Influence of processing on sterols of edible vegetable oils

Chemical conversions of free phytosterols during the bleaching of corn oil

Phytosterols have health benefits; however, they are partially removed during the bleaching of corn oil. We evaluated the chemical conversion of free phytosterols (FPs) during bleaching. FP degradation accelerated with increased time and temperature, following a first-order kinetic model. In the n-heptane system, air and activated clay promoted the chemical conversion of the FPs. Sterenes formation was analysed under different conditions using a zero-order kinetic model. The apparent activation energies revealed sterene formation decreasing in the following order: campesta-3,5-diene ≈ stigmasta-3,5,22-triene > stigmasta-3,5-diene. Isomers of the above were not detected, indicating that these sterenes were the only primary products of FPs. The desorption test indicated that the FP loss from corn oil was not only due to FPs being adsorbed the activated clay, but also FPs adsorbed at acidic activated sites being degraded. This study presents a vital scientific foundation for retaining FPs to develop healthier and more nutritious oils.

Highlights to phytosterols accumulation and equilibrium in plants: Biosynthetic pathway and feedback regulation

Phytosterols are a group of sterols exclusive to plants and fungi, but are indispensable to humans because of their medicinal and nutritional values. However, current raw materials used for phytosterols extraction add to the cost and waste in the process. For higher sterols production, major attention is drawn to plant materials abundant in phytosterols and genetic modification. To provide an insight into phytosterols metabolism, the research progress on key enzymes involved in phytosterols biosynthesis and conversions were summarized. CAS, SSR2, SMT, DWF1 and CYP710A, the enzymes participating in the biosynthetic pathway, and PSAT, ASAT and SGT, the enzymes involved in the conversion of free sterols to conjugated ones, were reviewed. Specifically, SMT and CYP710A were emphasized for their function on modulating the percentage composition of different kinds of phytosterols. The thresholds of sterol equilibrium and the resultant phytosterols accumulation, which vary in plant species and contribute to plasma membrane remodeling under stresses, were also discussed. By retrospective analysis of the previous researches, we proposed a feedback mechanism regulating sterol equilibrium underlying sterols metabolism. From a strategic perspective, we regard salt tolerant plant as an alternative to present raw materials, which will attain higher phytosterols production in combination with gene-modification.

Assessment of free plant sterols in cold pressed Citrus essential oils

A fast, sensitive, accurate and robust GC-FID and confirmatory GC-MS method, was developed to simultaneously determine squalene and underivatized free plant sterols in Citrus essential oils (cEOs). The method was applied to assess the content of squalene and free plant sterols in four most commonly employed cold-pressed cEOs (bergamot, lemon, mandarin and orange). cEOs plant sterols exhibited distinctive molecular patterns, with levels ranging from 182 to 1100 mg kg^-1 in lemon and bergamot essential oils, respectively. β-sitosterol was the dominant compound in all cases, with an average content of ∼650 mg kg^-1 in bergamot and orange essential oils. Campesterol and brassicasterol occurred at much lower amount in all samples. Bergamot essential oil was also the richest in squalene (537 mg kg^-1) compared to the other cEOs. The method developed could contribute to define compositional patterns of cEOs, thus supporting their versatile utilisation in the food and flavour industry.

Phytosterol Contents of Edible Oils and Their Contributions to Estimated Phytosterol Intake in the Chinese Diet

Phytosterols are important micronutrients in human diets. Evidence has shown that phytosterols play an essential role in the reduction of cholesterol in blood and therefore decrease cardiovascular morbidity. In this study, the content and composition of phytosterols in different kinds of vegetable oils were analyzed, and the total phytosterol intake and contribution of foods to intake were estimated based on consumption data. The results showed that the phytosterol contents of rice bran oil, corn oil, and rapeseed oil were higher than those of other vegetable oils and the intake of phytosterol in the Chinese diet was about 392.3 mg/day. The main sources of phytosterols were edible vegetable oils (46.3%), followed by cereals (38.9%), vegetables (9.2%), nuts (2.0%), fruits (1.5%), beans and bean products (1.4%), and tubers (0.8%). Among all vegetable oils, rapeseed oil was the main individual contributor to phytosterol intake (22.9%), especially for the southern residents of China.

Effects of chemical refinement on the quality of coconut oil

Refinement is usually used to remove undesired components to improve coconut oil quality. In the present study, crude coconut oil (CCO) was refined in four stages: conventional degumming, neutralization, bleaching, and deodorization. Physiochemical indices during the refinement were evaluated: peroxide value (PV), free fatty acid (FFA), fatty acid composition; fat composition; triacylglycerol profile, micronutrient (e.g., tocopherols and sterols) and contaminant (e.g., 3-monochloropropane-1,2-diol esters (3-MCPD esters), and glycidyl esters (GEs) levels. Compared to CCO, the quality of refined oil was improved by reducing PV and FFA levels. No significant changes in triacylglycerol compositions were found during refinement. However, unsaturated fatty acids like oleic and linoleic acids were decreased after refinement. Also, some micronutrients like tocopherol and sterol were decreased from 12.39 to 0.10 mg/kg and from 679.69 to 426.50 mg/kg, respectively. The undesired contaminants, i.e., 3-MCPD esters and GEs, increased markedly during refinement.

Emerging technologies for food and drug safety

Emerging technologies are playing a major role in the generation of new approaches to assess the safety of both foods and drugs. However, the integration of emerging technologies in the regulatory decision-making process requires rigorous assessment and consensus amongst international partners and research communities. To that end, the Global Coalition for Regulatory Science Research (GCRSR) in partnership with the Brazilian Health Surveillance Agency (ANVISA) hosted the seventh Global Summit on Regulatory Science (GSRS17) in Brasilia, Brazil on September 18-20, 2017 to discuss the role of new approaches in regulatory science with a specific emphasis on applications in food and medical product safety. The global regulatory landscape concerning the application of new technologies was assessed in several countries worldwide. Challenges and issues were discussed in the context of developing an international consensus for objective criteria in the development, application and review of emerging technologies. The need for advanced approaches to allow for faster, less expensive and more predictive methodologies was elaborated. In addition, the strengths and weaknesses of each new approach was discussed. And finally, the need for standards and reproducible approaches was reviewed to enhance the application of the emerging technologies to improve food and drug safety. The overarching goal of GSRS17 was to provide a venue where regulators and researchers meet to develop collaborations addressing the most pressing scientific challenges and facilitate the adoption of novel technical innovations to advance the field of regulatory science.

Uncovered Diversity of a Predominantly Andean Butterfly Clade in the Brazilian Atlantic Forest: a Revision of the Genus Praepedaliodes Forster (Lepidoptera: Nymphalidae, Satyrinae, Satyrini)

The genus Praepedaliodes Forster, 1964, the only representative of the mega-diverse mostly Andean Pedaliodes complex lineage in the Brazilian Atlantic Forest, is revised. Prior to this study, four species were known, P. phanias (Hewitson, 1862), P. granulata (Butler, 1868), P. amussis (Thieme, 1905) and P. exul (Thieme, 1905). Here, a further six are described, all from SE Brazil, expanding to 10 the number of species in this genus. Lectotypes are designated for P. phanias, P. granulata and P. amussis. The genus is most diverse in the Serra da Mantiqueira (São Paulo, Rio de Janeiro, Minas Gerais) and in the Serra Geral (Paraná, Santa Catarina) with seven species occurring in both ranges. Praepedaliodes phanias is the most widespread species and the only one found in the western part of the Atlantic Forest; only this species and P. duartei Dias, Dolibaina & Pyrcz n. sp. occurring to near sea level. Other species, P. zaccae Dolibaina, Dias & Pyrcz n. sp., P. francinii Freitas & Pyrcz n. sp., P. sequeirae Pyrcz, Dias & Dolbaina n. sp., P. landryi Pyrcz & Freitas n. sp. and P. pawlaki Pyrcz & Boyer n. sp. are strictly montane and the highest species richness is reached at 1400-1800 m. One species, P. sequeirae n. sp., is a narrow endemic found only at timberline in the Agulhas Negras massif above 2300 m. Immature stages are described for two species, P. phanias and P. landryi n. sp. Molecular data (barcode region of cytochrome oxidase, subunit I) and adult morphology, including male and female genitalia, support the genus as monophyletic, belonging to a predominantly Andean clade of the Pedaliodes Butler, 1867 complex. Morphological evidences, in particular female genitalia comparative analysis, indicate the genera Physcopedaliodes Forster, 1964 and Panyapedaliodes Forster, 1964 as possibly the closest relatives to Praepedaliodes. Molecular data are inconclusive in this respect.

