phytosterols and Hyperlipidemias

Phytosterols (PSs) have been reported to improve blood lipids in patients with hypercholesterolemia for many years. However, meta-analyses of the effects of phytosterols on lipid profiles are limited and incomplete. A systematic search of randomized controlled trials (RCTs) published in PubMed, Embase, Cochrane Library, and Web of Science from inception to March 2022 was conducted according to the 2020 preferred reporting items of the guidelines for systematic reviews and meta-analysis (PRISMA) statement. These included studies of people with hypercholesterolemia, comparing foods or preparations containing PSs with controls. Mean differences with 95% confidence intervals were used to estimate continuous outcomes for individual studies. The results showed that in patients with hypercholesterolemia, taking a diet containing a certain dose of plant sterol significantly reduced total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) (TC: Weight Mean Difference (WMD) [95% CI] = -0.37 [-0.41, -0.34],

Topics: Cholesterol, HDL; Cholesterol, LDL; Dietary Supplements; Humans; Hypercholesterolemia; Hyperlipidemias; Lipids; Phytosterols; Randomized Controlled Trials as Topic; Triglycerides

Rice bran oil (RBO) has been demonstrated to affect complex malfunctioned conditions such as oxidative stress, hyperlipidemia, hyperglycemia, hypertension, inflammation, abnormal cell growth (cancer), ulceration, immune and cognitive modulation. This unique effect of RBO is due to the presence of well-balanced fatty acid composition and several bioactive compounds, γ- oryzanol (cycloartenyl ferulate, 24-methylenecycloartanyl ferulate, campesterol ferulate, and β-sitosteryl ferulate), vitamin E (tocopherol and tocotrienol), phytosterols (β-sitosterol, campesterol and stigmasterol) and other nutrients. The RBO composition of bioactive compounds varied geographically, thus the clear-cut mechanisms of action on complex disease cascades are still required. This review article summarized the RBO compositional profiling and compared it with other edible oils. This article also summarized Bangladesh RBO profiling and their proposed mechanism of action as well as the first line of defense in the prevention, management, and control of complex disease conditions. This review indicates how Bangladesh RBO increase their opportunity to be functional food for 21st century's ailment.

Topics: Anti-Inflammatory Agents; Bangladesh; Fatty Acids; Food Analysis; Functional Food; Hyperglycemia; Hyperlipidemias; Hypertension; Oxidative Stress; Phenylpropionates; Phytochemicals; Phytosterols; Rice Bran Oil; Vitamin E

Cardiovascular diseases associated with obesity are alarmingly increasing in both developed and developing countries. Obesity is mainly ascribed to higher lipid accumulation in the body. There are several simple approaches to treat this condition like lifestyle modification, dietary intervention, physical activities, drug treatment etc. There are many drugs available in the market to treat hyperlipidemia condition, but those drugs have many fatal adverse effects on human health. In view of this, it is reasonable to suggest some preventive measures by functional food ingredients as human health has acclimatized to these since thousands of years. Phytosterols have been studied since decades for its hypocholesterolemic effect in human nutrition. Although the mycosterols from fungi are still under- exploited, ergosterol and derivatives from fungal source have promising health beneficial effects in obesity associated cardiovascular diseases. This review aims to summarise the investigations on mycosterol with respect to obesity in the last decade and also scope of future research on its application in functional food supplements.

Topics: Dietary Supplements; Humans; Hyperlipidemias; Obesity; Phytosterols

Hyperlipidemia is one of the major risk factor for the development of cardiovascular disease. Hypolipidemic nutraceuticals and functional foods help improve serum lipid profiles as reducing total cholesterol, triglyceride, and low-density lipoprotein cholesterol, while elevating high-density lipoprotein cholesterol. The effectiveness of omega-3 polyunsaturated fatty acid, phytosterols, dietary fiber, and tea catechin in management of hyperlipidemia has been clearly demonstrated in epidemiological and interventional trials. Studies on mechanism reveal that they act as inhibitor or activator of critical enzyme, agonist or inhibitor of transcription factor, competitor of transporter, and sequestrant of bile acid to modulate lipid homeostasis. Hypolipidemic effects are also claimed in dietary proteins, many polyphenols, other phytochemicals, raw extract, or even whole food. This review attempts to give an overview of lipid homeostasis and summarize recent findings of hypolipidemic nutraceuticals and functional foods according to their active ingredients, focusing on the efficacy and underlying mechanisms.

Topics: Cardiovascular Diseases; Catechin; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Dietary Fiber; Dietary Supplements; Fatty Acids, Omega-3; Functional Food; Humans; Hyperlipidemias; Hypolipidemic Agents; Lipids; Phytosterols; Polyphenols; Tea; Triglycerides

Plant sterols and stanols are plant steroids with a similar chemical structure and cellular function to human cholesterol, and are recommended as dietary modifiers of serum lipids. Plant sterols have a higher degree of absorption than plant stanols, suggesting differential efficacy between the two.. A meta-analysis of randomized controlled trials was performed to summarize direct comparisons between the effect of plant sterols vs plant stanols on serum lipid levels in healthy patients and patients with hypercholesterolemia.. A systematic literature search of MEDLINE, EMBASE, Cochrane CENTRAL, and the Natural Medicines Comprehensive Database was conducted from January 1950 through January 2009. Trials were included in the analysis if they were randomized controlled trials evaluating the effect of plant sterols vs plant stanols in healthy patients or patients with hypercholesterolemia who reported efficacy data on total, low-density lipoprotein, and high-density lipoprotein cholesterols or triglycerides. The weighted mean difference (WMD) of the change from baseline (in mg/dL) with 95% confidence interval was calculated as the difference between the means in the plant sterol and plant stanol groups using a random-effects model.. Fourteen studies (n=531 patients) met the inclusion criteria. Upon meta-analysis, the results showed that there is no statistically or clinically significant difference between plant sterols and plant stanols in their abilities to modify total cholesterol (WMD -1.11 mg/dL [-0.0286 mmol/L], 95% confidence interval [CI] -4.12 to 1.90, P=0.47), low-density lipoprotein cholesterol (WMD -0.35 mg/dL [-0.0091 mmol/L], 95% CI -2.98 to 2.28, P=0.79), high-density lipoprotein cholesterol (WMD -0.28 mg/dL [-0.00073 mmol/L], 95% CI -1.18 to 0.62, P=0.54), or triglycerides (WMD -1.80 mg/dL [-0.0203 mmol/L], 95% CI -6.80 to 3.21, P=0.48).. Plant sterols and plant stanols do not have statistically or clinically relevant differing effects on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglyceride levels. The selection of plant sterols vs plant stanols should then be based on potential differences in safety parameters and further study is required to elucidate such differences.

Topics: Anticholesteremic Agents; Cholesterol, HDL; Cholesterol, LDL; Humans; Hyperlipidemias; Lipid Metabolism; Phytosterols; Phytotherapy; Randomized Controlled Trials as Topic; Sitosterols; Treatment Outcome; Triglycerides

Phytosterols and omega-3 fatty acids are natural compounds with potential cardiovascular benefits. Phytosterols inhibit cholesterol absorption, thereby reducing total- and LDL cholesterol. A number of clinical trials have established that the consumption of 1.5-2.0 g/day of phytosterols can result in a 10-15% reduction in LDL cholesterol in as short as a 3-week period in hyperlipidemic populations. Added benefits of phytosterol consumption have been demonstrated in people who are already on lipid-lowering medications (statin drugs). On the other hand, omega-3 fatty acid supplementation has been associated with significant hypotriglyceridemic effects with concurrent modifications of other risk factors associated with cardiovascular disease, including platelet function and pro-inflammatory mediators. Recent studies have provided evidence that the combination of phytosterols and omega-3 fatty acids may reduce cardiovascular risk in a complementary and synergistic way. This article reviews the health benefits of phytosterols and omega-3 fatty acids, alone or in combination with statins, for the treatment/management of hyperlipidemia, with particular emphasis on the mechanisms involved.

Topics: Anticholesteremic Agents; Cardiovascular Diseases; Cholesterol, LDL; Diet; Eicosanoids; Fatty Acids, Omega-3; Food, Fortified; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Intestinal Absorption; Lipids; Micelles; Phytosterols; Risk Factors

Hyperlipidemia is a risk factor for the development of coronary heart disease. Many patients decline prescription lipid-lowering agents and opt instead for supplements. Before any supplement can be routinely recommended it is crucial to examine the types of clinical trials that have been performed, the mechanism by which a supplement is felt to alter lipids, the population studied, potential adverse effects, and the possibility that investigators might be biased. Clinical trial evidence strongly supports the notion that both red yeast rice and plant stanols and sterols effectively lower low-density lipoprotein (LDL) cholesterol. Preliminary evidence supports the possibility that green tea catechins and black tea theaflavins may lower LDL. Data do not support an LDL-lowering claim for guggulipid, policosanol, or cinnamon. Finally, there is strong clinical trial evidence suggesting that marine omega-3 fatty acids lower triglycerides.

Topics: Anticholesteremic Agents; Cholesterol, LDL; Coronary Disease; Humans; Hyperlipidemias; Phytosterols; Risk Factors

Plant sterols and stanols are similar in chemical structure to cholesterol, differing in their side chain configuration. The mechanism by which they lower cholesterol is thought to involve inhibition of cholesterol absorption. A number of products containing plant sterols are now available. A limitation on the development of such products is the poor water solubility of plant sterols. The most common solution is to esterify plant stanols or sterols with fatty acids to enhance availability in food fats such as margarines and salad dressings. A number of studies have shown the efficacy of plant stanol- and sterol-enriched margarines for lowering cholesterol. However, there have been no studies demonstrating that consumption of these stanol ester-containing margarines influences the incidence of coronary heart disease.

Topics: Administration, Oral; Clinical Trials as Topic; Coronary Artery Disease; Diet Therapy; Dietary Supplements; Evidence-Based Medicine; Food, Formulated; Humans; Hyperlipidemias; Hypolipidemic Agents; Phytosterols; Phytotherapy; Plant Extracts; Sitosterols

Prompted by current dietary recommendations for the control of serum cholesterol to new targets to reduce the risk of coronary heart disease (CHD), and by the CHD risk reduction claims made for certain foods or food components, studies are now being undertaken using combinations of cholesterol-lowering foods in one diet (eg, a dietary portfolio) rather than single foods to achieve more effective dietary control of serum cholesterol. This approach has increased the potential relevance of dietary therapy and may yield nutrition strategies that bridge the gap between what is regarded as a good diet and drug therapy.

Topics: Cardiovascular Diseases; Cholesterol, LDL; Coronary Disease; Diet; Dietary Fiber; Food; Health Behavior; Humans; Hypercholesterolemia; Hyperlipidemias; Lipids; Nuts; Phytosterols; Risk Factors; Risk Reduction Behavior; Soy Foods

To compare the efficacy and safety of plant sterols and stanols as well as policosanol in the treatment of coronary heart disease, as measured by a reduction in low-density lipoprotein cholesterol (LDL) levels.. Systematic review and meta-analysis of randomized controlled trials.. A total of 4596 patients from 52 eligible studies.. We searched MEDLINE, EMBASE, the Web of Science, and the Cochrane Library from January 1967-June 2003 to identify pertinent studies. Reduction of LDL levels was the primary end point; effects on other lipid parameters and withdrawal of study patients due to adverse effects were the secondary end points. Weighted estimates of percent change in LDL were -11.0% for plant sterol and stanol esters 3.4 g/day (range 2-9 g/day [893 patients]) versus -2.3% for placebo (769 patients) in 23 eligible studies, compared with -23.7% for policosanol 12 mg/day (range 5-40 mg/day [1528 patients]) versus -0.11% for placebo (1406 patients) in 29 eligible studies. Cumulative p values were significantly different from placebo for both (p<0.0001). The net LDL reduction in the treatment groups minus that in the placebo groups was greater with policosanol than plant sterols and stanols (-24% versus -10%, p<0.0001). Policosanol also affected total cholesterol, high-density lipoprotein cholesterol (HDL), and triglyceride levels more favorably than plant sterols and stanols. Policosanol caused a clinically significant decrease in the LDL:HDL ratio. Pooled withdrawal rate due to adverse effects and combined relative risk for patients who withdrew were 0% and 0.84, respectively (95% confidence interval [CI] 0.36-1.95, p=0.69), for plant sterols and stanols across 20 studies versus 0.86% and 0.31, respectively (95% CI 0.20-0.48, p<0.0001), for policosanol across 28 studies.. Plant sterols and stanols and policosanol are well tolerated and safe; however, policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy.

