Objectives: To compare effects on plasma total-, LDL-, and HDL-cholesterol concentrations of margarines enriched with different vegetable oil sterols or sitostanol-ester. Design: A randomized double-blind placebo-controlled balanced incomplete Latin square design with ®ve treatments and four periods of 3.5 weeks. Margarines enriched with sterols from soybean, sheanut or ricebran oil or with sitostanol-ester were compared to a non-enriched control margarine. Sterol intake was between 1.5 ± 3.3 gad. Two thirds of the soybean oil sterols were esteri®ed to fatty acids. Setting: Unilever Research Laboratory, Vlaardingen, The Netherlands. Subjects: One hundred healthy non-obese normocholesterolaemic and mildly hypercholesterolaemic volunteers aged 45 AE 12.8 y, with plasma total cholesterol levels below 8 mmolaL at entry. Main outcome measures: Plasma lipid, carotenoid and sterol concentrations, blood clinical chemistry and haematology, fatty acid composition of plasma cholesterylesters and food intake. Results: Ninety-®ve volunteers completed the study. None of the margarines induced adverse changes in blood clinical chemistry, serum total bile acids or haematology. Plasma total-and LDL-cholesterol concentrations were signi®cantly reduced by 8 ± 13% (0.37 ± 0.44 mmolaL) compared to control for margarines enriched in soybean oil sterol-esters or sitostanol-ester. No effect on HDL-cholesterol concentrations occurred. The LDL-to HDLcholesterol ratio was reduced by 0.37 and 0.33 units for these margarines, respectively. Effects on blood lipids did not differ between normocholesterolaemic and mildly hypercholesterolaemic subjects. Plasma sitosterol and campesterol levels were signi®cantly higher for the soybean oil sterol margarine and signi®cantly lower for the sitostanol-ester margarine compared to control. Dietary intake was very similar across treatments. The fatty acid composition of plasma cholesterylesters con®rmed the good compliance to the treatment. All sterol enriched margarines reduced lipid-standardized plasma a-plus b-carotene levels. Plasma lycopene levels were also reduced but this effect was not signi®cant for all products. Conclusions: A margarine with sterol-esters from soybean oil, mainly esters from sitosterol, campesterol and stigmasterol, is as effective as a margarine with sitostanol-ester in lowering blood total-and LDL-cholesterol levels without affecting HDL-cholesterol concentrations. Incorporation in edible fat containing products of such substances may substantially reduce the risk of cardiovascular disease in the population. Sponsorship: Unilever Research.

Objective: To investigate the dose-response relationship between cholesterol lowering and three different, relatively low intake levels of plant sterols (0.83, 1.61, 3.24 gad) from spreads. To investigate the effects on lipidsoluble (pro)vitamins. Design: A randomized double-blind placebo controlled balanced incomplete Latin square design using ®ve spreads and four periods. The ®ve study spreads included butter, a commercially available spread and three experimental spreads forti®ed with three different concentrations of plant sterols. Subjects: One hundred apparently healthy normocholesterolaemic and mildly hypercholesterolaemic volunteers participated. Interventions: Each subject consumed four spreads, each for a period of 3.5 week. Conclusions:The three relatively low dosages of plant sterols had a signi®cant cholesterol lowering effect ranging from 4.9 ± 6.8%, 6.7 ± 9.9% and 6.5 ± 7.9%, for total, LDL-cholesterol and the LDLaHDL cholesterol ratio, respectively, without substantially affecting lipid soluble (pro)vitamins. No signi®cant differences in cholesterol lowering effect between the three dosages of plant sterols could be detected. This study would support that consumption of about 1.6 g of plant sterols per day will bene®cally affect plasma cholesterol concentrations without seriously affecting plasma carotenoid concentrations.

The global high prevalence of hypertension and cardiovascular disease has raised concerns regarding the sodium content of the foods which we consume. Over 75% of sodium intake in industrialized diets is likely to come from processed and restaurant foods. Therefore international authorities, such as the World Health Organisation, are encouraging the food industry to reduce sodium levels in their products. Significant sodium reduction is not without complications as salt plays an important role in taste, and in some products is needed also for preservation and processing. The most promising sodium reduction strategy is to adapt the preference of consumers for saltiness by reducing sodium in products in small steps. However, this is a time-consuming approach that needs to be applied industry-wide in order to be effective. Therefore the food industry is also investigating solutions that will maintain the same perceived salt intensity at lower sodium levels. Each of these has specific advantages, disadvantages, and time lines for implementation. Currently applied approaches are resulting in sodium reduction between 20-30%. Further reduction will require new technologies. Research into the physiology of taste perception and salt receptors is an emerging area of science that is needed in order to achieve larger sodium reductions.

At estimated biologically equivalent intakes, dietary ALA and EPA+DHA have different physiologic effects.

Salt reduction is important for reducing hypertension and the risk of cardiovascular events, nevertheless worldwide salt intakes are above recommendations. Consequently strategies to reduce intake are required, however these require an understanding of salt intake behaviours to be effective. As limited information is available on this, an international study was conducted to derive knowledge on salt intake and associated behaviours in the general population. An online cohort was recruited consisting of a representative sample from Germany, Austria, United States of America, Hungary, India, China, South Africa, and Brazil (n=6987; aged 18-65 years; age and gender stratified). Participants completed a comprehensive web-based questionnaire on salt intake and associated behaviours. While salt reduction was seen to be healthy and important, over one third of participants were not interested in salt reduction and the majority were unaware of recommendations. Salt intake was largely underestimated and people were unaware of the main dietary sources of salt. Participants saw themselves as mainly responsible for their salt intake, but also acknowledged the roles of others. Additionally, they wanted to learn more about why salt was bad for health and what the main sources in the diet were. As such, strategies to reduce salt intake must raise interest in engaging in salt reduction through improving understanding of intake levels and dietary sources of salt. Moreover, while some aspects of salt reduction can be globally implemented, local tailoring is required to match level of interest in salt reduction. These findings provide unique insights into issues surrounding salt reduction and should be used to develop effective salt reduction strategies and/or policies.