Plant stanols dose-dependently decrease LDL-cholesterol concentrations, but not cholesterol-standardized fat-soluble antioxidant concentrations, at intakes up to 9 g/d

Mensink, Ronald P.; Jong, A. de; Lütjohann, Dieter; Haenen, Guido R.M.M.; Plat, Jogchum

doi:10.3945/ajcn.2009.29143

Cited by 53 publications

(33 citation statements)

References 24 publications

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“…A lower beta-carotene and alphatocopherol bioavailability described by some authors [17], has not been confirmed in other studies [19,20] therefore it has been hypothesized that the effect could be related to phytosterol structures. Consumers, in particular children, pregnant and breastfeeding women, should be informed about the possible negative effect on fat-soluble vitamins absorption.…”

Section: Discussionmentioning

confidence: 80%

“…However, other authors have reported no significant effects on fat-soluble vitamin levels even at high intake of plant stanols (9 g/day) [19]. No effect of cholesterolstandardized beta-carotene, alpha-tocopherol and lutein concentrations were observed by other authors [20]. Therefore, a structure-function relationship has been suggested that deserves future studies.…”

Section: Effect Of Phytosterols On Intestinal Absorption Of Cholestermentioning

confidence: 83%

“…Even though many different clinical trials have clearly demonstrated that phytosterols reduce LDL-cholesterol, it is unclear whether phytosterols have a positive effect on cardiovascular disease [20]. Some studies have recently demonstrated that there is evidence that elevated levels of plant sterols are associated with an increased cardiovascular risk [46].…”

Section: Discussionmentioning

confidence: 99%

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Phytosterols, phytostanols and their esters: from natural to functional foods

Bacchetti

Masciangelo

Bicchiega

et al. 2011

Mediterr J Nutr Metab

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Phytosterols, phytostanols and their esters are a group of steroid alcohols that occur naturally in plants. As natural constituents of plant structures, phytosterols contribute to the regulation of the fluidity and permeability of cell membranes. They are found mostly in vegetable oils, fruits, nuts, cereals and legumes. The most abundant phytosterols are b-sitosterol, campesterol and stigmasterol. During the last 15 years the market for phytosterols, as dietary supplements, has lead to a rapidly growing worldwide market for functional foods containing phytosterols and stanols. Even though many different clinical trials have clearly demonstrated that phytosterols reduce LDL-cholesterol, it is unclear whether phytosterols have a positive effect on cardiovascular disease. Until now, there are no data related to the effect of phytosterol consumption on the development of cardiovascular diseases. This review focuses on the biochemistry of phytosterols, their metabolism and role in health and in pathological conditions.

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Section: Discussionmentioning

confidence: 80%

Section: Effect Of Phytosterols On Intestinal Absorption Of Cholestermentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Phytosterols, phytostanols and their esters: from natural to functional foods

Bacchetti

Masciangelo

Bicchiega

et al. 2011

Mediterr J Nutr Metab

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“…Les expériences à des doses supérieures à 4 g/jour sont rares, et trop hétérogènes pour être rassemblées. On peut citer le travail de Mensink et al (2010) (4 groupes en parallèle, 4 semaines, cholestérol total entre 5-8 mmol/l) qui montre pour 3 g/j, 6 g/j et 9 g/j de stanols des baisses de -7,4 %, -11,9 %, et -17,4 % respectivement. *Non réponse = baisse de moins de 5 % du LDL-C. Zhao et al (2008), la variation de LDLC chez les 38 % de nonrépondeurs est une augmentation de 9,4 %.…”

Section: Effet-dose Des Phytostérols/stanolsunclassified

Phytostérols : un point sur les recommandations de l’ANSES

Fumeron

Bard

Vergès

et al. 2015

OCL

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Résumé -Récemment, l'ANSES a rendu un avis prudent sur la consommation des phytostérols/stanols dans le but de réduire le risque cardiovasculaire. Parmi les principales raisons justifiant la prudence de l'ANSES figurent notamment, d'une part la variabilité inter-individuelle de la réponse à la consommation de phytostérols/stanols, et, d'autre part, les relations entre phytostérolémie plasmatique et risque cardiovasculaire. Ces deux points font l'objet de la présente revue. Il existe une variabilité de la réponse individuelle à l'apport de stérols/stanols végétaux, avec une absence de réponse (baisse LDLC) chez 20 à 42 % des sujets. Parmi les sujets non-répondeurs, certains augmentent le LDLC. La diminution du cholestérol LDLC est proportionnelle à sa concentration initiale en valeur absolue, et constante en pourcentage. La réponse est corrélée négativement au taux de synthèse du cholestérol et positivement au niveau d'absorption. L'effet des facteurs génétiques sur la réponse reste encore à démontrer. Il existe un manque de puissance statistique générale dans toutes les études génétiques publiées à ce jour. Concernant la relation entre phytostérolémie et le risque cardiovasculaire, de nombreux résultats contradictoires ont été publiés. Une méta-analyse montre globalement une absence de relation, mais l'hétérogénéité significative entre ces études ne permet pas de conclure. D'autre part, des études génétiques montrent que les variants qui augmentent la phytostérolémie sont associés à une augmentation du risque. La phytostérolémie est liée à l'absorption du cholestérol. L'absorption pourrait être le facteur causal de la relation entre phytostérolémie et risque cardiovasculaire, mais il n'est pas exclu que les phytostérols circulants aient aussi un effet délétère. L'ANSES estime que des études cliniques sont nécessaires pour conclure sur l'impact cardiovasculaire de la consommation des produits contenant des phytostérols/stanols.Mots clés : Phytostérols / cholestérol, absorption intestinale et synthèse / LDL-cholestérol / réponse individuelle / risque cardiovasculaire Abstract -Update on the ANSES (French agency for food, environmental and occupational health & safety) recommendations. Recently, ANSES gave a prudent advice concerning consumption of plant sterols/stanols in order to lower cardiovascular risk. In particular, two of the main reasons for this advice were the inter-individual variability in the response to diet supplemented with these products on one side, and a relationship between plasma levels of plant sterols and cardiovascular risk on the other side. These two points are discussed in the present review. There is a large inter-individual variability in the response to plant sterols/stanols consumption, with a lack of response (LDLC lowering) in 20-42% of the subjects. In some of the non-responders, plasma LDLC were found to be increased. LDLC decrease is correlated with initial LDLC concentration. The response is positively correlated with cholesterol absorption and inversely with synthesis rate. Th...