Nonglyceride Components of Edible Oils and Fats. 1. Chemistry and Distribution

Dietary fats and oils are essentially glycerides of fatty acids (triglycerides), which account for 90% to 98% of their mass. The remaining 2% to 10% consists of fat-soluble phytochemicals derived from oil-bearing seeds, nuts, or fruits. These nonglyceride components of fats and oils represent a wide range of chemical classes, such as sterols, terpene alcohols, tocopherols, hydrocarbons, long-chain alcohols including waxes, carotenoid pigments, and sulfur- and nitrogen-containing flavor compounds. Each of these classes of chemicals consists of a number of different compounds. Their number and type and the quantity present vary from one oil to another. Modern analytical tools developed in recent decades have enabled separation and identification of the individual chemicals of each class in a number of oils. The nonglyceride chemical components of oils pass into the unsaponifiable fraction as such or in a modified form. There is still a gap in our knowledge concerning the identity and nature of several of these chemicals in the nonglyceride components, particularly in some of the unconventional edible oils. Earlier, these nonglyceride components were considered adventitious chemicals. For the past two decades, however, it has been recognized that many of them have nutritional and physiological functions that have been proved by animal and human studies to be useful in preventing noncommunicable diseases and promote health. The nonglyceride components of edible oils (i.e., palm, rice bran, and sesame oils) are particularly rich in such health-promoting chemicals.

Competitive Solubilization of Cholesterol/Cholesteryl Oleate and Seven Species of Sterol/Stanol in Model Intestinal Solution System

The addition of plant sterols/stanols (sterols or stanols) can reduce the solubilization of cholesterol in a model intestinal solution system. We studied the molecular structure of seven different sterols/stanols and the effect they had on the solubilization of cholesterol or cholesterol ester in a model intestinal solution. The differences in the molecular structures of the sterol/stanol species influenced their abilities to reduce the solubility of cholesterol in the competitive solubilization experiments. Cholestanol whose molecular structure resembled cholesterol was the most effective at reducing the solubilization of cholesterol and cholesterol ester, with the solubilities of cholesterol and cholesteryl oleate being 41% and 39% respectively of the values observed for the single solubilizate systems. β-Sitosterol was also able to reduce the solubilities of cholesterol and cholesteryl oleate to 43% and 45% of those observed in a single solubilizate system. Both, stigmasterol and brassicasterol have an unsaturated double bond in a steroid side chain and did not exhibit major cholesterol-lowering effects. These results were reflected by the Gibbs free energy change values (ΔG(0)) for solubilization, where the sterol/stanol species with cholesterol-lowering effects had similar or larger negative ΔG(0) values than those observed for cholesterol.

Phytosterols and their extraction from various plant matrices using supercritical carbon dioxide: a review

Phytosterols provide important health benefits: in particular, the lowering of cholesterol. From environmental and commercial points of view, the most appropriate technique has been searched for extracting phytosterols from plant matrices. As a green technology, supercritical fluid extraction (SFE) using carbon dioxide (CO2) is widely used to extract bioactive compounds from different plant matrices. Several studies have been performed to extract phytosterols using supercritical CO2 (SC-CO2) and this technology has clearly offered potential advantages over conventional extraction methods. However, the efficiency of SFE technology fully relies on the processing parameters, chemistry of interest compounds, nature of the plant matrices and expertise of handling. This review covers SFE technology with particular reference to phytosterol extraction using SC-CO2. Moreover, the chemistry of phytosterols, properties of supercritical fluids (SFs) and the applied experimental designs have been discussed for better understanding of phytosterol solubility in SC-CO2.

Analysis of pecan nut (Carya illinoinensis) unsaponifiable fraction. Effect of ripening stage on phytosterols and phytostanols composition

Changes in 4-desmethylsterol, 4-monomethylsterol, 4,4-dimethylsterol and phytostanol composition were quantitatively and qualitatively investigated during the ripening of three varieties of Tunisian-grown pecan nuts (Mahan, Moore and Burkett). These components have many health benefits, especially in lowering LDL-cholesterol and preventing heart disease. The phytosterol composition of whole pecan kernel was quantified by Gas Chromatography-Flame Ionisation Detection (GC-FID) and identified by Gas Chromatography-Mass Spectrometry (GC-MS). Fifteen phytosterols and one phytostanol were quantified. The greatest amount of phytosterols (2852.5mg/100g of oil) was detected in Mahan variety at 20 weeks after the flowering date (WAFD). Moore had the highest level of phytostanols (7.3mg/100g of oil) at 20 WAFD. Phytosterol and phytostanol contents showed a steep decrease during pecan nut development. Results from the quantitative characterisation of pecan nut oils revealed that β-sitosterol, Δ5-avenasterol, and campesterol were the most abundant phytosterol compounds at all ripening stages.

