Use of phytosterol-fortified foods to improve LDL cholesterol levels: A systematic review and meta-analysis

Fontané, Laia; Pedro‐Botet, Juan; Garcia-Ribera, Sonika; Climent, Elisenda; Muns, María Dolors; Ballesta, Silvia; Satorra, Pau; Roux, Juana A. Flores‐Le; Benaiges, David

doi:10.1016/j.numecd.2023.04.014

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…Plant sterol's lipid-lowering effect was confirmed in this study, which had a longer intervention period compared to previous ones [40]. In a recent systematic review and meta-analysis, an average LDL-C reduction of 0.55 mmol/L was reported, highlighting the importance of plant sterols dosage and the food matrix as main determinants of LDL-C reduction [41]. In recently published studies including cohorts of patients with FH, a low-fat diet combined with plant stanols resulted more effective in plasma total and LDL cholesterol values reduction if compared to dietary intervention alone (−0.62 mmol/L and −0.58 mmol/L respectively) [42].…”

Section: Plant Sterols and Stanols In Human Disease And In Cardiovasc...supporting

confidence: 73%

Plant Sterols and Stanols for Pediatric Patients with Increased Cardiovascular Risk

Pederiva,

Biasucci,

Banderali

et al. 2024

Children

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The atherosclerotic process begins in childhood and progresses throughout adult age. Hypercholesterolemia, especially familial hypercholesterolemia (FH) and metabolic dysfunctions linked to weight excess and obesity, are the main atherosclerosis risk factors in pediatric patients and can be detected and treated starting from childhood. Nutritional intervention and a healthy-heart lifestyle are cornerstones and first-line treatments, with which, if necessary, drug therapy should be associated. For several years, functional foods enriched with plant sterols and stanols have been studied in the treatment of hypercholesterolemia, mainly as nutritional complements that can reduce LDL cholesterol; however, there is a lack of randomized controlled trials defining their long-term efficacy and safety, especially in pediatric age. This review aims to evaluate what the main published studies on sterols and stanols in pediatric subjects with dyslipidemia have taught us, providing an updated picture of the possible use of these dietary supplements in children and adolescents with dyslipidemia and increased cardiovascular risk. Nowadays, we can state that plant sterols and stanols should be considered as a valuable therapy in pediatric patients with hypercholesterolemia, bearing in mind that nutritional and lifestyle counseling and, when necessary, pharmacologic therapy, are the cornerstones of the treatment in developmental age.

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Section: Plant Sterols and Stanols In Human Disease And In Cardiovasc...supporting

confidence: 73%

Plant Sterols and Stanols for Pediatric Patients with Increased Cardiovascular Risk

Pederiva,

Biasucci,

Banderali

et al. 2024

Children

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“…The dietary supplement was well tolerated and compliance with the treatment was high. The LDL-C reduction we observed was higher than that obtained with plant sterol-enriched foods such as bread, biscuits, and cereals, but lower than that registered with plant sterol-enriched foods such as butter, margarine, and spreads [37]. This is potentially relevant considering that a standard Mediterranean diet contains a large amount of bread and cereals but a low content of butter, margarine, and spreads.…”

Section: Discussioncontrasting

confidence: 48%

The Effect of Dietary Supplementation with Plant Sterols on Total and LDL-Cholesterol in Plasma Is Affected by Adherence to Mediterranean Diet: Insights from the DESCO Randomized Clinical Study

Cicero,

Fogacci,

Giovannini

et al. 2023

Nutrients

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Plant sterols are well-known natural lipid-lowering agents. The DESCO (Diet and plant sterols in the control of cholesterolemia) study was a single-center, randomized, double-blind, placebo-controlled, two-way crossover clinical trial designed to investigate the effect of a once-a-day ready-to-drink dietary supplement containing 2.5 g of phytosterols on the lipid profile, also in relation to the quality of the diet, in a cohort of 50 Italian individuals with polygenic hypercholesterolemia and low global cardiovascular risk. Eligible individuals were enrolled in a run-in period of 2 weeks. Then, participants who qualified for continuation in the study were randomly allocated (1:1) to a 3-week treatment with either phytosterols or placebo. After a 2-week washout period, enrolled individuals were crossed over to receive the alternative treatment. Dietary supplementation with phytosterols was associated with significant improvement in plasma levels of total cholesterol (TC; −11.8 ± 4.0 mg/dL, p = 0.016), low-density lipoprotein cholesterol (LDL-C; −7.8 ± 7.7 mg/dL, p = 0.021), and apolipoprotein B-100 (Apo B-100, −3.7 ± 4.1 mg/dL, p = 0.048) compared to baseline. The changes in TC and LDL-C were also significant compared to placebo, and greater adherence to the Mediterranean diet was significantly associated with greater reductions in LDL-C. Dietary supplementation with phytosterols was well tolerated and adherence to treatment was high. According to the findings of DESCO, the once-a-day ready-to-drink dietary supplement we tested is able to quickly and significantly decrease plasma levels of TC, LDL-C, and Apo B-100, with a greater effect in individuals more adhering to the Mediterranean dietary pattern.

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“…Since phytosterols and stanols cannot be synthesized by humans, their dietary intake through food is crucial. Foods rich in these compounds include fresh fruits, nuts, vegetables, seeds, cereals, pulses, and vegetable oils [60]. The evidence regarding the effect of phytosterols in pediatric subjects is still limited, but recent trials have demonstrated that supplementation with plant sterols is associated with a decrease in the total cholesterol plasma values in pediatric subjects with moderate hypercholesterolemia [61] and in those with familial hypercholesterolemia [62].…”

Section: Nutraceutical Inhibitors Of Intestinal Cholesterol Absorptionmentioning

confidence: 99%

Diet and Lipid-Lowering Nutraceuticals in Pediatric Patients with Familial Hypercholesterolemia

Capra,

Biasucci,

Banderali

et al. 2024

Children

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Familial hypercholesterolemia is a genetically determined disease characterized by elevated plasma total and LDL cholesterol levels from the very first years of life, leading to early atherosclerosis. Nutritional intervention is the first-line treatment, complemented with nutraceuticals and drug therapy when necessary. Nutraceuticals with a lipid-lowering effect have been extensively studied in the past few decades, and have been recently included in international guidelines as a complement to nutritional and pharmacological treatment in subjects with dyslipidemia. In this review, we explore current nutritional interventions for dyslipidemia in childhood, with a specific focus on the main nutraceuticals studied for treating severe dyslipidemia in pediatric patients. Additionally, we briefly describe their primary mechanisms of action and highlight the advantages and risks associated with the use of lipid-lowering nutraceuticals in childhood.

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Use of phytosterol-fortified foods to improve LDL cholesterol levels: A systematic review and meta-analysis

Cited by 7 publications

References 26 publications

Plant Sterols and Stanols for Pediatric Patients with Increased Cardiovascular Risk

Plant Sterols and Stanols for Pediatric Patients with Increased Cardiovascular Risk

The Effect of Dietary Supplementation with Plant Sterols on Total and LDL-Cholesterol in Plasma Is Affected by Adherence to Mediterranean Diet: Insights from the DESCO Randomized Clinical Study

Diet and Lipid-Lowering Nutraceuticals in Pediatric Patients with Familial Hypercholesterolemia

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