Topics: Anticholesteremic Agents; Coronary Disease; Fatty Alcohols; Humans; Hyperlipidemias; Phytosterols; Randomized Controlled Trials as Topic; Sitosterols

National guidelines indicate patients with elevated low- density lipoprotein cholesterol should consume less than 7% of calories from saturated fat and less than 200 mg of cholesterol. Trans fatty acids should also be limited. Incorporation of functional foods, such as stanol-containing margarine, soy products, and soluble fiber-rich cereals and vegetables can provide further benefit. In addition to weight loss and physical activity, individuals with hypertriglyceridemia benefit from a diet moderate in fat and carbohydrate rather than a low-fat diet. Including monounsaturated or omega-3 fatty acids lowers serum triglycerides. Many of the dietary strategies to optimize serum lipids also contribute to glycemic control in patients with diabetes mellitus.

Topics: Cholesterol, Dietary; Cholesterol, HDL; Cholesterol, LDL; Dietary Fats; Dietary Fiber; Energy Intake; Fatty Acids; Fatty Acids, Omega-3; Female; Humans; Hyperlipidemias; Male; Metabolic Syndrome; Obesity; Phytosterols; Soybean Proteins; Triglycerides

FM-VP4 is a phytosterol analog under development by Forbes Medi-Tech for the potential treatment of hyperlipidemia and hypercholesterolemia. By March 2002, FM-VP4 had entered phase I clinical trials and phase II trials were underway by late 2002.

Topics: Animals; Cholesterol, LDL; Clinical Trials, Phase I as Topic; Clinical Trials, Phase II as Topic; Humans; Hypercholesterolemia; Hyperlipidemias; Hypolipidemic Agents; Molecular Structure; Phytosterols; Randomized Controlled Trials as Topic; Structure-Activity Relationship

This paper reviews phytonutrients from rice bran that have shown promising disease-preventing and health-related benefits in experimental research studies. Candidate products studied and under investigation include: inositol and related compounds, inositol hexaphosphate (IP6 or phytate), rice oil, ferulic acid, gamma-oryzanol, plant sterols, tocotrienols and RICEO, a new rice-bran-derived product. Diseases in which preventive and/or nutraceutical effects have been detected include: cancer, hyperlipidemia, fatty liver, hypercalciuria, kidney stones, and heart disease. In addition, rice-bran products may have potential applications as nutritional ingredients in the context of their utility in functional foods.

Topics: Animals; Anticholesteremic Agents; Coumaric Acids; Dietary Fiber; Fatty Liver; Free Radical Scavengers; Heart Diseases; Hyperlipidemias; Inositol; Kidney Calculi; Neoplasms; Oryza; Phytosterols; Plant Extracts; Plant Oils; Rice Bran Oil; Triterpenes; Vitamin E

Consumption of a cholesterol lowering dietary portfolio including plant sterols (PS), viscous fibre, soy proteins and nuts for 6 months improves blood lipid profile. Plant sterols reduce blood cholesterol by inhibiting intestinal cholesterol absorption and concerns have been raised whether PS consumption reduces fat soluble vitamin absorption.. The objective was to determine effects of consumption of a cholesterol lowering dietary portfolio on circulating concentrations of PS and fat soluble vitamins.. Using a parallel design study, 351 hyperlipidemic participants from 4 centres across Canada were randomized to 1 of 3 groups. Participants followed dietary advice with control or portfolio diet. Participants on routine and intensive portfolio involved 2 and 7 clinic visits, respectively, over 6 months.. No changes in plasma concentrations of α and γ tocopherol, lutein, lycopene and retinol, but decreased β-carotene concentrations were observed with intensive (week 12: p = 0.045; week 24: p = 0.039) and routine (week 12: p = 0.031; week 24: p = 0.078) portfolio groups compared to control. However, cholesterol adjusted β-carotene and fat soluble compound concentrations were not different compared to control. Plasma PS concentrations were increased with intensive (campesterol:p = 0.012; β-sitosterol:p = 0.035) and routine (campesterol: p = 0.034; β-sitosterol: p = 0.080) portfolio groups compared to control. Plasma cholesterol-adjusted campesterol and β-sitosterol concentrations were negatively correlated (p < 0.001) with total and LDL-C levels.. Results demonstrate that consuming a portfolio diet reduces serum total and LDL-C levels while increasing PS values, without altering fat soluble compounds concentrations. The extent of increments of PS with the current study are not deleterious and also maintaining optimum levels of fat soluble vitamins are of paramount necessity to maintain overall metabolism and health. Results indicate portfolio diet as one of the best options for CVD risk reduction.. clinicaltrials.gov Identifier: NCT00438425.

Topics: Adult; beta Carotene; Canada; Carotenoids; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Diet; Dietary Fiber; Feeding Behavior; Female; Follow-Up Studies; Humans; Hyperlipidemias; Lutein; Lycopene; Male; Middle Aged; Nuts; Phytosterols; Single-Blind Method; Sitosterols; Tocopherols; Triglycerides; Vitamin A; Vitamins

Hypolipidemic and/or hypocholesterolemic effects are presumed for dietary milk phospholipid (PL) as well as plant sterol (PSt) supplementation. The aim was to induce changes in plasma lipid profile by giving different doses of milk PL and a combination of milk PL with PSt to healthy volunteers.. In an open-label intervention study, 14 women received dairy products enriched with moderate (3 g PL/day) or high (6 g PL/day) dose of milk PL or a high dose of milk PL combined with PSt (6 g PL/day + 2 g PSt/day) during 3 periods each lasting 10 days.. Total cholesterol concentration and HDL cholesterol concentration were reduced following supplementation with 3 g PL/day. No significant change in LDL cholesterol concentration was found compared with baseline. High PL dose resulted in an increase of LDL cholesterol and unchanged HDL cholesterol compared with moderate PL dose. The LDL/HDL ratio and triglyceride concentration remained constant within the study. Except for increased phosphatidyl ethanolamine concentrations, plasma PL concentrations were not altered during exclusive PL supplementations. A combined high-dose PL and PSt supplementation led to decreased plasma LDL cholesterol concentration, decreased PL excretion, increased plasma sphingomyelin/phosphatidyl choline ratio, and significant changes in plasma fatty acid distribution compared with exclusive high-dose PL supplementation.. Milk PL supplementations influence plasma cholesterol concentrations, but without changes of LDL/HDL ratio. A combined high-dose milk PL and PSt supplementation decreases plasma LDL cholesterol concentration, but it probably enforces absorption of fatty acids or fatty acid-containing hydrolysis products that originated during lipid digestion.

Topics: Adult; Algorithms; Animals; Beverages; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Dairy Products; Fatty Acids; Feces; Female; Food, Formulated; Humans; Hypercholesterolemia; Hyperlipidemias; Hypolipidemic Agents; Lipids; Milk; Phospholipids; Phytosterols

Non-cholesterol sterols reflect cholesterol metabolism. Statins reduce cholesterol synthesis usually with a rise in cholesterol absorption. Common hyperlipemias have shown different patterns of cholesterol metabolism. We evaluated whether cholesterol absorption and synthesis may differ after statin therapy in primary hyperlipemias.. We determined lipid profile, apoprotein B and serum sterols (lathosterol, sitosterol, campesterol by gas chromatography/mass spectrometry) before and after statins in 80 untreated hyperlipemic patients, 40 with polygenic hypercholesterolemia (PH) and 40 with familial combined hyperlipemia (FCH).. At baseline in FCH lathosterol was significantly higher while campesterol and sitosterol were significantly lower than in PH. After statins, the reduction in LDL-C did not significantly differ between the two groups; in PH there was a significant decrease of lathosterol from 96.1 to 52.6 102 μmol/mmol cholesterol (p=0.0001) with no significant modifications in campesterol and sitosterol; on the opposite, in FCH lathosterol decreased from 117 to 43 102 μmol/mmol cholesterol (p=0.0001) and campesterol and sitosterol significantly increased from 38 to 48 102 μmol/mmol cholesterol (p=0.0001), and from 75 to 86 102 μmol/mmol cholesterol, (p=0.022), respectively. After statin therapy only in FCH Δ-LDL-C showed a significant inverse correlation with Δ-sitosterol and with Δ-campesterol.. Primary hyperlipemias show different patterns of response to statins: in PH LDL reduction appears completely "synthesis inhibition" dependent, while in FCH LDL decrease appears to be synthesis dependent, partially limited by absorption increase. Studying cholesterol metabolism before and after hypolipemic therapy might be useful in identifying the best tailored treatment.

Topics: Adult; Aged; Atorvastatin; Cholesterol; Cholesterol, LDL; Female; Gas Chromatography-Mass Spectrometry; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Hyperlipidemia, Familial Combined; Hyperlipidemias; Lipids; Male; Middle Aged; Phytosterols; Pyrroles; Simvastatin; Sitosterols

Plant sterols lower serum cholesterol concentration. Available data have confirmed the lipid-lowering efficacy in adults, while there is a relative dearth of data in children and almost exclusively restricted to subjects with familial hypercholesterolemia (FH). Aim of the present study was to evaluate the efficacy, tolerability and safety of plant sterol supplementation in children with different forms of primary hyperlipidemias. The effect of plant sterol consumption on plasma lipids was evaluated in 32 children with heterozygous FH, 13 children with Familial Combined Hyperlipidemia (FCH) and 13 children with Undefined Hypercholesterolemia (UH) in a 12-week open-label intervention study using plant sterol-enriched yoghurt. Plasma lipids and apolipoproteins were measured by routine methods. Markers of cholesterol synthesis (lathosterol) and absorption (campesterol and sitosterol) were measured by GC-MS. Tolerability and adherence to recommended regimen was very high. A significant reduction was observed in LDL-cholesterol in the three groups (10.7, 14.2 and 16.0% in FH, FCH and UH, respectively). Lathosterol concentrations were unchanged, reflecting a lack of increased synthesis of cholesterol. Of the two absorption markers, only sitosterol showed a slight but significant increase. Daily consumption of plant sterol dairy products favorably changes lipid profile by reducing LDL-cholesterol. To our knowledge, this is the first report of the use of plant sterols-enriched foods in treating children with primary hyperlipidemia such as FCH and UH, likely to be the most frequent form also in the young age in the western populations.

Topics: Absorption; Adolescent; Anticholesteremic Agents; Biomarkers; Child; Cholesterol; Dietary Supplements; Female; Food, Fortified; Humans; Hyperlipidemias; Lipids; Male; Phytosterols; Yogurt

Combining foods with recognized cholesterol-lowering properties (dietary portfolio) has proven highly effective in lowering serum cholesterol under metabolically controlled conditions.. To assess the effect of a dietary portfolio administered at 2 levels of intensity on percentage change in low-density lipoprotein cholesterol (LDL-C) among participants following self-selected diets.. A parallel-design study of 351 participants with hyperlipidemia from 4 participating academic centers across Canada (Quebec City, Toronto, Winnipeg, and Vancouver) randomized between June 25, 2007, and February 19, 2009, to 1 of 3 treatments lasting 6 months.. Participants received dietary advice for 6 months on either a low-saturated fat therapeutic diet (control) or a dietary portfolio, for which counseling was delivered at different frequencies, that emphasized dietary incorporation of plant sterols, soy protein, viscous fibers, and nuts. Routine dietary portfolio involved 2 clinic visits over 6 months and intensive dietary portfolio involved 7 clinic visits over 6 months.. Percentage change in serum LDL-C.. In the modified intention-to-treat analysis of 345 participants, the overall attrition rate was not significantly different between treatments (18% for intensive dietary portfolio, 23% for routine dietary portfolio, and 26% for control; Fisher exact test, P = .33). The LDL-C reductions from an overall mean of 171 mg/dL (95% confidence interval [CI], 168-174 mg/dL) were -13.8% (95% CI, -17.2% to -10.3%; P < .001) or -26 mg/dL (95% CI, -31 to -21 mg/dL; P < .001) for the intensive dietary portfolio; -13.1% (95% CI, -16.7% to -9.5%; P < .001) or -24 mg/dL (95% CI, -30 to -19 mg/dL; P < .001) for the routine dietary portfolio; and -3.0% (95% CI, -6.1% to 0.1%; P = .06) or -8 mg/dL (95% CI, -13 to -3 mg/dL; P = .002) for the control diet. Percentage LDL-C reductions for each dietary portfolio were significantly more than the control diet (P < .001, respectively). The 2 dietary portfolio interventions did not differ significantly (P = .66). Among participants randomized to one of the dietary portfolio interventions, percentage reduction in LDL-C on the dietary portfolio was associated with dietary adherence (r = -0.34, n = 157, P < .001).. Use of a dietary portfolio compared with the low-saturated fat dietary advice resulted in greater LDL-C lowering during 6 months of follow-up.. clinicaltrials.gov Identifier: NCT00438425.

