Influence of Phytosterol and Phytostanol Food Supplementation on Plasma Liposoluble Vitamins and Provitamin A Carotenoid Levels in Humans: An Updated Review of the Evidence

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.

Vitamin E Bioavailability: Mechanisms of Intestinal Absorption in the Spotlight

“…The underlying mechanisms still need to be resolved, but we can suggest that polyphenols can impair (micro) nutrient absorption by interfering with membrane protein functioning, as previously shown with digestive enzymes [ 90 ]. Although this is still debated [ 91 ], a study showed that phytosterols (2.2 g per day during 1 week) could inhibit vitamin E absorption in normocholesterolemic subjects [ 92 ].…”

Microencapsulation as a Tool for the Formulation of Functional Foods: The Phytosterols’ Case Study

“…The different studies led to the conclusion that there is a reduction of the level of about 24% of β-carotene and a reduction of about 9% for α-carotene, while there are no significant changes for retinol (vitamin A) and vitamin D. However, this negative effect can easily be countered by eating more colored fruits and vegetables [20].…”

Phytosterol enhances oral nifedipine treatment in pregnancy-induced preeclampsia: A placebo-controlled, double-blinded, randomized clinical trial

“…Phytosterol is a kind of` natural compound extracted from plant products, especially plant oils, grains, as well as some vegetables and fruits. 12 Phytosterol-based preparations are incorporated into various food vectors and natural drugs. 13 In fact, considerable amount of circulating phytosterols has been detected in normal females, as well as lactating mothers.…”