Cholesterol-lowering effect

The reason for the cholesterol-lowering effect of polyunsaturated fatty acids is still not fully understood. It is clear, however, that one of the mechanisms involved is the up-regulation of LDL receptors by poly-and monounsaturated as compared with saturated fatty acids, causing an increase in the catabolic rate of LDL, the main atherogenic lipoprotein. In addition, saturated fatty acids cause the formation of smaller VLDL particles that contain relatively more cholesterol, and they are utilized by extrahepatic tissues at a slower rate than are larger particles—tendencies that may be regarded as atherogenic. 

Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) have been shown to improve vascular outcomes due to their cholesterol-lowering effects as well as multiple pleiotropic effects. In high-risk populations, statin therapy is known to reduce the risk of vascular events such as myocardial infarction and stroke. A meta-analysis of 10 trials involving 79,494 subjects showed that statin therapy reduced the incidence of stroke by 18%, major coronary events by 27%, and all-cause mortality by 15%. The SPARCL trial recently showed that high-dose HMG-CoA reductase inhibitors prevent recurrent stroke and transient ischemic attacks. ... 

Anderson, J. W., Zettwoch, N., Feldman, T., Tietyen-Clark, J., Oeltgen, P., and Bishop, C. (1988). Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholes-terolemic men. Arch. Intern. Med. 148, 292-296. 

Anderson, J. W., Allgood, L. D., Laurence, A., Altringer, L. A., Jerdack, G. R., Hengehold, D. A., and Morel, J. G. (2000a). Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia Metaanalysis of 8 controlled trials. Am. J. Clin. Nutr. 71, 472 79. 

Anderson, J. W., Davidson, M. H., Blonde, L., Brown, W. V., Howard, W. J., Ginsberg, H., Allgood, L. D., and Weingand, K. W. (2000b). Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of h3piercholesterolemia. Am. ]. Clin. Nutr. 71, 1433-1438. 

Bell, L. P., Hectorn, K. J., Reynolds, H., and Hunninghake, D. B. (1990). Cholesterol-lowering effects of soluble-fiber cereals as part of a prudent diet for patients with mild to moderate hypercholesterolemia. Am. ]. Clin. Nutr. 52,1020-1026. 

L. Morin. Cholesterol-lowering effect of barley bran flour and oil. J Amer Diet Ass 1994 94(1) 65-70. 

Segawa, K., T. Kataoka, and Y. Fukuo. Cholesterol-lowering effects of psyllium seed associated with urea metabolism. Biol Pharm Bull 1998 21(2) 184-187. 

POOH Anderson]. W., S. Riddell-Mason, N. J. Gustafson, S. F. Smith, and M. Mackey. Cholesterol-lowering effects of psyllium-enriched cereal as an adjunct to a prudent diet in the treatment of mild to moderate hypercholesterolemia. Amer J Clin Nutr 1992 56(1) 93-98. Day, C. E. Activity of psyllium hydrophilic colloid for reducing serum cholesterol in sea quail fed diet supplemented with cholesterol. Artery 1991 18(3) 163-167. 

PO032 Wolever, T., D. Jenkins, S. Mueller, et al. Method of administration influences the serum cholesterol lowering effect of psyllium. Amer J Clin Nutr 1994 59(5) 1055-1059. 

A recent meta-analysis of eight randomized controlled trials of soy protein consumption in humans has found that with identical soy protein intake, high isoflavone intake led to significantly greater decreases in serum LDL cholesterol than low isoflavone intake, indicating that isoflavones have LDL-cholesterol-lowering effects that are independent of the soy protein. 

Hussi, E., Miettinen, T. A., Ollus, A., Kostiainen, E., Ehnholm, C., Haglund, B., Huttu-nen, J. K. and Manninen, V. 1981. Lack of serum cholesterol-lowering effect of skimmed milk and buttermilk under controlled conditions. Atherosclerosis 39, 267-272. 

The cholesterol-lowering effect of garlic was also seen in rabbits that were fed 2 g choles-terol/day for 16 weeks. A dose-dependent reduction of serum cholesterol in garlic-fed rats was observed in these experiments. 

Brown, L., Rosner, B., Willett, W.W., and Sacks, F.M. 1999. Cholesterol-lowering effects of dietary fiber A meta analysis. Am. J. Clin. Nutr. 69, 30-42. 

Favier, M.L., Bost, P.E., Demigne, C., and Remesy, C. 1998. The cholesterol-lowering effect of guar gum in rats is not accompanied by an interruption of bile acid cycling. Lipids 33, 765-771. 

Lin, Y., Meijer, G.W., Vermeer, M.A., and Trautwein, E.A. 2004. Soy protein enhances the cholesterol-lowering effect of plant sterol esters in cholesterol-fed hamsters. J. Nutr. 134, 143-148. 

Kleemann R, Princen HM, Emeis JJ, et al. Rosuvastatin reduces atherosclerosis development beyond and independent of its plasma cholesterol-lowering effect in APOE 3-Leiden transgenic mice Evidence for anti-inflammatory effects of rosuvastatin. Circulation 2003 108 1368-1374. 

III. Mechanisms of the Cholesterol-Lowering Effects of Reductase Inhibitors. .. 89... 

---