Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations - A meta-analysis of randomized controlled studies

Atherosclerosis

Volumn 230, Issue 2, 2013, Pages 336-346

  Ras, Rouyanne T ^a   Hiemstra, Harry ^a   Lin, Yuguang ^a   Vermeer, Mario A ^a   Duchateau, Guus S M J E ^a   Trautwein, Elke A ^a  

^a UNILEVER RESEARCH VLAARDINGEN   (Netherlands)

Author keywords

Cholesterol; Dietary intervention; Meta analysis; Plant sterols; Plasma serum

Indexed keywords

CAMPESTEROL; CHOLESTEROL; EZETIMIBE; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; LOW DENSITY LIPOPROTEIN CHOLESTEROL; MARGARINE; PHYTOSTEROL; RAPESEED OIL; SITOSTEROL; YOGHURT;

CHOLESTEROL BLOOD LEVEL; DATA EXTRACTION; EMBASE; FOOD INTAKE; HUMAN; MEDLINE; META ANALYSIS; MILK; POST HOC ANALYSIS; PRIORITY JOURNAL; REVIEW; SYSTEMATIC REVIEW;

CHOLESTEROL; DIETARY INTERVENTION; META-ANALYSIS; PLANT STEROLS; PLASMA/SERUM;

CHOLESTEROL; CHOLESTEROL, LDL; DIET; FOOD, FORTIFIED; HUMANS; PHYTOSTEROLS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RISK FACTORS; SITOSTEROLS;

EID: 84884522834     PISSN: 00219150     EISSN: 18791484     Source Type: Journal    
DOI: 10.1016/j.atherosclerosis.2013.08.012     Document Type: Review

References (77)