Topics: Cholesterol, LDL; Counseling; Diet; Dietary Fats; Dietary Fiber; Female; Humans; Hyperlipidemias; Male; Middle Aged; Nuts; Patient Compliance; Phytosterols; Soybean Proteins

Risk factors of cardiovascular disease such as lipid aberrations, hypertension, abdominal adiposity and elevations in systemic inflammation, are prominent aetiologies in hyperlipidemia. Supplementation with n-3 PUFA is associated with a reduction in cardiovascular events through its hypotriglyceridemic, anti-aggregatory and anti-inflammatory properties. Plant sterols have potent hypocholesterolemic properties, although their effect on the inflammatory cascade is uncertain. This study investigated the effect of combined supplementation with n-3 PUFA and plant sterols on cardiovascular risk factors, blood pressure, body composition, markers of systemic inflammation and overall risk, in hyperlipidemic individuals.. The study was a 3-week randomised, double-blind, placebo-controlled, 2 x 2 factorial design, in four parallel groups. Sixty hyperlipidemic participants were randomised to receive either sunola oil or 1.4 g/d n-3 PUFA capsules with or without 2g plant sterols per day.. The combination of n-3 PUFA and plant sterols reduced several inflammatory markers. High sensitivity C-reactive protein (hs-CRP) was reduced by 39% (P=0.009), tumor necrosis factor-alpha (TNF-alpha) by 10% (P=0.02), interleukin-6 (IL-6) by 10.7% (P=0.009), leukotriene B(4) (LTB(4)) by 29.5% (P=0.01) and adiponectin was increased by 29.5% (P=0.05). Overall cardiovascular risk was reduced by 22.6% (P=0.006) in the combination group.. We have demonstrated, for the first time that dietary intervention with n-3 PUFA and plant sterols reduces systemic inflammation in hyperlipidemic individuals. Furthermore, our results suggest that reducing inflammation provides a potential mechanism by which the combination of n-3 PUFA and plant sterols are cardioprotective.

Topics: Administration, Oral; Adult; Aged; Anti-Inflammatory Agents; Blood Pressure; Body Composition; Capsules; Cardiovascular Diseases; Dietary Supplements; Double-Blind Method; Fatty Acids, Omega-3; Female; Humans; Hyperlipidemias; Hypolipidemic Agents; Inflammation Mediators; Lipids; Male; Middle Aged; Phytosterols; Risk Assessment; Risk Factors; Treatment Outcome

We measured plasma markers of cholesterol synthesis (lathosterol) and absorption (campesterol, sitosterol, and cholestanol) in order to compare the effects of maximal doses of rosuvastatin with atorvastatin and investigate the basis for the significant individual variation in lipid lowering response to statin therapy. Measurements were performed in participants (n = 135) at baseline and after 6 weeks on either rosuvastatin (40 mg/day) or atorvastatin (80 mg/day) therapy. Plasma sterols were measured using gas-liquid chromatography. Rosuvastatin and atorvastatin significantly (P < 0.001) altered plasma total cholesterol (C) levels by -40%, and the ratios of lathosterol/C by -64% and -68%, and campesterol/C by +52% and +72%, respectively, with significant differences (P < 0.001) between the treatment groups for the latter parameter. When using absolute values of these markers, subjects with the greatest reductions in both synthesis (lathosterol) and absorption (campesterol) had significantly greater reductions in total C than subjects in whom the converse was true (-46% versus -34%, P = 0.001), with similar effects for LDL-C. Rosuvastatin and atorvastatin decreased markers of cholesterol synthesis and increased markers of fractional cholesterol absorption, with rosuvastatin having significantly less effect on the latter parameter than atorvastatin. In addition, alterations in absolute values of plasma sterols correlated with the cholesterol lowering response.

Topics: Absorption; Adult; Aged; Atorvastatin; Biomarkers; Cholesterol; Diabetes Complications; Female; Fluorobenzenes; Glycated Serum Albumin; Glycation End Products, Advanced; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Lipids; Lipoproteins; Male; Middle Aged; Phytosterols; Pyrimidines; Pyrroles; Rosuvastatin Calcium; Serum Albumin; Sterols; Sulfonamides

The present study was designed to evaluate the independent and interactive effects of a once-a-day yoghurt drink providing 2 g plant sterols/d and capsules providing 2 g fish oil n-3 long-chain (LC) PUFA/d on plasma lipids, apolipoproteins and LDL particle size. Following a 2-week run-in period, 200 mildly hypercholesterolaemic Indian adults aged 35-55 years were randomised into one of four groups of a 2 x 2 factorial, double-blind controlled trial. The 4-week treatments consisted of (1) control yoghurt drink and control capsules, (2) control yoghurt drink and fish oil capsules, (3) plant sterol-enriched yoghurt drink and control capsules, or (4) plant sterol-enriched yoghurt drink and fish oil capsules. Blood was drawn before and after the 4-week intervention. Changes in health status, lifestyle and dietary habits, and daily compliance were recorded. The main effects of plant sterols were a 4.5 % reduction in LDL-cholesterol and a 15 % reduction in TAG without a significant change in HDL-cholesterol. Overall, fish oil n-3 LC-PUFA did not significantly affect cholesterol concentrations but reduced TAG by 15 % and increased HDL-cholesterol by 5.4 %. The combination significantly lowered TAG by 15 % v. control. No significant interaction between plant sterols and n-3 LC-PUFA was observed on plasma cholesterol concentrations. In conclusion, once-a-day intake of 2 g plant sterols/d in a yoghurt drink, 2 g fish oil n-3 LC-PUFA/d in capsules, and their combination had beneficial effects on the lipid profile of mildly hypercholesterolaemic Indian adults. The potent hypotriacylglycerolaemic effect of plant sterols observed in the present study and this population warrants additional investigation.

Topics: Adult; Age Factors; Apolipoproteins; Capsules; Energy Intake; Fatty Acids, Omega-3; Feeding Behavior; Female; Fish Oils; Humans; Hypercholesterolemia; Hyperlipidemias; India; Life Style; Lipids; Lipoproteins, LDL; Male; Middle Aged; Patient Compliance; Phytosterols; Reproducibility of Results

Plant sterol (PS) consumption decreases low-density lipoprotein cholesterol (LDL-C) levels; however, high variability of responsiveness of lipid levels to PS intervention has been observed. We hypothesized that common single-nucleotide polymorphisms (SNPs) in the genes for the ATP binding cassette proteins G5 (ABCG5) and G8 (ABCG8), Niemann-Pick C1-like 1 (NPC1L1), or other proteins of the cholesterol pathway, would underline inter-individual variations in response to PS. Twenty-six hyperlipidemic subjects completed a randomized trial of 3 PS phases and a control phase. Three non-responders were identified who failed on 3 consecutive occasions to decrease either total cholesterol or LDL-C level vs. control. It was observed that after 3 PS phases compared with a control phase, cholesterol absorption changed to a lesser degree (-7.7% +/- 10.8%) in the non-responders than in the top 3 responders (-22.1% +/- 8.8%); however, cholesterol synthesis rates did not differ between sub-groups. No common polymorphisms in ABCG8, ABCG5, or NPC1L1 were demonstrated between the 3 top responders and the non-responders. Yet, 1 non-responsive subject did demonstrate a rare SNP in NPC1L1. Results indicate PS intake did not decrease cholesterol absorption rates to the same degree in certain subjects, possibly clarifying the inter-individual variability in the cholesterol-lowering effect; hence, this work should be expanded.

Topics: Adult; Aged; Aged, 80 and over; Case-Control Studies; Cholesterol; Cross-Over Studies; Female; Humans; Hyperlipidemias; Lipids; Male; Middle Aged; Phytosterols; Polymerase Chain Reaction; Polymorphism, Genetic; Polymorphism, Single Nucleotide; Single-Blind Method

Plant sterols (PS) consumed as a snack may not have the same cholesterol-lowering potential as when consumed with a meal due to poor solubilization. It was hypothesized that the consumption of a single dose, low-fat yogurt rich in PS (1.6 g/d) with a meal over an afternoon snack will lead to favourable changes in plasma lipids, plasma PS concentrations, and cholesterol synthesis without negatively affecting alpha-tocopherol or carotenoids levels.. Twenty-six hyperlipidemic males and females completed the randomized trial of three phases (control, single PS dose consumed with a meal, or single PS dose as an afternoon snack) while consuming controlled, low-fat diets. Plasma lipids, cholesterol synthesis rates, plasma PS and serum fat-soluble antioxidants were measured at baseline and after 4 weeks.. Endpoint total cholesterol (TC) levels after the PS snack phase were decreased (p = 0.04) (5.30 +/- 0.2 mmol/L) compared to the control phase (5.53 +/- 0.2 mmol/L). However, endpoints for TC (5.37 +/- 0.2 mmol/L) for PS dose with a meal were comparable to control phase. Low-density lipoprotein-cholesterol tended to be different (p = 0.06) at the end of the intervention phases (3.51 +/- 0.1, 3.43 +/- 0.1, and 3.33 +/- 0.1 mmol/L; control, meal and snack, respectively). Cholesterol fractional synthesis rates were higher (p = 0.007) by 25.8% and 19.5% at the end of the snack and meal phases, respectively, compared with the control phase. Plasma campesterol and beta-sitosterol concentrations, adjusted for TC, were higher (p < 0.01) in the snack phase (2.30 +/- 0.3 and 0.54 +/- 0.1 micromol/mmol, respectively) and in the meal phase (2.00 +/- 0.3 and 0.51 +/- 0.1 micromol/mmol, respectively) when compared to the control phase (1.81 +/- 0.3 and 0.40 +/- 0.1 micromol/mmol, respectively). No changes in alpha-tocopherol or carotenoids levels were detected after adjusting for TC, for all phases.. These results indicate that a single dose of PS in low-fat yogurt, provided as a snack, lowers cholesterol levels but does not alter fat-soluble vitamin or carotenoid concentrations in hyperlipidemic participants.

Topics: Adult; Aged; Aged, 80 and over; Carotenoids; Cholesterol; Cross-Over Studies; Diet; Female; Food, Fortified; Humans; Hyperlipidemias; Lipids; Male; Middle Aged; Phytosterols; Single-Blind Method; Vitamins; Yogurt

We studied effect of antiatherogenic diet with inclusion of a sour milk product Danacor enriched with phytosterols on clinical and biochemical parameters of patients with cardiovascular diseases. Results of the study showed that antiatherogenic diet with phytosterols facilitated improvement of clinical status, anthropometric parameters, and lipid spectrum of blood.

