Cholesterol-Lowering Efficacy of Plant Sterols/Stanols Provided in Capsule and Tablet Formats: Results of a Systematic Review and Meta-Analysis

Shaghaghi, Mandana Amir; AbuMweis, Suhad S.; Jones, Peter J.H.

doi:10.1016/j.jand.2013.07.006

Cited by 78 publications

(53 citation statements)

References 87 publications

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“…Los alimentos enriquecidos en EV poseen un efecto reductor del LDL-c bien documentado (25), además de una reducción eficaz de las concentraciones de CT, y un aumento de las concentraciones de EV en plasma (26).…”

Section: Discussionunclassified

“…El análisis detallado de Amir Shaghaghi y cols. (2013) (25) no mostró diferencias significativas entre el efecto reductor del LDL-c de los suplementos de EV (-12 mg/dl; 95% IC -0,39 a -0,24; p < 0,0001) vs. los alimentos enriquecidos con EV (-12 mg/dl; 95% IC -0,35 a -0,27; p < 0,0001). Pero el consumo de suplementos sí disminuyó las concentraciones de LDL-c en 12 mg/dl (IC del 95%: -0,39 a -0,23; p < 0,000) en comparación con el placebo.…”

Section: Discussionunclassified

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Efecto de esteroles vegetales en la reducción del colesterol plasmático: ensayo clínico, controlado, aleatorizado, cruzado y doble ciego

et al. 2016

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Palabras clave:Colesterol. Riesgo cardiovascular. Esteroles vegetales. Lipoproteínas de baja densidad (LDL). Key words:Cholesterol. Cardiovascular risk. Plant sterols. Low density lipoproteins (LDL). AbstractIntroduction: Hypercholesterolemia is one of the most relevant risk factors in cardiovascular disease, and plant sterols have been postulated as benefi cial regulator agents for the control of the disease. Objective: Analyze the effect of added plant sterols in milk in reducing plasma cholesterol in young adults. Methods: A randomized, clinical controlled trial, double-blind crossover study. Sterols (2.24 g per day) were administrated in two doses of 350 ml of commercial skimmed milk, during two phases of three weeks respectively separated by a washout period of 2 weeks, in the experimental group. The same amount of skimmed milk was administrated to the control group, but with no sterols. At the beginning and end of each phase blood draws were performed. Anthropometric data and health habits were analyzed and the following blood laboratory markers: lipid profi le, hematology, infl ammation, etc. were collected. Results: Fifty four people were included in the study with an average age of 38.8 ± 7.3 years. Differences between baseline and fi nal scores percentage were 9.73 %, 12.5 %, 1.9 %, 3.15 % y 13.2 % for total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and No HDL-cholesterol, respectively. Statistically signifi cant differences were found between the experimental group and the control group for all biomarkers analyzed except for triglycerides. Conclusion: Plant sterols supplied in commonly consumed food, such as milk, may be a non-pharmacological therapeutic strategy of hypercholesterolemia with high health interest.

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Section: Discussionunclassified

Efecto de esteroles vegetales en la reducción del colesterol plasmático: ensayo clínico, controlado, aleatorizado, cruzado y doble ciego

et al. 2016

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“…On the other hand, phytosterol esters intake as capsules have been shown to be ineffective in reducing plasma LDL-C levels in subjects with mild to moderate hypercholesterolemia (48). In another study, however, the relative LDL-C lowering efficacy of plant sterols/ stanols provided as supplements (tablets/capsules) have not been shown to differ from that of phytosterols-enriched dietary products (16). Moreover, some clinical trials have demonstrated that the cholesterol-lowering efficacy of esterified sterols and stanols is independent of the food matrix (18,39).…”

Section: Factors Affecting the Cholesterol-lowering Activity Of Plantmentioning

confidence: 95%

“…Therefore, these compounds are of interest as therapeutic agents to reduce plasma cholesterol. However, the use of plant sterols/stanols as supplements or ingredients for functional foods is restricted by their crystalline nature, low solubility in fats, insolubility in water, high melting point of 140-150 °C, in addition to poor palatability (15)(16)(17)(18). Several attempts have been made to enhance the bioavailability of crystalline sterols by reducing the crystal size or by the use of microcrystalline suspensions (18,19).…”