1. Katan M.B., Grundy S.M., Jones P., Law M., Miettinen T.A., Paoletti R. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clinic Proceedings 2003, 78:965-978.
2. Law M. Plant sterol and stanol margarines and health. British Medical Journal 2000, 320:861-864.
3. Demonty I., Ras R.T., Van der Knaap H.C.M., et al. Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. Journal of Nutrition 2009, 139:271-284.
4. Abumweis S.S., Barake R., Jones P.J.H. Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials. Food and Nutrition Research 2008, 52. doi:10.3402/fnr.v52i0.1811-.
5. Musa-Veloso K., Poon T.H., Elliot J.A., Chung C. Acomparison of the LDL-cholesterol lowering efficacy of plant stanols and plant sterols over a continuous dose range: results of a meta-analysis of randomized, placebo-controlled trials. Prostaglandins Leukotrienes and Essential Fatty Acids 2011, 85:9-28.
6. Hu F.B., Willett W.C. Optimal diets for prevention of coronary heart disease. The Journal of the American Medical Association 2002, 288:2569-2578.
7. Mihaylova B., Emberson J., Blackwell L., et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012, 380:581-590.
8. NCEP ATP 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) 2002.
9. Lichtenstein A., Appel L., Brands M., et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American heart association Nutrition committee. Circulation 2006, 114:82-96.
10. Reiner Z., Catapano A.L., De Backer G., et al. ESC/EAS Guidelines for the management of dyslipidaemias: the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European Heart Journal 2011, 32:1769-1818.
11. Trautwein E.A., Duchateau G.S.M.J., Lin Y., Mel'nikov S.M., Molhuizen H.O.F., Ntanios F.Y. Proposed mechanisms of cholesterol-lowering action of plant sterols. European Journal of Lipid Science and Technology 2003, 105:171-185.
12. Oram J.F., Vaughan A.M. ATP-Binding cassette cholesterol transporters and cardiovascular disease. Circulation Research 2006, 99:1031-1043.
13. Ostlund R.E., McGill J.B., Zeng C.M., et al. Gastrointestinal absorption and plasma kinetics of soy delta(5)-phytosterols and phytostanols in humans. American Journal of Physiology - Endocrinology and Metabolism 2002, 282:E911-E916.
14. Chan Y.M., Varady K.A., Lin Y., et al. Plasma concentrations of plant sterols: physiology and relationship with coronary heart disease. Nutrition Reviews 2006, 64:385-402.
15. Klingberg S., Andersson H.A., Mulligan A., et al. Food sources of plant sterols in the EPIC Norfolk population. European Journal of Clinical Nutrition 2008, 62:695-703.
16. Klingberg S., Ellegard L., Johansson I., et al. Inverse relation between dietary intake of naturally occurring plant sterols and serum cholesterol in northern Sweden. American Journal of Clinical Nutrition 2008, 87:993-1001.
17. Sioen I., Matthys C., Huybrechts I., Van Camp J., de Henauw S. Consumption of plant sterols in Belgium: estimated intakes and sources of naturally occurring plant sterols and beta-carotene. British Journal of Nutrition 2011, 105:960-966.
18. Jimenez-Escrig A., Santos-Hidalgo A.B., Saura-Calixto F. Common sources and estimated intake of plant sterols in the Spanish diet. Journal of Agricultural and Food Chemistry 2006, 54:3462-3471.
19. Jenkins D.J., Kendall C.W., Popovich D.G., et al. Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism 2001, 50:494-503.
20. Vuoristo M., Miettinen T.A. Absorption, metabolism, and serum concentrations of cholesterol in vegetarians - effects of cholesterol feeding. American Journal of Clinical Nutrition 1994, 59:1325-1331.
21. Sudhop T., Von Bergmann K. Sitosterolemia - a rare disease. Are elevated plant sterols an additional risk factor?. Zeitschrift fur Kardiologie 2004, 93:921-928.
22. Jessup W., Herman A., Chapman M.J. Phytosterols in cardiovascular disease: innocuous dietary components, or accelerators of atherosclerosis?. Future Lipidology 2008, 3:301-310.
23. Genser B., Silbernagel G., De Backer G., et al. Plant sterols and cardiovascular disease: a systematic review and meta-analysis. European Heart Journal 2012, 33:444-451.
24. Commission Decision 2004/335. Official Journal of the European Union 2004.
25. Naumann E., Plat J., Mensink R.P. Changes in serum concentrations of noncholesterol sterols and lipoproteins in healthy subjects do not depend on the ratio of plant sterols to stanols in the diet. Journal of Nutrition 2003, 133:2741-2747.
26. de Jong A., Plat J., Mensink R.P. Plant sterol or stanol consumption does not affect erythrocyte osmotic fragility in patients on statin treatment. European Journal of Clinical Nutrition 2006, 60:985-990.
27. de Jong A., Plat J., Lutjohann D., Mensink R.P. Effects of long-term plant sterol or stanol ester consumption on lipid and lipoprotein metabolism in subjects on statin treatment. Erratum appears in British Journal of Nutrition 2009 Dec, 102(11):1701-1702.
28. British Journal of Nutrition 2008, 100:937-941.
29. Plana N., Nicolle C., Ferre R., et al. Plant sterol-enriched fermented milk enhances the attainment of LDL-cholesterol goal in hypercholesterolemic subjects. European Journal of Nutrition 2008, 47:32-39.
30. DerSimonian R., Laird N. Meta-analysis in clinical trials. Controlled Clinical Trials 1986, 7:177-188.
31. Egger M., Davey S.G., Smith G., Schneider M., Minder C. Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 1997, 315:629-634.