Topics: Cultured Milk Products; Double-Blind Method; Female; Follow-Up Studies; Humans; Hyperlipidemias; Lipids; Male; Middle Aged; Myocardial Ischemia; Phytosterols; Treatment Outcome

To determine the effect on blood pressure of dietary advice to consume a combination of plant-based cholesterol-lowering foods (dietary portfolio).. For 1 year, 66 hyperlipidemic subjects were prescribed diets high in plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers (10 g/1000 kcal) and almonds (22.5 g/1000 kcal). There was no control group. Seven-day diet record, blood pressure and body weight were monitored initially monthly and later at 2-monthly intervals throughout the study.. Fifty subjects completed the 1-year study. When the last observation was carried forward for non-completers (n=9) or those who changed their blood pressure medications (n=7), a small mean reduction was seen in body weight 0.7+/-0.3 kg (P=0.036). The corresponding reductions from baseline in systolic and diastolic blood pressure at 1 year (n=66 subjects) were -4.2+/-1.3 mm Hg (P=0.002) and -2.3+/-0.7 mm Hg (P=0.001), respectively. Blood pressure reductions occurred within the first 2 weeks, with stable blood pressures 6 weeks before and 4 weeks after starting the diet. Diastolic blood pressure reduction was significantly related to weight change (r=0.30, n=50, P=0.036). Only compliance with almond intake advice related to blood pressure reduction (systolic: r=-0.34, n=50, P=0.017; diastolic: r=-0.29, n=50, P=0.041).. A dietary portfolio of plant-based cholesterol-lowering foods reduced blood pressure significantly, related to almond intake. The dietary portfolio approach of combining a range of cholesterol-lowering plant foods may benefit cardiovascular disease risk both by reducing serum lipids and also blood pressure.

Topics: Blood Pressure; Body Weight; Cholesterol; Cholesterol, Dietary; Diet Records; Dietary Fiber; Female; Humans; Hyperlipidemias; Hypertension; Male; Middle Aged; Obesity; Phytosterols; Prunus; Soybean Proteins; Weight Loss

Fish oils rich in (n-3) long-chain PUFA (LCPUFA) can reduce circulating triglycerides and raise HDL-cholesterol. Phytosterols have been shown to reduce total cholesterol and LDL-cholesterol in normocholesterolemic and hyperlipidemic populations. We investigated the combined effects of phytosterols and (n-3) LCPUFA on plasma lipid profile in hyperlipidemic individuals. This study was a 3-wk randomized, double-blind, placebo-controlled, 2 x 2 factorial trial in 4 parallel groups of 60 hyperlipidemic individuals. Subjects were randomized to receive either sunola oil or 1.4 g/d (n-3) LCPUFA capsules with or without 2 g phytosterols per day while maintaining their habitual diet. The combination of phytosterols and (n-3) LCPUFA reduced plasma total cholesterol by 13.3% (P = 0.001), which differed from (n-3) LCPUFA alone (P < 0.001). LDL-cholesterol concentrations followed the same pattern as that of plasma cholesterol with a 12.5% decrease (P = 0.002) in the combination group. The HDL-cholesterol concentration was increased by (n-3) LCPUFA (7.1%; P = 0.01) alone and in combination with phytosterols (8.6%; P = 0.04), whereas phytosterol treatment alone had no effect. Plasma triglyceride concentration was lowered by (n-3) LCPUFA (22.3%; P = 0.004) alone and in combination with phytosterols (25.9%; P = 0.005), whereas phytosterol treatment alone had no effect. In conclusion, the combined supplementation with phytosterols and (n-3) LCPUFA has both synergistic and complementary lipid-lowering effects in hyperlipidemic men and women.

Topics: Diet; Dietary Supplements; Double-Blind Method; Drug Synergism; Fatty Acids, Omega-3; Female; Humans; Hyperlipidemias; Lipids; Male; Middle Aged; Phytosterols

Phytosterols (PSs) have been recently added to various mediums. Nevertheless, matrices with functional properties, such as medium-chain triglycerides (MCTs), should be precisely examined for supplementary advantages. The objective of this study was to identify the existence of combined biological actions of a functional oil enriched in PSs within MCTs and high-oleic canola (HOC), relative to a control (olive oil), in overweight, hyperlipidemic men using a rigorously controlled dietary intervention. Twenty-three overweight, hyperlipidemic men consumed both types of oil in a randomized, crossover trial for 6 weeks each. Fasted plasma samples were collected on the first and last 2 days of each study period. Body weight decreased -1.22 +/- 0.35 kg (P = .0019) and -1.68 +/- 0.47 kg (P = .0016) after the 6-week study period in the olive oil and functional oil groups, respectively. The end points for total cholesterol and low-density lipoprotein cholesterol (LDL-C) in the functional oil group (P = .0006) were lower than in the olive oil group (P = .0002). Total cholesterol values decreased from comparable baseline to end point of 4.71 +/- 0.16 mmol/L (P < .0001) in the functional oil phase and 5.14 +/- 0.19 mmol/L (P = .0001) in the olive oil phase (P = .0592). In addition, LDL-C demonstrated a similar drop, to an end point of 3.12 +/- 0.16 mmol/L (P < .0001) and 3.54 +/- 0.18 mmol/L (P = .0002), for the functional oil and olive oil groups, respectively, with significant changes (P = .0221). High-density lipoprotein cholesterol levels did not change in either treatment. Triacylglycerol end points decreased in functional oil and olive oil groups (P = .0195 and .0105, respectively) to the same extent from baseline. Results indicate that PSs mixed within an MCT- and HOC-rich matrix lower plasma LDL-C, without significantly changing the high-density lipoprotein cholesterol concentrations, in hyperlipidemic, overweight men, and may therefore decrease the risk of cardiovascular events.

Topics: Adolescent; Adult; Cholesterol; Cholesterol, LDL; Cross-Over Studies; Fatty Acids, Monounsaturated; Humans; Hyperlipidemias; Lipids; Male; Middle Aged; Oleic Acid; Olive Oil; Overweight; Phytosterols; Plant Oils; Rapeseed Oil; Single-Blind Method; Triglycerides

3-Hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors reduce serum cholesterol and are increasingly advocated in primary prevention to achieve reductions in LDL cholesterol. Newer dietary approaches combining cholesterol-lowering foods may offer another option, but these approaches have not been compared directly with statins in the same persons.. The objective was to compare, in the same subjects, the cholesterol-lowering potential of a dietary portfolio with that of a statin.. Thirty-four hyperlipidemic participants underwent all three 1-mo treatments in random order as outpatients: a very-low-saturated-fat diet (control diet), the same diet plus 20 mg lovastatin (statin diet), and a diet high in plant sterols (1.0 g/1000 kcal), soy-protein foods (including soy milks and soy burgers, 21.4 g/1000 kcal), almonds (14 g/1000 kcal), and viscous fibers from oats, barley, psyllium, and the vegetables okra and eggplant (10 g/1000 kcal) (portfolio diets). Fasting blood samples were obtained at 0, 2, and 4 wk.. LDL-cholesterol concentrations decreased by 8.5+/-1.9%, 33.3+/-1.9%, and 29.6+/-1.3% after 4 wk of the control, statin, and portfolio diets, respectively. Although the absolute difference between the statin and the portfolio treatments was significant at 4 wk (P=0.013), 9 participants (26%) achieved their lowest LDL-cholesterol concentrations with the portfolio diet. Moreover, the statin (n=27) and the portfolio (n=24) diets did not differ significantly (P=0.288) in their ability to reduce LDL cholesterol below the 3.4-mmol/L primary prevention cutoff.. Dietary combinations may not differ in potency from first-generation statins in achieving current lipid goals for primary prevention. They may, therefore, bridge the treatment gap between current therapeutic diets and newer statins.

Topics: Adult; Aged; Anticholesteremic Agents; Cholesterol, Dietary; Cholesterol, LDL; Cross-Over Studies; Dietary Fiber; Drug Therapy, Combination; Fasting; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Lovastatin; Male; Middle Aged; Phytosterols; Primary Prevention; Soybean Proteins; Treatment Outcome

Reductions in low-density lipoprotein-cholesterol (LDL-C) result from diets containing almonds, or diets that are either low in saturated fat or high in viscous fibers, soy proteins, or plant sterols. We have therefore combined all of these interventions in a single diet (portfolio diet) to determine whether cholesterol reductions could be achieved of similar magnitude to those reported in recent statin trials which reduced cardiovascular events. Twenty-five hyperlipidemic subjects consumed either a portfolio diet (n=13), very low in saturated fat and high in plant sterols (1.2 g/1,000 kcal), soy protein (16.2 g/1,000 kcal), viscous fibers (8.3 g/1,000 kcal), and almonds (16.6 g/1,000 kcal), or a low-saturated fat diet (n=12) based on whole-wheat cereals and low-fat dairy foods. Fasting blood, blood pressure, and body weight were obtained at weeks 0, 2, and 4 of each phase. LDL-C was reduced by 12.1% +/- 2.4% (P<.001) on the low-fat diet and by 35.0% +/- 3.1% (P<.001) on the portfolio diet, which also reduced the ratio of LDL-C to high-density lipoprotein-cholesterol (HDL-C) significantly (30.0% +/- 3.5%; P<.001). The reductions in LDL-C and the LDL:HDL-C ratio were both significantly lower on the portfolio diet than on the control diet (P<.001 and P<.001, respectively). Mean weight loss was similar on test and control diets (1.0 kg and 0.9 kg, respectively). No difference was seen in blood pressure, HDL-C, serum triglycerides, lipoprotein(a) [Lp(a)], or homocysteine concentrations between diets. Combining a number of foods and food components in a single dietary portfolio may lower LDL-C similarly to statins and so increase the potential effectiveness of dietary therapy.

Topics: Adult; Aged; Aged, 80 and over; Cholesterol; Cholesterol, Dietary; Dietary Carbohydrates; Dietary Fats; Dietary Fiber; Erythrocyte Deformability; Female; Food Preferences; Homocysteine; Humans; Hypercholesterolemia; Hyperlipidemias; Male; Middle Aged; Phytosterols; Prunus; Risk Factors; Satiety Response; Soybean Proteins

Dietary plant sterols (phytosterols) have been shown to lower plasma lipid concentrations in animals and humans. However, the effect of phytosterol intake from tall oil on cholesterol and phytosterol metabolism has not been assessed in subjects fed precisely controlled diets.. Our objective was to examine the effects of sitostanol-containing phytosterols on plasma lipid and phytosterol concentrations and de novo cholesterol synthesis rate in the context of a controlled diet.. Thirty-two hypercholesterolemic men were fed either a diet of prepared foods alone or a diet containing 1.7 g phytosterols/d for 30 d in a parallel study design.. No overall effects of diet on total cholesterol concentrations were observed, although concentrations were lower with the phytosterol-enriched than with the control diet on day 30 (P < 0.05). LDL-cholesterol concentrations on day 30 had decreased by 8.9% (P < 0.01) and 24.4% (P < 0.001) with the control and phytosterol-enriched diets, respectively. HDL-cholesterol and triacylglycerol concentrations did not change significantly. Moreover, changes in circulating campesterol and beta-sitosterol concentrations were not significantly different between phytosterol-fed and control subjects. In addition, there were no significant differences in fractional (0.091 +/- 0.028 and 0.091 +/- 0.026 pool/d, respectively) or absolute (0.61 +/- 0.24 and 0.65 +/- 0.23 g/d, respectively) synthesis rates of cholesterol observed between control and phytosterol-fed subjects.. Addition of blended phytosterols to a prudent North American diet improved plasma LDL-cholesterol concentrations by mechanisms that did not result in significant changes in endogenous cholesterol synthesis in hypercholesterolemic men.

Topics: Adult; Anticholesteremic Agents; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Chromatography, Gas; Humans; Hyperlipidemias; Male; Middle Aged; Phytosterols; Sitosterols; Triglycerides

Phytosterols (PS) have been shown to regulate cholesterol metabolism and alleviate hyperlipidemia (HLP), but the mechanism is still unclear. In this study, we investigated the mechanism by which PS regulates cholesterol metabolism in high-fat diet (HFD) mice. The results showed that PS treatment reduced the accumulation of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) in the serum of HFD mice, while increasing the serum levels of high-density lipoprotein cholesterol (HDL-C). Compared with HFD mice, PS not only increased the antioxidant activity of the liver but also regulated the mRNA expression levels of enzymes and receptors related to cholesterol metabolism. The hypolipidemic effect of PS was abolished by antibiotic (Abx) intervention and reproduced by fecal transplantation (FMT) intervention. The results of 16S rRNA sequencing analysis showed that PS modulated the gut microbiota of mice. PS reduced the relative abundance of Lactobacillus and other bile salt hydrolase- (BSH-) producing gut microbiota in HFD mice, which are potentially related to cholesterol metabolism. These findings partially explain the mechanisms by which PS regulates cholesterol metabolism. This implies that regulation of the gut microbiota would be a potential target for the treatment of HLP.

