Carotid artery compliance in users of plant stanol ester margarine

OBJECTIVE: To investigate the effects of stanol ester margarine use in healthy subjects on arterial compliance, endothelial function and intima-media thickness. DESIGN: Case-control study comparing regular stanol ester margarine users to non-users. SETTING: Occupational health service clinic. SUBJECTS: We recruited 50 cases and 50 controls (mean age 51+/-8, range 26-65 years). All subjects were non-smokers and the study groups were matched for age and sex. As cases, we invited subjects who had been using regularly (daily) plant stanol ester margarine for a period of 2 years or longer. