A Comparison of Pectin, Polyphenols, and Phytosterols, Alone or in Combination, to Lovastatin for Reduction of Serum Lipids in Familial Hypercholesterolemic Swine

Abstract

Greater than 50% of Americans use some form of a dietary supplement, and a diagnosis of coronary artery disease is associated with higher supplement use. The objective of this study was to compare nutritional supplements (pectin, polyphenols, and phytosterols) to lovastatin to reduce serum cholesterol. Familial hypercholesterolemic (FH) swine received the same amount of basal diet (control) in addition to pectin (30 g/day), polyphenols (20 g/day), phytosterols (6 g/day), and all possible combinations in contrast to lovastatin (3 mg/kg of body weight). The experimental design consisted of 4 weeks of basal diet followed by 4 weeks of basal diet plus the supplement treatment. All of the supplements, except pectin, reduced total cholesterol by an average of 71 +/- 19 mg/dL in comparison to the control diet (53 +/- 20 mg/dL) and lovastatin (143 +/- 21 mg/dL) during the 5-8-week treatment period. Serum high-density lipoprotein-cholesterol remained unchanged, while serum triglycerides changed independent of diet. During the 5-8-week treatment period serum low-density lipoprotein (LDL)-cholesterol was reduced maximally 22%, 19%, 20%, 17%, 18%, and 17% by polyphenols, phytosterols, pectin + polyphenols, pectin + phytosterols, polyphenols + phytosterols, and pectin + polyphenols + phytosterols, respectively, compared to control (8%) and lovastatin (40%). Phytosterols was the most effective supplementation, while both phytosterol and polyphenol supplements enhanced the reduction in LDL-cholesterol of pectin-containing diets. Supplements effectively reduced cholesterol in FH swine by half compared to lovastatin. Results suggest that more research on the use of dietary supplements, alone or in combination with statins, to reduce LDL-cholesterol is justified.

Pharmacological Actions of Statins: A Critical Appraisal in the Management of Cancer

“…Concomitant administration of statins with food may alter their pharmacokinetic and pharmacodynamic profile. It has been reported that consumption of pectin or oat bran soluble fiber together with lovastatin reduces its absorption (Metzger et al, 2009), whereas alcohol intake does not affect the efficacy and safety of fluvastatin treatment (Smit et al, 1995). On the other hand, fluvastatin treatment in rats on high-fat and high-sucrose diet was lethal, suggesting that both altered statin metabolism and elimination increase plasma levels of aspartate aminotransferase and creatine kinase, resulting in skeletal muscle toxicity (Sugatani et al, 2010).…”

Microsomal Transfer Protein Inhibitors, New Approach for Treatment of Familial Hypercholesterolemia, Review of the Literature, Original Findings, and Clinical Significance

“…In addition to the cholesterollowering diet, several other dietary interventions have been suggested as some nutritional supplements (pectin, polyphenols, phytosterols). Phytosterols seem to represent the most effective supplementation [27][28][29].…”

“…Phytosterol can also enforce the reduction of LDL cholesterol, while pectin should be added to another supplement to succeed a lower LDL concentration in familial hypercholesterolemia subjects [27]. In a review of 19 randomized controlled trials, it was concluded that phytosterols/stanols incorporated in different food vehicles such as margarine/fat spreads, butter, salad dressings, mayonnaise, chocolate, low-fat yogurt, bakery products, and ground beef significantly reduced LDL cholesterol concentrations between 8 and 15% at a dose of 1.5-3 g/daily [30].…”

Effects of Passiflora edulis on the Metabolic Profile of Diabetic Wistar Rat Offspring

“…This effect on lipids reduces vascular damage and heart disease. [39][40][41] Yapo et al 42 investigated the fiber content in P. edulis juice and found that the total dietary fiber from yellow passion fruit rind was greater than 73% dry matter, of which insoluble dietary fiber accounted for greater than 60% (w/w). The method they used also revealed that nonstarch polysaccharides were the predominant components (approximately 70%, w/w).…”