An oxygenase-independent cholesterol catabolic pathway operates under oxic conditions

Cholesterol is one of the most ubiquitous compounds in nature. The 9,10-seco-pathway for the aerobic degradation of cholesterol was established thirty years ago. This pathway is characterized by the extensive use of oxygen and oxygenases for substrate activation and ring fission. The classical pathway was the only catabolic pathway adopted by all studies on cholesterol-degrading bacteria. Sterolibacterium denitrificans can degrade cholesterol regardless of the presence of oxygen. Here, we aerobically grew the model organism with ¹³C-labeled cholesterol, and substrate consumption and intermediate production were monitored over time. Based on the detected ¹³C-labeled intermediates, this study proposes an alternative cholesterol catabolic pathway. This alternative pathway differs from the classical 9,10-seco-pathway in numerous important aspects. First, substrate activation proceeds through anaerobic C-25 hydroxylation and subsequent isomerization to form 26-hydroxycholest-4-en-3-one. Second, after the side chain degradation, the resulting androgen intermediate is activated by adding water to the C-1/C-2 double bond. Third, the cleavage of the core ring structure starts at the A-ring via a hydrolytic mechanism. The ¹⁸O-incorporation experiments confirmed that water is the sole oxygen donor in this catabolic pathway.

Effects of babassu nut oil on ischemia/reperfusion-induced leukocyte adhesion and macromolecular leakage in the microcirculation: observation in the hamster cheek pouch

Background

The babassu palm tree is native to Brazil and is most densely distributed in the Cocais region of the state of Maranhão, in northeastern Brazil. In addition to the industrial use of refined babassu oil, the milk, the unrefined oil and the nuts in natura are used by families from several communities of African descendants as one of the principal sources of food energy. The objective of this study was to evaluate the effects of babassu oil on microvascular permeability and leukocyte-endothelial interactions induced by ischemia/reperfusion using the hamster cheek pouch microcirculation as experimental model.

Methods

Twice a day for 14 days, male hamsters received unrefined babassu oil (0.02 ml/dose [BO-2 group], 0.06 ml/dose [BO-6 group], 0.18 ml/dose [BO-18 group]) or mineral oil (0.18 ml/dose [MO group]). Observations were made in the cheek pouch and macromolecular permeability increase induced by ischemia/reperfusion (I/R) or topical application of histamine, as well as leukocyte-endothelial interaction after I/R were evaluated.

Results

The mean value of I/R-induced microvascular leakage, determined during reperfusion, was significantly lower in the BO-6 and BO-18 groups than in the MO one (P < 0.001). In addition, histamine-induced increase of microvascular permeability was significantly less pronounced in BO groups compared to MO one. No significant differences among groups in terms of leukocyte adhesion, concentrations of tumor necrosis factor alpha, interleukin 1, and interleukin 6 were found.

Conclusions

Our findings suggest that unrefined babassu oil reduced microvascular leakage and protected against histamine-induced effects in postcapillary venules and highlights that these almost unexploited nut and its oil might be secure sources of food energy.

Minor lipid components of some Acacia species: potential dietary health benefits of the unexploited seeds

BACKGROUND

Oilseed samples from four Acacia species ( A. cyclops, A. ligulata, A. salicina and A. cyanophylla) were analyzed in order to evaluate the potential nutritional value of their unexploited seeds.

METHODS

Samples were collected from different Tunisian geographic locations. Seed oils were extracted and carotenoids, tocopherols and sterols were analyzed using chromatographic methods.

