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Gao Y, Xun R, Xia J, Xia H, Sun G. Effects of phytosterol supplementation on lipid profiles in patients with hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials. Food Funct 2023; 14:2969-2997. [PMID: 36891733 DOI: 10.1039/d2fo03663k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
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], p < 0.001; LDL-C: WMD [95% CI] = -0.34 [-0.37, -0.30], p < 0.001). In contrast, PSs had no effect on high density lipoprotein cholesterol (HDL-C) or triglycerides (TGs) (HDL-C: WMD [95% CI] = 0.00 [-0.01, 0.02], p = 0.742; TG: WMD [95% CI] = -0.01 [-0.04, 0.01], p = 0.233). Also, a significant effect of supplemental dose on LDL-C levels was observed in a nonlinear dose-response analysis (p-nonlinearity = 0.024). Our findings suggest that dietary phytosterols can help reduce TC and LDL-C concentrations in hypercholesterolemia patients without affecting HDL-C and TG concentrations. And the effect may be affected by the food substrate, dose, esterification, intervention cycle and region. The dose of phytosterol is an important factor affecting the level of LDL-C.
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Affiliation(s)
- Yusi Gao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Ruilong Xun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Jiayue Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China. .,China-DRIs Expert Committee on Other Dietary Ingredients, Beijing 100052, China
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2
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Kumar H, Bhardwaj K, Cruz-Martins N, Sharma R, Siddiqui SA, Dhanjal DS, Singh R, Chopra C, Dantas A, Verma R, Dosoky NS, Kumar D. Phyto-Enrichment of Yogurt to Control Hypercholesterolemia: A Functional Approach. Molecules 2022; 27:molecules27113479. [PMID: 35684416 PMCID: PMC9182380 DOI: 10.3390/molecules27113479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 02/05/2023] Open
Abstract
Cholesterol is essential for normal human health, but elevations in its serum levels have led to the development of various complications, including hypercholesterolemia (HC). Cholesterol accumulation in blood circulation formsplaques on artery walls and worsens the individuals’ health. To overcome this complication, different pharmacological and non-pharmacological approaches are employed to reduce elevated blood cholesterol levels. Atorvastatin and rosuvastatin are the most commonly used drugs, but their prolonged use leads to several acute side effects. In recent decades, the potential benefit of ingesting yogurt on lipid profile has attracted the interest of researchers and medical professionals worldwide. This review aims to give an overview of the current knowledge about HC and the different therapeutic approaches. It also discusses the health benefits of yogurt consumption and highlights the overlooked phyto-enrichment option to enhance the yogurt’s quality. Finally, clinical studies using different phyto-enriched yogurts for HC management are also reviewed. Yogurt has a rich nutritional value, but its processing degrades the content of minerals, vitamins, and other vital constituents with beneficial health effects. The option of enriching yogurt with phytoconstituents has drawn a lot of attention. Different pre-clinical and clinical studies have provided new insights on their benefits on gut microbiota and human health. Thus, the yogurtphyto-enrichment with stanol and β-glucan have opened new paths in functional food industries and found healthy andeffective alternatives for HC all along with conventional treatment approaches.
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Affiliation(s)
- Harsh Kumar
- School of Bioengineering & Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (H.K.); (R.S.); (A.D.)
| | - Kanchan Bhardwaj
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (K.B.); (R.V.)
| | - Natália Cruz-Martins
- Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal
- Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra PRD, Portugal
- Correspondence: (N.C.-M.); (N.S.D.); (D.K.)
| | - Ruchi Sharma
- School of Bioengineering & Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (H.K.); (R.S.); (A.D.)
| | - Shahida Anusha Siddiqui
- German Institute of Food Technologies (DIL e.V.), Prof.-von-Klitzing Str. 7, 49610 D-Quakenbrück, Germany;
- Department of Biotechnology and Sustainability, Technical University of Munich, Schulgasse 22, 94315 Straubing, Germany
| | - Daljeet Singh Dhanjal
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, Punjab, India; (D.S.D.); (R.S.); (C.C.)
| | - Reena Singh
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, Punjab, India; (D.S.D.); (R.S.); (C.C.)
| | - Chirag Chopra
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, Punjab, India; (D.S.D.); (R.S.); (C.C.)
| | - Adriana Dantas
- School of Bioengineering & Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (H.K.); (R.S.); (A.D.)
| | - Rachna Verma
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (K.B.); (R.V.)
| | - Noura S. Dosoky
- Aromatic Plant Research Center, 230 N 1200 E, Suite 100, Lehi, UT 84043, USA
- Correspondence: (N.C.-M.); (N.S.D.); (D.K.)
| | - Dinesh Kumar
- School of Bioengineering & Food Technology, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India; (H.K.); (R.S.); (A.D.)
- Correspondence: (N.C.-M.); (N.S.D.); (D.K.)
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3
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Matsuoka R. Property of Phytosterols and Development of Its Containing Mayonnaise-Type Dressing. Foods 2022; 11:foods11081141. [PMID: 35454728 PMCID: PMC9029110 DOI: 10.3390/foods11081141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/11/2022] Open
Abstract
Phytosterols are functional ingredients with known efficacy and safety. Phytosterols are found as free sterols or as their esters with fatty acids. Although phytosterol esters are soluble in oil and have been used in many commercial foods, it has been difficult to similarly use free phytosterols since they are insoluble in water and practically insoluble in oil. We have developed mayonnaise-type dressing materials using free phytosterols since people who are conscious about cholesterol intake are likely to be conscious about oil. In this review article, we summarized pieces of evidence for the development of phytosterol-containing mayonnaise-type dressing materials.
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Sharp E, D'Cunha NM, Ranadheera CS, Vasiljevic T, Panagiotakos DB, Naumovski N. Effects of lactose-free and low-lactose dairy on symptoms of gastrointestinal health: A systematic review. Int Dairy J 2021. [DOI: 10.1016/j.idairyj.2020.104936] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Hyperlipidemia is an abnormality of lipid metabolism, characterized by an elevation of total cholesterol, triglyceride, and low density lipoprotein-cholesterol, and/or a decreasing of high density lipoprotein cholesterol in circulating levels. Hyperlipidemia has been ranked as one of the greatest risk factors contributing to prevalence and severity of coronary heart diseases. Hyperlipidemia-associated lipid disorders are considered the cause of atherosclerotic cardiovascular disease. There has been a growing interest in natural products and their role in the maintenance and improvement of health and wellness. The cholesterol-lowering effect of dietary plants has been well studied and various natural products were shown to be helpful in lowering plasma cholesterol levels and encouraging safety profile. The main focus of this review is to describe what we know to date of natural products, along with their lipid-lowering mechanisms, which are either through inhibition of cholesterol absorption, inhibition of cholesterol synthesis or antioxidant mechanisms.
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Affiliation(s)
| | - Abeer Temraz
- b Pharmacognosy Department, College of Pharmacy , Umm Al-Qura University , Makkah , Saudi Arabia
- c Pharmacognosy Department , Faculty of Pharmacy (Girls), Al-Azhar University , Nasr City , Cairo , Egypt
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6
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Soto-Méndez MJ, Rangel-Huerta OD, Ruiz-López MD, Martínez de Victoria E, Anguita-Ruiz A, Gil A. Role of Functional Fortified Dairy Products in Cardiometabolic Health: A Systematic Review and Meta-analyses of Randomized Clinical Trials. Adv Nutr 2019; 10:S251-S271. [PMID: 31089744 PMCID: PMC6518140 DOI: 10.1093/advances/nmz001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/26/2018] [Indexed: 12/11/2022] Open
Abstract
There is insufficient evidence on the role of functional fortified dairy products in improving health and in preventing risk factors associated with noncommunicable chronic diseases. This systematic review was conducted to summarize effects of the consumption of fortified dairy products on biomarkers of cardiometabolic risk. MEDLINE and SCOPUS databases were used to perform searches to include studies published up to 30 April 2018. Randomized clinical trials with human subjects consuming dairy products fortified with phytosterols, FAs, vitamins or minerals and relating this consumption with cardiometabolic health were included in this review. Risk of bias assessment according to Cochrane guidelines was performed to determine the quality of the trials. Forty-one studies were finally selected for this synthesis; the selected studies tested dairy products fortified with the following nutrients and bioactive components: phytosterols (n = 31), FAs (n = 8), and vitamin D (n = 2). We found that the consumption of phytosterol-fortified dairy, led to an overall LDL cholesterol reduction of -0.36 (-0.41, -0.31) mmol/L, P < 0.001; this decrease was mainly related to the dosage. Likewise, consumption of ω-3 FA-fortified dairy products resulted in a plasma LDL cholesterol reduction of -0.18 (-0.27, -0.09) mmol/L as well as a decrease of -0.18 (-0.32, -0.05) mmol/L in triacylglycerols (TG). Performing meta-analyses of the consumption of dairy products fortified with vitamin D or FAs other than ω-3 FAs and biomarkers of cardiometabolic risk was not possible because of the few available publications. Our results indicate that consumption of dairy products fortified with phytosterols and ω-3 FAs can lead to a reduction of LDL cholesterol and consumption of fortified dairy products fortified with ω-3 FAs can reduce TG concentration. However, more studies with homogeneous designs are needed to determine the advantages of using dairy products as fortification vehicles to prevent cardiometabolic risk.
