Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population
Background. Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a...
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| Published in | The New England journal of medicine Vol. 333; no. 20; pp. 1308 - 1312 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Boston, MA
Massachusetts Medical Society
16.11.1995
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0028-4793 1533-4406 |
| DOI | 10.1056/NEJM199511163332002 |
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| Abstract | Background. Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia. Methods. We conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day). Results. The margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -32; P0.001). The respective reductions in low-density lipoprotein (LDL) cholesterol were 14.1 percent in the sitostanol group and 1.1 percent in the control group. The difference in the change in LDL cholesterol concentration between the two groups was -21 mg per deciliter (95 percent confidence interval, -14 to -29; P0.001). Neither serum triglyceride nor high-density lipoprotein cholesterol concentrations were affected by sitostanol. Serum campesterol, a dietary plant sterol whose levels reflect cholesterol absorption, was decreased by 36 percent in the sitostanol group, and the reduction was directly correlated with the reduction in total cholesterol (r |
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| AbstractList | Background Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia. Methods We conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day). Results The margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -32; P<0.001). The respective reductions in low-density lipoprotein (LDL) cholesterol were 14.1 percent in the sitostanol group and 1.1 percent in the control group. The difference in the change in LDL cholesterol concentration between the two groups was -21 mg per deciliter (95 percent confidence interval, -14 to -29; P<0.001). Neither serum triglyceride nor high-density lipoprotein cholesterol concentrations were affected by sitostanol. Serum campesterol, a dietary plant sterol whose levels reflect cholesterol absorption, was decreased by 36 percent in the sitostanol group, and the reduction was directly correlated with the reduction in total cholesterol (r = 0.57, P<0.001). Conclusions Substituting sitostanol-ester margarine for part of the daily fat intake in subjects with mild hypercholesterolemia was effective in lowering serum total cholesterol and LDL cholesterol. Background. Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia. Methods. We conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day). Results. The margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -32; P0.001). The respective reductions in low-density lipoprotein (LDL) cholesterol were 14.1 percent in the sitostanol group and 1.1 percent in the control group. The difference in the change in LDL cholesterol concentration between the two groups was -21 mg per deciliter (95 percent confidence interval, -14 to -29; P0.001). Neither serum triglyceride nor high-density lipoprotein cholesterol concentrations were affected by sitostanol. Serum campesterol, a dietary plant sterol whose levels reflect cholesterol absorption, was decreased by 36 percent in the sitostanol group, and the reduction was directly correlated with the reduction in total cholesterol (r Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia. We conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day). The margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -32; P < 0.001). The respective reductions in low-density lipoprotein (LDL) cholesterol were 14.1 percent in the sitostanol group and 1.1 percent in the control group. The difference in the change in LDL cholesterol concentration between the two groups was -21 mg per deciliter (95 percent confidence interval, -14 to -29; P < 0.001). Neither serum triglyceride nor high-density lipoprotein cholesterol concentrations were affected by sitostanol. Serum campesterol, a dietary plant sterol whose levels reflect cholesterol absorption, was decreased by 36 percent in the sitostanol group, and the reduction was directly correlated with the reduction in total cholesterol (r = 0.57, P < 0.001). Substituting sitostanol-ester margarine for part of the daily fat intake in subjects with mild hypercholesterolemia was effective in lowering serum total cholesterol and LDL cholesterol. Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia.BACKGROUNDDietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia.We conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day).METHODSWe conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day).The margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -32; P < 0.001). The respective reductions in low-density lipoprotein (LDL) cholesterol were 14.1 percent in the sitostanol group and 1.1 percent in the control group. The difference in the change in LDL cholesterol concentration between the two groups was -21 mg per deciliter (95 percent confidence interval, -14 to -29; P < 0.001). Neither serum triglyceride nor high-density lipoprotein cholesterol concentrations were affected by sitostanol. Serum campesterol, a dietary plant sterol whose levels reflect cholesterol absorption, was decreased by 36 percent in the sitostanol group, and the reduction was directly correlated with the reduction in total cholesterol (r = 0.57, P < 0.001).RESULTSThe margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -32; P < 0.001). The respective reductions in low-density lipoprotein (LDL) cholesterol were 14.1 percent in the sitostanol group and 1.1 percent in the control group. The difference in the change in LDL cholesterol concentration between the two groups was -21 mg per deciliter (95 percent confidence interval, -14 to -29; P < 0.001). Neither serum triglyceride nor high-density lipoprotein cholesterol concentrations were affected by sitostanol. Serum campesterol, a dietary plant sterol whose levels reflect cholesterol absorption, was decreased by 36 percent in the sitostanol group, and the reduction was directly correlated with the reduction in total cholesterol (r = 0.57, P < 0.001).Substituting sitostanol-ester margarine for part of the daily fat intake in subjects with mild hypercholesterolemia was effective in lowering serum total cholesterol and LDL cholesterol.CONCLUSIONSSubstituting sitostanol-ester margarine for part of the daily fat intake in subjects with mild hypercholesterolemia was effective in lowering serum total cholesterol and LDL cholesterol. Plant sterols, including sitosterol, stigmasterol, and campesterol, are present in the Western diet in an amount almost equal to dietary cholesterol intake — that is, 160 to 360 mg per day. 1 Since the 1950s, large amounts of these sterols, mainly sitosterol, have been added to patients' diets for the treatment of hypercholesterolemia. 2 – 6 Plant sterols inhibit cholesterol absorption, but the resulting decrease in serum cholesterol has only been slight. 4 – 7 Sitostanol, a 5α-saturated sitosterol derivative, reduces the intestinal absorption of cholesterol and serum cholesterol more effectively than does sitosterol. 8 – 10 In addition, sitostanol is virtually unabsorbable and other plant sterols . . . |
| Author | Vanhanen, H Puska, P Gylling, H Vartiainen, E Miettinen, T.A. (University of Helsinki, Helsinki, Finland.) |
| Author_xml | – sequence: 1 fullname: Miettinen, T.A. (University of Helsinki, Helsinki, Finland.) – sequence: 2 fullname: Puska, P – sequence: 3 fullname: Gylling, H – sequence: 4 fullname: Vanhanen, H – sequence: 5 fullname: Vartiainen, E |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2916682$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/7566021$$D View this record in MEDLINE/PubMed |
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| Keywords | Human Hypercholesterolemia Treatment Metabolic diseases Lipids Serum Hyperlipoproteinemia Margarine Statistical study Cholesterol Feeding Quantitative analysis |
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| References | Tilvis RS (r017) 1986; 43 Mattson FH (r021) 1982; 35 r010 r012 r023 Farquhar JW (r002) 1956; 14 Schwartzkopff W (r005) 1978; 120 r006 Law MR (r020) 1994; 308 r008 r019 r009 r013 r003 Miettinen TA (r001) 1990; 131 r004 r015 Grundy SM (r007) 1969; 10 Denke MA (r022) 1995; 61 Friedewald WT (r016) 1972; 18 Vanhanen HT (r014) 1994; 87 Vanhanen HT (r011) 1993; 34 7566029 - N Engl J Med. 1995 Nov 16;333(20):1350-1 |
