scholarly journals Optimal Use of Plant Stanol Ester in the Management of Hypercholesterolemia

Cholesterol ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Susanna Rosin ◽  
Ilkka Ojansivu ◽  
Aino Kopu ◽  
Malin Keto-Tokoi ◽  
Helena Gylling

Plant stanol ester is a natural compound which is used as a cholesterol-lowering ingredient in functional foods and food supplements. The safety and efficacy of plant stanol ester have been confirmed in more than 70 published clinical studies and the ingredient is a well-established and widely recommended dietary measure to reduce serum cholesterol. Daily intake of 2 g plant stanols as plant stanol ester lowers LDL-cholesterol by 10%, on average. In Europe, foods with added plant stanol ester have been on the market for 20 years, and today such products are also available in many Asian and American countries. Despite the well-documented efficacy, the full potential in cholesterol reduction may not be reached if plant stanol ester is not used according to recommendations. This review therefore concentrates on the optimal use of plant stanol ester as part of dietary management of hypercholesterolemia. For optimal cholesterol lowering aiming at a lower risk of cardiovascular disease, plant stanol ester should be used daily, in sufficient amounts, with a meal and in combination with other recommended dietary changes.

Cholesterol ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Essi Sarkkinen ◽  
Mari Lyyra ◽  
Sakari Nieminen ◽  
Päivi Kuusisto ◽  
Ingmar Wester

The cholesterol-lowering effect of foods with added plant sterols or stanols consumed as snacks might be compromised. The purpose of this study was to confirm the cholesterol-lowering efficacy of a specially formulated cereal-based snack bar with added plant stanol ester (1.6 g plant stanols/day) when consumed between meals twice a day. In a double-blind, placebo-controlled, 4-week parallel-design study, 71 mildly to moderately hypercholesterolemic subjects were randomized into one of two groups, stanol or placebo group. Subjects were advised to replace their ordinary snacks with test products in an isocaloric manner and otherwise keep their habitual diet unchanged. The study showed that a snack bar product with added plant stanol ester lowered LDL and non-HDL cholesterol by 8.6% and 9.2% (mean%-change), respectively, as compared to the placebo product. The change in LDL cholesterol was statistically significantly different (P=0.001) between the groups while the change in HDL cholesterol or triglycerides did not differ between the groups. In conclusion, the cereal-based snack bar with added plant stanol ester ingested without a meal reduced LDL cholesterol significantly without affecting HDL cholesterol or triglyceride concentrations in mildly hypercholesterolemic men and women. The study is registered as NCT03284918.


Cholesterol ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Pia Salo ◽  
Päivi Kuusisto

The aim of this study was to investigate the effects of yoghurt minidrinks containing two doses of plant stanol ester either with or without added camelina oil on the serum cholesterol levels in moderately hypercholesterolemic subjects. In this randomised, double-blind, parallel group study, 143 subjects consumed a 65 mL minidrink together with a meal daily for four weeks. The minidrink contained 1.6 or 2.0 grams of plant stanols with or without 2 grams of alpha-linolenic acid-rich camelina oil. The placebo minidrink did not contain plant stanols or camelina oil. All plant stanol treated groups showed statistically significant total, LDL, and non-HDL cholesterol lowering relative to baseline and relative to placebo. Compared to placebo, LDL cholesterol was lowered by 9.4% (p<0.01) and 8.1% (p<0.01) with 1.6 g and 2 g plant stanols, respectively. With addition of Camelina oil, 1.6 g plant stanols resulted in 11.0% (p<0.01) and 2 g plant stanols in 8.4% (p<0.01) reduction in LDL cholesterol compared to placebo. In conclusion, yoghurt minidrinks with plant stanol ester reduced serum LDL cholesterol significantly and addition of a small amount of camelina oil did not significantly enhance the cholesterol lowering effect. This trial was registered with ClinicalTrials.gov NCT02628990.


