Olestra ingestion and retinyl palmitate absorption in humans

Daily intake of multivitamins during long-term intake of olestra in men prevents declines in serum vitamins A and E but not carotenoids

The objective of this study was to determine whether vitamin supplementation during long-term (36 wk) ingestion of olestra supplemented with vitamin E could prevent decreases in vitamin E, vitamin A, and carotenoids. This was a 36-wk study of 37 healthy males randomly assigned to consume a control diet composed of 33% energy from fat, a similar diet in which one third of the energy from fat had been replaced with olestra, or a fat-reduced (25% of energy from fat) diet. Subjects also ingested a daily multivitamin (Centrum). Serum concentrations of alpha-tocopherol, retinol, beta-carotene, lycopene, and lutein + zeaxanthin were analyzed by HPLC. Subjects eating the olestra-containing diet had substantial decreases in serum beta-carotene, lycopene, and lutein + zeaxanthin, which occurred by 12 wk; these changes were found despite correcting for serum total cholesterol or BMI. Serum beta-carotene and lycopene concentrations were below the lower limit of the reference range (<0.186 and <0.298 mumol/L, respectively) at one or more time points. The slight decline in serum alpha-tocopherol concentration, significant at 24 wk, was caused by the decline in serum cholesterol. Retinol concentrations decreased with time in all 3 groups, but were not affected by olestra. We conclude that supplementation with a multivitamin containing vitamins A and E was adequate to prevent olestra-induced decrease in serum alpha-tocopherol and retinol. Olestra-induced decreases in serum beta-carotene, lycopene, and lutein + zeaxanthin were not prevented by the vitamin supplement used in this study.

Authors' financial relationships with the food and beverage industry and their published positions on the fat substitute olestra

OBJECTIVES

This study examined the association between authors' published positions on the safety and efficacy in assisting with weight loss of the Procter & Gamble (P&G) fat substitute olestra and their financial relationships with the food and beverage industry.

METHODS

Journal articles about olestra, and their authors, were classified as supportive, critical, or neutral with respect to its use. Authors not known to have industry affiliations were surveyed about their financial relationships.

RESULTS

Supportive authors were significantly more likely than critical or neutral authors to have financial relationships with P&G (80% vs 11% and 21%, respectively; P <.0001). All authors disclosing an affiliation with P&G were supportive.

CONCLUSIONS

Because authors' published opinions were associated with their financial relationships, obtaining noncommercial funding may be more essential to maintaining objectivity than disclosing personal financial interests.

An indirect means of assessing potential nutritional effects of dietary olestra in healthy subgroups of the general population

The potential for olestra to affect the absorption of dietary components was measured in 18- to 44-y-old humans and the weanling pig. Results from the studies were assessed to determine if they were relevant to subgroups of the population not included in the studies. Hypothetrically, two factors that might cause the study results not to be relevant to certain subgroups are dietary pattern and metabolic need. A dietary pattern resulting in olestra-to-nutrient intake ratios greater than those tested in the studies might produce effects greater than those measured. Metabolic needs (i.e., nutrient requirements) among subgroups greater than those of the study population might mean that any effects on nutrient absorption seen in the studies would be larger among subgroups. If olestra-to-nutrient ratios and nutrient requirements of a subgroup were less than those covered in the studies, then the effects of olestra on the nutritional status of the subgroup should be no different than the effects measured in the studies. Subgroups with high olestra-to-nutrient intake ratios were identified by calculating the ratios for those nutrients assessed in the studies [i.e., macronutrients, vitamins A (including beta-carotene), D, E and K, folate, vitamin B12, calcium, iron and zinc]. Subgroups with the greatest olestra-to-nutrient intake ratios for one or more nutrients included children, teenagers and young adults, women from low income families and vegetarians. Subgroups with the greatest metabolic need for one or more nutrients included children, teenagers, and pregnant and lactating women. The olestra-to-nutrient ratios and nutrient requirements of the subgroups having the greatest ratios and requirements were compared with those of the test population. The olestra-to-nutrient intake ratios fed in the studies were greater than those for any subgroup for all nutrients except calcium, which is not affected by olestra. Metabolic needs of the test population were greater than those of all population subgroups for all nutrients. The effects of olestra on nutritional status should not be different or greater than those measured in the controlled clinical tests for subgroups not directly tested.

