Hostname: page-component-6bf8c574d5-b4m5d Total loading time: 0 Render date: 2025-02-21T13:16:11.534Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of yoghurt enriched with plant sterols on serum lipids in patients with moderate hypercholesterolaemia

Published online by Cambridge University Press:  09 March 2007

Robert Volpe ,
Leena Niittynen ,
Riitta Korpela ,
Cesare Sirtori ,
Antonello Bucci ,
Nadia Fraone  and
Franco Pazzucconi
Robert Volpe
Affiliation:
Institute of Systematic Medical Theraphy, University of Rome ‘La Sapienza’, Rome, Italy
Leena Niittynen
Affiliation:
Valio Ltd, Research Centre, Po Box 30, FIN-00039 Helsinki, Finland
Riitta Korpela*
Affiliation:
Valio Ltd, Research Centre, Po Box 30, FIN-00039 Helsinki, Finland Foundation for Nutrition Research, Helsinki, Finland
Cesare Sirtori
Affiliation:
Institute of Pharmacologiacal Sciences, University of Milan, Milan, Italy
Antonello Bucci
Affiliation:
Institute of Systematic Medical Theraphy, University of Rome ‘La Sapienza’, Rome, Italy
Nadia Fraone
Affiliation:
Institute of Pharmacologiacal Sciences, University of Milan, Milan, Italy
Franco Pazzucconi
Affiliation:
Institute of Systematic Medical Theraphy, University of Rome ‘La Sapienza’, Rome, Italy
*
*Corresponding author: Dr R. Korpela, fax +358 10381 3019, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The objective of the present study was to assess the effect of consumption of a yoghurt-based drink enriched with 1–2 g plant sterols/d on serum lipids, transaminases, vitamins and hormone status in patients with primary moderate hypercholesterolaemia. Thirty patients were randomly assigned to one of two treatment groups: a low-fat low-lactose yoghurt-based drink enriched with 1 g plant sterol extracted from soyabean/d v. a low-fat low-lactose yoghurt, for a period of 4 weeks. After a 2-week wash-out period, patients were crossed over for an additional 4-week period. Second, after a 4-week wash-out period, eleven patients were treated with 2 g plant sterols/d in a second open part of the study for a period of 8 weeks. The yoghurt enriched with plant sterols significantly reduced, in a dose-dependent manner, serum total cholesterol and LDL-cholesterol levels and LDL-cholesterol:HDL-cholesterol (P<0·001), whereas no changes were observed in HDL-cholesterol and triacylglycerol levels, either in the first or the second part of the study. There were only slight, not statistically significant, differences in serum transaminase, vitamin and hormone levels. To conclude, a low-fat yoghurt-based drink moderately enriched with plant sterols may lower total cholesterol and LDL-cholesterol effectively in patients with primary moderate hypercholesterolaemia.

Keywords

Plant sterolsHypercholesterolaemiaSex hormonesFat-soluble vitamins
Type
Research Article
Information
British Journal of Nutrition , Volume 86 , Issue 2 , August 2001 , pp. 233 - 239
Copyright
Copyright © The Nutrition Society 2001

