Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials

AbuMweis, Suhad S.; Baraké, Roula; Jones, Peter J.H.

doi:10.3402/fnr.v52i0.1811

Cited by 285 publications

(201 citation statements)

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“…Many chemical compounds derived from natural foods have been reported to exert strong biological activity against T2DM [30,31]. Among of them, plant sterols and stanols have drawn particular attention due to their wide distribution in food plants and potent ability to reduce blood fat content [12]. In the present study, we mainly investigated the effects of SMR, which is one kind of plant sterol involved in T2DM, and its possible mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…Phytosterol is a bioactive natural product present in plants that has a structure similar to cholesterol, has no influence on human cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), and increases the ratio of HDL-C/LDL-C and HDL-C/TC in blood [12]. As a member of the phytosterol family, stigmasterol (SMR) (Figure 1(a)) is widely present in plant oil and plant-based foods, such as soybean, corn, peanut, and sunflower oils [13].…”

Section: Introductionmentioning

confidence: 99%

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Anti-diabetic activity of stigmasterol from soybean oil by targeting the GLUT4 glucose transporter

Wang

Yang

et al. 2017

Food & Nutrition Research

104

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The present study investigated the anti-diabetic activity and potential mechanism of stigmasterol (SMR), which is a kind of phytosterols derived from the edible soybean oil in vitro and in vivo. SMR displayed a mild GLUT4 translocation activity by 1.44-fold in L6 cells. L6 cells were treated with different concentration of SMR, showing significant effects on the enhancing glucose uptake. SMR administrated orally to the KK-Ay mice significantly alleviated their insulin resistance and oral glucose tolerance with reducing fasting blood-glucose levels and blood lipid indexes such as triglyceride and cholesterol. Moreover, the GLUT4 expression in L6 cells, skeletal muscle and white adipose tissue had been also enhanced. In this paper we conclude that, stigmasterol seems to have potential beneficial effects on the treatment of type 2 diabetes mellitus with the probable mechanism of targeting GLUT4 glucose transporter included increasing GLUT4 translocation and expression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anti-diabetic activity of stigmasterol from soybean oil by targeting the GLUT4 glucose transporter

Wang

Yang

et al. 2017

Food & Nutrition Research

104

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“…A similar health claim also exists in the USA (28) . Evidence from two early analyses (29,30) and two more recent meta-analyses (31,32) were cited in support of the claim. In brief, the more recent analyses involved pooling of data from a large number of RCT, either eighty-four trials including 141 trial arms (6805 subjects) (31) , or fiftynine RCT (n .…”

Section: Plant Stanols and Sterolsmentioning

confidence: 99%

“…In brief, the more recent analyses involved pooling of data from a large number of RCT, either eighty-four trials including 141 trial arms (6805 subjects) (31) , or fiftynine RCT (n . 4500 subjects) (32) . A non-linear equation comprising two parameters (the maximal LDL-cholesterol lowering and an incremental dose step) was used to describe the dose-response curve, and the overall pooled absolute (mmol/l) and relative (%) LDL-cholesterol-lowering effects of phytosterols were also assessed with a random-effects model (31) .…”

Section: Plant Stanols and Sterolsmentioning

confidence: 99%

Food combinations for cholesterol lowering

Harland

2012

Nutr. Res. Rev.