Topics: Animals; Cholesterol, LDL; Diet, High-Fat; Gastrointestinal Microbiome; Hyperlipidemias; Lipid Metabolism; Liver; Mice; Mice, Inbred C57BL; Phytosterols; RNA, Ribosomal, 16S

The high blood level of low-density lipoprotein cholesterol (LDL-C) is a primary risk factor for cardiovascular disease. Plant sterols, known as phytosterols (PSs), can reduce LDL-C in a range of 8-14%. The extent of LDL-C reduction depends on its formulation. Encapsulation into liposomes is one formulation strategy to enhance the efficiency of PSs. PSs (campesterol, stigmasterol, and β-sitosterol) have frequently been assessed alone or in combination for their LDL-C-lowering ability. However, one naturally abundant PS, brassicasterol, has not yet been tested for its efficacy. We have previously developed a novel liposomal formulation containing the PS mixture present naturally in canola that is composed of brassicasterol, campesterol, and β-sitosterol. In this work, the efficacy of our novel liposomal PS formulation that includes brassicasterol was assessed in a hamster model. Animals were divided into five groups: (i) liposomal PS in orange juice, (ii) liposomal PS in water, (iii) marketed PS in orange juice, (iv) control orange juice, and (v) control water. The animals were fed a high-fat, cholesterol-supplemented (0.5%) diet to induce hypercholesterolemia. The treatment was administered orally once daily for 4 weeks. Fasting blood samples were collected at baseline, week 2, and week 4. The extent of the reduction of total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides was compared among the groups. Liposomal PSs in both orange juice and water significantly reduced LDL-C compared to their controls. Furthermore, the liposomal PS was as effective as a marketed PS-containing product in reducing LDL-C. Liposomal PSs in both orange juice and water showed similar efficacy in LDL-C reduction, highlighting that these vehicles/food matrices do not affect the efficacy of PSs. The liposomal formulation of a natural PS mixture extracted from canola oil, with brassicasterol as a major component, exhibited a significant LDL-C reduction in a hamster model.

Topics: Animals; Cholesterol; Cholesterol, LDL; Diet; Hypercholesterolemia; Hyperlipidemias; Liposomes; Phytosterols

Hyperlipidemia,as one of the severe risk factors of cardiovascular disease,could easily trigger atherosclerosis,coronary heart disease,peripheral vascular disease,pancreatitis,etc.,and could also increase the incidence of type 2 diabetes and fatty liver disease. Improving dyslipidemia could slow down the progression of atherosclerosis and reduce the risk of coronary heart disease. This is of great importance for prevention and treatment of cardiovascular disease. Phytosterols are natural active ingredients in plants. Many researches have shown that phytosterols have significant lipid-lowering activity,which could effectively lower blood cholesterol and triglyceride levels. Foods containing phytosterols have been widely used as therapeutic diets for improving dyslipidemia. In the early years,it was believed that the lipid-lowering effect of phytosterols was achieved by competitively inhibiting the absorption of dietary cholesterol in the intestine since phytosterols had similar chemical structures with cholesterol. In further researches in recent years,more progress has been made in the lipid-lowering mechanisms of phytosterols. In this paper,PubMed and Web of Science were used to review the cholesterol-lowering and triglyceride-lowering mechanisms of phytosterols according to the available data published,so as to use phytosterols more rationally in clinical application to improve hyperlipidemia and other induced diseases.

Topics: Cholesterol; Diabetes Mellitus, Type 2; Humans; Hyperlipidemias; Hypolipidemic Agents; Phytosterols; Triglycerides

Hypolipidemic effect of Portulaca oleracea L. seed extract and its fractions have been studied on streptozotocin (STZ) at dose 75 mg/kg b.wt. After fractionation of the alcoholic extract; petroleum ether fraction was the most active fraction that decreased different hyperlipidemia biochemical parameters. After chromatographic analysis; oleamide, ethylpalmitate, β-amyrin, stigmasterol and β-sitosterol were identified. The GLC analysis of unsaponifiable matter revealed the presence of; lignoceric acid as a major constituent in the most bioactive fraction. In conclusion, petroleum ether fraction possessed a hypolipidemic effect in STZ-induced diabetic rats, which may be attributed to its phytosterols, fatty acid and amide compounds. The finding of the present investigation strongly demonstrates the potential of non-polar fraction of P. oleracea L. seed in combating hyperlipidemia in diabetic condition. So the petroleum ether fractions and its constituents can be used as hypolipdemic supplement in the developing countries towards the development of new therapeutic agents.

Topics: Animals; Diabetes Mellitus, Experimental; Hyperlipidemias; Hypolipidemic Agents; Male; Phytosterols; Phytotherapy; Plant Extracts; Portulaca; Rats; Seeds; Sitosterols; Stigmasterol; Streptozocin

Topics: Biomarkers; Cholesterol; Humans; Hypercholesterolemia; Hyperlipidemias; Intestinal Diseases; Lipid Metabolism, Inborn Errors; Lipoproteins; Phytosterols; Postprandial Period; Prognosis; Risk Factors; Triglycerides

Atherosclerosis is associated with coronary artery disease and occurs in developing as well as developed countries. In the present investigation, hypolipidaemic and anti-oxidative properties of encapsulated herb (Terminalia arjuna, 1.8%) added vanilla chocolate dairy drink was evaluated in high cholesterol fed Wistar rats for 60 days.. At the end of the experimental period, a significant decrease in the body weight gain by rats receiving the encapsulated herb extract was noted as compared to high cholesterol fed rats. Administration of microencapsulated herb showed a statistically significant decrease in organ weights (epididymal fat and liver). Moreover, a significant decrease in serum lipids such as triglycerides, total cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol and atherogenic index was observed with encapsulated Terminalia arjuna extract in high cholesterol fed group. Increases in reduced glutathione and decreases in TBARS levels were also reported in both liver and red blood cell lysates with encapsulated herb supplementation.. The results demonstrated that the bioactive components (phytosterols, flavanoids, saponins and tannins etc.) which are present in the encapsulated T. arjuna not only withstand the processing conditions but also are effectively released in the intestine and show their effects, such as hypolipidaemic and antioxidant activities, for better treating cardiovascular disease.

Topics: Adipose Tissue; Animals; Antioxidants; Cholesterol, Dietary; Diet, High-Fat; Flavonoids; Hyperlipidemias; Hypolipidemic Agents; Lipids; Liver; Male; Milk; Organ Size; Phytosterols; Plant Extracts; Rats; Rats, Wistar; Terminalia

Evidence is increasing that plant sterols and stanols not only lower fasting serum low-density lipoprotein concentrations, but also those of triglycerides (TG). Insight into effects of these components on postprandial TG metabolism, an emerging risk factor for cardiovascular disease, is missing.. Our objective was to examine the 8-hour postprandial response after consuming plant sterol or stanol enriched margarine as part of a mixed meal.. This postprandial study was part of a randomized crossover study in which 42 subjects consumed plant sterol enriched (3 g/d plant sterols), plant stanol enriched (3 g/d plant stanols), and control margarines for 4 weeks. After each period, subjects consumed a shake enriched with 3g plant sterols (sterol period), 3g plant stanols (stanol period) or no addition (control period). Subjects received a second shake with no addition after 4 hours.. TG and apoB48 incremental areas under the curves (iAUC) of the total (0-8h) and 1st meal response (0-4h) were comparable between the meals and in all age categories (I:18-35y, II:36-52y, III:53-69y). In subjects aged 53-69y, TG iAUC after the 2nd meal (4-8h) was higher in the stanol period as compared with the sterol (63.1±53.0 mmol/L/min; P < 0.01) and the control period (43.2±52.4 mmol/L/min; P < 0.05). ApoB48 iAUC after the 2nd meal was higher after the stanol than after the sterol period (67.1±77.0 mg/L/min; P < 0.05) and tended to be higher than after the control period (43.1±64.5 mg/L/min; P = 0.08) in subjects aged 53-69y. These increased postprandial responses may be due to reduced lipoprotein lipase activity, since postprandial apoCIII/II ratios were increased after stanol consumption compared with the control meal.. Postprandial TG and apoB48 responses are age-dependently increased after plant stanol consumption, which might be related to a changed clearance of triglyceride-rich lipoproteins.. ClinicalTrials.gov NCT01559428.

Topics: Biomarkers; Blood Glucose; Diet; Fasting; Female; Healthy Volunteers; Humans; Hyperlipidemias; Lipid Metabolism; Lipids; Male; Meals; Phytosterols; Postprandial Period

A well-balanced diet is the first-line treatment in hyperlipidemia. The objective was to study the association between serum phytosterols and dietary patterns to use them as surrogate markers of dietary compliance in primary dyslipidemias.. 288 patients with primary hyperlipidemias (192 autosomal dominant hypercholesterolemia (ADH) and 96 familial combined hyperlipidemia (FCHL)) were included. Principal factor analysis identified 2 major dietary patterns using a 137-item food frequency questionnaire. "Vegetable & Fruits pattern" was characterized by higher intake of fruits, green beans, nuts, tomatoes, roasted or boiled potatoes, lettuce and chard and lower of processed baked goods, pizza and beer. "Western pattern" was positively characterized by hamburgers, pasta, sunflower oil, rice, chickpeas, whole milk, veal, red beans and negatively with white fish. Serum non-cholesterol sterols were determined by HPLC-MS/MS.. Plant sterols to-total cholesterol (TC) levels were lower with a higher adherence to a "Vegetable & Fruits pattern" (P = 0.009), mainly in ADH subjects (R(2) = 0.019). Their concentration was greater with higher compliance to "Western pattern" especially in FCHL (P = 0.014). Higher levels of synthesis markers-to-TC with a greater adherence to "Vegetable & Fruits pattern" were found (P = 0.001) (R(2) = 0.033 and R(2) = 0.109 in ADH and FCHL respectively).. In subjects with primary dislipidemia, dietary patterns associate with serum absorption and synthesis markers, but no with lipid concentrations. The influence of diet on non-cholesterol sterols levels is not powerful enough to use them as subrogate markers.

Topics: Adult; Biomarkers; Cholesterol, HDL; Cholesterol, LDL; Chromatography, High Pressure Liquid; Diet; Diet, Western; Female; Fruit; Humans; Hyperlipidemias; Male; Middle Aged; Nutrition Assessment; Nuts; Patient Compliance; Phytosterols; Plant Oils; Principal Component Analysis; Spain; Sunflower Oil; Surveys and Questionnaires; Tandem Mass Spectrometry; Vegetables

Rhizoma A. officinarum (Hance) Farw, synonymously is called rhizoma galangae or smaller galangal (hereafter abbreviated as AO). Numerous studies reported that AO possesses anti-inflammatory, anticancer, chemoprotective, antibacterial, antifungal and diuretic properties. To understand whether AO exhibits antihyperlipidemic bioactivity and what is the mechanism of action, we performed chemical and animal studies using hamsters (age: 4 weeks, body weight: 45 ± 4 g). The grouping of the animals was as follows: control, high fat (HF) diet, HF + AO2%, HF + AO4%, HF + AO6%, HF + AO8% and HF + AO10%. AO contained curcumin 5.67 mg g(-1) (on wet basis), crude fiber 1.3% ± 0.0%, soluble diet fiber 92 ± 2 mg g(-1), insoluble diet fiber 502 ± 5 mg g(-1), and phytosterols 63.9 ± 1.6 mg/100 g. Its methanolic extract consisted of high polyphenolics 4927.8 ± 101.1 mgGAE/100 g and flavonoids 593.2 ± 22.2 mgQE/100 g. The enlarged organs, including liver, kidney, and spleen, which were elicited by HF were completely alleviated by AO supplement diets. Levels of serum cholesterol, triglyceride, LDL-C, HDL-C and LDL-C/HDL-C ratio for the control originally were 138 ± 6, 98 ± 4, 40 ± 5, 168 ± 7 mg dL(-1) and 0.24, which were elevated by HF to 319 ± 12, 223 ± 13, 108 ± 11, 194 ± 6 mg dL(-1) and 0.05, and alleviated completely by HF + AO8% and HF + AO10%. In vitro, AO extracts showed potent DPPH free radical-scavenging and superoxide anion scavenging capabilities. In vivo, AO (at dose ≥8%) dose-dependently alleviated levels of superoxide dismutase, catalase, GSH, and MDA to 117 ± 6.9 U mL(-1), 32.9 ± 3.7 U mL(-1), 7.0 ± 1.7 μmol mL(-1) and 1.8 ± 0.4 nmol L(-1), respectively, exhibiting the remarkable antioxidative and antihyperlipidemic effects of AO. Conclusively, we are the first to report the occurrence of curcumin in rhizoma A. officinarum. Curcumin synergistically elicits promising anti-dyslipidemic bioactivity with coexisting total polyphenolics, dietary fibers and phytosterols.