RESULTS

The studied Acacia seeds seem to be quite rich in lipids (from 6% to 12%). All Acacia species contain mainly the xanthophylls zeaxanthin and lutein compounds: from ca. 38 mg.kg⁻¹ of total lipids (A. cyclops) to ca. 113 mg.kg⁻¹ of total lipids (A. cyanophylla). Total tocopherols varied from ca. 221 mg.kg⁻¹ of total lipids (A. cyclops) to ca. 808 mg.kg-1 of total lipids (A. ligulata). Sterols are highly present and their contents ranged between ca. 7 g. kg⁻¹ of total lipids (A. salicina) and 11 g. kg⁻¹ of total lipids (A. cyclops).

CONCLUSION

This study highlights that these unexploited seeds might have a potential nutritional value and encourages researchers to more explore and find developments for these plants for healthy purposes.

Beyond cholesterol-lowering effects of plant sterols: clinical and experimental evidence of anti-inflammatory properties

Inflammation is a strong risk factor for cardiovascular disease. Dietary plant sterols are known to reduce plasma cholesterol levels and thereby reduce cardiovascular risk. Recent observations from animal and human studies have demonstrated anti-inflammatory effects of phytosterols. For example, several animal and human studies report reductions in the levels of proinflammatory cytokines, including C-reactive protein, after consumption of dietary plant sterols. Although the cholesterol-lowering effects of phytosterols in humans are well documented, studies on the effects of phytosterols on inflammatory markers have produced inconsistent results. This review summarizes and discusses findings from recent animal and human studies with regard to the potential anti-inflammatory effects of dietary phytosterols. Findings on the effects of plant sterols on inflammation remain limited and confounding. Future research using better-designed and well-controlled laboratory studies and clinical trials are needed to fully understand the mechanisms through which phytosterols influence inflammation. Additional well-designed placebo-controlled studies are needed to better understand how and to what extent dietary plant sterols may modify the immune system and the production of inflammatory markers.

Competitive solubilization of cholesterol and six species of sterol/stanol in bile salt micelles

Slight differences in the molecular structures of a category of sterol/stanol species affect the solubility of cholesterol in a bile salt solution. We systematically studied the preferential solubilization of cholesterol and sterol/stanol in sodium taurodeoxycholate solutions using relatively minor plant species of sterol/stanol (brassicasterol and stigmasterol) and a non-plant sterol (cholestanol). As relatively major sterol/stanol species (beta-sitosterol, beta-sitostanol, and campesterol) have already been examined using nearly identical procedures to that used in our system, we were able to sufficiently discuss the cholesterol-lowering effects resulting from the molecular structures of six sterol/stanol species. The results of competitive solubilization revealed that cholestanol has the largest cholesterol-lowering effect, decreasing cholesterol solubility to 33% of that in a single solubilizate system. The molecular structure of cholestanol is also most similar to that of cholesterol. In contrast, brassicasterol and stigmasterol have little ability to decrease cholesterol solubility in a mixed binary system. Both have an unsaturated double bond at the side chain of the steroid ring. By applying thermodynamic analyses to these results, we found that the Gibbs energy changes (DeltaG degrees ) of solubilization for sterol/stanol species with cholesterol-lowering effects show larger negative values than that for cholesterol.

Review article: effects of plant sterols and stanols beyond low-density lipoprotein cholesterol lowering

Consumption of foods and supplements enriched with plant sterols/stanols (PS) may help reduce low-density lipoprotein cholesterol (LDL-C) levels. In this review, we consider the effects of PS beyond LDL-C lowering. Plant sterols/stanols exert beneficial effects on other lipid variables, such as apolipoprotein (apo) B/apoAI ratio and, in some studies, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Plant sterols/stanols may also affect inflammatory markers, coagulation parameters, as well as platelet and endothelial function. Evidence also exists about a beneficial effect on oxidative stress, but this does not seem to be of greater degree than that expected from the LDL-C lowering. Many of these effects have been demonstrated in vitro and animal models. Some in vitro effects cannot be seen in vivo or in humans at usual doses. The epidemiological studies that evaluated the association of plasma PS concentration with cardiovascular disease (CVD) risk do not provide a definitive answer. Long-term randomized placebo-controlled studies are required to clarify the effects of supplementation with PS on CVD risk and progression of atherosclerosis.

