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  • Original Article
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Baseline plasma plant sterol concentrations do not predict changes in serum lipids, C-reactive protein (CRP) and plasma plant sterols following intake of a plant sterol-enriched food

European Journal of Clinical Nutrition volume 63, pages 543–551 (2009)Cite this article

Abstract

Background/Objectives:

Plant sterol (PS) consumption lowers serum cholesterol levels, while modestly increasing plasma PS concentrations. Plasma PS concentrations may reflect sterol absorption, thus individuals with high plasma plant sterol (HPS) concentrations may show greater changes in circulating cholesterol and PS than individuals with low plasma plant sterol (LPS) concentrations. The objective of this study was to examine whether HPS and LPS concentrations are related to subsequent changes in plasma PS, serum lipid and C-reactive protein (CRP) concentrations, following dietary PS intake in otherwise healthy hypercholesterolemic men.

Subjects/Methods:

This single-blinded, randomized, diet-controlled study consisted of two 4-week phases, separated by a 4-week washout, where a diet with a placebo or the 2.0 g per day PS-enriched spread was consumed during the phases.

Results:

At baseline, men with HPS possessed higher (P<0.01) mean serum cholesterol concentration, while those with LPS had higher (P<0.05) body mass index. Following PS intake, plasma sum of campesterol plus sitosterol concentrations were elevated from 34.6±4.2 to 46.2±3.3 μmol l−1 (mean±SE) and 16.5±0.9 to 20.8±1.2 μmol l−1 after PS intake in men with HPS and LPS, respectively. Changes in plasma PS concentrations, however, were not different between individuals with either HPS or LPS baseline concentrations. Total cholesterol and low-density lipoprotein cholesterol levels were decreased (P<0.0001) by 6.3 and 7.8%, respectively, with PS consumption for all individuals. Changes in lipid parameters were not different between individuals with HPS or LPS baseline concentrations. No changes in CRP were apparent subsequent to PS intervention.

Conclusions:

Baseline plasma PS concentrations are not associated or predictive of changes in serum cholesterol or plasma PS concentrations after PS intervention. Thus, individuals with HPS show similar increases in PS concentrations as individuals with LPS following PS supplementation. Plasma PS remained in the range of previously reported concentrations.

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References

  • AbuMweis SS, Vanstone CA, Ebine N, Kassis A, Ausman LM, Jones PJ et al. (2006). Intake of a single morning dose of standard and novel plant sterol preparations for 4 weeks does not dramatically affect plasma lipid concentrations in humans. J Nutr 136, 1012–1016.

    Article  CAS  PubMed  Google Scholar 

  • Assmann G, Cullen P, Erbey J, Ramey DR, Kannenberg F, Schulte H (2006). Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Munster (PROCAM) study. Nutr Metab Cardiovasc Dis 16, 13–21.

    Article  CAS  PubMed  Google Scholar 

  • Bouic PJ (2001). The role of phytosterols and phytosterolins in immune modulation: a review of the past 10 years. Curr Opin Clin Nutr Metab Care 4, 471–475.

    Article  CAS  PubMed  Google Scholar 

  • Chan YM, Varady KA, Lin Y, Trautwein E, Mensink RP, Plat J et al. (2006). Plasma concentrations of plant sterols: physiology and relationship with coronary heart disease. Nutr Rev 64, 385–402.

    Article  PubMed  Google Scholar 

  • Clifton PM, Noakes M, Ross D, Fassoulakis A, Cehun M, Nestel P (2004). High dietary intake of phytosterol esters decreases carotenoids and increases plasma plant sterol levels with no additional cholesterol lowering. J Lipid Res 45, 1493–1499.

    Article  CAS  PubMed  Google Scholar 

  • Devaraj S, Autret BC, Jialal I (2006). 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 84, 756–761.

    Article  CAS  PubMed  Google Scholar 

  • Esterbauer H, Gebicki J, Puhl H, Jurgens G (1992). The role of lipid peroxidation and antioxidants in oxidative modification of LDL. Free Radic Biol Med 13, 341–390.