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Affiliation(s)
| | - Oscar D Rangel-Huerta
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - María D Ruiz-López
- Iberoamerican Nutrition Foundation –FINUT–, Granada, Spain
- Department of Nutrition and Food Sciences, School of Pharmacy
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
| | - Emilio Martínez de Victoria
- Iberoamerican Nutrition Foundation –FINUT–, Granada, Spain
- Department of Physiology, School of Sciences
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
| | - Augusto Anguita-Ruiz
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
- Biomedical Research Institute ibs GRANADA, University Hospital Complex in Granada, Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
| | - Angel Gil
- Iberoamerican Nutrition Foundation –FINUT–, Granada, Spain
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
- Biomedical Research Institute ibs GRANADA, University Hospital Complex in Granada, Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
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7
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Ghaedi E, Varkaneh HK, Rahmani J, Mousavi SM, Mohammadi H, Fatahi S, Pantovic A, Darooghegi Mofrad M, Zhang Y. Possible anti‐obesity effects of phytosterols and phytostanols supplementation in humans: A systematic review and dose–response meta‐analysis of randomized controlled trials. Phytother Res 2019; 33:1246-1257. [DOI: 10.1002/ptr.6319] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/19/2018] [Accepted: 01/28/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Ehsan Ghaedi
- Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences Tehran Iran
- Students' Scientific Research Center (SSRC)Tehran University of Medical Sciences (TUMS) Tehran Iran
| | - Hamed Kord Varkaneh
- Student Research Committee, Department Clinical Nutrition and DieteticsFaculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Jamal Rahmani
- Student Research Committee, Department Clinical Nutrition and DieteticsFaculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences Tehran Iran
| | - Hamed Mohammadi
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical Sciences Isfahan Iran
- Students' Research CommitteeIsfahan University of Medical Sciences Isfahan Iran
| | - Somaye Fatahi
- Department of Nutrition, School of Public HealthIran University of Medical Sciences Tehran Iran
| | - Ana Pantovic
- Institute for Medical Research, Centre of Research Excellence in Nutrition and MetabolismUniversity of Belgrade Serbia
| | - Manije Darooghegi Mofrad
- Department of Community Nutrition, School of Nutritional Sciences and DieteticsTehran University of Medical Sciences Tehran Iran
| | - Yong Zhang
- Department of Nutrition and Food Hygiene, School of Public Health and Health ManagementChongqing Medical University Chongqing China
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8
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Anastasova L, Petreska Ivanovska T, Petkovska R, Petrusevska-Tozi L. Concepts, benefits and perspectives of functional dairy food products. MAKEDONSKO FARMACEVTSKI BILTEN 2019. [DOI: 10.33320/maced.pharm.bull.2018.64.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The rising awareness of the consumers towards the health benefits of food has resulted in the development of the so-called functional foods. These added value products which refer to prevention and/or therapeutic effects of food beyond its nutritional value, are especially useful for health improvement and reduction of medical care costs. The combination between health and nutrition and its potential to improve the quality of life has become one of the key attention points of consumers who are aware of and are seeking nutritional solutions to their health concerns.
Milk and dairy products have been used in human nutrition for thousands of years, providing important nutrients for the human body such as proteins, fats and calcium. It is now widely recognized that in addition to their basic nutritive role they also exert functional properties beneficial for human health, so the development of functional dairy products is one of the fastest growing areas in the dairy industry as well as one of the largest sectors in the global market of functional foods.
This review provides a brief overview of the health benefits and the natural functionality of dairy products as well as the challenges together with the future perspectives of their application as delivery vehicles for beneficial compounds to the human body.
Keywords: functional foods, milk, dairy products
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Affiliation(s)
- Liljana Anastasova
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, Ss. Cyril and Methodius University, Mother Theresa 47, 1000 Skopje, Republic of Macedonia
| | - Tanja Petreska Ivanovska
- Institute of Applied Biochemistry, Faculty of Pharmacy, Ss. Cyril and Methodius University, Mother Theresa 47, 10000 Skopje, Republic of Macedonia
| | - Rumenka Petkovska
- Institute of Applied Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy, Ss. Cyril and Methodius University, Mother Theresa 47, 1000 Skopje, Republic of Macedonia
| | - Lidija Petrusevska-Tozi
- Institute of Applied Biochemistry, Faculty of Pharmacy, Ss. Cyril and Methodius University, Mother Theresa 47, 10000 Skopje, Republic of Macedonia
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9
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Ahmadi K, Oktafa H, Estiasih T. The Effect of Phytosterol-Rich Fraction from Palm Fatty Acid Distillate on Blood Serum Lipid Profile of Dyslipidemia Rats. J Diet Suppl 2018; 15:728-739. [PMID: 29336623 DOI: 10.1080/19390211.2017.1406025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Phytosterol-rich fraction (PRF) obtained from palm fatty acid distillate (PFAD) was investigated for its effect on blood serum lipid profile of dyslipidemia rats. Dyslipidemia was induced by force feeding cholesterol to five groups of rats; one group was a control or normal group. Cholesterol force-fed groups were treated with 0, 10, 20, 30, and 40 mg PRF/kg/day for 4 weeks. All groups of rats were fed standard diet. A normal group was fed standard diet without PRF treatment and cholesterol force feeding. Lipid profile was measured every week (0, 1, 2, 3, and 4). Four-week treatment resulted in significant blood serum lipid profile improvement. PRF improved blood serum lipid profile by decreasing total cholesterol, triglyceride, and low density lipoprotein (LDL) cholesterol level and increasing high density lipoprotein (HDL) cholesterol level. The doses of PRF significantly affected blood serum lipid profile as well as duration of PRF treatment. PRF inhibited cholesterol absorption, which delayed blood serum total cholesterol rise. Cholesterol absorption inhibition was also indicated by higher fecal cholesterol concentration after PRF feeding. These results indicate the beneficial effect of PRF in the treatment of dyslipidemia.
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Affiliation(s)
- Kgs Ahmadi
- a Department of Agroindustry Technology , Faculty of Agriculture, Tribhuwana Tunggadewi University , Jl. Telaga Warna, Tlogomas, Malang, Jawa Timur , Indonesia
| | - Huda Oktafa
- b Department of Food Science and Technology , Faculty of Agricultural Technology, Brawijaya University , Jl. Veteran, Malang, Jawa Timur , Indonesia
| | - Teti Estiasih
- b Department of Food Science and Technology , Faculty of Agricultural Technology, Brawijaya University , Jl. Veteran, Malang, Jawa Timur , Indonesia
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Qasimi MI, Nagaoka K, Watanabe G. Feeding of phytosterols reduced testosterone production by modulating GnRH and GnIH expression in the brain and testes of male Japanese quail (Coturnix coturnix japonica). Poult Sci 2018; 97:1066-1072. [DOI: 10.3382/ps/pex370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 11/14/2017] [Indexed: 11/20/2022] Open
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Aryana KJ, Olson DW. A 100-Year Review: Yogurt and other cultured dairy products. J Dairy Sci 2017; 100:9987-10013. [DOI: 10.3168/jds.2017-12981] [Citation(s) in RCA: 204] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/01/2017] [Indexed: 11/19/2022]
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Fardet A, Morise A, Kalonji E, Margaritis I, Mariotti F. Influence of phytosterol and phytostanol food supplementation on plasma liposoluble vitamins and provitamin A carotenoid levels in humans: An updated review of the evidence. Crit Rev Food Sci Nutr 2017; 57:1906-1921. [PMID: 26193046 DOI: 10.1080/10408398.2015.1033611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Phytosterols and phytostanols (PAP) compete with cholesterol absorption in the intestine, resulting in a 5-15%-reduction in plasma total and LDL cholesterol. An important issue is the PAP potential to reduce the plasma concentrations of fat-soluble vitamins and provitamin A carotenoids. Here, an update of the scientific evidence is reviewed to evaluate plant PAP-enriched foods impact on plasma fat-soluble vitamins and carotenoid levels, and to discuss potential implications in terms of cardiovascular risk. Based on 49 human interventional and 3 bioavailability studies, results showed that regular consumption, particularly over the long term, of foods fortified with PAP as recommended in labeling does not significantly impact plasma vitamins A, D, and K concentration. A 10% significant median reduction was observed for α-tocopherol. Concerning carotenoids, while 13 studies did not demonstrate statistically significant plasma β-carotene reduction, 20 studies showed significant reductions, with median effect size of -24%. This decline can be mitigated or offset by increased fruits and vegetables consumption. Furthermore, higher cardiovascular risk was observed for differences in plasma β-carotene concentration of the same magnitude as the estimated average decrease by PAP consumption. These results are supported by the only study of β-carotene bioavailability showing decrease in absorption by phytosterols daily intake.
