Sitostanol esters

Vanhanen, H. X, Blomqvist, S., Ehnholm, C., et al., 1993. Sernm cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic subjects widi different apoE phenotypes during dietary sitostanol ester treatment. Journal of Lipid Research 34 1535-1544. 

Normen L, Dutta P, Lia A and Andersson H. 2000. Soy sterol esters and 3-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am J Clin Nutt 71(4) 908—913. 

Plant sterols Commercially available margarines containing hydrogenated plant sterols and sterol esters (predominantly sitostanol esters), when used in place of regular margarine, can reduce LDL plasma cholesterol concentrations. The mechanism by which these compounds lower LDL cholesterol concentrations is to inhibit intestinal absorption of dietary cholesterol and cholesterol secreted into the bile. 

Normen, L., Dutta, P., Lia, A., and Andersson, H. 2000. Soy sterol esters and beta-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am. J. Clin. Nutr. 71, 908-913. Normen, L., Brants, H. A. M., Voorrips, L.E., Andersson, H.A., van den Brandt, P.A., and Gold-bohm, R.A. 2001. Plant sterol intakes and colorectal cancer risk in the Netherlands cohort study on diet and cancer. Am. J. Clin. Nutr. 74, 141-148. 

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. 

The proportions of delta 8-cholesterol and desmosterol in the serum rose while those of cholestanol, campesterol and sitosterol dropped, implying a decreased absorption of cholesterol and a compensatory increase in its synthesis. High basal precursor sterol proportions were predictive of a large decrement in titer of LDL cholesterol. It appeared that partial substitution of normal dietary lipid consumption with sitostanol was a safe and effective therapeutic measure for children with FH (Lees et al., 1977 Wang and Ng, 1999). The effect of a small amount of sitosterol, sitostanol and sitostanol esters dissolved in rapeseed oil on serum lipids and cholesterol metabolism in patients with primary hypercholesterolemia and various apolipoprotein E phenotypes on a rapeseed oil diet showed a diminution in TC and LDL-cholesterol levels in the serum (Gylling and Miettinen, 1994). 

Gylling, H. and Miettinen, T.A. 1994. Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolemic NIDDM patients before and during sitostanol ester-margarine treatment. 

Miettinen, T.A., Puska, P., Gylling, H., Vanhanen, H., and Vartiainen, E. 1995. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N. Engl. J. Med. 333, 1308-1312. 

Gylling, H., Radhakrishnan, R., and Miettinen, T.A., Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine. Circulation, 96,4226, 1997. 

Gylling, H. et al., Retinol, vitamin D, carotenes and alpha-tocopherol in serum of a moderately hypercholesterolemic population consuming sitostanol ester margarine, Atherosclerosis, 145, 279, 1999. 

The growing recognition of the health benefits associated with phytosterol esters leads to the marketing of new products. Several companies have marketed stanol and sterol ester products. In 1995/1996, Raisio Company from Finland introduced the margarine Benecol with 9% of sitostanol ester. Benecol was also launched in the United States in May 1999. In 1999, Unilever launched its product. Take Control , which contained vegetable oil derived sterol esters. In addition to existing products on the market in 2000, Phytrol , unesterified taU oil phytosterols, was announced (Hicks and Moreau, 2001). 

Kritchevsky D, Tepper SA, Czamecki SK, Wolfe B, Setchell KDR (2003) Serum and aortic levels of phytosterols in rabbits fed sitosterol or sitostanol ester preparations. Lipids 38(11) 1115-1118. doi 10.1007/sll745-003-1168-8... 

Table 2. Absorption of certain 4-desmethyl sterols of interest to functional foods before and during sitostanol ester margarine consumption ...

Figure 9. Interaction of sitostanol with intestinal phases. Sitostanol may be introduced directly into the intestinal micellar phase as a sitostanol-lecithin complex, or sitostanol ester may be dissolved in dietary fat for entry into the oil phase. Unesterified or non-complexed sitostanol does not readily enter either the oil or the micellar phase. Taken from Ostlund etal. (1999). Reproduced with permission by (ixe American Journal of Clinical Nutrition. Am. J. Clin. Nutr. American Society for Clinical Nutrition.

Gylling, H, Siimes, MA and Miettinen, TA (1995) Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia. J. Lipid Res., 36, 1807-1812. 

Niinikoski, H, Viikari, J and Palmu,T (1997) Cholesterol-lowering effect and sensory properties of sitostanol ester margarine in normocholesterolemic adults. Scand. J. Nutr., 41, 9-12. 

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