References

Anderson, KM, Castelli, WP & Levy, D (1987) Cholesterol and mortality. 30 years of follow-up from the Framingham Study. Journal of the American Medical Association 257, 2176–2180.CrossRefGoogle ScholarPubMed
Atwater, WO & Bryant, AP (1989) The availability and fuel value of food materials. Report of the Storrs Agricultural Experimental Station no. 1900, pp.73–110. Storrs, CT: University of Connecticut.Google Scholar
Becker, M, Staab, D & von Bergmann, K (1992) Treatment of severe familial hypercholesterolemia in children: effect of sitosterol and bezafibrate. Pediatrics 89, 138–142.CrossRefGoogle ScholarPubMed
Becker, M, Staab, D and Von Bergmann, K (1993) Treatment of severe familiar hypercholesterolemia in childhood with sitosterol and sitostanol. Journal of Pediatrics 122, 292–296.CrossRefGoogle Scholar
Best, MM, Duncan, CH, van Loon, EJ & Wathen, JD (1955) The effect of sitosterol on serum lipids. American Journal of Medicine 15, 61–70.CrossRefGoogle Scholar
Consensus Development Conferences (1985) Lowering blood cholesterol to prevent heart disease. Journal of the American Medical Association 263, 2080–2086.Google Scholar
Denke, MA (1994) Lack of efficacy of low-dose sitostanol therapy as an adjunct cholesterol-lowering diet in men with moderate hypercholesterolemia. American Journal of Clinical Nutrition 61, 392–396.CrossRefGoogle Scholar
Farquhar, JW, Smith, RE & Dempsey, ME (1956) The effect of beta sitosterol on the serum lipids of young men with arteriosclerotic heart disease. Circulation 14, 77–82.CrossRefGoogle Scholar
Frick, MH, Elo, O, Haapa, K, Heinonen, OP, Heinsalmi, P, Helo, P, Huttunen, JK, Kaitaniemi, P, Koskinen, P & Manninen, V (1987) Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia. New England Journal of Medicine 317, 1237–1245.CrossRefGoogle ScholarPubMed
Friedewald, WT, Levy, RI & Fredrickson, DS (1972) Estimation of the concentration of low density lipoprotein cholesterol in plasma without the use of ultracentrifuge. Clinical Chemistry 18, 499–502.CrossRefGoogle ScholarPubMed
Ghidini, A, Sicherer, S & Willner, J (1992) Congenital abnormalities (VATER) in baby born to mother using lovastatin. Lancet 339, 1416–1417.CrossRefGoogle ScholarPubMed
Glatz, JF & Katan, MB (1993) Dietary saturated fatty acids increase cholesterol synthesis and fecal steroid excretions in healthy men and women. European Journal of Clinical Investigation 23, 648–655.CrossRefGoogle ScholarPubMed
Grundy, SM & Mok, HY (1976) Effects of low dose phytosterols on cholesterol absorption in man. In Lipoprotein Metabolism, pp. 112–118. [Greten, H, editor]. Berlin, Heidelberg and New York: Springer.CrossRefGoogle Scholar
Gylling, H, Puska, P, Vartiainen, P & Miettinen, TA (1996) Serum retinol α-tocopherol, carotenes and lipid peroxide production during serum cholesterol lowering by sitostanol ester margarine in a mildly hypercholesterolemic population. Circulation 94 Suppl. 1, 578.Google Scholar
Gylling, H, Radhakrishnan, R & Miettinen, TA (1997) Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine. Circulation 96, 4226–4231.CrossRefGoogle ScholarPubMed
Gylling, H, Siimes, MA & Miettinen, TA (1995) Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia. Journal of Lipid Research 36, 1807–1812.CrossRefGoogle ScholarPubMed
Heinemann, T, Axtmann, G & von Bergmann, K (1993) Comparison of intestinal absorption of cholesterol with different plant sterols in man. European Journal of Clinical Investigation 23, 827–831.CrossRefGoogle ScholarPubMed
Heinemann, T, Leiss, O & von Bergmann, K (1986) Effect of low-dose sitostanol on serum cholesterol in patients with hypercholesterolemia. Atherosclerosis 61, 219–223.CrossRefGoogle ScholarPubMed
Ikeda, I, Tanabe, Y & Sugano, M (1989) Effects of sitosterol and sitostanol on micellar solubility of cholesterol. Journal of Nutritional Science and Vitaminology 35, 361–369.CrossRefGoogle ScholarPubMed
Isaacsohn, J, Stein, E, Weinstein, R, Orchard, T, Huh, C, Whalen, E & Ripen, S (1998) Cerivastatin, a novel potent HMG-CoA reductase inhibitor: comparative efficacy versus fluvastatin. In XIIIth International Symposium on Drugs Affecting Lipid Metabolism (DALM), pp. 62. Florence, Italy. Milan, Italy: Lorenzini Foundation.Google Scholar
Instituto Nazionale della Nutrizione (1996) LARN Livelli di Assunzione Raccomandati di Enrgia e Nutrienti per la Popolazione Italiana (The enzymatic determination of serum total cholesterol). Roma: Instituto Nationale della Nutrizione.Google Scholar
Jones, PHJ, MacDougall, DE, Ntanios, F & Vanstone, CA (1997) Dietary phytosterols as cholesterol lowering agents in humans. Canadian Journal of Physiology and Pharmacology 75, 217–227.CrossRefGoogle ScholarPubMed
Lees, RS & Lees, AM (1976) Effects of sitosterol therapy on plasma lipid and lipoprotein concentrations. In Lipoprotein Metabolism pp. 119–124. [Greten, H, editor]. Berlin, Heidelberg and New York: Springer.CrossRefGoogle Scholar
Lees, AM, Mok, HYI, Lees, RS, McLuskey, A & Grundy, SM (1977) Plant sterols as cholesterol-lowering agents: clinical trials in patients with hypercholesterolemia and studies of sterol balance. Atherosclerosis 28, 325–338.CrossRefGoogle ScholarPubMed