Olestra's effect on vitamins D and E in humans can be offset by increasing dietary levels of these vitamins

One hundred two normal healthy males and females were given 0, 8, 20 or 32 g/d olestra to which had been added graded amounts of vitamins A, D and E for 8 wk in a parallel, double-blind study. The primary purpose of the study was to determine the amounts of vitamins D and E needed to offset the effect of olestra on the availability of these vitamins. Serum concentrations of retinol, carotenoids, 25-hydroxyvitamin D metabolites, alpha-tocopherol, phylloquinone, lipids, ferritin and total iron, iron-binding capacity and hematology parameters, plasma concentrations of des-gamma-carboxyprothrombin and prothrombin, and urinary gamma-carboxyglutamic acid (Gla) excretion were measured biweekly. Clinical chemistry and urinalysis parameters, vitamin B12 absorption, and serum 1,25-dihydroxyvitamin D concentration were measured at wk 0 and 8. Serum concentrations of alpha-tocopherol and 25-hydroxyergocalciferol were restored to control concentration by adding 2.1 mg d-alpha-tocopheryl acetate and 0.06 microg ergocalciferol per gram of olestra, respectively, to the diet. Olestra reduced serum concentrations of 25-hydroxyergocalciferol, carotenoids and phylloquinone in a dose-responsive manner but did not affect Gla excretion, plasma des-gamma-carboxyprothrombin and prothrombin concentrations, overall vitamin D status, vitamin B12 absorption or iron status. Laboratory evaluations showed no olestra-related effects. Subjects in all groups reported mild to moderately severe transient gastrointestinal symptoms. These symptoms did not affect study compliance or the integrity of the data.

Assessment of the nutritional effects of olestra, a nonabsorbed fat replacement: summary

Olestra is a zero-calorie fat replacement intended to replace 100% of the fat used in the preparation of savory snacks. Olestra can affect the absorption of other dietary components, especially highly lipophilic ones, when ingested at the same time. The potential effects of olestra on the absorption of essential fat-soluble and water-soluble dietary components have been investigated in pigs and in humans. In these studies, subjects were fed daily amounts of olestra up to 10 times the estimated mean intake from savory snacks and the olestra was eaten each day of the studies. In real life, snacks are eaten on average five times in a 14-d period. Olestra did not affect the availability of water-soluble micronutrients or the absorption and utilization of macronutrients. Olestra reduced the absorption of fat-soluble vitamins A, D, E and K; however, the effects can be offset by adding specified amounts of the vitamins to olestra foods. Olestra also reduced the absorption of carotenoids; analysis of dietary patterns showed that in real life the reduction will likely be <10%. Any effect on vitamin A stores caused by a reduction in carotenoid uptake is offset by the addition of vitamin A to olestra foods. Because of the olestra-to-nutrient ratios fed and the nutritional requirements of the test subjects, the effects of olestra on nutritional status of subgroups of the population are unlikely to be different than those measured in the studies. An analysis of lipophilicity showed that olestra is unlikely to significantly affect the uptake of potentially beneficial phytochemicals from fruits and vegetables. Some people eating large amounts of olestra snacks may experience common GI symptoms such as stomach discomfort or changes in stool consistency, similar to symptoms accompanying other dietary changes. These symptoms present no health risks.

Physical or temporal separation of olestra and vitamins A, E and D intake decreases the effect of olestra on the status of the vitamins in the pig

A study was conducted in the domestic pig to determine 1 ) whether feeding olestra mixed in the diet exaggerated olestra effects on fat-soluble vitamin status compared with the effects of feeding it in a typical snack food, and 2) whether separating olestra consumption temporally from vitamin consumption affected the influence of olestra on vitamin status. Groups of 10 pigs each, five castrated males and five females, were fed 2.2% (wt/wt) olestra for 4 wk in purified diet that provided 1 time the National Research Council's requirements for swine of all micronutrients. The olestra was either mixed in the purified diet or fed in potato chips. The potato chips were given to the pigs at all three feedings, at the noon feeding only, or between the noon and the evening feedings. A control group was fed the purified diet with no olestra. The effects of olestra on indices of vitamin A, D and E status were from 1.7 to 4.5 times greater when olestra was fed three times daily mixed in the diet than when it was fed three times daily in potato chips. Because the effect of olestra on the status of the fat-soluble vitamins was diminished substantially by feeding the olestra in potato chips, it was not possible to conclude definitively how the temporal separation of olestra and vitamin consumption affected the olestra effect on vitamin status.