32. Carr T.P., Krogstrand K.L., Schlegel V.L., Fernandez M.L. Stearate-enriched plant sterol esters lower serum LDL cholesterol concentration in normo- and hypercholesterolemic adults. Journal of Nutrition 2009, 139:1445-1450.
33. Christiansen L.I., Lahteenmaki P.L., Mannelin M.R., Seppanen-Laakso T.E., Hiltunen R.V., Yliruusi J.K. Cholesterol-lowering effect of spreads enriched with microcrystalline plant sterols in hypercholesterolemic subjects. European Journal of Nutrition 2001, 40:66-73.
34. Clifton P.M., Mano M., Duchateau G.S., van der Knaap H.C., Trautwein E.A. Dose-response effects of different plant sterol sources in fat spreads on serum lipids and C-reactive protein and on the kinetic behavior of serum plant sterols. European Journal of Clinical Nutrition 2008, 62:968-977.
35. Hansel B., Nicolle C., Lalanne F., et al. Effect of low-fat, fermented milk enriched with plant sterols on serum lipid profile and oxidative stress in moderate hypercholesterolemia. American Journal of Clinical Nutrition 2007, 86:790-796.
36. Hendriks H.F., Brink E.J., Meijer G.W., Princen H.M., Ntanios F.Y. Safety of long-term consumption of plant sterol esters-enriched spread. European Journal of Clinical Nutrition 2003, 57:681-692.
37. Hernandez-Mijares A., Banuls C., Rocha M., et al. Effects of phytosterol ester-enriched low-fat milk on serum lipoprotein profile in mildly hypercholesterolaemic patients are not related to dietary cholesterol or saturated fat intake. British Journal of Nutrition 2010, 104:1018-1025.
38. Korpela R., Tuomilehto J., Hogstrom P., et al. Safety aspects and cholesterol-lowering efficacy of low fat dairy products containing plant sterols. European Journal of Clinical Nutrition 2006, 60:633-642.
39. Kurokawa M., Masuda Y., Noda M., et al. Effects of dressing containing plant sterol on serum cholesterol concentration and the safety evaluation in borderline or mildly hypercholesterolemic Japanese subjects. Journal of Oleo Science 2008, 57:35-45.
40. Maki K.C., Davidson M.H., Umporowicz D.M., et al. Lipid responses to plant-sterol-enriched reduced-fat spreads incorporated into a National Cholesterol Education Program Step I diet. American Journal of Clinical Nutrition 2001, 74:33-43.
41. Mannarino E., Pirro M., Cortese C., et al. Effects of a phytosterol-enriched dairy product on lipids, sterols and 8-isoprostane in hypercholesterolemic patients: a multicenter Italian study. Nutrition Metabolism & Cardiovascular Diseases 2009, 19:84-90.
42. Masuda O., Higuchi T., Kitano D., Kajimoto Y. Drink containing plant sterols improves the serum cholesterol in humans with mild cholesterolemia. Japanese Pharmacology and Therapeutics 2007, 35:989-1003.
43. Neil H.A., Meijer G.W., Roe L.S. Randomised controlled trial of use by hypercholesterolaemic patients of a vegetable oil sterol-enriched fat spread. Atherosclerosis 2001, 156:329-337.
44. Saito S., Takeshita M., Tomonobu K., et al. Dose-dependent cholesterol-lowering effect of a mayonnaise-type product with a main component of diacylglycerol-containing plant sterol esters. Nutrition 2006, 22:174-178.
45. Seki S., Hidaka I., Kojima K., et al. Effects of phytosterol ester-enriched vegetable oil on plasma lipoproteins in healthy men. Asia Pacific Journal of Clinical Nutrition 2003, 12:282-291.
46. Seki S., Abe T., Hidaka I., et al. Effects of phytosterol ester-enriched vegetable oil on serum cholesterol and assessment of safety in healthy men. Journal of Oleo Science 2003, 52:205-213.
47. Takeshita M., Saito S., Moriwaki J., et al. Effects of dietary diacylglycerol oil containing phytosterols in mayonnaise on abdominal fat and blood cholesterol levels in Japanese men. Japanese Pharmacology & Therapeutics 2007, 35:973-987.
48. Takeshita M., Katsuragi Y., Kusuhara M., et al. Phytosterols dissolved in diacylglycerol oil reinforce the cholesterol-lowering effect of low-dose pravastatin treatment. Nutrition Metabolism & Cardiovascular Diseases 2008, 18:483-491.
49. Varady K.A., Ebine N., Vanstone C.A., Parsons W.E., Jones P.J. Plant sterols and endurance training combine to favorably alter plasma lipid profiles in previously sedentary hypercholesterolemic adults after 8 wk. American Journal of Clinical Nutrition 2004, 80:1159-1166.
50. Abumweis S.S., Vanstone C.A., Ebine N., et al. Intake of a single morning dose of standard and novel plant sterol preparations for 4 weeks does not dramatically affect plasma lipid concentrations in humans. Journal of Nutrition 2006, 136:1012-1016.
51. Rudkowska I., Abumweis S.S., Nicolle C., Jones P.J. Cholesterol-lowering efficacy of plant sterols in low-fat yogurt consumed as a snack or with a meal. Journal of the American College of Nutrition 2008, 27:588-595.
52. Amundsen A.L., Ntanios F., Put N., Ose L. Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread. European Journal of Clinical Nutrition 2004, 58:1612-1620.
53. Casas-Agustench P., Serra M., Perez-Heras A., et al. Effects of plant sterol esters in skimmed milk and vegetable-fat-enriched milk on serum lipids and non-cholesterol sterols in hypercholesterolaemic subjects: a randomised, placebo-controlled, crossover study. British Journal of Nutrition 2012, 107:1766-1775.
54. Clifton P.M., Noakes M., Sullivan D., et al. Cholesterol-lowering effects of plant sterol esters differ in milk, yoghurt, bread and cereal. European Journal of Clinical Nutrition 2004, 58:503-509.