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Affiliation(s)
- Anthony Fardet
- a INRA, JRU 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand & Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine , Clermont - Ferrand , France
| | - Anne Morise
- b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France
| | - Esther Kalonji
- b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France
| | - Irène Margaritis
- b ANSES, Unité d'Evaluation de Risques liés à la Nutrition , Maison-Alfort , France
| | - François Mariotti
- c AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior , Paris , France.,d INRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior , Paris , France
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13
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Semeniuc CA, Cardenia V, Mandrioli M, Muste S, Borsari A, Rodriguez-Estrada MT. Stability of flavoured phytosterol-enriched drinking yogurts during storage as affected by different packaging materials. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2016; 96:2782-2787. [PMID: 26332790 DOI: 10.1002/jsfa.7443] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/06/2015] [Accepted: 08/27/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND The aim of this study was to investigate the influence of different packaging materials on storage stability of flavoured phytosterol-enriched drinking yogurts. White vanilla (WV) and blood orange (BO) phytosterol-enriched drinking yogurts conditioned in mono-layer and triple-layer co-extruded plastic bottles were stored at +6 ± 1 °C for 35 days (under alternating 12 h light and 12 h darkness) to simulate shelf-life conditions. Samples were collected at three different storage times and subjected to determination of total sterol content (TSC), peroxide value (PV) and thiobarbituric acid reactive substances (TBARs). RESULTS TSC was not significantly affected by packaging material or storage time and met the quantity declared on the label. PV was significantly influenced by yogurt type × packaging material × storage time interaction and TBARs by packaging material × storage time interaction. CONCLUSION Between the two packaging materials, the triple-layer plastic mini bottle with black coloured and completely opaque intermediate layer offered the best protection against lipid oxidation. © 2015 Society of Chemical Industry.
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Affiliation(s)
- Cristina Anamaria Semeniuc
- Department of Food Engineering, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, 3-5 Mănăştur St, 400372 Cluj-Napoca, Romania
| | - Vladimiro Cardenia
- Inter-Departmental Centre for Agri-Food Industrial Research, Alma Mater Studiorum-Università di Bologna, Piazza Goidanich 60, 47521 Cesena, Italy
| | - Mara Mandrioli
- Department of Food Science, Alma Mater Studiorum-Università di Bologna, Viale Fanin 40, 40127 Bologna, Italy
| | - Sevastiţa Muste
- Department of Food Engineering, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, 3-5 Mănăştur St, 400372 Cluj-Napoca, Romania
| | - Andrea Borsari
- Granarolo S.p.A., Via Cadriano 27/2, 40127 Bologna, Italy
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Prasad C, Imrhan V, Juma S, Maziarz M, Prasad A, Tiernan C, Vijayagopal P. Bioactive Plant Metabolites in the Management of Non-Communicable Metabolic Diseases: Looking at Opportunities beyond the Horizon. Metabolites 2015; 5:733-65. [PMID: 26703752 PMCID: PMC4693193 DOI: 10.3390/metabo5040733] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 12/02/2015] [Accepted: 12/09/2015] [Indexed: 02/06/2023] Open
Abstract
There has been an unprecedented worldwide rise in non-communicable metabolic diseases (NCDs), particularly cardiovascular diseases (CVD) and diabetes. While modern pharmacotherapy has decreased the mortality in the existing population, it has failed to stem the rise. Furthermore, a large segment of the world population cannot afford expensive pharmacotherapy. Therefore, there is an urgent need for inexpensive preventive measures to control the rise in CVD and diabetes and associated co-morbidities. The purpose of this review is to explore the role of food bioactives in prevention of NCDs. To this end, we have critically analyzed the possible utility of three classes of food bioactives: (a) resistant starch, a metabolically resistant carbohydrate known to favorably modulate insulin secretion and glucose metabolism; (b) cyclo (His-Pro), a food-derived cyclic dipeptides; and (c) polyphenol-rich berries. Finally, we have also briefly outlined the strategies needed to prepare these food-bioactives for human use.
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Affiliation(s)
- Chandan Prasad
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX 76204, USA.
- Department of Medicine, LSU Health Sciences Center, New Orleans, LA 70112, USA.
| | - Victorine Imrhan
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX 76204, USA.
| | - Shanil Juma
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX 76204, USA.
| | - Mindy Maziarz
- Department of Nutrition and Food Sciences, Texas Woman's University, Houston, TX 77030, USA.
| | - Anand Prasad
- Department of Medicine, Division of Cardiology, UT Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | - Casey Tiernan
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX 76204, USA.
| | - Parakat Vijayagopal
- Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX 76204, USA.
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Kietsiriroje N, Kwankaew J, Kitpakornsanti S, Leelawattana R. Effect of phytosterols and inulin-enriched soymilk on LDL-cholesterol in Thai subjects: a double-blinded randomized controlled trial. Lipids Health Dis 2015; 14:146. [PMID: 26553006 PMCID: PMC4640379 DOI: 10.1186/s12944-015-0149-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/03/2015] [Indexed: 12/29/2022] Open
Abstract
Background Hypercholesterolemia, particularly high LDL-c and non-HDL-c levels, is a traditional risk for cardiovascular disease. Ingestion of diets containing phytosterols and inulin can reduce plasma LDL-c and triglyceride levels, respectively. Phytosterols and inulin-enriched soymilk may be an alternative for a supplemental diet to improve both LDL-c and non-HDL-c to reduce the risk of cardiovascular disease. Methods Two hundred and forty subjects who were 18 years old or older and had a baseline LDL-c of 130 mg/dl or higher were enrolled into the double-blinded randomized controlled trial study. Subjects were randomly assigned into the study group that received 2 g/day of phytosterols and 10 g/day of inulin-enriched soymilk or into the control group that received standard soymilk. The lipid profile was measured every 2 weeks for 8 weeks. Primary outcomes were 1) to determine the LDL-c reduction after consumption of phytosterols and inulin-enriched soymilk for 8 weeks and 2) to compare the difference of the LDL-c levels between the study and control groups. The secondary outcomes were to compare the difference of TC, TG and HDL-c between the study and control groups. Results At the end of the study, the median LDL-c levels decreased significantly from 165 (132, 254) mg/dl to 150 (105, 263) mg/dl in the study group (p < 0.001) and from 165 (130, 243) mg/dl to 159 (89, 277) mg/dl in the control group (p = 0.014). The LDL-c reduction was significantly better in the study group (−10.03 %, (−37.07, 36.00) vs −1.31 % (−53.40, 89.73), p < 0.001). TC also reduced significantly by 6.60 % in the study group while it reduced only by 1.76 % in the control group (p < 0.001). There were no statistical differences in TG and HDL-c levels between both study groups. The adverse events in the study group and the control groups were not different (RR 1.33 [0.871-2.030, 95 % CI]). Conclusion Daily consumption of soymilk containing 2 g of phytosterols and 10 g of inulin reduced TC and LDL-c better than standard soymilk. It had no effect on TG and HDL-c levels compared to standard soymilk. Both soymilk products were comparably safe. Trial registration Thai Clinical Trial Registry: TCTR20150417001 date: April 17, 2015 Electronic supplementary material The online version of this article (doi:10.1186/s12944-015-0149-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Noppadol Kietsiriroje
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanish Rd, Hat Yai, Songkhla, 90110, Thailand.
| | - Jirateep Kwankaew
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanish Rd, Hat Yai, Songkhla, 90110, Thailand. .,Internal Medicine Clinic, Samitivej Srinakarin Hospital, Bangkok, 10250, Thailand.
| | - Sunita Kitpakornsanti
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanish Rd, Hat Yai, Songkhla, 90110, Thailand. .,Division of Internal Medicine, Trang Hospital, Trang, 92000, Thailand.
| | - Rattana Leelawattana
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanish Rd, Hat Yai, Songkhla, 90110, Thailand.
