet MÁ, Marchini JS, Martínez JA. Bioactive compounds with effects on inflammation markers in humans. Int J Food Sci Nutr 2012; 63:749-65. [DOI: 10.3109/09637486.2011.649250] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Granado-Lorencio F, Donoso-Navarro E, Sánchez-Siles LM, Blanco-Navarro I, Pérez-Sacristán B. Bioavailability of β-cryptoxanthin in the presence of phytosterols: in vitro and in vivo studies. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2011; 59:11819-11824. [PMID: 21954852 DOI: 10.1021/jf202628w] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Bioactive compounds are used in the design and development of new food products with potential health benefits, although little is known regarding their bioavailability and interactions. This study assessed the stability, in vitro bioaccessibility, and human bioavailability of β-cryptoxanthin from β-cryptoxanthin-rich drinks with and without added phytosterols developed for this purpose. The developed drinks showed no difference in the content of β-cryptoxanthin, and they were stable over 6 months. In vitro, hydrolysis of β-cryptoxanthin esters and the amount of free β-cryptoxanthin at duodenal and micellar phases were similar regardless of the presence of phytosterols. In the human study, the daily intake provoked significant increments of β-cryptoxanthin in serum regardless of the type of the drink. In conclusion, in vitro and in vivo human studies have shown that the bioavailability of β-cryptoxanthin is not significantly affected by the presence of phytosterols when they are simultaneously supplied in a drink.
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Devaraj S, Jialal I, Rockwood J, Zak D. Effect of orange juice and beverage with phytosterols on cytokines and PAI-1 activity. Clin Nutr 2011; 30:668-71. [DOI: 10.1016/j.clnu.2011.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2008] [Revised: 03/15/2011] [Accepted: 03/15/2011] [Indexed: 10/18/2022]
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Bitzur R, Cohen H, Cohen T, Dror TW, Herzog Y, Lifshitz Y, Lubish T, Harats D, Rubinstein A. The metabolic effects of omega-3 plant sterol esters in mixed hyperlipidemic subjects. Cardiovasc Drugs Ther 2011; 24:429-37. [PMID: 20617456 DOI: 10.1007/s10557-010-6249-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE The aim of the current study was to evaluate the therapeutic effects of omega-3 plant sterol esters (n-3-PSE) on lipid profile and other coronary heart disease risk factors in subjects with mixed hyperlipidemia. METHODS Ninety-one patients with mixed hyperlipidemia were randomized in a double blind fashion to receive either placebo (corn oil) or n-3-PSE. Twenty four patients dropped out or were excluded from the efficacy analysis due to protocol violation. The primary efficacy endpoint was mean change in plasma low-density lipoprotein cholesterol (LDL-C) levels after 12 weeks of treatment. Other efficacy measures included plasma lipids, lipoproteins, and high-sensitivity C-reactive protein (hsCRP) levels. Participants who completed the double-blind study were given the option to continue into an open-label, 12-weeks follow up phase. RESULTS n-3-PSE treatment did not result in a significant change in LDL-C levels. Triglyceride levels were reduced significantly by 19% (51 mg/dL, p < 0.0001) in the n-3-PSE group in comparison with the placebo group (p = 0.025). Diastolic blood pressure and hsCRP were reduced by 7% (5.9 mmHg) and 7.8% (0.6 mg/L), respectively, and were significantly different from the placebo group (p = 0.036 and p = 0.018, respectively). CONCLUSIONS In patients with mixed hyperlipidemia, n-3-PSE treatment may offer a safe and effective therapy for triglyceride level reduction while avoiding the typical increase in LDL-C levels associated with n-3 fatty acid treatment. The observed reduction in blood pressure and inflammation markers warrants further evaluation. The positive effect of n-3-PSE treatment was preserved at the end of the follow up phase.
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Affiliation(s)
- Rafael Bitzur
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Tel Hashomer, Israel.
