Assessment of Plant Sterols in the Diet of Adult Polish Population with the Use of a Newly Developed Database

Plant sterols are compounds with multiple biological functions, mainly cholesterol-reducing. There are no comprehensive databases on plant sterols, which makes it difficult to estimate their intake in the Polish population. This work attempted to use international food databases, additionally supplemented by scientific data from the literature, to create a database of plant sterols, which would cover various kinds of foods and dishes consumed in Poland. The aim was to assess the size and sources of dietary plant sterols in the adult population of Poland. The literature search was conducted using PubMed, Web of Science, Scopus, and Google Scholar to identify possible sources of published food composition data for plant sterols. The study group consisted of 5690 participants of the WOBASZ II survey. We identified 361 dietary sources of plant sterols based on the consumption of foods and dishes reported by participants. Cereals and fats provided 61% of the total plant sterols, and together with vegetables and fruits, this totaled 80%. The median intake of plant sterols in the Polish population was 255.96 mg/day, and for men and women 291.76 and 230.61 mg/day, respectively. Canola oil provided the most plant sterols at 16.92%, followed by white bread at 16.65% and soft margarine at 8.33%. The study found that plant sterol intake in Poland is comparable to other populations, and women’s diets are more dense in plant sterols. Due to the lack of literature sources on plant sterol content in some foods, future studies should expand and complete the databases on plant sterol content in foods.

Dietary intake of plant sterols in cardiovascular diseases: a population-based study of Polish adults

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology, Warsaw, Poland Introduction. Cardiovascular diseases (CVD) are a major cause of premature mortality and disability in developed countries. Among various risk factors, disorders of lipid metabolism are prevalent. Scientific evidence shows that plant sterols have a positive effect on dyslipidemia. The primary mechanism of hypolipemic effect of plant sterols is inhibition of cholesterol absorption in the small intestine, and this effect depends on the dose. Purpose. The aim of the study was to determine the intake of plant sterols, which was never studied in the Polish population. Methods. In total, 5690 participants of the population-based cross-sectional Polish National Multicenter Health Examination Survey WOBASZ II (2013-2014), aged 20+, were evaluated in the study (1). Nutritional data were collected using a single 24-hour dietary recall method. A dietary plant sterol database was compiled from available experimental data including total and individual plant sterols such as β-sitosterol, campesterol and stigmasterol. Plant sterol intakes were calculated taking into account plant sterol contents in individual food products and the volume of food consumption. Statistical calculations were performed using Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA). Results. The dietary plant sterol intake (DPSI) for the general population, 283 mg/day, was dependent on the age and gender. The intake of sterols among people over 65 years of age (264 mg/day in men and 208 mg/day in women) was lower than in younger age groups (20-44 years) of participants (343 mg/day in men and 259 mg/day in women). The main dietary plant sterol for both genders was β-sitosterol (∼62% of intake), followed by campesterol (∼21%) and stigmasterol (∼9%). Overall, men and women with cardiovascular disease had significantly lower DPSI (p > 0.002) than men and women without cardiovascular disease, 298.6 and 237.8 vs. 326.1 and 255.9 mg/d, respectively, and men but not women with diabetes had significantly (p > 0.04) lower DPSI than men without diabetes, 301.7 vs. 323.3, respectively. Conclusions. In the view of current recommendations to lower cholesterol, this research confirms findings for other populations, that the dietary intake of plant sterols in the Polish population is insufficient to beneficially modulate lipid metabolism, especially in CVD and diabetic patients.

A Database of Plant Sterols and Their Assessment in the Diet of the Adult Population of Poland

Plant sterols are compounds with multiple biological functions, mainly cholesterol-reducing. There are no comprehensive databases on plant sterols, which makes it difficult to estimate their intake in the Polish population. In this study we used international food databases, supplemented by scientific data from the literature, to create a database on plant sterols in the food consumed in Poland to assess the size and sources of dietary plant sterols in the adult population of Poland. The literature search was conducted using PubMed, Web of Science, Scopus, and Google Scholar to identify possible sources of published food composition data for plant sterols. The study group consisted of 5690 participants of the WOBASZ II survey. We identified 361 dietary sources of plant sterols based on the consumption of foods and dishes reported by participants. Cereals and fats provided 61% of the total plant sterols, and together with vegetables and fruits, this totaled 80%. Total plant sterol intake for the Polish population was 282.97 mg/day, and divided by men and women was 320.77 and 252.19 mg/day, respectively. Canola oil provided the most plant sterols at 16.92%, followed by white bread at 16.65% and soft margarine at 8.33%. This study found that the database of plant sterols facilitates the calculation of plant sterols in the typical Polish diet, and the results are comparable to those of other studies, despite different methodologies of nutritional assessment and slightly different databases. The main sources of dietary plant sterols did not differ from the data for other populations. This study confirmed the observations of other research that women's diets may have a higher plant sterol density compared to men.