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Barbagallo CM, Cefalù AB, Noto D, Averna MR. Role of Nutraceuticals in Hypolipidemic Therapy. Front Cardiovasc Med 2015; 2:22. [PMID: 26664894 PMCID: PMC4671351 DOI: 10.3389/fcvm.2015.00022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/22/2015] [Indexed: 11/29/2022] Open
Abstract
Nutraceuticals are food components or active ingredients present in foods and used in therapy. This article analyzes the characteristics of the molecules with a lipid-lowering effect. The different nutraceuticals may have different mechanisms of action: inhibition of cholesterol synthesis primarily through action on the enzyme HMG-CoA reductase (policosanol, polyphenols, garlic and, above all, red yeast rice), increase in LDL receptor activity (berberine), reduction of intestinal cholesterol absorption (garlic, plant sterols, probiotics), and also the ability to interfere with bile metabolism (probiotics, guggul). Based on the different mechanisms of action, some nutraceuticals are then able to enhance the action of statins. Nutraceuticals are often used without relevant evidence: mechanisms of action are not clearly confirmed; most of clinical data are derived from small, uncontrolled studies, and finally, except for fermented red rice, there are no clinical trials which may document the relationship between these interventions and the reduction of clinical events. Therefore, among all nutraceuticals, it is necessary to extrapolate those having a really documentable efficacy. However, these kinds of treatments are usually well-tolerated by patients. Overall, subjects with a middle or low cardiovascular risk are the best indication of nutraceuticals, but they may also be useful for patients experiencing side effects during classical therapies. Finally, in consideration of the additive effect of some nutraceuticals, a combination therapy with classical drugs may improve the achievement of clinical targets. Thus, nutraceuticals may be a helpful alternative in hypolipidemic treatment and, if properly used, might represent a valid strategy of cardiovascular prevention.
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Affiliation(s)
- Carlo M Barbagallo
- Biomedical Department of Internal Medicine and Specialistics (DIBIMIS), University of Palermo , Palermo , Italy
| | - Angelo Baldassare Cefalù
- Biomedical Department of Internal Medicine and Specialistics (DIBIMIS), University of Palermo , Palermo , Italy
| | - Davide Noto
- Biomedical Department of Internal Medicine and Specialistics (DIBIMIS), University of Palermo , Palermo , Italy
| | - Maurizio R Averna
- Biomedical Department of Internal Medicine and Specialistics (DIBIMIS), University of Palermo , Palermo , Italy
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Ramprasath VR, Jenkins DJA, Lamarche B, Kendall CWC, Faulkner D, Cermakova L, Couture P, Ireland C, Abdulnour S, Patel D, Bashyam B, Srichaikul K, de Souza RJ, Vidgen E, Josse RG, Leiter LA, Connelly PW, Frohlich J, Jones PJH. Consumption of a dietary portfolio of cholesterol lowering foods improves blood lipids without affecting concentrations of fat soluble compounds. Nutr J 2014; 13:101. [PMID: 25326876 PMCID: PMC4223745 DOI: 10.1186/1475-2891-13-101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 10/07/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND 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. OBJECTIVE The objective was to determine effects of consumption of a cholesterol lowering dietary portfolio on circulating concentrations of PS and fat soluble vitamins. METHODS 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. RESULTS 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. CONCLUSION 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. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00438425.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Peter J H Jones
- Richardson Centre for Functional Foods and Nutraceuticals, Winnipeg, MB R3T 2 N2, Canada.
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Amir Shaghaghi M, Harding SV, Jones PJ. Water dispersible plant sterol formulation shows improved effect on lipid profile compared to plant sterol esters. J Funct Foods 2014. [DOI: 10.1016/j.jff.2013.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
SummaryCardiovascular disease (CVD) is a major cause of morbidity and mortality in the Western world in older people. Diet and lifestyle change can reduce CVD risk in older people, and this evidence base is reviewed. For example, diets low in trans fats can reduce CVD risk, while for saturated fats the CVD-lowering effect depends on what is substituted for the saturated fat. Diets rich in fish reduce CVD risk, although n-3 supplements have not been shown to have a consistent effect on CVD end-points. Antioxidant and B-group vitamin supplementation are unlikely to reduce CVD risk, but diets rich in these micronutrients (e.g. rich in fruits and vegetables and the Mediterranean diet) are associated with lower CVD risk, while, for the Mediterranean diet, this has been supported by randomized controlled trials. Maintaining a healthy weight and being physically active reduce CVD risk factors and CVD incidence and mortality.
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Amir Shaghaghi M, Abumweis SS, Jones PJ. Cholesterol-Lowering Efficacy of Plant Sterols/Stanols Provided in Capsule and Tablet Formats: Results of a Systematic Review and Meta-Analysis. J Acad Nutr Diet 2013; 113:1494-1503. [DOI: 10.1016/j.jand.2013.07.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 06/18/2013] [Indexed: 11/29/2022]
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Buyuktuncer Z, Fisunoğlu M, Guven GS, Unal S, Besler HT. The cholesterol lowering efficacy of plant stanol ester yoghurt in a Turkish population: a double-blind, placebo-controlled trial. Lipids Health Dis 2013; 12:91. [PMID: 23786762 PMCID: PMC3695842 DOI: 10.1186/1476-511x-12-91] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/28/2013] [Indexed: 11/25/2022] Open
Abstract
Background We evaluated the cholesterol lowering efficacy of low-fat spoonable yoghurt with 1.9 g/d plant stanols as esters on plasma lipid profiles of Turkish subjects with mild to moderate hypercholesterolemia. Methods Using a randomised, double-blind, placebo-controlled study design, intervention (n = 35) and control (n = 35) groups consumed either 115 g low-fat yoghurt with 1.9 g/d plant stanols as esters or placebo yoghurt, respectively, for 4 weeks. Seventy subjects with untreated mild to moderate hypercholesterolemia (aged 23-65 years) were recruited. Changes in the lipid profile, including lipoproteins, apolipoproteins, and triglycerides, and anthropometric measurements were monitored at screening, baseline, and at the end of the second, third, and fourth weeks of intervention. The general linear model repeated measures procedure was used to test differences in the repeated continuous variables between study groups. Results Serum total cholesterol (4.6%), LDL cholesterol (6.3%), and non-HDL cholesterol (6.2%) concentrations were reduced significantly from baseline in the plant stanol group compared to the control group (p = 0.007, p = 0.005 and p = 0.005, respectively). A variation in the response of serum total and LDL cholesterol between the subjects in plant stanol group was obtained. No clinically significant change in anthropometrical measurements was observed during the intervention. Conclusions The spoonable low-fat yoghurt with 1.9 g/d plant stanols as esters lowered total, LDL, and non-HDL cholesterol levels in Turkish subjects with mild to moderate hypercholesterolemia. Nevertheless variation in baseline cholesterol levels, genetic predisposition of the subjects and compliance may contribute to a large individual variability.
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Pasha I, Saeed F, Waqas K, Anjum FM, Arshad MU. Nutraceutical and functional scenario of wheat straw. Crit Rev Food Sci Nutr 2013; 53:287-95. [PMID: 23216000 DOI: 10.1080/10408398.2010.528080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In the era of nutrition, much focus has been remunerated to functional and nutraceutical foodstuffs. The health endorsing potential of such provisions is attributed to affluent phytochemistry. These dynamic constituents have functional possessions that are imperative for cereal industry. The functional and nutraceutical significance of variety of foods is often accredited to their bioactive molecules. Numerous components have been considered but wheat straw and its diverse components are of prime consideration. In this comprehensive dissertation, efforts are directed to elaborate the functional and nutraceutical importance of wheat straw. Wheat straw is lignocellulosic materials including cellulose, hemicellulose and lignin. It hold various bioactive compounds such as policosanols, phytosterols, phenolics, and triterpenoids, having enormous nutraceutical properties like anti-allergenic, anti-artherogenic, anti-inflammatory, anti-microbial, antioxidant, anti-thrombotic, cardioprotective and vasodilatory effects, antiviral, and anticancer. These compounds are protecting against various ailments like hypercholesterolemia, intermittent claudication, benign prostatic hyperplasia and cardiovascular diseases. Additionally, wheat straw has demonstrated successfully, low cost, renewable, versatile, widely distributed, easily available source for the production of biogas, bioethanol, and biohydrogen in biorefineries to enhance the overall effectiveness of biomass consumption in protected and eco-friendly environment. Furthermore, its role in enhancing the quality and extending the shelf life of bakery products through reducing the progression of staling and retrogradation is limelight of the article.