2020 ◽  
Vol 40 (9) ◽  
pp. 2310-2321 ◽  
Author(s):  
Maija Ruuth ◽  
Lauri Äikäs ◽  
Feven Tigistu-Sahle ◽  
Reijo Käkelä ◽  
Harri Lindholm ◽  
...  

Objective: Plant stanol ester supplementation (2–3 g plant stanols/d) reduces plasma LDL (low-density lipoprotein) cholesterol concentration by 9% to 12% and is, therefore, recommended as part of prevention and treatment of atherosclerotic cardiovascular disease. In addition to plasma LDL-cholesterol concentration, also qualitative properties of LDL particles can influence atherogenesis. However, the effect of plant stanol ester consumption on the proatherogenic properties of LDL has not been studied. Approach and Results: Study subjects (n=90) were randomized to consume either a plant stanol ester-enriched spread (3.0 g plant stanols/d) or the same spread without added plant stanol esters for 6 months. Blood samples were taken at baseline and after the intervention. The aggregation susceptibility of LDL particles was analyzed by inducing aggregation of isolated LDL and following aggregate formation. LDL lipidome was determined by mass spectrometry. Binding of serum lipoproteins to proteoglycans was measured using a microtiter well-based assay. LDL aggregation susceptibility was decreased in the plant stanol ester group, and the median aggregate size after incubation for 2 hours decreased from 1490 to 620 nm, P =0.001. Plant stanol ester-induced decrease in LDL aggregation was more extensive in participants having body mass index<25 kg/m 2 . Decreased LDL aggregation susceptibility was associated with decreased proportion of LDL-sphingomyelins and increased proportion of LDL-triacylglycerols. LDL binding to proteoglycans was decreased in the plant stanol ester group, the decrease depending on decreased serum LDL-cholesterol concentration. Conclusions: Consumption of plant stanol esters decreases the aggregation susceptibility of LDL particles by modifying LDL lipidome. The resulting improvement of LDL quality may be beneficial for cardiovascular health. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01315964.


2005 ◽  
Author(s):  
Pia Salo ◽  
Anu Hopia ◽  
Jari Ekblom ◽  
Ritva Lahtinen ◽  
Päivi Laakso

2019 ◽  
pp. 699-730
Author(s):  
Pia Salo ◽  
Anu Hopia ◽  
Jari Ekblom ◽  
Ritva Lahtinen ◽  
Päivi Laakso

2015 ◽  
Vol 129 (5) ◽  
pp. 439-446 ◽  
Author(s):  
Piia Simonen ◽  
Ulf-Håkan Stenman ◽  
Helena Gylling

The present randomized, controlled clinical intervention demonstrated that plant stanol ester consumption does not affect serum proprotein convertase subtilisin/kexin type 9 concentration thus offering an effective dietary means to lower LDL cholesterol concentration.


2010 ◽  
Vol 6 (3) ◽  
pp. 18 ◽  
Author(s):  
Helena Gylling ◽  
Tatu A Miettinen ◽  
◽  

Different food products enriched with plant stanol esters have proved effective and safe as a dietary hypocholesterolaemic tool in about 60 published clinical studies during 15 years on the market. In addition to lowering low-density lipoprotein (LDL) cholesterol by 10% with a dose of 2g/day, plant stanol effectively reduces serum plant sterols and also, in some studies, serum triglycerides. It has been shown to be an effective dietary hypocholesterolaemic agent in adults and children with primary hypercholesterolaemia, in familial hypercholesterolaemia, in coronary subjects and in type 1 and type 2 diabetes. Plant stanol ester can be combined with statin to obtain more powerful serum total and LDL cholesterol reduction. This combination therapy inhibits both cholesterol synthesis and absorption. Plant stanol ester reduced the C-reactive protein (CRP) level in recent studies and, in contrast to ezetimibe, it does not change the LDL particle size. Plant stanol ester consumption tends to reduce the plant sterol contents of arterial wall, and in some, but not all, studies it improves endothelial function, a surrogate marker of pre-clinical atherosclerosis.


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