Ling, WH & Jones, PJH (1995) Minireview. Dietary phytosterols: a review of metabolism, benefits and side effects. Life Sciences 57, 195–206.CrossRefGoogle Scholar
Lipid Research Clinics Program (1984) The Lipid Research Clinics Coronary Primary Prevention Trial results: I and II. Journal of the American Medical Association 251, 351–374.CrossRefGoogle Scholar
MacLatchy, DL & Van der Kraak, GJ (1995) The phytoestrogen beta-sitosterol alters the reproductive endocrine status of coldfish. Toxicology and Applied Pharmacology 134, 305–312.CrossRefGoogle Scholar
Malini, T & Vanithakumari, G (1993) Effect of β-sitosterol on uterine biochemistry: A comparative study with estradiol and progesterone. Biochemistry and Molecular Biology International 31, 659–668.Google ScholarPubMed
Miettinen, TA, Puska, P, Gylling, H, Vanhanen, H & Vartiainen, E (1995) Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. New England Journal of Medicine 333, 1308–1312.CrossRefGoogle Scholar
Miettinen, TA & Vanhanen, H (1994) Dietary sitostanol related to absorption, synthesis and serum level of cholesterol in different apolipoprotein E phenotypes. Atherosclerosis 105, 217–226.CrossRefGoogle ScholarPubMed
National Cholesterol Education Program Expert Panel (1993) Expert Panel on detection evaluation and treatment of high blood cholesterol in adults: summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on detection evaluation and treatment of high blood cholesterol in adults (Adult treatment panel 2). Journal of the American Medical Association 34, 1535–1544.Google Scholar
Pelletier, X, Belbraouet, S, Mirabel, D, Mordret, F, Perrin, JL, Pages, X & Derby, G (1995) A diet moderate enriched in phytosterols lowers plasma cholesterol concentrations in normocholesterolemic humans. Annals of Nutrition and Metabolism 39, 291–295.CrossRefGoogle ScholarPubMed
Pollak, OJ (1953) Reduction of blood cholesterol in man. Circulation 7, 702–706.CrossRefGoogle ScholarPubMed
Pollak, OJ (1985) Effect of plant sterols on serum lipids and atherosclerosis. Pharmacology and Therapeutics 31, 177–208.CrossRefGoogle ScholarPubMed
Roschlau, P, Bernt, E & Gruber, W (1974) Enzymatische Bestimmung des Gesamtcholesterins in Serum. Zeitschrift für Klinische Chemie und Klinische Biochemie 12, 403–407.Google ScholarPubMed
Sacks, FM, Pfeffer, MA, Moye, LA, Rouleau, JL, Rutherford, JD, Cole, TG, Brown, L, Warnica, JW, Arnold, JM, Wun, CC, Davis, BR & Braunwald, E (1996) The effect of Pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. New England Journal of Medicine 335, 1001–1009.CrossRefGoogle ScholarPubMed
Salen, G, Ahrens, EH & Grundy, SM (1970) Metabolism of β-sitosterol in man. Journal of Clinical Investigation 49, 952–967.CrossRefGoogle ScholarPubMed
Scandinavian Simvastatin Survival Study Group (1994) Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 344, 1383–1389.Google Scholar
Schlierf, G, Oster, P, Heuck, CC, Raetzer, H & Schellenberg, B (1978) Sitosterolemia in juvenile type II hyperlipoproteinemia. Atherosclerosis 30, 245–248.CrossRefGoogle Scholar
Shepherd, J, Cobbe, SM, Ford, I, Isles, CG, Lorimer, AR, MacFarlane, PW, McKillop, JH & Packard, CJ (1995) Prevention of coronary heart disease with Pravastatin in men with hypercholesterolemia. New England Journal of Medicine 333, 1301–1307.CrossRefGoogle ScholarPubMed
Stamler, J, Wentworth, D & Neaton, JD for MRFIT Research Group(1986) Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous or graded? Findings in 356222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). Journal of the American Medical Association 256, 2823–2828.CrossRefGoogle ScholarPubMed
The Long-term Intervention with Pravastatin in Ischaemic Disease(LIPID) Study Group (1998) Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. New England Journal of Medicine 339, 1349–1357.CrossRefGoogle Scholar
Vanhanen, HT, Blomquist, S, Ehnholm, C, Hyvönen, M, Jauhiainen, M, Torstila, I & Miettinen, TA (1993) Serum cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic subjects with different apoE phenotypes during dietary sitostanol ester treatment. Journal of Lipid Research 34, 1535–1544.CrossRefGoogle ScholarPubMed
Vanhanen, HT, Kajander, J, Lehtovirta, H & Miettinen, TA (1994) Serum levels, absorption efficiency, faecal elimination and synthesis of cholesterol during increasing doses of dietary sitostanol esters in hypercholesterolaemic subjects. Clinical Science 87, 61–67.CrossRefGoogle ScholarPubMed
Volpe, R, Angelico, F & Arca, M (1992) Effects of simple dietary advice on serum lipids in severe and moderate primary hypercholesterolemia. In Treatment of Severe Dyslipoproteinemia in the Prevention of Coronary Heart Disease pp. 226–230. [Gotto, A, Mancini, M, Richter, WO and Schwandt, P, editors]. Basel: Karger.Google Scholar
Wada, T, Omuro, K & Shirai, K (1979) Assay of triglycerides on use of alfa-glycerophosphate oxidase. Eisei-Kensa 29, 367.Google Scholar
Warnich, GR, Cheung, MC & Albers, JJ (1979) Comparison of current methods for high density lipoprotein cholesterol quantitation. Clinical Chemistry 25, 596–604.CrossRefGoogle Scholar
Weststrate, JA & Meijer, QW (1998) Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. European Journal of Clinical Nutrition 52, 334–343.CrossRefGoogle ScholarPubMed