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Affiliation(s)
- Imran Pasha
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan
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Panpipat W, Xu X, Guo Z. Improved acylation of phytosterols catalyzed by Candida antarctica lipase A with superior catalytic activity. Biochem Eng J 2013. [DOI: 10.1016/j.bej.2012.09.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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A highly sensitive quantification of phytosterols through an inexpensive derivatization. Chem Phys Lipids 2013; 166:18-25. [DOI: 10.1016/j.chemphyslip.2012.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 11/29/2012] [Accepted: 12/07/2012] [Indexed: 11/21/2022]
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25
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Comparable reduction in cholesterol absorption after two different ways of phytosterol administration in humans. Eur J Nutr 2012; 52:1215-22. [DOI: 10.1007/s00394-012-0432-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 07/26/2012] [Indexed: 10/28/2022]
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Solà R, Valls RM, Godàs G, Perez-Busquets G, Ribalta J, Girona J, Heras M, Cabré A, Castro A, Domenech G, Torres F, Masana L, Anglés N, Reguant J, Ramírez B, Barriach JM. Cocoa, hazelnuts, sterols and soluble fiber cream reduces lipids and inflammation biomarkers in hypertensive patients: a randomized controlled trial. PLoS One 2012; 7:e31103. [PMID: 22383996 PMCID: PMC3287993 DOI: 10.1371/journal.pone.0031103] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Accepted: 01/02/2012] [Indexed: 02/05/2023] Open
Abstract
Background Cocoa, mixed with other food ingredients, intake can have beneficial effects on cardiovascular disease (CVD) biomarkers. We compared the effects of 4 cocoa cream products on some of these biomarkers. Methods and Findings In this multi-centered, randomized, controlled, double-blind, parallel trial, volunteers (n = 113; age range: 43–65 years) who were pre-hypertensive, stage-1 hypertensive and hypercholesterolemic received one of 4 cocoa cream products (13 g/unit; 1 g cocoa/unit, 6 units/d; 465 Kcal/d) added to a low saturated fat diet for 4 weeks. The groups were: A) (n = 28), cocoa cream considered as control; B) (n = 28), cocoa+hazelnut cream (30 g/d hazelnuts); C) (n = 30), cocoa+hazelnuts+phytosterols (2 g/d); and D) (n = 27), cocoa+hazelnuts+phytosterols+soluble fiber (20 g/d) the patented “LMN product”. Primary outcome measures were BP, LDL-c, apolipoprotein B-100 (Apo B), ApoB/ApoA ratio, oxidized LDL (oxLDL) and high-sensitive C-reactive protein (hsCRP) determined at baseline and post-cocoa cream product intake. Statistical analysis used was ANCOVA or mixed models (in case of repeated measurements), with baseline observation included as a covariate. After 4 weeks, compared to product A, product C reduced LDL-c by 11.2%, Apo B by 8.1% and ApoB/ApoA ratio by 7.8% (P = 0.01). LMN decreased LDL-c by 9.2%, Apo B-100 by 8.5%, ApoB/ApoA ratio by 10.5%, hsCRP by 33.4% and oxLDL by 5.9% (P = 0.01). Surprisingly, even “control” product A reduced systolic BP (−7.89 mmHg; 95%CI: −11.45 to −4.3) and diastolic BP (−5.54 mmHg; 95%CI: −7.79 to −3.29). The BP reductions were similar with the other 3 products. Limitations of the study are that the trial period was relatively short and that a better “BP control” product would have been preferable. Conclusion The creams (particularly the LMN) have anti-inflammatory and antioxidant effects in addition to lowering LDL-c, Apo B and ApoB/ApoA ratio. Thus, the soluble fiber effects amplified with sterols (as contained in the cocoa creams) provide new dietary therapeutic perspectives. Trial Registration Clinicaltrials.gov NCT00511420
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Affiliation(s)
- Rosa Solà
- Unitat de Recerca en Lípids i Arteriosclerosi, CIBERDEM, Hospital Universitari Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, Reus, Spain.
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Maki KC, Lawless AL, Reeves MS, Dicklin MR, Jenks BH, Shneyvas E, Brooks JR. Lipid-altering effects of a dietary supplement tablet containing free plant sterols and stanols in men and women with primary hypercholesterolaemia: a randomized, placebo-controlled crossover trial. Int J Food Sci Nutr 2011; 63:476-82. [PMID: 22087585 PMCID: PMC3399633 DOI: 10.3109/09637486.2011.636345] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This randomized, placebo-controlled, crossover trial assessed the lipid-altering efficacy of a dietary supplement (tablet form) providing 1.8g/day free (non-esterified) plant sterols and stanols versus placebo for 6 weeks as part of a therapeutic lifestyle changes (TLC) diet in 32 men and women with primary hypercholesterolaemia. Mean ± SE baseline (end of a 5-week TLC diet lead-in) lipid concentrations (mmol/1) were total cholesterol (TC), 5.88 ± 0.08; non-high-density lipoprotein cholesterol (non-HDL-C), 4.71 ± 0.09; low-density lipoprotein cholesterol (LDL-C), 4.02 ± 0.08; HDL-C, 1.17 ± 0.06 and triglycerides (TGs), 1.51 ± 0.12. Differences from control in responses (plant sterol/stanol — control) were significant (p < 0.05) for LDL-C (− 4.9%), non-HDL-C (− 3.6%) and TC (− 2.8%). HDL-C and TG responses were not significantly different between treatment conditions. These results indicate that 1.8g/day free plant sterols/stanols administered in a tablet produced favourable lipoprotein lipid changes in men and women with hypercholesterolaemia.
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Affiliation(s)
- Kevin C Maki
- Provident Clinical Research/Biofortis North America, 489 Taft Avenue, Glen Ellyn, IL 60137, USA.
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Musa-Veloso K, Poon TH, Elliot JA, Chung C. A comparison of the LDL-cholesterol lowering efficacy of plant stanols and plant sterols over a continuous dose range: results of a meta-analysis of randomized, placebo-controlled trials. Prostaglandins Leukot Essent Fatty Acids 2011; 85:9-28. [PMID: 21345662 DOI: 10.1016/j.plefa.2011.02.001] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine if plant stanols and plant sterols differ with respect to their low-density lipoprotein cholesterol (LDL-CH) lowering efficacies across a continuous dose range. METHODS Dose-response relationships were evaluated separately for plant stanols and plant sterols and reductions in LDL-CH, using a first-order elimination function. RESULTS Altogether, 113 publications and 1 unpublished study report (representing 182 strata) complied with the pre-defined inclusion and exclusion criteria and were included in the assessment. The maximal LDL-CH reductions for plant stanols (16.4%) and plant stanol ester (17.1%) were significantly greater than the maximal LDL-CH reductions for plant sterols (8.3%) and plant sterol ester (8.4%). These findings persisted in several additional analyses. DISCUSSION AND CONCLUSIONS Intakes of plant stanols in excess of the recommended 2g/day dose are associated with additional and dose-dependent reductions in LDL-CH, possibly resulting in further reductions in the risk of coronary heart disease (CHD).
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Gladine C, Meunier N, Blot A, Bruchet L, Pagès X, Gaud M, Floter E, Metin Z, Rossignol A, Cano N, Chardigny J. Preservation of micronutrients during rapeseed oil refining: A tool to optimize the health value of edible vegetable oils? Rationale and design of the Optim'Oils randomized clinical trial. Contemp Clin Trials 2011; 32:233-9. [DOI: 10.1016/j.cct.2010.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 11/02/2010] [Accepted: 11/04/2010] [Indexed: 11/16/2022]
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Marinangeli CPF, Jones PJH. Functional food ingredients as adjunctive therapies to pharmacotherapy for treating disorders of metabolic syndrome. Ann Med 2010; 42:317-33. [PMID: 20486826 DOI: 10.3109/07853890.2010.484026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract Information regarding the use of functional foods and nutraceuticals (FFN) in combating disease is rarely communicated to health care practitioners as medicinal strategies for patients. Metabolic syndrome (MetS) is an ideal paradigm for demonstrating the therapeutic properties of FFN. Encompassing multiple etiologies, including atherogenic dyslipidemia, insulin resistance, and hypertension, MetS affects over a third of American adults. However, as disease-related risk factors accumulate over time, guidelines for treating disorders of MetS progressively de-emphasize the use of FFN. Using marine omega-3 fatty acids, plant sterols, fiber, and tomato extract as examples, the purpose of this review is to endorse FFN as long-term adjunctive therapies to pharmaceutical treatment for disorders and risk factors for MetS. An additional goal is to compare physiological and molecular targets of FFN against corresponding prescription medications. Results reveal that FFN are viable treatment strategies for disorders of MetS, complementing pharmacological interventions by targeting and improving the biological processes that foster the development of disease. Thus, efficacious FFN therapies should be emphasized throughout all stages of treatment as adjuncts to pharmacotherapy for disorders of MetS. Accordingly, new developments in FFN research must be implemented into clinical guidelines with the prospect of improving disease prognoses as accessories to prescription medications.