Section: Introductionmentioning

confidence: 99%

Lipid-lowering Activity of Natural and Semi-Synthetic Sterols and Stanols

2015

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-Consumption of plant sterols/ stanols has long been demonstrated to reduce plasma cholesterol levels. The objective of this review is to demonstrate the lipid-lowering activity and antiatherogenic effects of natural and semi-synthetic plant sterols/ stanols based on evidence from cell-culture studies, animal studies and clinical trials. Additionally, this review highlights certain molecular mechanisms by which plant sterols/ stanols lower plasma cholesterol levels with a special emphasis on factors that affect the cholesterol-lowering activity of plant sterols/stanols. The crystalline nature and the poor oil solubility of these natural products could be important factors that limit their cholesterol-lowering efficiency. Several attempts have been made to improve the cholesterol-lowering activity by enhancing the bioavailability of crystalline sterols and stanols. Approaches involved reduction of the crystal size and/or esterification with fatty acids from vegetable or fish oils. However, the most promising approach in this context is the chemical modification of plant sterols /stanols into water soluble disodium ascorbyl phytostanyl phosphates analogue by esterification with ascorbic acid. This novel semi-synthetic stanol derivative has improved efficacy over natural plant sterols/ stanols and can provide additional benefits by combining the cholesterol-lowering properties of plant stanols with the antioxidant potential of ascorbic acid.

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“…The reduction in plasma LDL-C concentrations associated with sterol/stanol consumption may be as large as 10% (19,20). This could lead to reductions in CVD if the effect is associated with a reduction in cardiovascular events similar to that induced by other drugs with similar lipidlowering efficacy.…”

Section: Sterols/stanolsmentioning

confidence: 99%

The role of nutraceuticals in the prevention of cardiovascular disease

Sosnowska

Penson

Banach

2017

Cardiovasc. Diagn. Ther.

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IntroductionCardiovascular disease (CVD) is common, indeed the majority of adults above sixty years of age will experience some manifestation of CVD. Based on data from 2012 and 2013, it has been estimated that CVD is responsible for 17.3 million deaths annually worldwide (1). Morbidity is also high, and in Europe, 200 billion Euros of healthcare expenditure is attributable to CVD (2). Risk factors for CVD can be categorized as modifiable and non-modifiable. Modifiable risk factors include obesity, hypertension, hyperlipidemia, diabetes mellitus, metabolic syndrome and lifestyle risk factors such as unhealthy diet, smoking and physical inactivity. Dietary factors are also important contributors to cardiovascular risk, either directly, or through their effects on other risk factors including hypertension, dyslipidemia and diabetes mellitus (3). Reduction of risk factors in the population, especially blood pressure reduction and lipid-lowering can have important impacts upon mortality from CVD (4).Protective effects against CVD have been demonstrated for several foods and dietary supplements (5) thus presenting new possibilities for population-level reduction of CVD risk. Evidence suggests that this approach is very promising. For example, in the PREDIMED observational study, participants in the highest quintile of polyphenol consumption had a relative risk of CVD of 54% compared to those in the lowest quintile (6). The aim of this review is to present an update on the most recent evidence relating to the use of nutraceuticals in the context of the prevention and treatment of CVD. Unfortunately, few studies have measured the associations between nutraceutical consumptions and "hard" outcomes such as mortality. Large randomized controlled trials are particularly rare, and thus there is a paucity of evidence in this area. Thus, our discussion will be largely focused on the effects of NutraceuticalsThe term "nutraceuticals" was introduced by Stephen DeFelice, founder and chairman of the Foundation for Innovation in Medicine, in 1989. A nutraceutical is defined as a "food, or parts of a food, that provide medical or health benefits, including the prevention and treatment of disease" (7). The definition encompasses medicinal products made from natural ingredients. Several classes of nutraceuticals have been proposed to have potential benefits in the treatment of CVD and the ones with the strongest evidence are briefly summarized below. Sterols/stanolsPlant sterols/stanols are phytosterols, and have been identified in a range of plant products including various fruits and vegetables, cereals, seeds and nuts. Their biological activity results from their molecular structural similarity to cholesterol (8). PolyphenolsPolyphenols are phytochemicals with widespread distribution in foods of plant origin. They are found in fruits, vegetables, cereal and legumes. Additionally, they are found in beverages produced from plant products such as tea, coffee, wine and cocoa. Polyphenols are structurally diverse, and over 8,000 have...

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Cholesterol-Lowering Efficacy of Plant Sterols/Stanols Provided in Capsule and Tablet Formats: Results of a Systematic Review and Meta-Analysis

Cited by 78 publications

References 87 publications

Efecto de esteroles vegetales en la reducción del colesterol plasmático: ensayo clínico, controlado, aleatorizado, cruzado y doble ciego

Efecto de esteroles vegetales en la reducción del colesterol plasmático: ensayo clínico, controlado, aleatorizado, cruzado y doble ciego

Lipid-lowering Activity of Natural and Semi-Synthetic Sterols and Stanols

The role of nutraceuticals in the prevention of cardiovascular disease

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