The possibility that the heightened cardiovascular risk associated with the menopause, which is said to be ameliorated by soybeans, can be reduced with soy isoflavones was tested in 21 women. Although several were perimenopausal, all have been included. A placebo-controlled crossover trial tested the effects of 80-mg daily isoflavones (45 mg genistein) over 5- to 10-week periods. Systemic arterial compliance (arterial elasticity), which declined with age in this group, improved 26% (P < .001) compared with placebo. Arterial pressure and plasma lipids were unaffected. The vasodilatory capacity of the microcirculation was measured in nine women; high acetylcholine-mediated dilation in the forearm vasculature was similar with active and placebo treatments. LDL oxidizability measured in vitro was unchanged. Thus, one important measure of arterial health, systemic arterial compliance, was significantly improved in perimenopausal and menopausal women taking soy isoflavones to about the same extent as is achieved with conventional hormone replacement therapy.

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The compliance or elasticity of the arterial system, an important index of circulatory function, diminishes with increasing cardiovascular risk. Conversely, systemic arterial compliance improves through eating of fish and fish oil. We therefore tested the value of high intake of alpha-linolenic acid, the plant precursor of fish fatty acids. Fifteen obese people with markers for insulin resistance ate in turn four diets of 4 weeks each; saturated/high fat (SHF), alpha-linolenic acid/low fat (ALF), oleic/low fat (OLF), and SHF. Daily intake of alpha-linolenic acid was 20 g from margarine products based on flax oil. Systemic arterial compliance was calculated from aortic flow velocity and aortic root driving pressure. Plasma lipids, glucose tolerance, and in vitro LDL oxidizability were also measured. Systemic arterial compliance during the first and last SHF periods was 0.42 +/- 0.12 (mean +/- SD) and 0.56 +/- 0.21 units based on milliliters per millimeter of mercury. It rose significantly to 0.78 +/- 0.28 (P < .0001) with ALF; systemic arterial compliance with OLF was 0.62 +/- 0.19, lower than with ALF (P < .05). Mean arterial pressures and results of oral glucose tolerance tests were similar during ALF, OLF, and second SHF; total cholesterol levels were also not significantly different. However, insulin sensitivity and HDL cholesterol diminished and LDL oxidizability increased with ALF. The marked rise in arterial compliance at least with alpha-linolenic acid reflected rapid functional improvement in the systemic arterial circulation despite a rise in LDL oxidizability. Dietary n-3 fatty acids in flax oil thus confer a novel approach to improving arterial function.

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Objectives: To determine the efficacy on plasma cholesterol-lowering of plant sterol esters or non-esterified stanols eaten within low-fat foods as well as margarine. Design: Randomised, controlled, single-blind study with sterol esters and non-esterified plant stanols provided in breakfast cereal, bread and spreads. Study 1 comprised 12 weeks during which sterol esters (2.4 g) and stanol (2.4 g) -containing foods were eaten during 4 week test periods of cross-over design following a 4 week control food period. In Study 2, in a random order cross-over design, a 50% dairy fat spread with or without 2.4 g sterol esters daily was tested. Subjects: Hypercholesterolaemic subjects; 22 in study 1 and 15 in study 2. Main outcome measures: Plasma lipids, plasma sterols, plasma carotenoids and tocopherols. Results: Study 1 -median LDL cholesterol was reduced by the sterol esters (713.6%; P < 0.001 by ANOVA on ranks; P < 0.05 by pairwise comparison) and by stanols (78.3%; P ¼ 0.003, ANOVA and < 0.05 pairwise comparison). With sterol esters plasma plant sterol levels rose (35% for sitosterol, 51% for campesterol; P < 0.001); plasma lathosterol rose 20% (P ¼ 0.03), indicating compensatory increased cholesterol synthesis. With stanols, plasma sitosterol fell 22% (P ¼ 0.004), indicating less cholesterol absorption. None of the four carotenoids measured in plasma changed significantly. In study 2, median LDL cholesterol rose 6.5% with dairy spread and fell 12.2% with the sitosterol ester fortified spread (P ¼ 0.03 ANOVA and < 5% pairwise comparison). Conclusion: 1. Plant sterol esters and non-esterified stanols, two-thirds of which were incorporated into low-fat foods, contributed effectively to LDL cholesterol lowering, extending the range of potential foods. 2. The LDL cholesterol-raising effect of butter fat could be countered by including sterol esters. 3. Plasma carotenoids and tocopherols were not reduced in this study. Sponsorship: Meadow Lea Foods, Australia. Descriptors: sterolesters; sitostanol; low-fat foods; cholesterol European Journal of Clinical Nutrition (2001Nutrition ( ) 55, 1084Nutrition ( -1090 Introduction Plant stanol and sterol esters incorporated within spreads have been shown to augment the low density lipoprotein cholesterol lowering effect of other strategies. Alone, in dosages of around 2 g daily, stanol or unhydrogenated sterol esters lower LDL cholesterol by about 10% or more (Miettinen et al, 1995;Westrate & Meijer, 1998;Gylling & Miettinen, 1994). When added to a cholesterollowering diet, sitostanol ester-containing margarine reduces LDL cholesterol by at least a further 5% Andersson et al, 1999). Each of these studies had provided sterols in the form of esters and within margarine.Non-esterified or free sterols have also been shown to be effective by a 17% reduction in LDL cholesterol during treatment with a high dose of a soy sterol suspension, although lesser amounts (3 g tall oil sterols, mainly sitosterol) were also effective (Lees et al, 1977). The effect of non-esterified sitostanol is les...