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Affiliation(s)
- Christopher P F Marinangeli
- The Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
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Nijjar PS, Burke FM, Bloesch A, Rader DJ. Role of dietary supplements in lowering low-density lipoprotein cholesterol: A review. J Clin Lipidol 2010; 4:248-58. [DOI: 10.1016/j.jacl.2010.07.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 06/30/2010] [Accepted: 07/01/2010] [Indexed: 12/16/2022]
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Derdemezis CS, Filippatos TD, Mikhailidis DP, Elisaf MS. Review article: effects of plant sterols and stanols beyond low-density lipoprotein cholesterol lowering. J Cardiovasc Pharmacol Ther 2010; 15:120-34. [PMID: 20200328 DOI: 10.1177/1074248409357921] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
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.
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Affiliation(s)
- Christos S Derdemezis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
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Niittynen LH, Jauhiainen TA, Poussa TA, Korpela >R. Effects of yoghurt enriched with free plant sterols on the levels of serum lipids and plant sterols in moderately hypercholesterolaemic subjects on a high-fat diet. Int J Food Sci Nutr 2009; 59:357-67. [DOI: 10.1080/09637480701554137] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Demonty I, Ras RT, van der Knaap HCM, Duchateau GSMJE, Meijer L, Zock PL, Geleijnse JM, Trautwein EA. Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr 2009; 139:271-84. [PMID: 19091798 DOI: 10.3945/jn.108.095125] [Citation(s) in RCA: 304] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Phytosterols (plant sterols and stanols) are well known for their LDL-cholesterol (LDL-C)-lowering effect. A meta-analysis of randomized controlled trials in adults was performed to establish a continuous dose-response relationship that would allow predicting the LDL-C-lowering efficacy of different phytosterol doses. Eighty-four trials including 141 trial arms were included. A nonlinear equation comprising 2 parameters (the maximal LDL-C lowering and an incremental dose step) was used to describe the dose-response curve. The overall pooled absolute (mmol/L) and relative (%) LDL-C-lowering effects of phytosterols were also assessed with a random effects model. The pooled LDL-C reduction was 0.34 mmol/L (95% CI: -0.36, -0.31) or 8.8% (95% CI: -9.4, -8.3) for a mean daily dose of 2.15 g phytosterols. The impacts of subject baseline characteristics, food formats, type of phytosterols, and study quality on the continuous dose-response curve were determined by regression or subgroup analyses. Higher baseline LDL-C concentrations resulted in greater absolute LDL-C reductions. No significant differences were found between dose-response curves established for plant sterols vs. stanols, fat-based vs. non fat-based food formats and dairy vs. nondairy foods. A larger effect was observed with solid foods than with liquid foods only at high phytosterol doses (>2 g/d). There was a strong tendency (P = 0.054) towards a slightly lower efficacy of single vs. multiple daily intakes of phytosterols. In conclusion, the dose-dependent LDL-C-lowering efficacy of phytosterols incorporated in various food formats was confirmed and equations of the continuous relationship were established to predict the effect of a given phytosterol dose. Further investigations are warranted to investigate the impact of solid vs. liquid food formats and frequency of intake on phytosterol efficacy.
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Rudkowska I, AbuMweis SS, Nicolle C, Jones PJH. Cholesterol-lowering efficacy of plant sterols in low-fat yogurt consumed as a snack or with a meal. J Am Coll Nutr 2009; 27:588-95. [PMID: 18845709 DOI: 10.1080/07315724.2008.10719742] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Iwona Rudkowska
- School of Dietetics and Human Nutrition, Faculty of Agricultural and Environmental Sciences, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
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Weidner C, Krempf M, Bard JM, Cazaubiel M, Bell D. Cholesterol lowering effect of a soy drink enriched with plant sterols in a French population with moderate hypercholesterolemia. Lipids Health Dis 2008; 7:35. [PMID: 18837970 PMCID: PMC2569033 DOI: 10.1186/1476-511x-7-35] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 10/06/2008] [Indexed: 11/10/2022] Open
Abstract
Background Plant sterols are an established non-pharmacological means to reduce total and LDL blood cholesterol concentrations and are therefore recommended for cholesterol management by worldwide-renown health care institutions. Their efficacy has been proven in many types of foods with the majority of trials conducted in spreads or dairy products. As an alternative to dairy products, soy based foods are common throughout the world. Yet, there is little evidence supporting the efficacy of plant sterols in soy-based foods. The objective of this study was to investigate the effect of a soy drink enriched with plant sterols on blood lipid profiles in moderately hypercholesterolemic subjects. Methods In a randomized, placebo-controlled double-blind mono-centric study, 50 subjects were assigned to 200 ml of soy drink either enriched with 2.6 g plant sterol esters (1.6 g/d free plant sterol equivalents) or without plant sterols (control) for 8 weeks. Subjects were instructed to maintain stable diet pattern and physical activity. Plasma concentrations of lipids were measured at initial visit, after 4 weeks and after 8 weeks. The primary measurement was the change in LDL cholesterol (LDL-C). Secondary measurements were changes in total cholesterol (TC), non-HDL cholesterol (non-HDL-C), HDL cholesterol (HDL-C) and triglycerides. Results Regular consumption of the soy drink enriched with plant sterols for 8 weeks significantly reduced LDL- C by 0.29 mmol/l or 7% compared to baseline (p < 0.05). TC and non-HDL-C concentrations decreased by 0.26 mmol/l and 0.31 mmol/l (each p < 0.05), respectively. Mean reductions in total, LDL and non-HDL cholesterol were significantly greater than in the placebo group (p < 0.05). HDL-C and triglycerides were not affected. Compliance was very high (>96%), and products were well tolerated. Conclusion Daily consumption of a plant sterol-enriched soy drink significantly decreased total, non-HDL and LDL cholesterol and is therefore an interesting and convenient aid in managing mild to moderate hypercholesterolemia.
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Plant Sterols and Blood Cholesterol - Scientific substantiation of a health claim related to plant sterols and lower/reduced blood cholesterol and reduced risk of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA J 2008. [DOI: 10.2903/j.efsa.2008.781] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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AbuMweis SS, Barake R, Jones PJ. Plant sterols/stanols as cholesterol lowering agents: A meta-analysis of randomized controlled trials. Food Nutr Res 2008; 52:1811. [PMID: 19109655 PMCID: PMC2596710 DOI: 10.3402/fnr.v52i0.1811] [Citation(s) in RCA: 216] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Revised: 06/24/2008] [Accepted: 06/27/2008] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Consumption of plant sterols has been reported to reduce low density lipoprotein (LDL) cholesterol concentrations by 5-15%. Factors that affect plant sterol efficacy are still to be determined. OBJECTIVES To more precisely quantify the effect of plant sterol enriched products on LDL cholesterol concentrations than what is reported previously, and to identify and quantify the effects of subjects' characteristics, food carrier, frequency and time of intake on efficacy of plant sterols as cholesterol lowering agents. DESIGN Fifty-nine eligible randomized clinical trials published from 1992 to 2006 were identified from five databases. Weighted mean effect sizes were calculated for net differences in LDL levels using a random effect model. RESULTS Plant sterol containing products decreased LDL levels by 0.31 mmol/L (95% CI, -0.35 to -0.27, P= < 0.0001) compared with placebo. Between trial heterogeneity was evident (Chi-square test, P = <0.0001) indicating that the observed differences between trial results were unlikely to have been caused by chance. Reductions in LDL levels were greater in individuals with high baseline LDL levels compared with those with normal to borderline baseline LDL levels. Reductions in LDL were greater when plant sterols were incorporated into fat spreads, mayonnaise and salad dressing, milk and yoghurt comparing with other food products such as croissants and muffins, orange juice, non-fat beverages, cereal bars, and chocolate. Plant sterols consumed as a single morning dose did not have a significant effect on LDL cholesterol levels. CONCLUSION Plant sterol containing products reduced LDL concentrations but the reduction was related to individuals' baseline LDL levels, food carrier, and frequency and time of intake.
