Key points for maximum effectiveness and safety for cholesterol-lowering properties of plant sterols and use in the treatment of metabolic syndrome

Journal of the Science of Food and Agriculture

Volumn 93, Issue 11, 2013, Pages 2605-2610

  Rondanelli, Mariangela ^a   Monteferrario, Francesca ^a   Faliva, Milena Anna ^a   Perna, Simone ^a   Antoniello, Neldo ^b  

^a UNIVERSITY OF PAVIA   (Italy)

^b Direzione Medica RSA 'F Pertusati'   (Italy)

Author keywords

Cholesterol; Dietary supplement; Metabolic syndrome; Plant sterols

Indexed keywords

ANTILIPEMIC AGENT; PHYTOSTEROL;

DOSE RESPONSE; HUMAN; HYPERCHOLESTEROLEMIA; METABOLIC SYNDROME X;

DOSE-RESPONSE RELATIONSHIP, DRUG; HUMANS; HYPERCHOLESTEROLEMIA; HYPOLIPIDEMIC AGENTS; METABOLIC SYNDROME X; PHYTOSTEROLS;

EID: 84880165930     PISSN: 00225142     EISSN: 10970010     Source Type: Journal    
DOI: 10.1002/jsfa.6174     Document Type: Review

References (56)

1. Alberti KG, Zimmet P, Shaw J and IDF Epidemiology Task Force Consensus Group, The metabolic syndrome-a new world-wide definition. Lancet 366:1059-1062 (2005).
2. American Diabetes Association, Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 31(Suppl. 1):S61-S78 (2008).
3. Eilat-Adar S and Goldbourt U, Nutritional recommendations for preventing coronary heart disease in women: evidence concerning whole foods and supplements. Nutr Metab Cardiovasc Dis 20:459-466 (2010).
4. Peterson DW, Effect of soybean sterols in the diet on plasma and liver cholesterol in chicks. Proc Soc Exp Biol Med 78:143-147 (1951).
5. Moreau RA, Whitaker BD and Hicks KB, Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Prog Lipid Res 41:457-500 (2002).
6. Piironen V, Lindsay DG, Miettinen TA, Toivo J and Lampi AM, Plant sterols: biosynthesis, biological function and their importance to human nutrition. J Sci Food Agric 80:939-966 (2000).
7. Patel MD and Thompson PD, Phytosterols and vascular disease. Atherosclerosis 186:12-19 (2006).
8. Han JH, Yang YX and Feng MY, Contents of phytosterols in vegetables and fruits commonly consumed in China. Biomed Environ Sci 21:449-453 (2008).
9. Von Bergmann K, Sudhop T and Lütjohann D, Cholesterol and plant sterol absorption: recent insights. Am J Cardiol 96:10D-14D (2005).
10. Jones PJH and AbuMweis SS, Phytosterols as functional food ingredients: linkages to cardiovascular disease and cancer. Curr Opin Clin Nutr Metab Care 12:147-151 (2009).
11. Berger A, Jones PJ and Abumweis SS, Plant sterols: factors affecting their efficacy and safety as functional food ingredients. Lipids Health Dis 3:5 (2004).
12. De Jong A, Plat J and Mensink RP, Metabolic effects of plant sterols and stanols (review). J Nutr Biochem 14:362-369 (2003).
13. Ostlund Jr RE, Phytosterols and cholesterol metabolism. Curr Opin Lipidol 15:37-41 (2004).
14. Plat J and Mensink RP, Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects. Am J Cardiol 96:15D-22D (2005).
15. Gylling H and Miettinen TA, The effect of plant stanol- and sterol-enriched foods on lipid metabolism, serum lipids and coronary heart disease. Ann Clin Biochem 42:254-263 (2005).
16. Calpe-Berdiel L, Escolà-Gil JC and Blanco-Vaca F, New insights into the molecular actions of plant sterols and stanols in cholesterol metabolism. Atherosclerosis 203:18-31 (2009).
17. De Smet E, Mensink RP and Plat J, Effects of plant sterols and stanols on intestinal cholesterol metabolism: suggested mechanisms from past to present. Mol Nutr Food Res 56:1058-1072 (2012).
18. Pollack OJ, Reduction of blood cholesterol in man. Circulation 7:702-706 (1953).