55. Demonty I., Chan Y.M., Pelled D., Jones P.J. Fish-oil esters of plant sterols improve the lipid profile of dyslipidemic subjects more than do fish-oil or sunflower oil esters of plant sterols. American Journal of Clinical Nutrition 2006, 84:1534-1542.
56. Hallikainen M.A., Sarkkinen E.S., Gylling H., Erkkila A.T., Uusitupa M.I. Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on a low-fat diet. European Journal of Clinical Nutrition 2000, 54:715-725.
57. Heggen E., Granlund L., Pedersen J.I., et al. Plant sterols from rapeseed and tall oils: effects on lipids, fat-soluble vitamins and plant sterol concentrations. Nutrition Metabolism & Cardiovascular Diseases 2010, 20:258-265.
58. Houweling A.H., Vanstone C.A., Trautwein E.A., Duchateau G.S., Jones P.J. Baseline plasma plant sterol concentrations do not predict changes in serum lipids, C-reactive protein (CRP) and plasma plant sterols following intake of a plant sterol-enriched food. European Journal of Clinical Nutrition 2009, 63:543-551.
59. Jakulj L., Trip M.D., Sudhop T., von B.K., Kastelein J.J., Vissers M.N. Inhibition of cholesterol absorption by the combination of dietary plant sterols and ezetimibe: effects on plasma lipid levels. Journal of Lipid Research 2005, 46:2692-2698.
60. Jones P.J., Raeini-Sarjaz M., Ntanios F.Y., Vanstone C.A., Feng J.Y., Parsons W.E. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters. Journal of Lipid Research 2000, 41:697-705.
61. Kratz M., Kannenberg F., Gramenz E., et al. Similar serum plant sterol responses of human subjects heterozygous for a mutation causing sitosterolemia and controls to diets enriched in plant sterols or stanols. European Journal of Clinical Nutrition 2007, 61:896-905.
62. Lau V.W., Journoud M., Jones P.J. Plant sterols are efficacious in lowering plasma LDL and non-HDL cholesterol in hypercholesterolemic type 2 diabetic and nondiabetic persons. American Journal of Clinical Nutrition 2005, 81:1351-1358.
63. Mussner M.J., Parhofer K.G., von Bergmann K., Schwandt P., Broedl U., Otto C. Effects of phytosterol ester-enriched margarine on plasma lipoproteins in mild to moderate hypercholesterolemia are related to basal cholesterol and fat intake. Metabolism: Clinical & Experimental 2002, 51:189-194.
64. Myrie S.B., Mymin D., Triggs-Raine B., Jones P.J. Serum lipids, plant sterols, and cholesterol kinetic responses to plant sterol supplementation in phytosterolemia heterozygotes and control individuals. American Journal of Clinical Nutrition 2012, 95:837-844.
65. Ooi E.M., Watts G.F., Barrett P.H., et al. Dietary plant sterols supplementation does not alter lipoprotein kinetics in men with the metabolic syndrome. Asia Pacific Journal of Clinical Nutrition 2007, 16:624-631.
66. Takeshita M., Saito S., Katsuragi Y., et al. Combination of plant sterols and diacylglycerol oil lowers serum cholesterol and lipoprotein (a) concentrations in postmenopausal women with mild to moderate hypercholesterolemia. e-SPEN 2007, 2:4-11.
67. Vanstone C.A., Raeini-Sarjaz M., Parsons W.E., Jones P.J. Unesterified plant sterols and stanols lower LDL-cholesterol concentrations equivalently in hypercholesterolemic persons. American Journal of Clinical Nutrition 2002, 76:1272-1278.
68. Weststrate J.A., Meijer G.W. Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. European Journal of Clinical Nutrition 1998, 52:334-343.
69. Niittynen L.H., Jauhiainen T.A., Poussa T.A., Korpela R. Effects of yoghurt enriched with free plant sterols on the levels of serum lipids and plant sterols in moderately hypercholesterolaemic subjects on a high-fat diet. International Journal of Food Sciences & Nutrition 2008, 59:357-367.
70. Davidson M.H., Maki K.C., Umporowicz D.M., et al. Safety and tolerability of esterified phytosterols administered in reduced-fat spread and salad dressing to healthy adult men and women. Journal of the American College of Nutrition 2001, 20:307-319.
71. Tuomilehto J., Tikkanen M., Hogstrom P., et al. Safety assessment of common foods enriched with natural nonesterified plant sterols. European Journal of Clinical Nutrition 2009, 63:684-691.
72. Horenstein R.B., Mitchell B.D., Post W.S., et al. The ABCG8 G574R variant, serum plant sterol levels, and cardiovascular disease risk in the Old order Amish. Arteriosclerosis Thrombosis and Vascular Biology 2013, 33:413-419.
73. Stalenhoef A.F., Hectors M., Demacker P.N. Effect of plant sterol-enriched margarine on plasma lipids and sterols in subjects heterozygous for phytosterolaemia. Journal of Internal Medicine 2001, 249:163-166.
74. Kwiterovich P.O., Chen S.C., Virgil D.G., Schweitzer A., Arnold D.R., Kratz L.E. Response of obligate heterozygotes for phytosterolemia to a low-fat diet and to a plant sterol ester dietary challenge. Journal of Lipid Research 2003, 44:1143-1155.
75. Lorenz M.W., Polak J.F., Kavousi M., et al. Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data. Lancet 2012, 379:2053-2062.
76. Teupser D., Baber R., Ceglarek U., et al. Genetic regulation of serum phytosterol levels and risk of coronary artery disease. Circulation Cardiovascular Genetics 2010, 3:331-339.
77. Plat J., Mackay D., Baumgartner S., Clifton P.M., Gylling H., Jones P.J. Progress and prospective of plant sterol and plant stanol research: report of the Maastricht meeting. Atherosclerosis 2012, 225:521-533.