Metabolic and genetic factors modulating subject specific LDL-C responses to plant sterol therapy1This article is an invited review for the Journal's Made In Canada section. The authors gratefully acknowledge the training that was acquired at the Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba. We would specifically like to thank Dr. Peter Jones for his mentorship and significant contribution to the research contained within this manuscript.

2012 ◽  
Vol 90 (5) ◽  
pp. 509-514 ◽  
Author(s):  
Todd C. Rideout ◽  
Scott V. Harding ◽  
Dylan S. Mackay
Keyword(s):  
Plant Sterol ◽  
Disease Risk ◽  
Current Knowledge ◽  
Cardiovascular Disease Risk ◽  
Cholesterol Absorption ◽  
Plant Sterols ◽  
Lipid Lowering ◽  
Clear Understanding ◽  
Significant Heterogeneity ◽  
Intestinal Cholesterol Absorption

Reducing intestinal cholesterol absorption with plant sterol consumption is a well-characterized strategy to lower LDL-C and potentially reduce cardiovascular disease risk. However, over 50 years of clinical research demonstrate that there is significant heterogeneity in the individual LDL-C lowering response to plant sterol therapy. A clear understanding of why plant sterols work effectively in some individuals but not in others will ensure optimal integration of plant sterols in future personalized nutritional lipid-lowering strategies. This review will examine the current knowledge base surrounding the metabolic and genetic determinants of LDL-C lowering in response to plant sterol consumption.

scholarly journals Plant sterols and stanols as dietary factors reducing hypercholesterolemia by inhibiting intestinal cholesterol absorption

2011 ◽  
Vol 10 (6) ◽  
pp. 124-132
Author(s):  
M. A. Khuchieva ◽  
N. V. Perova ◽  
N. M. Akhmedzhanov
Keyword(s):  
Disease Risk ◽  
Structural Characteristics ◽  
Cardiovascular Disease Risk ◽  
Plasma Concentrations ◽  
Fold Increase ◽  
Dietary Factors ◽  
Lipid Lowering ◽  
Blood Levels ◽  
Intestinal Cholesterol Absorption ◽  
Sterol Esters

The review is focussed on the mechanisms of action, lipid-lowering activity, structural characteristics, and safety of plant sterins and stanols. Phytosterins and phytostanols inhibit intestinal cholesterol (CH) absorption, therefore decreasing plasma CH levels. The emphasis is put on prospective epidemiological studies of representative samples, which demonstrated that plasma concentrations of phytosterins and phytostanols in patients with coronary heart disease (CHD) are substantially lower than in CHD-free participants. A two-fold increase in serum sytosterin concentration was associated with a reduction in relative risk of CHD by 22 %. Plant sterin and sterol esters could be regarded as effective and safe dietary ingredients decreasing blood levels of CH — one of the major cardiovascular disease risk factors.

scholarly journals A Newly Integrated Model for Intestinal Cholesterol Absorption and Efflux Infers How Plant Sterol Intake Reduces Circulating Cholesterol Levels

2018 ◽  
Author(s):  
Takanari Nakano ◽  
Ikuo Inoue ◽  
Takayuki Murakoshi
Keyword(s):  
Cholesterol Efflux ◽  
Plant Sterol ◽  
Brush Border Membrane ◽  
Plasma Cholesterol ◽  
Cholesterol Absorption ◽  
Plant Sterols ◽  
Intestinal Epithelial ◽  
Intestinal Cholesterol Absorption ◽  
Cholesterol Levels ◽  
Lower Plasma Cholesterol

Hypercholesterolemia accelerates atherosclerosis, and extensive research has been undertaken to ameliorate this abnormality. Plant sterols have been shown to inhibit cholesterol absorption and lower plasma cholesterol level since the 1950s. This ingredient has recently been reappraised as a food additive that can be taken daily in a preclinical period to prevent hypercholesterolemia, considering that cardiovascular-related diseases are the top cause of death globally even with clinical interventions. Intestinal cholesterol handling is still elusive, making it difficult to clarify the mechanism for plant sterol-mediated inhibition. Notably, although the small intestine absorbs cholesterol, it is also the organ that excretes it abundantly, via trans-intestinal cholesterol efflux (TICE). In this review, we show a model where the brush border membrane (BBM) of intestinal epithelial cells stands as the dividing ridge for cholesterol fluxes, making cholesterol absorption and TICE inversely correlated. With this model, we tried to explain the plant sterol-mediated inhibitory mechanism. As well as cholesterol, plant sterols diffuse into the BBM but are effluxed back to the lumen rapidly. We propose that repeated plant sterol shuttling between the BBM and lumen promotes cholesterol efflux, and plant sterol in the BBM may disturb the trafficking machineries that transport cholesterol to the cell interior.

scholarly journals Obesity and Hypogonadism—A Narrative Review Highlighting the Need for High-Quality Data in Adolescents