19. Grundy SM and Mok HY, Determination of cholesterol absorption in man by intestinal perfusion. J Lipid Res 18:263-271 (1977).
20. Mattson FH, Volpenhein RA and Erickson BA, Effect of plant sterol esters on the absorption of dietary cholesterol. J Nutr 107:1139-1146 (1977).
21. Mattson FH, Grundy SM and Crouse JR, Optimizing the effect of plant sterols on cholesterol absorption in man. Am J Clin Nutr 35:697-700 (1982).
22. Miettinen TA, Puska P, Gylling H, Vanhanen H and Vartiainen E, Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. New Engl J Med 333:1308-1312 (1995).
23. Arca M, Pigna G and Favoccia C, Management of statin-intolerant patient. Panminerva Med 54:105-118 (2012).
24. Hendriks HF, Weststrate JA, van Vliet T and Meijer GW, Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr 53:319-327 (1999).
25. Vanhanen HT, Kajander J, Lehtovirta H and Miettinen TA, Serum levels, absorption efficiency, faecal elimination and synthesis of cholesterol during increasing doses of dietary sitostanol esters in hypercholesterolaemic subjects. Clin Sci 87:61-67 (1994).
26. Hallikainen MA, Sarkkinen ES and Uusitupa MI, Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner. J Nutr 130:767-776 (2000).
27. Katan MB, Grundy SM, Jones P, Law M, Miettinen T and Paoletti R, Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 78:965-978 (2003).
28. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation 106:3143-3421 (2002).
29. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). J Am Med Assoc 285:2486-2497 (2001).
30. American Heart Association Nutrition Committee, Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 114:82-96 (2006).
31. Mensink RP, Ebbing S, Lindhout M, Plat J and van Heugten MM, Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 160:205-213 (2002).
32. Homma Y, Ikeda I, Ishikawa T, Tateno M, Sugano M and Nakamura H, Decrease in plasma low-density lipoprotein cholesterol, apolipoprotein B, cholesteryl ester transfer protein, and oxidized low-density lipoprotein by plant stanol ester-containing spread: a randomized, placebo-controlled trial. Nutrition 19:369-374 (2003).
33. Carr TP, Ash MM and Brown AW, Cholesterol-lowering phytosterols: factors affecting their use and efficacy. Nutr Diet Suppl 2:59-72 (2010).
34. Eussen SR, de Jong N, Rompelberg CJ, Garssen J, Verschuren WM and Klungel OH, Dose-dependent cholesterol-lowering effects of phytosterol/phytostanol-enriched margarine in statin users and statin non-users under free-living conditions. Publ Health Nutr 14:1823-1832 (2011).
35. Clifton PM, Noakes M, Sullivan D, Erichsen N, Ross D, Annison G, et al, Cholesterol-lowering effects of plant sterol esters differ in milk, yoghurt, bread and cereal. Eur J Clin Nutr 58:503-509 (2004).
36. Salo P and Wester I, Low-fat formulations of plant stanols and sterols. Am J Cardiol 96:51D-54D (2005).
37. McPherson TB, Ostlund RE, Goldberg AC, Bateman JH, Schimmoeller L and Spilburg CA, Phytostanol tablets reduce human LDL-cholesterol. J Pharm Pharmacol 57:889-896 (2005).
38. Goldberg AC, Ostlund Jr RE, Bateman JH, Schimmoeller L, McPherson TB and Spilburg CA, Effect of plant stanol tablets on low-density lipoprotein cholesterol lowering in patients on statin drugs. Am J Cardiol 97:376-379 (2006).
39. Acuff RV, Cai DJ, Dong ZP and Bell D, The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects. Lipids Health Dis 6:11 (2007).
40. Windler E, Zyriax BC, Eidenmüller B and Boeing H, Hormone replacement therapy and risk for coronary heart disease. Data from the CORA-study-a case-control study on women with incident coronary heart disease. Maturitas 57:239-246 (2007).