| References_xml | – ident: r003 doi: 10.1007/978-3-642-66323-9_16 – volume: 34 start-page: 1535 year: 1993 ident: r011 publication-title: J Lipid Res doi: 10.1016/S0022-2275(20)36946-7 – ident: r012 doi: 10.1016/0021-9150(94)90052-3 – ident: r015 doi: 10.1093/ije/23.3.495 – volume: 43 start-page: 92 year: 1986 ident: r017 publication-title: Am J Clin Nutr doi: 10.1093/ajcn/43.1.92 – volume: 61 start-page: 392 year: 1995 ident: r022 publication-title: Am J Clin Nutr doi: 10.1093/ajcn/61.2.392 – volume: 131 start-page: 20 year: 1990 ident: r001 publication-title: Am J Epidemiol doi: 10.1093/oxfordjournals.aje.a115479 – volume: 120 start-page: 1575 year: 1978 ident: r005 publication-title: MMW Munch Med Wochenschr – ident: r009 doi: 10.1007/BF01409411 – ident: r008 doi: 10.1016/0021-9150(86)90141-3 – ident: r023 doi: 10.1172/JCI115499 – volume: 87 start-page: 61 year: 1994 ident: r014 publication-title: Clin Sci doi: 10.1042/cs0870061 – ident: r019 doi: 10.1136/bmj.292.6522.746 – volume: 308 start-page: 367 year: 1994 ident: r020 publication-title: BMJ doi: 10.1136/bmj.308.6925.367 – volume: 14 start-page: 77 year: 1956 ident: r002 publication-title: Circulation doi: 10.1161/01.CIR.14.1.77 – volume: 35 start-page: 697 year: 1982 ident: r021 publication-title: Am J Clin Nutr doi: 10.1093/ajcn/35.4.697 – ident: r010 doi: 10.1016/S0022-3476(06)80136-8 – ident: r006 doi: 10.1055/s-0028-1104262 – ident: r013 doi: 10.1007/BF00404334 – ident: r004 doi: 10.1016/0021-9150(77)90180-0 – volume: 18 start-page: 499 year: 1972 ident: r016 publication-title: Clin Chem doi: 10.1093/clinchem/18.6.499 – volume: 10 start-page: 304 year: 1969 ident: r007 publication-title: J Lipid Res doi: 10.1016/S0022-2275(20)43088-3 – reference: 7566029 - N Engl J Med. 1995 Nov 16;333(20):1350-1 |
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| Snippet | Background. Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more... Plant sterols, including sitosterol, stigmasterol, and campesterol, are present in the Western diet in an amount almost equal to dietary cholesterol intake —... Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a... Background Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more... |
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| SubjectTerms | ACIDE GRAS ACIDE GRAS POLYINSATURE ACIDE GRAS SATURE ACIDOS GRASOS ACIDOS GRASOS POLIINSATURADOS ACIDOS GRASOS SATURADOS administration & dosage Adult ADULTE ADULTOS adults analogs & derivatives Anticholesteremic Agents Anticholesteremic Agents - administration & dosage Anticholesteremic Agents - therapeutic use Biological and medical sciences blood blood lipids blood serum campesterol CHOLESTEROL Cholesterol - analogs & derivatives Cholesterol - blood Cholesterol, HDL Cholesterol, HDL - blood Cholesterol, LDL Cholesterol, LDL - blood COLESTEROL CORPS GRAS DIETA dietary fat Dietary Fats Dietary Fats - administration & dosage Disorders of blood lipids. Hyperlipoproteinemia dose response Double-Blind Method drug therapy ESTER ESTERES ESTEROLES Fatty acids Female Finland FINLANDE FINLANDIA FITOSTEROLES GRASAS HEMOLIPIDOS high density lipoprotein HIPERLIPIDEMIA Humans hypercholesterolemia Hypercholesterolemia - blood Hypercholesterolemia - drug therapy HYPERLIPIDEMIE INGESTION DE NUTRIENTES INGESTION DE SUBSTANCES NUTRITIVES LIPIDE SANGUIN LIPOPROTEINAS LIPOPROTEINE longitudinal studies low density lipoprotein Male MARGARINA MARGARINE Medical sciences Metabolic diseases Middle Aged monounsaturated fatty acids nutrient intake PHYTOSTEROL Phytosterols polyunsaturated fatty acids REGIME ALIMENTAIRE saturated fatty acids SERUM SANGUIN Sitosterols Sitosterols - administration & dosage Sitosterols - therapeutic use STEROL sterol esters Sterols SUERO SANGUINEO therapeutic use Trans fats triacylglycerols TRIGLICERIDOS TRIGLYCERIDE Triglycerides Triglycerides - blood |
| Title | Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population |
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