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Reducing elevated LDL-cholesterol is a key public health challenge. There is substantial evidence from randomised controlled trials (RCT) that a number of foods and food components can significantly reduce LDL-cholesterol. Data from RCT have been reviewed to determine whether effects are additive when two or more of these components are consumed together. Typically components, such as plant stanols and sterols, soya protein, b-glucans and tree nuts, when consumed individually at their target rate, reduce LDL-cholesterol by 3 -9 %. Improved dietary fat quality, achieved by replacing SFA with unsaturated fat, reduces LDL-cholesterol and can increase HDL-cholesterol, further improving blood lipid profile. It appears that the effect of combining these interventions is largely additive; however, compliance with multiple changes may reduce over time. Food combinations used in ten 'portfolio diet' studies have been reviewed. In clinical efficacy studies of about 1 month where all foods were provided, LDL-cholesterol is reduced by 22-30 %, whereas in community-based studies of .6 months' duration, where dietary advice is the basis of the intervention, reduction in LDL-cholesterol is about 15 %. Inclusion of MUFA into 'portfolio diets' increases HDL-cholesterol, in addition to LDL-cholesterol effects. Compliance with some of these dietary changes can be achieved more easily compared with others. By careful food component selection, appropriate to the individual, the effect of including only two components in the diet with good compliance could be a sustainable 10 % reduction in LDL-cholesterol; this is sufficient to make a substantial impact on cholesterol management and reduce the need for pharmaceutical intervention.

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“…However, two recent meta-analyses evaluated the LDL-cholesterol-lowering effects of plant sterols and/or stanols. Both found that LDL-cholesterol reduction was approximately 0·33 mmol/l for a mean daily intake of 2·1-2·5 g plant sterols and/or stanols (23,24) . Plant sterols and stanols have approved health claims in the USA and in Europe.…”

Section: Mechanism Of Supporting Statin Therapymentioning

confidence: 99%

Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

et al. 2010

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Functional foods and dietary supplements might have a role in supporting drug therapy. These products may (1) have an additive effect to the effect that a drug has in reducing risk factors associated with certain conditions, (2) contribute to improve risk factors associated with the condition, other than the risk factor that the drug is dealing with, or (3) reduce drug-associated side effects, for example, by restoring depleted compounds or by reducing the necessary dose of the drug. Possible advantages compared with a multidrug therapy are lower drug costs, fewer side effects and increased adherence. In the present review we have focused on the support of statin therapy using functional foods or dietary supplements containing plant sterols and/or stanols, soluble dietary fibre, n-3 PUFA or coenzyme Q 10 . We conclude that there is substantial evidence that adding plant sterols and/or stanols to statin therapy further reduces total and LDL-cholesterol by roughly 6 and 10 %, respectively. Adding n-3 PUFA to statin therapy leads to a significant reduction in plasma TAG of at least 15 %. Data are insufficient and not conclusive to recommend the use of soluble fibre or coenzyme Q 10 in patients on statin therapy and more randomised controlled trials towards these combinations are warranted. Aside from the possible beneficial effects from functional foods or dietary supplements on drug therapy, it is important to examine possible (negative) effects from the combination in the long term, for example, in post-marketing surveillance studies. Moreover, it is important to monitor whether the functional foods and dietary supplements are taken in the recommended amounts to induce significant effects. Combination therapy: Dyslipidaemia: Statins: Functional foodsThe world market for functional foods (FF) and dietary supplements (DS) is expanding rapidly. In 2010 FF are expected to represent 5 % of the total global food market (1) and the market for DS is estimated at more than $60 billion worldwide (2) . In general, the target population of FF or DS is healthy individuals with slightly elevated risk factors or some physical discomfort. However, due to the fast growing market of FF or DS and the accompanying strong advertising and marketing, also patients on medication may be stimulated to use FF or DS. This may have several consequences for the quality of drug treatment as stated by de Jong et al. with the example of the combined intake of plant sterols and/or stanols and statins (3) . Whereas they addressed the additive effect of plant sterols and/or stanols on reducing LDL-cholesterol values in patients on statin treatment, their main focus was the possible negative aspects of the combination, such as unfavourable effects on patient adherence with drug treatment and increasing the potential for food-drug interactions.In the present review we will focus on the possible beneficial effects that FF or DS may have on drug therapy. Because of the large number of subjects treated suboptimally with statins (hydroxymethylglutaryl Co...

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Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials

Cited by 285 publications

References 83 publications

Anti-diabetic activity of stigmasterol from soybean oil by targeting the GLUT4 glucose transporter

Anti-diabetic activity of stigmasterol from soybean oil by targeting the GLUT4 glucose transporter

Food combinations for cholesterol lowering

Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

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