41. SCF, General view of the Scientific Committee on Food on the long-term effects of the intake of elevated levels of phytosterols from multiple dietary sources with particular attention to the effects on β-carotene. SCF/CS/NF/DOS/20 ADD 1 Final [Online]. European Commission, Health & Consumer Protection Directorate-General (2002). Available: http://ec.europa.eu/food/fs/sc/scf/out192_en.pdf.
42. Scientific Panel on Dietetic Products, Nutrition and Allergies, Opinion of the Scientific Panel on Dietetic Products, Nutrition and Allergies on a request from the Commission related to a Novel Food application from Forbes Medi-Tech for approval of plant sterol-containing milk-based beverages (Request N° EFSA-Q-2003-075). EFSA J 15:1-12 (2003).
43. Genser B, Silbernagel G, De Backer G, Bruckert E, Carmena R, Chapman MJ, et al, Plant sterols and cardiovascular disease: a systematic review and meta-analysis. Eur Heart J 33:444-451 (2012).
44. Plat J, Mackay D, Baumgartner S, Clifton PM, Gylling H and Jones PJ, Progress and prospective of plant sterol and plant stanol research: report of the Maastricht meeting. Atherosclerosis 225:521-533 (2012).
45. Silbernagel G, Genser B, Nestel P and März W, Plant sterols and atherosclerosis. Curr Opin Lipidol 24:12-17 (2013).
46. St-Onge MP and Jones PJ, Phytosterols and human lipid metabolism: efficacy, safety, and novel foods. Lipids 38:367-375 (2003).
47. Gupta AK, Savopoulos CG, Ahuja J and Hatzitolios AI, Role of phytosterols in lipid-lowering: current perspectives. QJM 104:301-308 (2011).
48. Korpela R, Tuomilehto J, Högström P, Seppo L, Piironen V, Salo-Väänänen P, et al, Safety aspects and cholesterol-lowering efficacy of low fat dairy products containing plant sterols. Eur J Clin Nutr 60:633-642 (2006).
49. Richelle M, Enslen M, Hager C, Groux M, Tavazzi I, Godin JP, et al, Both free and esterified plant sterols reduce cholesterol absorption and the bioavailability of β-carotene and α-tocopherol in normocholesterolemic humans. Am J Clin Nutr 80:171-177 (2004).
50. Tikkanen MJ, Plant sterols and stanols. Handbook Exp Pharmacol 170:215-230 (2005).
51. Noakes M, Clifton P, Ntanios F, Shrapnel W, Record I and McInerney J, An increase in dietary carotenoids when consuming plant sterols or stanols is effective in maintaining plasma carotenoid concentrations. Am J Clin Nutr 75:79-86 (2002).
52. Colgan HA, Floyd S, Noone EJ, Gibney MJ and Roche HM, Increased intake of fruit and vegetables and a low-fat diet, with and without low-fat plant sterol-enriched spread consumption: effects on plasma lipoprotein and carotenoid metabolism. J Hum Nutr Diet 17:561-569 (2004).
53. Clifton PM, Noakes M, Ross D, Fassoulakis A, Cehun M and Nestel P, High dietary intake of phytosterol esters decreases carotenoids and increases plasma plant sterol levels with no additional cholesterol lowering. J Lipid Res 45:1493-1499 (2004).
54. Doornbos AM, Meynen EM, Duchateau GS, van der Knaap HC and Trautwein EA, Intake occasion affects the serum cholesterol lowering of a plant sterol-enriched single-dose yoghurt drink in mildly hypercholesterolaemic subjects. Eur J Clin Nutr 60:325-333 (2006).
55. Brufau G, Canela MA and Rafecas M, Phytosterols: physiologic and metabolic aspects related to cholesterol-lowering properties. Nutr Res 28:217-225 (2008).
56. Laitinen K and Gylling H, Dose-dependent LDL-cholesterol lowering effect by plant stanol ester consumption: clinical evidence. Lipids Health Dis 11:140 (2012).