Children ◽  
2019 ◽  
Vol 6 (5) ◽  
pp. 63 ◽  
Author(s):  
Tasnim Mushannen ◽  
Priscilla Cortez ◽  
Fatima Cody Stanford ◽  
Vibha Singhal
Keyword(s):  
Reproductive System ◽  
Disease Risk ◽  
Current Knowledge ◽  
Clomiphene Citrate ◽  
Cardiovascular Disease Risk ◽  
Quality Data ◽  
Male Hypogonadism ◽  
Hpg Axis ◽  
Organ Systems ◽  
Sexual Characteristics

The prevalence of obesity continues to rise in adult and pediatric populations throughout the world. Obesity has a direct impact on all organ systems, including the reproductive system. This review summarizes current knowledge about the effects of obesity on the male reproductive system across age, highlighting the need for more data in children and adolescents. Male hypogonadism is commonly seen in patients with obesity and affects the onset, duration, and progression of puberty. Different pathophysiologic mechanisms include increased peripheral conversion of testosterone to estrone and increased inflammation due to increased fat, both of which lead to suppression of the hypothalamic-pituitary-gonadotropin (HPG) axis and delayed development of secondary sexual characteristics in adolescent males. Evaluation of the HPG axis in obesity includes a thorough history to exclude other causes of hypogonadism and syndromic associations. Evaluation should also include investigating the complications of low testosterone, including increased visceral fat, decreased bone density, cardiovascular disease risk, and impaired mood and cognition, among others. The mainstay of treatment is weight reduction, but medications such as testosterone and clomiphene citrate used in adults, remain scarcely used in adolescents. Male hypogonadism associated with obesity is common and providers who care for adolescents and young adults with obesity should be aware of its impact and management.

The effect of plant stanol- and sterol-enriched foods on lipid metabolism, serum lipids and coronary heart disease

2005 ◽  
Vol 42 (4) ◽  
pp. 254-263 ◽  
Author(s):  
Helena Gylling ◽  
Tatu A Miettinen
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Serum Cholesterol ◽  
Plant Sterol ◽  
Plant Sterols ◽  
Intestinal Cholesterol Absorption ◽  
Sterol Esters ◽  
Cholesterol Lowering ◽  
Plant Stanol ◽  
Plant Stanol Esters

Phytosterols are plant sterols, mainly campesterol and sitosterol, and their respective stanols (5α-saturated derivatives), which chemically resemble cholesterol. They are present in a normal diet and are absorbed proportionally to cholesterol, but to a much lesser extent, such that less than 0.1% of serum sterols are plant sterols. Phytosterols inhibit intestinal cholesterol absorption, and fat-soluble plant stanol esters were introduced as a functional food for lowering serum cholesterol in the early 1990s; plant sterol esters entered the market at the end of the 1990s. Inhibition of the intestinal absorption of cholesterol stimulates cholesterol synthesis, a factor which limits serum cholesterol lowering to about 10% with phytosterols. Enrichment of the diet with plant stanol esters reduces absorption and serum concentrations of both cholesterol and plant sterols, whereas enrichment of the diet with plant sterol esters, especially in combination with statins, lowers serum cholesterol but increases serum plant sterol levels. Recent studies have suggested that high-serum plant sterol levels may be associated with increased coincidence of coronary heart disease. Estimates of coronary heart disease reduction by 20-25% with plant sterols/stanols is based mainly on short-term studies. Long-term cholesterol lowering, needed for the prevention of coronary heart disease, may be successful with plant stanol esters, which lower serum cholesterol in both genders over at least a year.

scholarly journals Assessing Atherosclerotic Cardiovascular Disease Risk with Advanced Lipid Testing: State of the Science

2020 ◽  
Vol 15 ◽  
Author(s):  
Charles Amir German ◽  
Michael David Shapiro
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Medicine ◽  
Plasma Lipids ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Lipid Lowering ◽  
Atherosclerotic Cardiovascular Disease ◽  
Lipid Lowering Therapy ◽  
Obesity And Diabetes ◽  
Lipid Panel

Cardiovascular disease is the number one cause of death and disability worldwide. While substantial gains have been made in reducing cardiovascular mortality, future projections suggest that we have reached a nadir and may be at an inflection point, given the rising tide of obesity and diabetes. Evaluation and management of plasma lipids is central to the prevention of atherosclerotic cardiovascular disease. Although the standard lipid panel represents a well-established platform to assess risk, this test alone can be insufficient and/or misleading. Advances in our understanding of atherosclerosis have led to the development of lipid-based biomarkers that help to discriminate the risk of cardiovascular disease when it is unclear. While these biomarkers provide novel information, their implementation into clinical medicine remains difficult given discrepancies in the literature, lack of assay standardisation, poor accessibility and high cost. However, additional measures of atherogenic lipoproteins or their surrogates may offer insight beyond the standard lipid panel, providing a more precise assessment of risk and more accurate assessment of lipid-lowering therapy.

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