Plant sterols cholesterol-lowering effects

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. 

The use of plant sterols—(3-sitostcrol and sitostanol in consumer products to decrease cholesterol is supported by numerous clinical studies that document their efficacy in lowering mild hyperlipidemia (Jones et al., 1998 Hallikainen and Uusitupa, 1999). Although the normal diet contains plant sterols that range from 160 to 360 mg/day, a 5- to 10-fold increase is required to exert a cholesterol-lowering effect. Consumer products with increased amounts of phytosterols that exceed the content found in the diet have been made available to the consumer. In evaluating the efficacy of including sitostanol ester in margarine as a dietary supplement for children with familial hypercholesterolemia (FH), it was found that serum total cholesterol (TC), intermediate density lipoprotein-cholesterol and LDL-cholesterol levels fell while the HDL-cholesterol/LDL-cholesterol ratio was elevated. 

Phytosterols and phytostanols (also called plant sterols and stanols) serve as important functional food ingredients due to their cholesterol-lowering effects. Thus, the Food and Drug Administration (FDA) has issued a rare health claim for sterol- and stanol-containing products [127]. Therefore, the presence and amount of phytosterols and phytostanols in hazelnuts is important. 

Wester, L, Cholesterol-lowering effect of plant sterols, Eur. J. Lipid Sci. TechnoL, 102, 37-44, 2000. 

Othman RA, Moghadasian MH (2011) Beyond cholesterol-lowering effects of plant sterols clinical and experimental evidence of anti-inflammatory properties. Nutr Rev 69(7) 371-382.doi 10.1111/j.l753-4887.2011.00399.x... 

Potential Health Benefits. Plant sterols may have potential health benefits, mainly based on their cholesterol-lowering effect. A comprehensive study on the composition and content of sterols in plant-based foods commonly consumed in Spain with regard to the intake of these metabolites in the Spanish diet has been published recently including solanaceous vegetables [Capsicum annuum var. 

In 1976 and 1977 Sugano et al reported that p-sitostanol had a greater hypocholesterolemic effect than P-sitosterol in cholesterol-fed rats. Similar results were obtained with rabbits (Ikeda et al, 1981). In addition, sitostanol decreased the formation of aortic atheromas caused by cholesterol feeding more than sitosterol. Similar results have recently been reported in animal models, where the cholesterol-lowering effect of plant sterol blends with different compositions in cholesterol-challenged animals were shown to be dependent on the sitostanol content (Ntanios and Jones, 1998 Ntanios et al, 1998a, 1998b). 

Irrespective of the actual mechanisms behind the reduction of cholesterol absorption by plant sterols, solubilization into the emulsified fat phase of the food digest is a prerequisite for plant sterols to be incorporated into the micelles. The physical properties of free, crystalline plant sterols and stanols limit their applicability in foods and their cholesterol-lowering effect in many food matrices, but these limitations can be partly solved by producing fat dispersions of plant sterols or emulsifier-sterol aggregates. Currently, however, plant sterols are mainly used as fatty acid esters in functional foods. 

The serum cholesterol-lowering effect of plant sterols and stanols has been proven in several clinical studies. The hypocholesterolemic effects have been verified in normocholesterolemic individuals, in individuals with mild to moderate hypercholesterolemia or with familial hypercholesterolemia, in women with coronary heart disease, and in men with non-insulin-dependent diabetes -in conjunction with cholesterol-lowering statin therapy and irrespective of the background diet. In addition, studies have been conducted with normocholesterolemic children and with children with slightly elevated cholesterol levels, or with familial hypercholesterolemia. 

Nestel, P, Cehun, M, Pomeroy, S, Ahhey, M and Weldon, G (2001) Cholesterol-lowering effects of plant sterol esters and non-esterified stanols in margarine, butter and low-fat foods. Eur. J. Clin. Nutr., 55,1084—1090. 

The practical development of plant sterol drugs as cholesterol-lowering agents will depend both on structural features of the sterols themselves and on the form of the administered agent. For example, the unsaturated sterol sitosterol is poorly absorbed in the human intestine, whereas sitostanol, the saturated analog, is almost totally unabsorbable. In addition, there is evidence that plant sterols administered in a soluble, micellar form (see page 261 for a description of micelles) are more effective in blocking cholesterol absorption than plant sterols administered in a solid, crystalline form. 

Hallikainen, M.A., Sarkkinen, E.S., Gylling, H., Erkkila, A.T., and Uusitupa, MX 2000. 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. Eur. J. Clin. Nutr. 54, 715-725. 

Simons, L.A., Additive effect of plant sterol-ester margarine and cerivastatin in lowering low-density lipoprotein cholesterol in primary hypercholesterolemia. Am. J. Cardiol, 90, 737, 2002. 

At the University of Toronto, studies examining specific dietary effects related to lowering blood cholesterol show that people adhere to a prescribed diet more faithfully and have reduced cholesterol levels when strawberries are included in daily meals. Such diets incorporate fruits, vegetables, soy products, prebiotic fiber (such as from oatmeal), plant sterols, and nuts. Look for references to this work in Appendix D and more information in Part III on the Portfolio diet... 

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