Role of Physical Structures in Bulk Oils on Lipid Oxidation

Lipid oxidation is important to food manufacturers especially when they increase unsaturated lipids in their products to improve nutritional profiles. Unfortunately, the number of antioxidants available to food manufacturers to control oxidative rancidity is limited and the approval of new antioxidants is unlikely due to economic barriers in obtaining government approval for new food additives. Therefore, new antioxidant technologies are needed for food oils. This paper reviews the current knowledge of lipid oxidation in foods with emphasis on how physical properties of food systems impact oxidation chemistry. In particular, the role of association colloids in bulk oils on lipid oxidation chemistry is discussed in an attempt to understand mechanisms of oxidation. Increasing the understanding of how physical properties impact lipid oxidation could lead to the development of novel antioxidant technologies that not only protect the oil against oxidation and increase shelf-life but also allow food manufacturers to include more nutritionally beneficial fatty acids in their products.

Dietary plant sterols and cholesterol metabolism

Plant sterols, naturally occurring in foods of plant origin, reduce cholesterol absorption. Experimental studies show plant sterols to be an important part of the serum-cholesterol lowering effect of certain diets and dietary components. Epidemiological data show that individuals with higher intakes of plant sterols from their habitual diets have lower serum-cholesterol levels. To date, the role of naturally occurring plant sterols for lowering serum cholesterol has probably been underestimated. The consumption of dietary plant sterols should be a part of dietary advice to patients with hypercholesterolemia and the general public for the prevention and management of coronary heart disease.

Analysis of phytosterols in foods

Phytosterols are bioactive compounds, one of their most studied and outstanding properties being their cholesterol-lowering activity. This explains the growing interest in the phytosterol contents of foods as either intrinsic or added components. The different steps (extraction, saponification, clean up, chromatographic determination) of plant sterol determination are reviewed, and emphasis is placed on the methods used to assay different phytosterols in food.

Separation of Delta5- and Delta7-phytosterols by adsorption chromatography and semipreparative reversed phase high-performance liquid chromatography for quantitative analysis of phytosterols in foods

A method for the separation, isolation, and identification of phytosterols was developed. A commercial phytosterols mixture, Generol 95S, was fractionated first by adsorption silica gel column chromatography and then separated by means of a semipreparative reverse phase high-performance liquid chromatography fitted with a Polaris C8-A column (250 mm x 10 mm i.d., 5 microm) using isocratic acetonitrile:2-propanol:water (2:1:1, v/v/v) as the mobile phase. Milligram scales of six individual phytosterols, including citrostadienol, campesterol, beta-sitosterol, Delta7-avenasterol, Delta7-campesterol, and Delta7-sitosterol, were obtained. Purities of these isolated sterols were 85-98%. Relative response factors (RRF) of these phytosterols were calculated against cholestanol as an authentic commercial standard. These RRF values were used to quantify by gas chromatography-mass spectrometry (GC-MS) the phytosterols content in a reference material, oils, and chocolates.

Novel solid-phase extraction method to separate 4-desmethyl-, 4-monomethyl-, and 4,4'-dimethylsterols in vegetable oils

Conventional methods for sterol fractions separation by TLC have some drawbacks such as low recovery and time consuming. A new solid-phase extraction (SPE) method was developed with stepwise elution by increasing the polarity of solvents mixture: n-hexane and diethyl ether. This method was applied to separate sterol fractions of hazelnut and virgin olive oils, and our results were compared with those of TLC method. The recovery of spiked authentic sample of 4-desmethylsterols in oil was higher with the SPE method (94%) compared with the TLC method (62%). The amount of 4,4'-dimethylsterols and 4-desmethylsterols separated with SPE in both hazelnut and virgin olive oil samples were at least 75% and 35%, respectively, higher than that of TLC. Generally, both methods obtained similar results for 4-monomethylsterols of the two oils. This new SPE method to separate phytosterol fractions was less time consuming, simpler and can be used instead of preparative TLC to detect adulteration of virgin olive oil with hazelnut oil.

Plant sterols as dietary adjuvants in the reduction of cardiovascular risk: theory and evidence

Plant sterol-enriched foods are an effective dietary adjuvant in reducing cardiovascular risk by lowering total cholesterol and low density lipoprotein-cholesterol (LDL-C) in serum by up to approximately 15%. The mechanism of action of plant sterols is different from those of 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) and thus their effect is additive. Combining plant sterols with other dietary components known to reduce cholesterol in a portfolio approach has proven to be most effective for reduction of hypercholesterolemia and provide an alternative treatment option for clinicians. Plant sterol-enriched foods provides clinicians with a relatively cheap, safe, and effective way to help patients manage their cardiovascular risk.