Seventeen years of misdiagnosis in rare dyslipidaemia: a case report of sitosterolaemia in a young female

Background Sitosterolaemia is a rare, autosomal recessive dyslipidaemia with increased absorption of dietary plant sterol and often presents with hypercholesterolaemia, xanthomas, and haematologic manifestations. If left untreated, sitosterolaemia can lead to high symptomatic burden and coronary artery disease (CAD). Case summary We describe a case of a young female who initially presented at 4 years of age with classic manifestations of sitosterolaemia. She was misdiagnosed and treated for both juvenile arthritis and later familial hypercholesterolaemia until adulthood, when venous blood samples showed significantly elevated concentrations of plant sterols. DNA analyses showed that the patient was homozygous for a mutation in the ABCG5 gene, [c.1336C>T, p.(Arg446*)], which is known to be associated with sitosterolaemia. Discussion Sitosterolaemia presents with multiple manifestations, which can initially be misinterpreted leading to prolonged misdiagnosis. Early diagnosis is key in order to relieve symptoms and prevent CAD.

Cross-Sectional Study of Plant Sterols Intake as a Basis for Designing Appropriate Plant Sterol-Enriched Food in Indonesia

Coronary heart disease (CHD) is one of the leading causes of mortality in many low-income and middle-income countries, including Indonesia, with elevated blood cholesterol level being one of significant risk factors for this condition. The problem should be addressed by combining healthy lifestyle and diet, where functional foods having a cholesterol-lowering activity could play a significant role. A group of compounds that had been proven to show cholesterol-lowering ability are plant sterols. To develop more suitable functional foods that could substantially contribute to hypercholesterolemia prevention in Indonesian population, up-to-date data about plant sterols dietary intake are required, and were not available until this research was done. This study aimed to estimate daily plant sterols intake and to determine the consumption pattern of foods containing plant sterols in rural and urban area of Bogor, West Java, Indonesia. The research was conducted with a cross-sectional design, with 200 respondents. The study revealed that the level of plant sterols intake in Bogor reached on average 229.76 mg/day and was not significantly different between urban and rural area. Cereals, vegetables, and fruit products were the main food sources of plant sterols in both areas. In addition, a list of several surveyed food items possible to be enriched with plant sterols was developed within the study. These results provide baseline data to develop functional foods fortified with plant sterols suitable for the Indonesian needs and taste. However, further studies are needed to confirm efficacy and safety of introducing such phytosterol-enriched products into a habitual diet, especially considering possible long-term side effects of plant sterol treatment.

Plant sterol ester of α-linolenic acid ameliorates high-fat diet-induced nonalcoholic fatty liver disease in mice: association with regulating mitochondrial dysfunction and oxidative stress via activating AMPK signaling

Plant sterol ester of α-linolenic acid prevents nonalcoholic fatty liver disease by improving mitochondrial function, modifying lipid metabolism, and inhibiting oxidative stress via AMPK signaling.

The Influence of Galactooligosaccharide Addition to a Plant Sterol-Enriched Beverage upon Plant Sterol Colonic Metabolization: A Clinical Trial

The consumption of milk-based fruit beverages enriched with plant sterols (PSs) has previously showed a cholesterol-lowering effect in postmenopausal women [1]. The addition of galactooligosaccharides (GOSs) to these kinds of beverages could enhance their functionalities; however, their effect on the colonic metabolism of PSs is yet unknown. To shed light on this, a randomized, double blind, crossover study with postmenopausal women (n = 42, 58 ± 4 years) was carried out with the aim of evaluating GOS effects on PS colonic metabolism. Volunteers consumed 250 mL of a PS-enriched beverage (1%, w/v) daily with or without GOSs (1.8%, w/v) for 6 weeks, and feces samples were collected before and at the end of each intervention period. The contents of PS (sitosterol, sitostanol, campesterol, campestanol and stigmasterol) and its metabolites (ethylcoprostanol from sitosterol, methylcoprostanone from campesterol and ethylcoprostenol from stigmasterol) were measured by CG-MS [2]. Statistically significant increments (p < 0.05) in sterol concentrations (mg/g freeze-dry feces) were observed after the consumption of any of the beverages (with vs. without GOS addition) expressed as median (percentile 25; 75%): 8.29 (1.49; 17.27) vs. 10.79 (2.14; 19.30) for sitosterol, 12.95 (2.65; 20.66) vs. 14.47 (4.91; 21.56) for ethylcoprostanol, 2.84 (1.34; 4.91) vs. 3.16 (1.27; 4.80) for sitostanol, 1.09 (0.34; 2.03) vs. 1.41 (0.47; 2.11) for campesterol, 0.15 (0.03; 0.40) vs. 0.18 (0.03; 0.45) for methylcoprostanone, 0.46 (0.20; 0.80) vs. 0.44 (0.23; 0.82) for campestanol and 0.07 (0.00; 0.19) vs. 0.09 (0.02; 0.23) for stigmasterol. No significant changes were observed in ethylcoprostenol contents after the consumption of the beverage with or without GOSs (0.01 (−0.01; 0.02) vs. 0.002 (−0.02; 0.02)). No significant differences in net increments were observed between beverages. These results indicate that the presence of GOSs in PS-enriched beverages does not modify the colonic biotransformation of PSs.