    Article  CAS  PubMed  Google Scholar 

  • Fassbender K, Lutjohann D, Dik MG, Bremmer M, Konig J, Walter S (2006). Moderately elevated plant sterol levels are associated with reduced cardiovascular risk—the LASA study. Atherosclerosis (online).Available from:http://dx.doi.org/10.1016/j.atherosclerosis.2006.10.032[Accessed 22 October 2007].

  • Friedewald WT, Levy RI, Fredrickson DS (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18, 499–502.

    CAS  PubMed  Google Scholar 

  • Fuentes F, Lopez-Miranda J, Garcia A, Perez-Martinez P, Moreno J, Cofan M et al. (2007). Basal plasma concentrations of plant sterols can predict LDL-C response to sitosterol in patients with familial hypercholesterolemia. Eur J Clin Nutr doi:10.1038/sj.ejcn.1602731.

  • Glueck CJ, Speirs J, Tracy T, Streicher P, Illig E, Vandegrift J (1991). Relationships of serum plant sterols (phytosterols) and cholesterol in 595 hypercholesterolemic subjects, and familial aggregation of phytosterols, cholesterol, and premature coronary heart disease in hyperphytosterolemic probands and their first-degree relatives. Metabolism 40, 842–848.

    Article  CAS  PubMed  Google Scholar 

  • Gylling H, Hallikainen M, Pihlajamaki J, Agren J, Laakso M, Rajaratnam RA et al. (2004). Polymorphisms in the ABCG5 and ABCG8 genes associate with cholesterol absorption and insulin sensitivity. J Lipid Res 45, 1660–1665.

    Article  CAS  PubMed  Google Scholar 

  • Harris N, Galpchian V, Rifai N (1996). Three routine methods for measuring high-density lipoprotein cholesterol compared with the reference method. Clin Chem 42, 738–743.

    CAS  PubMed  Google Scholar 

  • Hendriks HF, Weststrate JA, van Vliet T, Meijer GW (1999). Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr 53, 319–327.

    Article  CAS  PubMed  Google Scholar 

  • Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Josse AR, Wong JM et al. (2005). Direct comparison of dietary portfolio vs statin on C-reactive protein. Eur J Clin Nutr 59, 851–860.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jones PJ, Raeini-Sarjaz M, Ntanios FY, Vanstone CA, Feng JY, Parsons WE (2000). Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters. J Lipid Res 41, 697–705.

    CAS  PubMed  Google Scholar 

  • Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R (2003). Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 78, 965–978.

    Article  CAS  PubMed  Google Scholar 

  • Lutjohann D, Meese CO, Crouse III JR, von Bergmann K (1993). Evaluation of deuterated cholesterol and deuterated sitostanol for measurement of cholesterol absorption in humans. J Lipid Res 34, 1039–1046.

    CAS  PubMed  Google Scholar 

  • Matthan NR, Lichtenstein AH (2004). Approaches to measuring cholesterol absorption in humans. Atherosclerosis 174, 197–205.

    Article  CAS  PubMed  Google Scholar 

  • Miettinen TA, Gylling H (2002). Ineffective decrease of serum cholesterol by simvastatin in a subgroup of hypercholesterolemic coronary patients. Atherosclerosis 164, 147–152.

    Article  CAS  PubMed  Google Scholar 

  • Miettinen TA, Railo M, Lepantalo M, Gylling H (2005). Plant sterols in serum and in atherosclerotic plaques of patients undergoing carotid endarterectomy. J Am Coll Cardiol 45, 1794–1801.

    Article  CAS  PubMed  Google Scholar 

  • Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO (1990). A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr 51, 241–247.

    Article  CAS  PubMed  Google Scholar 

  • Moreau RA, Whitaker BD, Hicks KB (2002). Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Prog Lipid Res 41, 457–500.