Evaluation of the potential for olestra to affect the availability of dietary phytochemicals

It has been hypothesized that phytochemicals found in fruits and vegetables are responsible for the inverse association observed between diets high in fruits and vegetables and risk of certain chronic diseases and cancer. This paper assesses the potential for olestra to affect the absorption of dietary phytochemicals and estimates the effect of olestra on the availability of carotenoids when olestra-containing snacks and foods containing carotenoids are eaten in free-living diets. Experimental data compiled on the effects of olestra on the availability of 29 compounds, mainly nutrients and oral medications, showed that olestra affects the availability of only molecules having octanol-water partition coefficients greater than approximately 7.5. Partition coefficients compiled for 382 dietary phytochemicals showed that only two classes of phytochemicals, phytosterols and carotenoids, contain molecules with octanol-water partition coefficients in the range in which olestra could potentially affect bioavailability. The potential effect on the bioavailability of phytosterols would be <10% and would not be expected to be of concern inasmuch as the hypothesized benefit of consuming pharmacological amounts of phytosterols is to reduce cholesterol availability, a function also of olestra. A 5.9% reduction in the average effective beta-carotene intake was calculated for individuals eating olestra-containing snack foods in free-living diets. The calculation was made by assuming that carotenoid bioavailability would be reduced to the extent measured in human clinical studies each time olestra-containing snacks and carotenoid-containing foods are eaten together and that all snacks eaten are made with olestra. Among individuals with low carotenoid intakes (the lowest 10%) the calculated reduction was 6.0%; for heavy snack eaters (the top 10%) it was 9.5%. These effects on carotenoid bioavailability are similar to those that can occur with other dietary factors.

Assessment of the nutritional effects of olestra

Olestra is a mixture of polyesters formed from sucrose and fatty acids derived from edible fats and oils. It is not absorbed or digested and can serve as a zero-calorie replacement for dietary fat. Because olestra is lipophilic and not absorbed, it has the potential to interfere with the absorption of other dietary components, especially lipophilic ones, when it is in the digestive tract with those components. A series of studies were conducted in the domestic pig and in healthy adult humans to define the nature and extent of olestra's effect on fat-soluble vitamins, selected water-soluble micronutrients, and macronutrients, and to demonstrate that the effects of olestra on the absorption of fat-soluble vitamins can be offset by adding extra amounts of the affected vitamins to olestra foods. Before conducting the human and pig studies, the intake of olestra from the consumption of snack foods made with olestra was estimated for various subgroups. The potential for olestra to affect the absorption of nonessential but potentially beneficial dietary phytochemicals was also assessed. In addition, an assessment of how consumption patterns influence the effect of olestra on the absorption of the highly lipophilic carotenoids was made. Finally, the results from the pig and human studies were used to assess the potential for olestra to affect the nutritional status of subgroups of the population who have particularly high nutrient needs or unique dietary patterns that may lead to large olestra-to-nutrient intake ratios.

The domestic pig as a model for evaluating olestra's nutritional effects

Experimental conditions for measuring the effect of the noncaloric fat substitute olestra on the availability of dietary nutrients were established in the weanling domestic pig. To evaluate the tolerance of the pig for dietary fat levels similar to those in the human diet, groups were fed a standard corn-soy-based swine feed with and without 14% (30% of energy) added fat for 4 wk. To evaluate the adequacy of a purified diet to produce good growth, groups of pigs were fed purified diets providing 30% of energy from fat and micronutrients at 1, 1.3 or 1.6 times the NRC's requirements for 5- to 10-kg swine. Cumulative body weight gain, digestible feed efficiency and a lack of adverse effects showed that the pig can tolerate diets providing 30% of energy from fat and that a purified diet providing the NRC's requirements for micronutrients produces growth comparable to a nutritionally complete swine feed. To determine whether tissue concentrations of vitamins A, D, E and K in the pig respond to olestra and dietary concentrations of the vitamins, two groups were fed purified diet providing 1 or 1.6 times the NRC's requirements for micronutrients and 4.8% olestra. Significant increases occurred in the serum concentration of 25-hydroxyergocalciferol and liver concentrations of retinol and alpha-tocopherol with increasing dietary concentrations of the vitamins. Olestra reduced the tissue concentrations of vitamins A, D and E. Prothrombin time was not affected by dietary concentration of either phylloquinone or olestra. To determine the amount of UV light exposure required to produce 50-80% of vitamin D status from vitamin D3, a range typical of humans, two groups of pigs were fed the NRC requirement for vitamin D and exposed to 15 or 45 min/d of UV light. Serum concentration of 25-hydroxycholecalciferol increased with increased exposure time. UV exposure of 1-2 min/d was calculated to be sufficient to produce 50-80% of total vitamin D status from vitamin D3. No antemortem observations indicated an adverse olestra effect.

Olestra dose response on fat-soluble and water-soluble nutrients in humans

Ninety normal healthy adults were given 0, 8, 20 or 32 g/d olestra for 8 wk as part of a diet that provided 1 +/- 0.2 of the recommended dietary allowance (RDA) of vitamins A, D, E and K, folate zinc, calcium and iron. In addition, a 20 microg/d supplement of vitamin D was supplied. The diet provided 15% of energy from protein, 35% from fat and 55% from carbohydrate. The purpose of the study was to determine the dose response of olestra on vitamins D, E and K, carotenoids, vitamin B12, folate and zinc. Circulating concentrations of retinol, carotenoids, tocopherols, 25-hydroxy- and 1,25-dihydroxyvitamin D metabolites, phylloquinone, des-gamma-carboxyprothrombin, prothrombin, folate and hematological parameters were measured biweekly, as were urine concentrations of zinc and gamma-carboxyglutamic acid (Gla). Clinical chemistry, urinalysis and vitamin B12 absorption were measured at wk 0 and 8. Olestra reduced serum concentrations of carotenoids, alpha-tocopherol, 25-hydroxyergocalciferol and phylloquinone in a dose-responsive manner. Olestra did not affect Gla excretion, plasma des-gamma-carboxyprothrombin or prothrombin concentrations, prothrombin time, vitamin B12 absorption, overall vitamin D status or the status of folate or zinc. Laboratory evaluations showed no health-related effects of olestra. Subjects in all groups reported common gastrointestinal symptoms such as loose stools, fecal urgency and flatulence, which were transient and generally mild to moderate in severity. These symptoms did not affect protocol compliance or the ability to measure the potential for olestra to affect nutrient availability.

Olestra ingestion and dietary fat absorption in humans

The effect of olestra, a zero-calorie fat replacement, on the absorption of dietary fat was determined with a dual-isotope technique in 67 healthy male subjects. After a 30-d adaptation period in which they consumed potato chips which delivered either 10 g/d olestra or 10 g/d triglyceride under free-living conditions, the subjects were housed in a metabolic ward and given 0, 8, 20 or 32 g olestra in potato chips. The chips were eaten as part of a breakfast containing about 38 g of fat, about 0.16 mg of 14C-triolein, and a nonabsorbable marker, 51CrCl3. Feces were collected for 7 d, and aliquots of the two daily collections containing the highest levels of 51Cr were oxidized. The CO2 was collected, and 14C content was determined by liquid scintillation spectrometry. The fractional absorption of 14C-triolein was calculated from the average ratios of 14C/51Cr dosed and measured in the feces. Olestra had a slight but significant dose-response effect on triglyceride absorption: the highest olestra dose (32 g) reduced absorption by 1.2%. This effect is not nutritionally significant with respect to either availability of essential fatty acids or energy intake.

Olestra ingestion and retinyl palmitate absorption in humans

This study examined the effect of olestra, a zero-calorie fat replacement, on the absorption of retinyl palmitate in humans. After a 30-d adaptation period during which they consumed 10 g olestra/d in potato chips under free-living conditions, 68 healthy male subjects were housed in a metabolic ward and given a single dose of retinyl palmitate (0.33 RDA) containing a trace amount of 3H-retinyl palmitate with a breakfast that contained 0, 8, 20 or 32 g of olestra and about 38 g of triglyceride. Blood was collected at defined intervals for 48 h and plasma analyzed for 3H-retinyl esters by HPLC and liquid scintillation spectrometry. There was no significant effect on retinyl palmitate absorption as determined from the area under the plasma 3H-retinyl esters concentration-time curve. However, an area under the plasma concentration-time curve in the 32-g olestra group that was 81% (mean value) or 70% (median value) of the area under the curve for the placebo group suggested that olestra may have affected retinyl palmitate absorption. Inclusion or exclusion of 13 high responders did not change the results.