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Affiliation(s)
- Suhad S. AbuMweis
- School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada (SSA and RB)
| | - Roula Barake
- School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada (SSA and RB)
| | - Peter J.H. Jones
- Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada
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Van Horn L, McCoin M, Kris-Etherton PM, Burke F, Carson JAS, Champagne CM, Karmally W, Sikand G. The evidence for dietary prevention and treatment of cardiovascular disease. ACTA ACUST UNITED AC 2008; 108:287-331. [PMID: 18237578 DOI: 10.1016/j.jada.2007.10.050] [Citation(s) in RCA: 171] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Indexed: 12/31/2022]
Abstract
During the past few decades numerous studies have reported the atherogenic potential of saturated fatty acids, trans-fatty acids, and cholesterol, and beneficial effects of fiber, phytostanols/phytosterols, n-3 fatty acids, a Mediterranean diet, and other plant-based approaches. The purpose of this article is to provide a comprehensive and systematic review of the evidence associated with key dietary factors and risk of cardiovascular disease-an umbrella term encompassing diseases that affect the heart and blood vessels, including coronary heart disease, coronary artery disease, dyslipidemia, and hypertension-in conjunction with the work of the American Dietetic Association Evidence Analysis Library review on diet and lipids, updated with new evidence from the past 2 years. The criteria used and results cited provide scientific rationale for food and nutrition professionals and other health professionals for counseling patients. Details of these searches are available within the American Dietetic Association Evidence Analysis Library online (http://adaevidencelibrary.com). Potential mechanisms and needs for future research are summarized for each relevant nutrient, food, or food component.
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Affiliation(s)
- Linda Van Horn
- Preventive Medicine, Northwestern University Freinberg School of Medicine, Chicago, IL 60611, USA.
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Plana N, Nicolle C, Ferre R, Camps J, Cos R, Villoria J, Masana L. Plant sterol-enriched fermented milk enhances the attainment of LDL-cholesterol goal in hypercholesterolemic subjects. Eur J Nutr 2008; 47:32-9. [DOI: 10.1007/s00394-007-0693-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 12/04/2007] [Indexed: 11/24/2022]
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Lipophilic Microconstituents of Milk. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2007; 606:109-25. [DOI: 10.1007/978-0-387-74087-4_3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Madsen MB, Jensen AM, Schmidt EB. The effect of a combination of plant sterol-enriched foods in mildly hypercholesterolemic subjects. Clin Nutr 2007; 26:792-8. [PMID: 17719702 DOI: 10.1016/j.clnu.2007.05.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Revised: 04/13/2007] [Accepted: 05/24/2007] [Indexed: 11/20/2022]
Abstract
BACKGROUND & AIMS The purpose of this study was to evaluate the effect of low-fat products enriched with plant sterols in addition to a National Cholesterol Education Program step 1 diet on serum lipids and lipoproteins. METHODS This study was a double-blind, randomised, placebo-controlled cross-over design with a run-in period and 2 intervention periods, each lasting 4 weeks. A total of 46 mildly hypercholesterolemic subjects (age 50.6+/-9.8) completed the trial. The study products consisted of 20 g low-fat margarine (35% fat) and 250 ml low-fat milk (0.7% fat), in total delivering 2.3g plant sterols/d. RESULTS Serum total and low-density lipoprotein cholesterol were significantly reduced by 5.5% (p<0.001, 95% CI: 2.5; 8.3) and 7.7% (p=0.001, 95% CI: 3.4; 11.9), respectively, by plant sterol-enriched products compared to placebo. Serum apolipoprotein B was significantly reduced by 4.6% (p<0.05, 95% CI: 1.7; 7.5), and apolipoprotein B/apolipoprotein A-I by 3.4% (p<0.05, 95% CI: 0.1; 6.6) after plant sterol intake compared to the placebo supplement. CONCLUSIONS A combination of low-fat margarine and milk enriched with plant sterols significantly reduced low-density lipoprotein cholesterol, apolipoprotein B and the ratio of apolipoprotein B to apolipoprotein A-I in mildly hypercholesterolemic subjects, but had no effect on C-reactive protein and lipoprotein (a) concentrations. SPONSORSHIP Unilever Denmark A/S.
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Affiliation(s)
- Martin B Madsen
- Department of Cardiology, Center for Cardiovascular Research, Arhus University Hospitals, Aalborg Hospital, Sdr. Skovvej 15, 9000 Aalborg, Denmark
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Hansel B, Nicolle C, Lalanne F, Tondu F, Lassel T, Donazzolo Y, Ferrières J, Krempf M, Schlienger JL, Verges B, Chapman MJ, Bruckert E. Effect of low-fat, fermented milk enriched with plant sterols on serum lipid profile and oxidative stress in moderate hypercholesterolemia. Am J Clin Nutr 2007; 86:790-6. [PMID: 17823447 DOI: 10.1093/ajcn/86.3.790] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Plant sterol (PS)-enriched foods have been shown to reduce plasma LDL-cholesterol concentrations. In most studies, however, PSs were incorporated into food products of high fat content. OBJECTIVE We examined the effect of daily consumption of PS-supplemented low-fat fermented milk (FM) on the plasma lipid profile and on systemic oxidative stress in hypercholesterolemic subjects. DESIGN Hypercholesterolemic subjects (LDL-cholesterol concentrations >or=130 and <or= 190 mg/dL; n = 194) consumed 2 low-fat portions of FM in the same meal daily for 6 wk. Subjects were randomly assigned to 2 groups: low-fat FM enriched with 0.8 g PS ester per portion or control FM. Plasma concentrations of lipids, oxidized LDL, beta-carotene, beta-sitosterol, campesterol, and high-sensitivity C-reactive protein were measured during the trial. RESULTS Plasma LDL-cholesterol concentrations were reduced by 9.5% and 7.8% after 3 and 6 wk, respectively, in the 1.6-g/d PS group compared with the control group, whereas plasma triacylglycerol and HDL-cholesterol concentrations were not significantly affected. In addition, there were no significant changes in serum beta-carotene on normalization to LDL cholesterol during the study period in both groups, whereas plasma concentrations of oxidized LDL were reduced significantly in the PS group compared with the control group (-1.73 compared with 1.40 U/L, respectively; P < 0.05). Plasma sitosterol concentrations were increased by 35% (P < 0.001 compared with control); however, campesterol concentrations did not change during the study period. CONCLUSION Daily consumption of 1.6 g PS in low-fat FM efficiently lowers LDL cholesterol in subjects with moderate hypercholesterolemia without deleterious effects on biomarkers of oxidative stress.
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Affiliation(s)
- Boris Hansel
- Service d'Endocrinologie-Métabolisme, AP-HP, Hôpital de la Pitié, Paris, France.
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Earnest CP, Mikus CR, Lemieux I, Arsenault BJ, Church TS. Examination of encapsulated phytosterol ester supplementation on lipid indices associated with cardiovascular disease. Nutrition 2007; 23:625-33. [PMID: 17644340 DOI: 10.1016/j.nut.2007.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2007] [Revised: 06/04/2007] [Accepted: 06/05/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE As opposed to traditional food based delivery we examined the efficacy of ingesting encapsulated phytosterol esters on indices of lipid health in hypercholesterolemic adults. METHODS We performed a randomized, double-blinded, parallel-group, placebo-controlled, clinical intervention examining 54 men and women (20-70 y of age) with a low-density lipoprotein cholesterol (LDL-C) level > or =3.33 mmol/L. Participants were not taking cholesterol-lowering medications. Treatment consisted of ingesting 2.6 g of encapsulated phytosterol esters (n = 25) or a matching placebo (n = 29) for 12 wk. RESULTS Total cholesterol (TC) levels at baseline (mean +/- SD) were 6.29 +/- 0.7 mmol/L in the phytosterol group and 6.00 +/- 0.7 mmol/L in the placebo group. Baseline LDL-C levels were 4.27 +/- 0.7 mmol/L in the treatment group and 4.00 +/- 0.8 mmol/L in the placebo group. Analysis of variance and Tukey's least significant difference post hoc analyses revealed a significant within-group reduction in TC (-0.23 +/- 0.4 mmol/L, P < 0.05) and LDL-C (-0.22 +/- 0.5 mmol/L, P < 0.05) for the phytosterol treatment group. Mean reductions in TC and LDL-C were greater than placebo (P < 0.05). Percentages of change from baseline for TC were -3.52% (95% confidence interval -6.44 to -0.40) for phytosterol treatment and 2.64% (95% confidence interval 0.30-5.60) for placebo. Those for LDL-C were -5.00% (95% confidence interval -9.92 to -0.08) for phytosterol and 4.89 (95% confidence interval 0.24-9.5) for placebo. No other significant effects were observed. CONCLUSION Encapsulated phytosterol ester ingestion appears to positively modulate LDL-C. Given that the reduction in LDL-C was not as extensive as in food-based trials, future investigations should examine potential timing and dose issues relative to encapsulated delivery.
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Affiliation(s)
- Conrad P Earnest
- Pennington Biomedical Research Center, Preventive Medicine Laboratory, Baton Rouge, Louisiana, USA.
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Rodrigues JN, Torres RP, Mancini-Filho J, Gioielli LA. Physical and chemical properties of milkfat and phytosterol esters blends. Food Res Int 2007. [DOI: 10.1016/j.foodres.2007.01.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rudkowska I, Jones PJH. Functional foods for the prevention and treatment of cardiovascular diseases: cholesterol and beyond. Expert Rev Cardiovasc Ther 2007; 5:477-90. [PMID: 17489672 DOI: 10.1586/14779072.5.3.477] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cardiovascular disease (CVD) is a major cause of death and disability in many developed countries. The purpose of this literature review is to establish a recommendation for the intake of functional food ingredients in a healthy diet--such as plant sterols (PSs) in low-fat and functional matrices, fatty acid composition and other nutrients of tree nuts and flavonoids in dark chocolate--for the prevention and treatment of CVD. These three specific functional foods are explored in this review, since there is a higher potential for their increased consumption by the population to prevent CVD. First, PS have been added to various nontraditional matrices, such as low-fat products and functional oils, which have shown cholesterol-lowering effects in most clinical trials. Secondly, a growing number of clinical studies indicate that the beneficial effect of tree nuts may not only be due to their fatty acid composition but to other key nutrients, which may provide supplementary health benefits, such as endothelial cell function, as well as decreasing total cholesterol and low-density lipoprotein cholesterol (LDL-C). Lastly, flavonoids in dark chocolate may protect LDL-C particles from undergoing oxidative modification. However, some gaps in our knowledge need to be filled before firm recommendations can be made for habitual dark chocolate consumption. Overall, these functional foods should be considered as an addition to current lipid-lowering recommendations for improving CVD risk.
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Affiliation(s)
- Iwona Rudkowska
- School of Dietetics and Human Nutrition McGill University, St-Anne-de-Bellevue, Québec, Canada.
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Acuff RV, Cai DJ, Dong ZP, Bell D. The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects. Lipids Health Dis 2007; 6:11. [PMID: 17419879 PMCID: PMC1852556 DOI: 10.1186/1476-511x-6-11] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Accepted: 04/09/2007] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Foods enriched with phytosterols have been proven to be an effective therapy to improve blood lipid profiles. However, none of the studies have investigated the efficacy in lipid lowering of plant sterol esters (PSE) in capsule form. The objective of this study is to determine if the plant sterol esters (PSE) in capsule form (1.3 grams of PSE/day) lowered plasma cholesterol levels and lipid ratios in free-living hypercholesterolemic subjects during a 4-week intervention period. METHODS Sixteen subjects participated in a double-blind, placebo-controlled, sequential study with a 4-week placebo phase followed by a 2-week wash-out period and a 4-week treatment phase. Subjects were instructed to maintain stable diet pattern and physical activities. Blood samples were collected at 7, 21 and 28 days of each phase. The primary measurements were change in plasma total cholesterol (TC), HDL-cholesterol (HDL) and LDL-cholesterol (LDL) between phases and within each phase. The secondary measurements were change in triglycerides, lipoprotein ratios (TC/HDL, LDL/HDL) and C-reactive protein (CRP). RESULTS In comparison to placebo, LDL-cholesterol was significantly reduced by 7% and 4% (P < 0.05) at both week 3 and week 4; HDL at week 3 of the treatment was significantly increased by 9% (P < 0.01), but not at week 4 (4%); total cholesterol was not significantly different from placebo throughout the period, TC/HDL and LDL/HDL were significantly reduced by (8%, 8%, 6%, 10%, respectively) (P < 0.01) at both week 3 and week 4. CRP and triglycerides did not differ either between the two phases or during the treatment phase. CONCLUSION In conclusion, plant sterol ester capsule is effective in improving lipid profiles among hypercholesterolemic subjects in a free-living setting at the minimum dosage recommended by FDA. The significant improved lipid profiles were reached after three weeks of administration. To achieve better lipid lowering results, higher dosages and combination with diets low in saturated fat and cholesterol are recommended.
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Affiliation(s)
- Robert V Acuff
- East Tennessee State University, College of Medicine, Johnson City, TN, USA
| | | | - Zhi-Ping Dong
- East Tennessee State University, College of Medicine, Johnson City, TN, USA
| | - Doris Bell
- Cognis Deutschland GmbH & Co. KG, Monheim, Germany
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Polagruto JA, Wang-Polagruto JF, Braun MM, Lee L, Kwik-Uribe C, Keen CL. Cocoa flavanol-enriched snack bars containing phytosterols effectively lower total and low-density lipoprotein cholesterol levels. ACTA ACUST UNITED AC 2006; 106:1804-13. [PMID: 17081832 DOI: 10.1016/j.jada.2006.08.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Indexed: 11/18/2022]
Abstract
BACKGROUND Dietary intervention studies incorporating phytosterol-enriched margarine spreads have reported significant decreases in total and low-density lipoprotein (LDL) cholesterol in populations with both normal lipid levels and those with hypercholesterolemia. There is emerging support for more diverse and lower-fat phytosterol-enriched matrixes. Controversy exists, however, over whether phytosterol-enriched foods affect serum fat-soluble vitamins. OBJECTIVE We investigated whether a flavanol-rich cocoa snack food containing phytosterols would decrease total and LDL cholesterol levels in subjects with hypercholesterolemia and significantly affect serum fat-soluble vitamins and carotenoids. DESIGN A randomized, double-blind parallel arm study design was used. Subjects were randomized to one of two dietary treatments: a cocoa flavanol-enriched snack bar containing 1.5 g phytosterol (n=32), or a control product containing no phytosterols (n=35). Subjects consumed two servings per day. RESULTS Consumption of the phytosterol-enriched snack bars but not control bars for 6 weeks was associated with significant reductions in plasma total (4.7%; P<0.01) and LDL cholesterol (6%; P<0.01), and the ratio of total to high-density lipoprotein cholesterol (7.4%; P<0.001). There were no changes in high-density lipoprotein cholesterol, triglycerides, or lipid-adjusted lycopene, beta-cryptoxanthin, lutein/zeaxanthin, alpha-carotene levels, or levels of serum vitamins A or E. A significant reduction in lipid-adjusted serum beta-carotene was observed in the phytosterol but not the no-phytosterol-added group (P<0.05). CONCLUSIONS This study supports the use of a novel phytosterol-enriched snack bar to effectively reduce plasma total and LDL cholesterol levels in a population with hypercholesterolemia. The data suggest that the incorporation of this snack food into a balanced diet represents a practical dietary strategy in the management of serum cholesterol levels.
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Devaraj S, Autret BC, Jialal I. Reduced-calorie orange juice beverage with plant sterols lowers C-reactive protein concentrations and improves the lipid profile in human volunteers. Am J Clin Nutr 2006; 84:756-61. [PMID: 17023701 DOI: 10.1093/ajcn/84.4.756] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dietary plant sterols effectively reduce LDL cholesterol when incorporated into fat matrices. We showed previously that supplementation with orange juice containing plant sterols (2 g/d) significantly reduced LDL cholesterol. Inflammation is pivotal in atherosclerosis. High-sensitivity C-reactive protein (hs-CRP), the prototypic marker of inflammation, is a cardiovascular disease risk marker; however, there is a paucity of data on the effect of plant sterols on CRP concentrations. OBJECTIVE The aim of this study was to examine whether plant sterols affect CRP concentrations and the lipoprotein profile when incorporated into a reduced-calorie (50 calories/240 mL) orange juice beverage. DESIGN Seventy-two healthy subjects were randomly assigned to receive a reduced-calorie orange juice beverage either without (Placebo Bev) or with (1 g/240 mL; Sterol Bev) plant sterols twice a day with meals for 8 wk. Fasting blood was obtained at baseline and after 8 wk of Placebo Bev or Sterol Bev supplementation. RESULTS Sterol Bev supplementation significantly reduced total cholesterol (5%; P < 0.01) and LDL cholesterol (9.4%; P < 0.001) compared with both baseline and Placebo Bev (P < 0.05). HDL cholesterol increased significantly with Sterol Bev (P < 0.02). No significant changes in triacylglycerol, glucose, or liver function tests were observed with Sterol Bev. Sterol Bev supplementation resulted in no significant change in vitamin E and carotenoid concentrations. Sterol Bev supplementation resulted in a significant reduction of CRP concentrations compared with baseline and Placebo Bev (median reduction: 12%; P < 0.005). CONCLUSION Supplementation with a reduced-calorie orange juice beverage containing plant sterols is effective in reducing CRP and LDL cholesterol and could be incorporated into the dietary portion of therapeutic lifestyle changes.
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Affiliation(s)
- Sridevi Devaraj
- Laboratory for Atherosclerosis and Metabolic Research and General Clinical Research Center, University of California Davis Medical Center, Sacramento, CA 95817, USA.
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