    Article  CAS  PubMed  Google Scholar 

  • Mussner MJ, Parhofer KG, Von Bergmann K, Schwandt P, Broedl U, Otto C (2002). Effects of phytosterol ester-enriched margarine on plasma lipoproteins in mild to moderate hypercholesterolemia are related to basal cholesterol and fat intake. Metabolism 51, 189–194.

    Article  CAS  PubMed  Google Scholar 

  • Nagele U, Hagele EO, Sauer G, Wiedemann E, Lehmann P, Wahlefeld AW et al. (1984). Reagent for the enzymatic determination of serum total triglycerides with improved lipolytic efficiency. J Clin Chem Clin Biochem 22, 165–174.

    CAS  PubMed  Google Scholar 

  • Normen L, Holmes D, Frohlich J (2005). Plant sterols and their role in combined use with statins for lipid lowering. Curr Opin Investig Drugs 6, 307–316.

    CAS  PubMed  Google Scholar 

  • Pinedo S, Vissers MN, von Bergmann K, Elharchaoui K, Lutjohann D, Luben R et al. (2007). Plasma levels of plant sterols and the risk of future coronary artery disease in apparently healthy men and women; the prospective EPIC-Norfolk population study. J Lipid Res 48, 139–144.

    Article  CAS  PubMed  Google Scholar 

  • QuIlez J, GarcIa-Lorda P, Salas-Salvado J (2003). Potential uses and benefits of phytosterols in diet: present situation and future directions. Clin Nutr 22, 343–351.

    Article  CAS  PubMed  Google Scholar 

  • Rajaratnam RA, Gylling H, Miettinen TA (2000). Independent association of serum squalene and noncholesterol sterols with coronary artery disease in postmenopausal women. J Am Coll Cardiol 35, 1185–1191.

    Article  CAS  PubMed  Google Scholar 

  • Sudhop T, von Bergmann K (2004). Sitosterolemia—a rare disease. Are elevated plant sterols an additional risk factor? Z Kardiol 93, 921–928.

    Article  CAS  PubMed  Google Scholar 

  • Sudhop T, Gottwald BM, von Bergmann K (2002). Serum plant sterols as a potential risk factor for coronary heart disease. Metabolism 51, 1519–1521.

    Article  CAS  PubMed  Google Scholar 

  • Thuluva SC, Igel M, Giesa U, Lutjohann D, Sudhop T, von Bergmann K (2005). Ratio of lathosterol to campesterol in serum predicts the cholesterol-lowering effect of sitostanol-supplemented margarine. Int J Clin Pharmacol Ther 43, 305–310.

    Article  CAS  PubMed  Google Scholar 

  • Wilund KR, Yu L, Xu F, Vega GL, Grundy SM, Cohen JC et al. (2004). No association between plasma levels of plant sterols and atherosclerosis in mice and men. Arterioscler Thromb Vasc Biol 24, 2326–2332.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Funding for this study was provided by Unilever R&D, Vlaardingen, the Netherlands. We thank Linda Lapensée and all the staff at the Mary Emily Clinical Nutrition Research Unit for all the time and effort that they committed to the clinical trial.

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Authors and Affiliations

  1. School of Dietetics and Human Nutrition, Macdonald Campus, McGill University, Quebec, Canada

    A H Houweling & C A Vanstone

  2. Unilever Food and Health Research Institute, Vlaardingen, The Netherlands

    E A Trautwein & G S M J E Duchateau

  3. Richardson Centre for Functional Foods and Nutraceuticals, University of Manitoba, Winnipeg, Manitoba, Canada

    P J H Jones

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  1. A H Houweling
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  2. C A Vanstone
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  3. E A Trautwein
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  4. G S M J E Duchateau
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  5. P J H Jones
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Correspondence to P J H Jones.

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Houweling, A., Vanstone, C., Trautwein, E. et al. Baseline plasma plant sterol concentrations do not predict changes in serum lipids, C-reactive protein (CRP) and plasma plant sterols following intake of a plant sterol-enriched food. Eur J Clin Nutr 63, 543–551 (2009). https://doi.org/10.1038/sj.ejcn.1602969

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