Plant Stanol Esters Affect Serum Cholesterol Concentrations of Hypercholesterolemic Men and Women in a Dose-dependent Manner

Abstract

The effect of plant stanol ester on serum cholesterol is dose-dependent. However, it is not clear what the dose is beyond which no additional benefit can be obtained. Therefore, we determined the dose-response relationship for serum cholesterol with different doses of plant stanol ester in hypercholesterolemic subjects. In a single-blind design each of 22 men or women consumed five different doses of plant stanol [target (actual) intake 0 (0), 0.8 (0.8), 1.6 (1.6), 2.4 (2.3), 3.2 (3.0) g/d] added as plant stanol esters to margarine for 4 wk. The order of dose periods was randomly determined. Serum total cholesterol concentration decreased (calculated in reference to control) by 2.8% (P = 0.384), 6.8% (P < 0.001), 10.3% (P < 0.001) and 11.3% (P < 0.001) by doses from 0.8 to 3.2 g. The respective decreases for LDL cholesterol were 1.7% (P = 0. 892), 5.6% (P < 0.05), 9.7% (P < 0.001) and 10.4% (P < 0.001). Although the decreases were numerically greater with 2.4 and 3.2 g doses than with the 1.6 g dose, these differences were not significant (P = 0.054-0.516). Serum plant stanols rose slightly, but significantly with the dose (P < 0.001). Apolipoprotein B concentration was decreased significantly already at the dose of 0.8 g (8.7%, P < 0.001). Apolipoprotein E genotype did not affect the lipid responses. We conclude that significant reduction of serum total and LDL cholesterol concentrations is reached with the 1.6-g stanol dose, and increasing the dose from 2.4 to 3.2 g does not provide clinically important additional effect.

Effects of low-fat hard cheese enriched with plant stanol esters on serum lipids and apolipoprotein B in mildly hypercholesterolaemic subjects

“…These symptoms were similar to those found in earlier studies (Hallikainen et al, 2000b;Neil et al, 2001) and occurred occasionally in both groups. As in earlier studies (Gylling et al, , 1999Miettinen et al, 1995;Mensink et al, 2002), no serious adverse effects were reported.…”

“…In earlier studies, serum apo B concentration has decreased significantly after the use of plant stanols (Gylling and Miettinen, 1994;Hallikainen et al, 2000b;Homma et al, Weeks LDL cholesterol (mmol/l) 2. Baseline cholesterol and apo B levels were defined as the mean of the values measured at weeks -1 and 0.…”

Safety of long-term consumption of plant sterol esters-enriched spread

“…Consumption of plant sterol esters-enriched spread appeared to have no adverse side effects, defined as reported adverse events or undesirable changes in clinical chemical parameters, hematological parameters and urinalysis. The absence of side effects is in agreement with the observations in earlier, shorter-term, clinical and safety studies (Hendriks et al, 1999;Weststrate & Meijer, 1998;Baker et al, 1999;Hepburn et al, 1999;Waalkens-Berendsen et al, 1999;Weststrate et al, 1999;Ayesh et al, 1999;Sanders et al, 2000;Miettinen et al, 1995;Hallikainen et al, , 2000a Safety of plant sterol esters-enriched spread HFJ Hendriks et al 1999; Denke, 1995, Jones et al, 2000Sierksma et al, 1999;Tammi et al, 2000;Vuorio et al, 2000;Nguyen et al, 1999;Blair et al, 2000). Plant sterols are slightly absorbed ( < 5%) and could subsequently be exchanged with cholesterol in an equilibrium fashion in various sterol pools, including cell membranes.…”

“…Efficacy may depend on many different factors like intake level (Hendriks et al, 1999;Hallikainen et al, 2000a), background diet (Hallikainen et al, 2000b;Denke, 1995), composition of the sterol mixture (Jones et al, 2000;Sierksma et al, 1999) and specific characteristics of the subjects studied Tammi et al, 2000;Vuorio et al, 2000), like genetic background, compliance and eating moment. Mietinen et al (1995) reported a slightly higher efficacy, most likely due to the larger intake of plant stanols as compared with the plant sterol intake in the trial reported here (2.6 g stanols vs 1.6 g sterols per day).…”

“…These effects may be dependent on intake level (Hendriks et al, 1999;Hallikainen et al, 2000a). Long-term effects as well as functional consequences of these changes in a-and b-carotene concentrations in blood have not been previously studied in detail.…”