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“…The average age across the 17 treatment arms was 54.2 ± 6.7 years and the average fasting baseline LDL-cholesterol was 3.6 ± 0.7 mmol/L (≈ 139 mg/dL). The study populations included healthy men and women with a mean age ranging from 36 to 58 years (Miettinen et al, 1995 treatment arms 1 and 2; Weststrate and Meijer, 1998 treatment arm 2; Nguyen et al, 1999 treatment arms 1 and 2; Mensink et al, 2002;Cater et al, 2005: treatment arm 2 of study 1 and study 2; Alhassan et al, 2006;Mensink et al, 2010); men and women on stable statin therapy (Blair et al, 2000); men with non-insulin dependent diabetes mellitus (Gylling and Miettinen, 1994;Gylling and Miettinen, 1996 treatment arms 1 and 2); post-menopausal women with previous myocardial infarction (Gylling et al, 1997 study 1); men with a positive history for CHD and on stable statin therapy (Cater et al, 2005 study 3); and men and women with Type 1 diabetes and receiving statins for hypercholesterolemia (Hallikainen et al, 2011).…”

Section: Blood Ldl-cholesterol Lowering Effect Ofmentioning

confidence: 99%

Scientific Opinion on the substantiation of a health claim related to 3 g/day plant stanols as plant stanol esters and lowering blood LDL-cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006

Products¹

2012

EFSA Journal

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Following an application from Raisio Nutrition Ltd, submitted pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of Finland, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver an opinion on the scientific substantiation of a health claim related to 3 g/day plant stanols as plant stanol esters per day and lowering blood LDL‐cholesterol by 12 % and reduced risk of (coronary) heart disease. The applicant has further requested that the minimum duration to obtain the effect be stated to be one to two weeks, and that the claims be authorised for an extended range of foods, including yellow fat spreads, dairy products, cheese, rye bread, oatmeal, fermented soy milk based products (drinkable and spoonable yoghurt‐type products), and oat based milk drinks. The applicant provided an unpublished meta‐analysis with 18 randomised, controlled human studies on the LDL‐lowering efficacy of plant stanol esters at intakes between 2.7 to 3.3 g per day plant stanols. On the basis of the data presented, the Panel concludes that plant stanol esters at a daily intake of 3 g plant stanols (range 2.7 g to 3.3 g) in matrices approved by Regulation (EC) No 376/2010 (yellow fat spreads, dairy products, mayonnaise and salad dressings) lowers LDL‐cholesterol by 11.4 % (95% CI: 9.8 – 13.0), that the minimum duration required to achieve the maximum effect of plant stanol esters on LDL‐cholesterol lowering is two to three weeks, and that while plant stanol esters added to foods such as margarine‐type spreads, mayonnaise, salad dressings, and dairy products such as milk, yoghurts including low‐fat yoghurts, and cheese have been shown consistently to lower blood LDL‐cholesterol levels, the size of the cholesterol‐lowering effect of plant stanols added to other food formats is less well established.

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Plant stanols dose-dependently decrease LDL-cholesterol concentrations, but not cholesterol-standardized fat-soluble antioxidant concentrations, at intakes up to 9 g/d

Abstract: Daily consumption of plant stanols up to 9 g reduces serum LDL-cholesterol concentrations linearly up to 17.4%. For cholesterol-standardized fat-soluble antioxidant concentrations, such a relation could not be ascertained.

Cited by 53 publications

References 24 publications

Phytosterols, phytostanols and their esters: from natural to functional foods

Phytosterols, phytostanols and their esters: from natural to functional foods

Phytostérols : un point sur les recommandations de l’ANSES

Scientific Opinion on the substantiation of a health claim related to 3 g/day plant stanols as plant stanol esters and lowering blood LDL-cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006

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