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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: 121] [Impact Index Per Article: 9.3] [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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Othman RA, Moghadasian MH. Beyond cholesterol-lowering effects of plant sterols: clinical and experimental evidence of anti-inflammatory properties. Nutr Rev 2011; 69:371-82. [PMID: 21729090 DOI: 10.1111/j.1753-4887.2011.00399.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Inflammation is a strong risk factor for cardiovascular disease. Dietary plant sterols are known to reduce plasma cholesterol levels and thereby reduce cardiovascular risk. Recent observations from animal and human studies have demonstrated anti-inflammatory effects of phytosterols. For example, several animal and human studies report reductions in the levels of proinflammatory cytokines, including C-reactive protein, after consumption of dietary plant sterols. Although the cholesterol-lowering effects of phytosterols in humans are well documented, studies on the effects of phytosterols on inflammatory markers have produced inconsistent results. This review summarizes and discusses findings from recent animal and human studies with regard to the potential anti-inflammatory effects of dietary phytosterols. Findings on the effects of plant sterols on inflammation remain limited and confounding. Future research using better-designed and well-controlled laboratory studies and clinical trials are needed to fully understand the mechanisms through which phytosterols influence inflammation. Additional well-designed placebo-controlled studies are needed to better understand how and to what extent dietary plant sterols may modify the immune system and the production of inflammatory markers.
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Affiliation(s)
- Rgia A Othman
- Department of Human Nutritional Sciences, University of Manitoba and Canadian Centre for Agri-food Research in Health and Medicine, St. Boniface Hospital Research Centre, Winnipeg, Canada
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Lin X, Racette SB, Lefevre M, Spearie CA, Most M, Ma L, Ostlund RE. The effects of phytosterols present in natural food matrices on cholesterol metabolism and LDL-cholesterol: a controlled feeding trial. Eur J Clin Nutr 2010; 64:1481-7. [PMID: 20808333 PMCID: PMC3715129 DOI: 10.1038/ejcn.2010.180] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 06/15/2010] [Accepted: 06/17/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Extrinsic phytosterols supplemented to the diet reduce intestinal cholesterol absorption and plasma low-density lipoprotein (LDL)-cholesterol. However, little is known about their effects on cholesterol metabolism when given in native, unpurified form and in amounts achievable in the diet. The objective of this investigation was to test the hypothesis that intrinsic phytosterols present in unmodified foods alter whole-body cholesterol metabolism. SUBJECTS/METHODS In all, 20 out of 24 subjects completed a randomized, crossover feeding trial wherein all meals were provided by a metabolic kitchen. Each subject consumed two diets for 4 weeks each. The diets differed in phytosterol content (phytosterol-poor diet, 126 mg phytosterols/2000 kcal; phytosterol-abundant diet, 449 mg phytosterols/2000 kcal), but were otherwise matched for nutrient content. Cholesterol absorption and excretion were determined by gas chromatography/mass spectrometry after oral administration of stable isotopic tracers. RESULTS The phytosterol-abundant diet resulted in lower cholesterol absorption (54.2±2.2% (95% confidence interval 50.5%, 57.9%) vs 73.2±1.3% (69.5%, 76.9%), P<0.0001) and 79% higher fecal cholesterol excretion (1322±112 (1083.2, 1483.3) vs 739±97 mg/day (530.1, 930.2), P<0.0001) relative to the phytosterol-poor diet. Plasma lathosterol/cholesterol ratio rose by 82% (from 0.71±0.11 (0.41, 0.96) to 1.29±0.14 μg/mg (0.98, 1.53), P<0.0001). LDL-cholesterol was similar between diets. CONCLUSIONS Intrinsic phytosterols at levels present in a healthy diet are biologically active and have large effects on whole-body cholesterol metabolism not reflected in circulating LDL. More work is needed to assess the effects of phytosterol-mediated fecal cholesterol excretion on coronary heart disease risk in humans.
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Affiliation(s)
- Xiaobo Lin
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Susan B. Racette
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
| | | | | | - Marlene Most
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Lina Ma
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Richard E. Ostlund
- Division of Endocrinology, Metabolism and Lipid Research, Department of Medicine, Washington University School of Medicine, St. Louis, MO
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