Topics: Alpinia; Animals; Cholesterol; Cricetinae; Curcumin; Dietary Fiber; Drug Synergism; Drugs, Chinese Herbal; Humans; Hyperlipidemias; Hypolipidemic Agents; Male; Mesocricetus; Phytosterols; Triglycerides

Obesity is a multifactorial disorder which is closely associated with hyperlipidemia. Avocados are edible fruits traditionally consumed for various health benefits including body weight reduction.. To determine the hypolipidemic and anti-obesity effect of hydro-alcoholic fruit extract of avocado (HFEA) in rats fed with high fat diet (HFD).. Male Sprague Dawley rats were divided into four groups. Groups 1 and 2 rats were fed with normal diet. Groups 3 and 4 rats were fed with HFD for 14 weeks. In addition, Groups 2 and 4 rats were co-administered with 100 mg/kg body weight of HFEA from 3rd week onwards.. The HFEA was subjected to HPLC to quantify the major phytonutrients. Body mass index (BMI), adiposity index (ADI), total fat pad mass (TFP), blood lipid levels were determined in all the groups of rats. The mRNA expression of fatty acid synthase (FASN), lipoprotein lipase (LPL), fibroblast growth factor 21 (FGF21) and leptin was also assessed.. HFEA was found to contain flavonoids: rutin-141.79, quercetin-5.25, luteolin-165, phenolic compounds: gallic acid-198.57, ellagic acid-238.22, vanillic acid-4.79 and phytosterols: betasitosterol-70, stigmasterol-12.5 (mg/100 g). HFEA reduced BMI, ADI, TFP, blood cholesterol, triglycerides, and LDL in rats fed with HFD. Serum leptin was found reduced in HFEA co-administered rats. The mRNA expression of FASN, LPL, and leptin in subcutaneous and visceral adipose tissue was found to be significantly reduced in HFEA co-administered rats. The gene expression of fibroblast growth factor-21 (FGF21) was found to be significantly increased in HFEA treated rats when compared to HFD control rats.. The hypolipidemic effect of HFEA may be partly due to its modulating effect on endogenous fat synthesis and adiponectin formation through the transcription factor FGF21. The results also show that avocado fruit extract has profound influence on leptin activity, which controls satiety and hunger to regulate the food intake.

Topics: Animals; Body Mass Index; Chemical Fractionation; Cholesterol; Diet, High-Fat; Fatty Acid Synthase, Type I; Fibroblast Growth Factors; Flavonoids; Fruit; Hyperlipidemias; Hypolipidemic Agents; Leptin; Lipoprotein Lipase; Male; Obesity; Persea; Phenols; Phytosterols; Plant Extracts; Rats; Rats, Sprague-Dawley; Triglycerides

Macrophages are key players in atherosclerotic lesion formation and progression. We have recently demonstrated that lipid-loaded macrophages show activation of the canonical Wnt signaling pathway.. To test the in vivo role of the canonical Wnt pathway in atherosclerosis we used mice deficient in the Wnt signaling receptor LRP5 (LRP5(-/-)) fed a hypercholesterolemic diet (HC) to induce atherosclerosis. These dietary groups were further subdivided into two subgroups receiving their respective diets supplemented with 2% plant sterol esters (PSE). All mice remained on their assigned diets until age 18 weeks.. HC WT mice had mildly increased non-HDL cholesterol levels, developed aortic atherosclerotic lesions and showed upregulated expression levels of aortic Lrp5. HC LRP5(-/-) mice develop larger aortic atherosclerotic lesions than WT mice indicating that LRP5 has a protective function in atherosclerosis progression. The oral administration of PSE, a dietary cholesterol-lowering agent, had an effect in the expression levels of the Wnt signaling receptor and in atherosclerosis progression. We found that PSE reduced serum total cholesterol levels, abolished HC-induced LRP5 overexpression and reduced aortic atherosclerotic plaques.. The proatherogenic effects of the excess of plasma lipids are in part mediated by modulation of LRP5 in the aorta. LRP5 and canonical Wnt signaling exert a protective defense mechanism against hyperlipidemia and atherosclerosis lesion progression.

Topics: Animals; Aorta; Atherosclerosis; Cholesterol; Cholesterol, Dietary; Dietary Supplements; Hyperlipidemias; Low Density Lipoprotein Receptor-Related Protein-5; Mice, Inbred C57BL; Phytosterols; Plaque, Atherosclerotic; Wnt Signaling Pathway

Although complex multivitamin products are widely used as dietary supplements to maintain health or as special medical food in certain diseases, the effects of these products were not investigated in hyperlipidemia which is a major risk factor for cardiovascular diseases. Therefore, here we investigated if a preparation developed for human use containing different vitamins, minerals and trace elements enriched with phytosterol (VMTP) affects the severity of experimental hyperlipidemia as well as myocardial ischemia/reperfusion injury.. Male Wistar rats were fed a normal or cholesterol-enriched (2% cholesterol + 0.25% cholate) diet for 12 weeks to induce hyperlipidemia. From week 8, rats in both groups were fed with a VMTP preparation or placebo for 4 weeks. Serum triglyceride and cholesterol levels were measured at week 0, 8 and 12. At week 12, hearts were isolated, perfused according to Langendorff and subjected to a 30-min coronary occlusion followed by 120 min reperfusion to measure infarct size.. At week 8, cholesterol-fed rats showed significantly higher serum cholesterol level as compared to normal animals, however, serum triglyceride level did not change. VMTP treatment significantly decreased serum cholesterol level in the hyperlipidemic group by week 12 without affecting triglyceride levels. However, VMTP did not show beneficial effect on infarct size. The inflammatory marker hs-CRP and the antioxidant uric acid were also not significantly different.. This is the first demonstration that treatment of hyperlipidemic subjects with a VMTP preparation reduces serum cholesterol, the major risk factor for cardiovascular disease; however, it does not provide cardioprotection.

Topics: Animals; C-Reactive Protein; Cholesterol; Cholesterol, Dietary; Dietary Supplements; Hyperlipidemias; Infusion Pumps; Male; Myocardial Infarction; Myocardial Reperfusion Injury; Myocardium; Organ Culture Techniques; Phytosterols; Rats; Rats, Wistar; Triglycerides; Uric Acid; Vitamins

The main proposal of this study was to evaluate in vivo whether flaxseed oils fortified with micronutrients would have beneficial effects on lipid profile and antioxidant status in high-fat fed rats. Male Wistar rats were fed synthetic diets containing 10% of flaxseed oil (FO), phytosterols (PS) fortified FO (PS-FO), vitamin E (V(E)) fortified FO (V(E)-FO), V(E) , and PS fortified FO (V(E)-PS-FO), respectively, for 4 wk. The results showed that V(E) fortified FO enhanced the enzymatic (SOD and GPX) and nonenzymatic (GSH and V(E)) antioxidant system, lowered the lipid peroxide (TBARS) concentration compared with FO (P < 0.05). And FO fortified with PS significantly reduced the plasma TG, TC and LDL-C levels, and hepatic TG and TC levels of rats compared with FO (P < 0.05), but had no significant effect on antioxidant defense capacities. Combined addition of V(E) and PS in FO had a synergetic effect. These results indicated that flaxseed oils fortified micronutrients V(E) and PS may contribute to reduce the risk factors of cardiovascular disease (CVD) by improving plasma antioxidant defenses and lipids profiles.. Flaxseed oil usually contains greater than 50% of alpha-linolenic acid (ALA) and is a desire origin for n-3 PUFA. But consuming high dose of n-3 PUFA could lead to oxidative damage through free radical-chain reaction in cellular and subcellular membranes. Our studies showed that a regular intake of V(E) and PS fortified flaxseed oils increased antioxidant defenses and ameliorated lipids profile in high-fat fed rats, and these indicated that the flaxseed oil fortified with these micronutrients might reduce the incidence of CVD.

Topics: Animals; Antioxidants; Cholesterol; Diet, High-Fat; Feces; Food, Fortified; Glutathione; Hyperlipidemias; Linseed Oil; Lipid Metabolism; Lipid Peroxidation; Lipids; Liver; Male; Oxidoreductases; Phytosterols; Rats; Rats, Wistar; Thiobarbituric Acid Reactive Substances; Vitamin E

Topics: Caloric Restriction; Cardiovascular Diseases; Cholesterol, LDL; Diet, Fat-Restricted; Feeding Behavior; Health Promotion; Humans; Hyperlipidemias; Life Style; Lipid Metabolism; Phytosterols; Risk Factors

Topics: Cholesterol, LDL; Diet; Dietary Fats; Dietary Fiber; Humans; Hyperlipidemias; Phytosterols; Research Design; Soybean Proteins; Vegetables

Atherosclerosis and its related complications are the leading causes of death in the West and in many developed countries. This study aims to investigate the hypolipidemic effect of bamboo shoot oil (BSO) in Sprague-Dawley rats. A group of rats had induced hyperlipidemia, hypercholesterolemia, and fatty liver by being fed with a high-fat, high-cholesterol diet for 4 wk. The control group was administered 10 mL distilled water per kg body weight, while the other groups were, respectively, administered 250 mg beta-sitosterol, 250 mg BSO, 500 mg BSO, and 1000 mg BSO per kg body weight by oral gavage. The results demonstrated that BSO could significantly decrease the levels of total cholesterol, triacylglycerol, low-density lipoprotein-cholesterol, phytosterol, lipoprotein lipase, hepatic lipase, and atherogenic index in serum, and increase the levels of cholesterol in feces. It could also significantly decrease the level of relative liver weight and liver lipids. The pronounced hypolipidemic effects of BSO might be attributed to its ability to inhibit cholesterol absorption and increase cholesterol excretion. These results suggest that consuming BSO may provide benefits in managing hypercholesterolemia. Therefore, BSO may be a good candidate for development as a functional food and nutraceutical.

