Reduction of Serum Cholesterol in Postmenopausal Women With Previous Myocardial Infarction and Cholesterol Malabsorption Induced by Dietary Sitostanol Ester Margarine

Gylling, Helena; Radhakrishnan, Rajaratnam; Miettinen, Tatu A.

doi:10.1161/01.cir.96.12.4226

Cited by 204 publications

(161 citation statements)

References 26 publications

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“…This result is similar to those of earlier studies, in which plant stanol esters (2-3 g/day of plant stanols) have reduced LDL-C by 9-15% (Vanhanen et al, 1993;Gylling and Miettinen, 1994;Gylling et al, 1995Gylling et al, , 1997Gylling et al, , 1999Miettinen et al, 1995;Hallikainen and Uusitupa, 1999;Hallikainen et al, 2000a;Mensink et al, 2002). Our result also confirms the fact that plant stanol ester does not affect serum HDL-C or TG.…”

Section: Discussionsupporting

confidence: 93%

“…Thus one can with confidence claim that the reduction in serum lipids in the stanol group was almost certainly owing to the plant stanols. The daily intake of plant stanol was 2 g, which was, on the basis of the earlier studies (Vanhanen et al, 1993;Gylling and Miettinen, 1994;Gylling et al, 1995Gylling et al, , 1997Gylling et al, , 1999Miettinen et al, 1995;Hallikainen and Uusitupa, 1999;Hallikainen et al, 2000a;Mensink et al, 2002), estimated to be adequate.The daily dose of the cheese product was taken in one or two portions with main meals. It has been reported that plant stanols, either consumed once a day or divided between the meals, resulted in a similar decrease in serum lipids .…”

Section: Discussionmentioning

confidence: 80%

“…In earlier clinical studies, the ingestion of plant stanols for 4-7 weeks has reduced serum cholesterol levels significantly (Gylling and Miettinen, 1994;Gylling et al, 1995Gylling et al, , 1997Hallikainen et al, 2000a, b;Mensink et al, 2002). It has also been reported that the full cholesterol-lowering effect can be reached within 1-2 weeks with the use of plant stanol (Hallikainen et al, 2002;Mensink et al, 2002).…”

Section: Discussionmentioning

confidence: 97%

“…In most studies, the cholesterol-lowering effect of plant stanol ester has been studied with plant stanols incorporated in an ordinary or low-fat margarine (Gylling and Miettinen, 1994;Gylling et al, 1995Gylling et al, , 1997Miettinen et al, 1995;Hallikainen and Uusitupa, 1999;Hallikainen et al, 2000aHallikainen et al, , b, 2002Tammi et al, 2002) or mayonnaise (Vanhanen et al, 1993;Miettinen and Vanhanen, 1994). Mensink et al (2002) also reported that a yoghurt enriched with 3 g/day of plant stanols reduced LDL cholesterol significantly.…”

Section: Introductionmentioning

confidence: 99%

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

Jauhiainen

Salo

Niittynen³

et al. 2006

Eur J Clin Nutr

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Objective: To investigate the cholesterol-lowering effects of a low-fat cheese enriched with plant stanol esters in mildly hypercholesterolaemic subjects, as part of their normal diet. Design: A randomized double-blind parallel-group study. Setting: Valio Ltd, Helsinki. Subjects: Sixty-seven mildly hypercholesterolaemic volunteers (24 men, 43 women) participated in the study, which all of them completed. Interventions: The subjects were randomly assigned to the plant stanol ester group or the control group. During the 5-week intervention, the subjects in the stanol group consumed a cheese enriched with 2 g of plant stanols per day, and the subjects in the control group, a control cheese with no plant stanols. Results: In the stanol ester group, as compared to the control group, both serum total and low-density lipoprotein (LDL) cholesterol decreased significantly, that is, by 5.8% (À0.32 mmol/l, 95% CI À0.50 to À0.15 mmol/l, Po0.001) and 10.3% (À0.36 mmol/l, 95% CI À0.53 to À0.18 mmol/l, Po0.001), respectively. There were no significant changes in high-density lipoprotein cholesterol (HDL), triglycerides or apolipoprotein B concentrations between the groups. Conclusion: Cheese enriched with 2 g of plant stanol in the form of fatty acid esters decreases serum total and LDL cholesterol significantly.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Jauhiainen

Salo

Niittynen³

et al. 2006

Eur J Clin Nutr

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“…Table 3 shows the results of studies investigating the differences in effects that plant sterols or stanols have on lipid levels in statin users and non-statin users. All studies have demonstrated that if plant sterols or stanols are added to a statin, the effect on cholesterol reduction is similar (40,43) or even higher (44) compared with that observed with the use of the plant sterols or stanols alone.…”

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: biosynthesis, biological function and their importance to human nutrition

Piironen

Lindsay

Miettinen

et al. 2000

J. Sci. Food Agric.

841

291

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Plant sterols are an essential component of the membranes of all eukaryotic organisms. They are either synthesised de novo or taken up from the environment. Their function appears to be to control membrane fluidity and permeability, although some plant sterols have a specific function in signal transduction. The phytosterols are products of the isoprenoid pathway. The dedicated pathway to sterol synthesis in photosynthetic plants occurs at the squalene stage through the activity of squalene synthetase. Although the activity of 3‐hydroxymethyl‐3‐glutaryl coenzyme A (HGMR) is rate‐limiting in the synthesis of cholesterol, this does not appear to be the case with the plant sterols. Up‐regulation of HGMR appears to increase the biosynthesis of cycloartenol but not the Δ5‐sterols. A decline in sterol synthesis is associated with a suppression of squalene synthetase activity, which is probably a critical point in controlling carbon flow and end‐product formation. The major post‐squalene biosynthetic pathway is regulated by critical rate‐limiting steps such as the methylation of cycloartenol into cycloeucalenol. Little is known about the factors controlling the biosynthesis of the end‐point sterol esters or stanols. The commonly consumed plant sterols are sitosterol, stigmasterol and campesterol which are predominantly supplied by vegetable oils. The oils are a rich source of the steryl esters. Less important sources of sterols are cereals, nuts and vegetables. The nutritional interest derives from the fact that the sterols have a similar structure to cholesterol, and have the capacity to lower plasma cholesterol and LDL cholesterol. Since the morbidity and mortality from cardiovascular disease have been dramatically reduced using cholesterol‐lowering drugs (statins), the interest in plant sterols lies in their potential to act as a natural preventive dietary product. Stanols (saturated at C‐5) occur in low amounts in the diet and are equally effective in lowering plasma cholesterol and do not cause an increase in plasma levels, unlike the sterols which can be detected in plasma. © 2000 Society of Chemical Industry

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Reduction of Serum Cholesterol in Postmenopausal Women With Previous Myocardial Infarction and Cholesterol Malabsorption Induced by Dietary Sitostanol Ester Margarine

Abstract: Dietary use of sitostanol ester margarine normalizes LDL cholesterol in about one third of women with previous myocardial infarction, especially in those with high baseline absorption and low synthesis of cholesterol, and in combination with statins reduces the needed drug dose.

Cited by 204 publications

References 26 publications

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

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

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

Plant sterols: biosynthesis, biological function and their importance to human nutrition

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