Topics: Animals; Cholesterol; Diet, Atherogenic; Dose-Response Relationship, Drug; Fatty Liver; Feces; Hyperlipidemias; Hypolipidemic Agents; Lipids; Liver; Male; Organ Size; Phytosterols; Phytotherapy; Plant Oils; Plant Shoots; Poaceae; Random Allocation; Rats; Rats, Sprague-Dawley

Rapeseed oil (RSO) is a novel source of plant sterols, containing the unique brassicasterol in concentrations higher than allowed for plant sterol blends in food products in the European Union. Effects of RSO sterols and stanols on aortic atherosclerosis were studied in cholesterol-fed heterozygous Watanabe heritable hyperlipidaemic (Hh-WHHL) rabbits. Four groups (n 18 per group) received a cholesterol-added (2 g/kg) standard chow or this diet with added RSO stanol esters (17 g/kg), RSO stanol esters (34 g/kg) or RSO sterol esters (34 g/kg) for 18 weeks. Feeding RSO stanol esters increased plasma campestanol (P < 0.001) and sitostanol (P < 0.001) and aortic campestanol (P < 0.05) compared with controls. Feeding RSO sterol esters increased concentrations of plasma campesterol (P < 0.001), sitosterol (P < 0.001) and brassicasterol (P < 0.001) and aortic campesterol (P < 0.01). Significantly lower plasma cholesterol (P < 0.001) was recorded in the treated groups after 3 weeks and throughout the study. LDL-cholesterol was reduced 50 % in the high-dose RSO sterol ester (P < 0.01) and high-dose RSO stanol ester (P < 0.001) groups compared with controls. Atherosclerotic lesions were found in three rabbits in each of the RSO stanol ester groups and in one in the RSO sterol ester group. Aortic cholesterol was decreased in the treated groups (P < 0.001) in response to lowering of plasma cholesterol induced by RSO sterol and stanol esters. In conclusion, RSO stanol and sterol esters with a high concentration of brassicasterol were well tolerated. They were hypocholesterolaemic and inhibited experimental atherosclerosis in cholesterol-fed Hh-WHHL rabbits. A significant uptake of plant sterols into the blood and incorporation of campesterol and campestanol into aortic tissue was recorded.

Topics: Animals; Aorta; Atherosclerosis; Cholestadienols; Cholesterol; Cholesterol, Dietary; Fatty Acids, Monounsaturated; Female; Heterozygote; Hyperlipidemias; Lipids; Male; Phytosterols; Plant Oils; Rabbits; Rapeseed Oil; Sitosterols

Plant sterols are bioactive compounds, found in all vegetable foods, which inhibit cholesterol absorption. Little is known about the effect of habitual natural dietary intake of plant sterols.. We investigated the relation between plant sterol density (in mg/MJ) and serum concentrations of cholesterol in men and women in northern Sweden.. The analysis included 37 150 men and 40 502 women aged 29-61 y, all participants in the Västerbotten Intervention Program.. Higher plant sterol density was associated with lower serum total cholesterol in both sexes and with lower LDL cholesterol in women. After adjustment for age, body mass index (in kg/m(2)), and (in women) menopausal status, men with high plant sterol density (quintile 5) had 0.15 mmol/L (2.6%) lower total serum cholesterol (P for trend = 0.001) and 0.13 mmol/L (3.1%) lower LDL cholesterol (P = 0.062) than did men with low plant sterol density (quintile 1). The corresponding figures for women were 0.20 mmol/L (3.5%) lower total serum cholesterol (P for trend < 0.001) and 0.13 mmol/L (3.2%) lower LDL cholesterol (P for trend = 0.001).. The present study is the second epidemiologic study to show a significant inverse relation between naturally occurring dietary plant sterols and serum cholesterol. To the extent that the associations found truly mirror plant sterol intake and not merely a diet high in vegetable fat and fiber, it highlights the importance of considering the plant sterol content of foods both in primary prevention of cardiovascular disease and in the dietary advice incorporated into nutritional treatment of patients with hyperlipidemia.

Topics: Adult; Anticholesteremic Agents; Body Mass Index; Cardiovascular Diseases; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Diet; Dose-Response Relationship, Drug; Female; Humans; Hyperlipidemias; Male; Menopause; Middle Aged; Phytosterols; Surveys and Questionnaires; Sweden

The incidence of hyperlipidemia in children is increasing in Japan, but drug therapy for such children is limited. The ingestion of 4% phytosterols-containing diacylglycerol (PS/DAG) decreases serum total cholesterol and low density lipoprotein cholesterol (LDL-C) concentrations in adults. In the present study, we examined the effect of PS/DAG as part of a diet therapy in pediatric patients with hyperlipidemia.. Pediatric patients with hyperlipidemia with > or =5.18mmol (200 mg/dL) serum total cholesterol and/or >or =1.70mmol (150 mg/dL) triglycerides (N=22) ingested bread containing PS/DAG (total daily intake, 10g) for 6 months. Blood chemistry was examined prior to and 2, 4, 6 months after the initiation of ingestion, and 4 months after the ingestion period.. No significant differences in energy intake or cholesterol intake during the study period were found. After 4 months of ingestion of PS/DAG, LDL-C, lipoprotein(a) [ Lp(a)], free fatty acids and total ketone bodies decreased significantly. In seven patients with familial hypercholesterolemia, total cholesterol and remnant-like lipoprotein particles (RLP)-cholesterol also significantly decreased in addition to LDL-C and Lp(a).. PS/DAG improves serum lipid metabolism in pediatric patients with hyperlipidemia for whom drug therapy is limited, suggesting that PS/DAG may reduce the risk of developing various diseases induced by hyperlipidemia.

Topics: Adolescent; Anticholesteremic Agents; Child; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Diglycerides; Female; Humans; Hyperlipidemias; Male; Phytosterols; Treatment Outcome

To observed the effects of phytosterol ester (PSE) on serum lipid level in rats.. (1) Under high-fat fed model, rats were oral administrated either no PSE (model), 4.0, 16.0 or 32.0 mg/kg bw PSE dissolved in oil. After 30 days of this treatment serum was obtained for lipid determination. (2) Ovariectomized rats were randomly assigned to model group, or treated with diethyl stilbestrol (E2, 22.5 microg/kg bw), PSE (32.0 mg/kg bw) or free phytosterol (FPE, 500 mg/kg bw). After fed for 60 days, body weight, liver and uterus weight, serum lipid and estrogen level were measured. In both experiments, another group of normal rats were taken as control.. High-fat fed rats administrated with 3 doses of PSE had significantly lower triglyceride (TG) following 30 days of treatment compared to model group. A significant decrease in total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) was observed in 32.0 mg/kg bw PSE group, while a significant increase in high density lipoprotein cholesterol (HDL-C) and ratio of HDL-C/TC was observed in the same group ( P < 0.05). For ovariectomized rats treated with PSE or FPE, a significant lower body and liver weight with lower TC and TG level were observed in comparison with model group (P < 0.05). A little increased uterus weight by PSE and FPE was also observed, though no significant elevation in estrogen was reported.. Phytosterol ester have potential to decrease hyperlipidemia.

Topics: Animals; Disease Models, Animal; Dose-Response Relationship, Drug; Estrogens; Female; Hyperlipidemias; Lipids; Ovariectomy; Phytosterols; Random Allocation; Rats; Rats, Sprague-Dawley

Topics: Coronary Disease; Cost-Benefit Analysis; Female; Food, Fortified; Humans; Hyperlipidemias; Hypolipidemic Agents; Intestinal Absorption; Male; Margarine; Patient Compliance; Phytosterols; Safety; Treatment Outcome

Cholesterol absorption is frequently determined using the plasma dual stable-isotope ratio method (PDSIRM). However, this method involves intravenous injection of stable-isotope-labeled cholesterol with simultaneous oral administration of differently labeled cholesterol, which results in high study costs and involves additional ethical considerations. The objective of the present study was to validate a simpler single-isotope method for determining cholesterol absorption against PDSIRM by using data from two previous studies. Enrichments of carbon-13 (13C and deuterium in red blood cells were analyzed by using differential isotope ratio MS. The area under the curve of 13C-enrichment in the plasma free-cholesterol pool was found to be significantly correlated with cholesterol absorption measured by using PDSIRM for study 1 (r = 0.85, P < 0.0001) and study 2 (r = 0.81, P < 0.0001). Average 13C-enrichment correlated with the area under the curve of 13C-enrichment in the plasma free cholesterol for both study 1 (r = 0.98, P < 0.0001) and study 2 (r = 1.00, P < 0.0001). Study 1 examined the efficacy and mechanisms of unesterified plant sterols and stanols on lipid profiles in hypercholesterolemic men and women, while study 2 investigated the effects of phytosterol vs. phytostanol esters on plasma lipid levels and cholesterol kinetics in hyperlipidemic men. Experimental approaches to determine cholesterol absorption were identical between the two studies. Consequently, in both studies, correlations (r = 0.88, P < 0.0001 for study 1, and r = 0.82, P < 0.0001 for study 2) were found between the average 13C-enrichment of plasma free cholesterol and cholesterol absorption measured by PDSIRM. These results suggest that a single-isotope-labeled cholesterol tracer approach can be used as a reliable noninvasive method to replace PDSIRM for examining changes in cholesterol absorption.

Topics: Absorption; Adult; Area Under Curve; Carbon Radioisotopes; Cholesterol; Deuterium; Erythrocytes; Esters; Female; Gas Chromatography-Mass Spectrometry; Humans; Hypercholesterolemia; Hyperlipidemias; Kinetics; Lipids; Male; Middle Aged; Phytosterols; Reproducibility of Results

Screening of 932 adults on the Pacific island of Kosrae for plasma plant sterol levels disclosed three subjects, two of them asymptomatic, with phytosterolemia. Sequencing the ATP binding cassette subfamily G member 8 (ABCG8) gene revealed a novel exon 2 mutation that causes a change in codon 24 from glutamine to histidine and a frame shift followed by a premature stop codon, precluding the formation of a functional ABCG8 protein. Genotyping of 1,090 Kosraens revealed 150 as carriers, a 13.8% carrier rate. DNA sequencing of 67 carriers revealed the same mutation as in the probands. In carriers, plasma campesterol and sitosterol levels were 55% and 30% higher, respectively, than in noncarriers. Moreover, compared with noncarriers, carriers showed 21% lower plasma levels of lathosterol, a surrogate marker for cholesterol biosynthesis. There was no difference between the groups in plasma total cholesterol, triglycerides, apolipoprotein B, or apolipoprotein A-I levels. In summary, on the island of Kosrae, a strong founder effect of a mutant ABCG8 allele results in a large number of carriers with increased plasma plant sterol levels and decreased lathosterol levels. The latter finding suggests that heterozygosity for a mutated ABCG8 allele results in a modest increase in dietary cholesterol absorption and a decrease in cholesterol biosynthesis.

Topics: Adult; Aged; Aged, 80 and over; ATP Binding Cassette Transporter, Subfamily G, Member 8; ATP-Binding Cassette Transporters; Diet; Female; Founder Effect; Gene Frequency; Genotype; Humans; Hyperlipidemias; Lipoproteins; Male; Micronesia; Middle Aged; Mutation; Phylogeny; Phytosterols

To assess the specificity and sensitivity of the commonly used enzymatic colorimetric test for plasma cholesterol determination.. Interference with an enzymatic method for cholesterol measurement by several non-cholesterol sterols (beta sitosterol, campesterol, stigmasterol, stigmastanol, desmosterol, and lathosterol) was assessed. Some of these compounds are present in plasma at higher than normal concentrations either in rare genetic disorders, such as phytosterolaemia, or after the consumption of phytosterol enriched foods.. The non-cholesterol sterols were detected by the assay in a linear manner. There was no competitive interference in the presence of cholesterol.. This crossreactivity may affect the diagnosis and treatment of non-cholesterol dyslipidaemias, including phytosterolaemia and cerebrotendinous xanthomatosis. Similarly, changes in plasma lipid compositions after the consumption of phytosterol enriched foods cannot be specifically determined by this enzymatic assay. Until a more specific enzymatic assay is developed, alternative methods such as gas chromatography should be used to differentiate between cholesterol and non-cholesterol sterols.

Topics: Cholesterol; Colorimetry; Cross Reactions; Humans; Hyperlipidemias; Phytosterols; Sensitivity and Specificity; Sterols

Topics: Aged; Alcoholic Beverages; Cholesterol, Dietary; Dietary Fats; Dietary Fiber; Energy Intake; Exercise; Fatty Acids, Omega-3; Female; Humans; Hyperlipidemias; Lipoproteins, HDL; Lipoproteins, LDL; Male; Margarine; Metabolic Syndrome; Middle Aged; Phytosterols; Smoking; Triglycerides

Used as a substitute for normal dietary intake of saturated fatty acids, margarines containing plant sterols can cause a modest reduction in serum total cholesterol and low-density lipoprotein cholesterol levels. They have been shown effective in patients with mild hypercholesterolemia, but they are also useful in the general population.

Topics: Anticholesteremic Agents; Cholesterol; Cholesterol, LDL; Coronary Disease; Costs and Cost Analysis; Female; Humans; Hypercholesterolemia; Hyperlipidemias; Hypolipidemic Agents; Margarine; Phytosterols; Randomized Controlled Trials as Topic; Simvastatin; Sitosterols; Time Factors

Hypolipidemic effects of gamma-oryzanol (OZ) and cycloartenol ferulic acid ester (CAF) on the hyperlipidemia induced by ingestion of a high cholesterol diet (HCD) in male Sprague-Dawley rats were investigated. The test drugs were given orally and intravenously, daily for 12 days with the HCD feeding. The oral administration with OZ and CAF at 100 mg/kg daily for 6 or 12 days did not apparently prevent the hyperlipidemia induced by HCD-feeding. The intravenous administrations with OZ and CAF at 10 mg/kg for 6 days significantly inhibited the increases in serum total cholesterol (TC), phospholipid (PL) and free cholesterol by HCD. OZ and CAF did not inhibit the decreases of TC in high density lipoprotein (HDL-TC) and HDL-PL by HCD. The increases of atherogenic index [( TC-HDL-TC]/[HDL-TC] and [PL-HDL-PL]/[HDL-PL]) with the HCD feeding were reduced by the intravenous administrations of OZ and CAF. Triglyceride, nonesterified fatty acid, lactate dehydrogenase and transaminase (GOT and GPT) markedly decreased below the control level by the intravenous administrations of OZ and CAF for 12 days. These results suggest that the intravenous administrations of OZ and CAF may have accelerated the excretion of lipids in the blood.

Topics: Animals; Blood Proteins; Body Weight; Cholesterol, Dietary; Cinnamates; Coumaric Acids; Enzymes; Hyperlipidemias; Hypolipidemic Agents; Male; Organ Size; Phenylpropionates; Phytosterols; Rats; Rats, Inbred Strains

The bulk of the plasma plant sterol in phytosterolemia occurs in the esterified form and is carried mostly in the low and high density lipoproteins. We have determined the fatty acid composition of the individual plasma steryl esters from a newly discovered subject with phytosterolemia and xanthomatosis. For this purpose the intact steryl esters were subject to high temperature gas liquid chromatography (GLC) on a polar capillary column, which separated the major esters on the basis of molecular weight and degree of unsaturation of the fatty acids. The saturated and unsaturated sterols esterified to saturated, monoenic, dienoic and tetraenoic fatty acids were identified by GLC analysis of the sterol moieties of the corresponding AgNO3-TLC fractions of the steryl esters. The GLC results were confirmed by reversed phase high performance liquid chromatography combined with mass spectrometry via direct liquid inlet interface. It was found that, in general, each fatty acid was esterified to the same complement of sterols, and that the esterified sterols possessed a composition comparable to that of the free plasma sterols, which was comprised of about 75% cholesterol, 6% campesterol, 4% 22,23-dihydrobrassicasterol and 15% beta-sitosterol. The fatty acid composition of the steryl esters differed from that of the 2-position of the plasma phosphatidylcholines, which contained significantly less palmitic and oleic and more linoleic acid. On the basis of these results and a review of the literature it is suggested that the plasma cholesteryl and plant steryl esters in phytosterolemia originate from both synthesis in plasma via the lecithin-cholesterol acyltransferase and synthesis in tissues via the acylCoA-cholesterol acyltransferase.

Topics: Chromatography, Gas; Chromatography, High Pressure Liquid; Fatty Acids; Humans; Hyperlipidemias; Lipoproteins; Mass Spectrometry; Phosphatidylcholines; Phytosterols; Sterols; Xanthomatosis

Topics: Animals; Body Weight; Hyperlipidemias; Hypolipidemic Agents; Lipid Metabolism; Liver; Male; Nicotinic Acids; Organ Size; Pantetheine; Phytosterols; Rats; Rats, Inbred Strains; Sulfhydryl Compounds; Vitamin E

A fourth case is described in which phytosterolaemia, earlier diagnosed as familial hypercholesterolaemia, was associated with normocholesterolaemia, hypersplenism and premature atherosclerotic arterial disease requiring a three-vessel coronary bypass at the age of 29 years. During a follow-up of 5 years 22-26% and 27-30% of serum and bile sterols were plant sterols, respectively. In addition to campesterol and beta-sitosterol, stigmasterol and a fourth major plant sterol, tentatively identified as avenasterol, were found in bile, and in free and esterified forms in all serum lipoproteins. Analysis of faecal steroids and measurement of biliary lipid secretion indicated that in addition to enhanced absorption of plant sterols their decreased biliary secretion contributed to the development of phytosterolaemia. Impaired biliary cholesterol secretion was compensated for by a markedly reduced cholesterol but normal bile acid synthesis and resulted in bile undersaturated with respect to cholesterol, in a reduced intestinal cholesterol pool and in a very low faecal excretion of cholesterol as neutral sterols. Cholestyramine brought about a modest increase in cholesterol elimination as bile acids, increased cholesterol synthesis as evidenced by the sterol balance value and the increased cholesterol precursors squalene and methyl sterols in plasma and bile, and reduced the plasma cholesterol by 21% and plant sterols by 16%, but had no effect on the biliary composition of main sterols.

Topics: Absorption; Adult; Arteriosclerosis; Bile; Bile Acids and Salts; Cholesterol; Cholestyramine Resin; Coronary Disease; Feces; Humans; Hypercholesterolemia; Hyperlipidemias; Lipid Metabolism; Lipoproteins; Male; Phytosterols; Squalene; Xanthomatosis

The data relating diet to coronary heart disease, when critically examined, clearly show that there is a normal spectrum of blood serum values, and that normal persons do not develop pathological levels upon the ingestion of eggs and other cholesterol-containing the ingestion of large amounts of cholesterol-containing foods. Average data obtained from mixed populations of normal and pathological blood lipid values should not be used to advise the normal majority of that population. The harmful effects of such policy are outlined. The data demonstrating the concept that the risk of coronary heart disease is a function of serum lipids at any level is no longer valid are reviewed. The data of the National Cooperative Pooling Project of the American Heart Association are used to show that up to 250 mg/dl there is no relationship between serum cholesterol concentration and risk.

Topics: Adolescent; Adult; Age Factors; Aged; American Heart Association; American Medical Association; Arteriosclerosis; Child; Child, Preschool; Cholesterol; Cholesterol, Dietary; Coronary Disease; Diet; Dietary Fats; Evaluation Studies as Topic; Fats, Unsaturated; Female; Humans; Hyperlipidemias; Infant; Infant, Newborn; Lipids; Male; Middle Aged; Phytosterols; Sex Factors; Triglycerides; United States

We have evaluated the efficacy of plant sterol preparations from two different sources and in two different physical forms in lowering the plasma cholesterol of a total of 46 patients with type II hyperlipoproteinemia when given in addition to appropriate diet therapy. In addition, the mechanisms of the hypocholesterolemic effect were investigated in 7 patients by a sterol balance technique. The maximal mean cholesterol lowering in response to any preparation was 12 percent, although it was much greater in some individual patients. Sterol balance data showed that plant sterols inhibit cholesterol absorption with maximal negative cholesterol balance in adults at a dose of 3 g/day of a tall oil sterol suspension. Interestingly, maximal plasma cholesterol reduction in the adult outpatients on this preparation was seen at the same dose level. Since the tall oil sterol suspension is relatively palatable and is poorly absorbed, it has potential value as an adjunct to dietary therapy in patients with mild hypercholesterolemia for whom long-term drug therapy is deemed advisable.

Topics: Cholesterol; Humans; Hypercholesterolemia; Hyperlipidemias; Phytosterols; Triglycerides

Studies were carried out to determine effects of combined chemotherapy in patients with hyperlipidemia. In one study, 14 patients were treated first with colestipol and then with the combination of colestipol and clofibrate. In a second study, six patients were given clofibrate followed by addition of phytosterols. The following measurements were made in most patients: (1) plasma lipid concentrations, (2) fecal excretions of neutral steroids and bile acids, and (3) lipid composition of gallbladder bile. In six patients of the first study, hepatic secretion rates of biliary lipids and pool sizes of bile acids were also estimated. In the first study, colestipol alone caused a marked increase in fecal bile acids that resulted in a sizable decrease in plasma cholesterol concentrations (average 21 percent). In several patients, however, triglycerides were increased somewhat by colestipol. Despite interruption of the enterohepatic circulation of bile acids, the bile acid pool was not reduced, since a compensatory increase took place in bile acid synthesis. Also, except in one patient who developed gallstones following institution of colestipol, saturation of gallbladder bile with cholesterol was not markedly increased by this drug alone. Addition of clofibrate frequently produced a further decrement in plasma cholesterol, and the mild hypertriglyceridemia induced by colestipol was reversed. However, colestipol plus clofibrate usually caused a striking increase in saturation of gallbladder bile. Previous studies have shown that clofibrate causes a flux of cholesterol from tissue pools by simultaneously decreasing cholesterol synthesis and increasing its excretion. To further increase cholesterol excretion, phytosterols, which block cholesterol absorption, were added to clofibrate in the second study. Although phytosterols did not cause a further reduction in plasma cholesterol in these particular patients, they nevertheless greatly enhanced cholesterol excretion.

Topics: Adult; Bile; Bile Acids and Salts; Cholesterol; Clofibrate; Colestipol; Drug Therapy, Combination; Feces; Humans; Hypercholesterolemia; Hyperlipidemias; Lipid Metabolism; Liver; Male; Middle Aged; Phytosterols; Polyamines; Steroids; Triglycerides

Direct gas liquid chromatography (GLC) of total plasma lipids showed small peaks (0.5-1.5% of total free sterol area) corresponding to free C28 and C29 sterols in ca. 50% of some 3,000 normal subjects and patients with hyperlipemia. Comparable proportions of similar peaks were present in the sterol fraction isolated from the red blood cells of many of these subjects. The maximum levels of these components in the plasma and red blood cells of domestic and laboratory animals were up to 10 times higher than those seen in man. Detailed gas chromatography/mass spectrometry analyses of the plasma lipids from a much more limited number of subjects and animals showed that the GLC peaks corresponding to the free C28 and C29 sterols were largely due to the plant sterols campesterol, stigmasterol, and beta-sitosterol. In all instances, variable amounts (0.05-0.2% of the total free sterol area) of 7-dehydrocholesterol, desmosterol, lanosterol, and cholesterol alpha-oxide were also detected. While the total content and composition of the plasma plant sterols appeared to vary greatly among the subjects, it never exceeded 2% of total sterol in the normal subjects and patients examined. There was no evidence for a significant increase in the plant sterol content of the plasma of patients with hypercholesterolemia or hypertriglyceridemia.

Topics: Animals; Cholesterol; Chromatography, Gas; Desmosterol; Erythrocytes; Gas Chromatography-Mass Spectrometry; Humans; Hypercholesterolemia; Hyperlipidemias; Phytosterols; Sitosterols; Species Specificity

Human intestinal specificity toward sterols was studied by a balance method in 10 hyperlipoproteinemic patients fed plant sterol mixture with chromium sesquioxide as fecal flow marker. The mean fecal recovery of campesterol (C28) was 20% less than that of beta-sitosterol (C29). This difference persisted when corrected for fecal flow (by marker recovery), indicating differences in their intestinal uptake (C28 greater than C29). The ratio of fecal cholesterol to its 5beta-reduction products was lower than that of beta-sitosterol in all patients; in vitro, 5beta-reduction of both sterols was similar. The recovery of sterols from patients was unrelated to their 5beta-reduction in the intestine.

Topics: Cholesterol; Cholesterol, Dietary; Chromium; Feces; Humans; Hyperlipidemias; Intestinal Mucosa; Phytosterols; Sitosterols

Topics: Arteriosclerosis; Cholesterol; Clofibrate; Genotype; Humans; Hyperlipidemias; Lipoproteins; Nicotinic Acids; Phytosterols

Topics: Bile; Bile Acids and Salts; Chenodeoxycholic Acid; Cholesterol; Cholic Acids; Chromatography, Gas; Deoxycholic Acid; Humans; Hyperlipidemias; Lithocholic Acid; Phytosterols; Stigmasterol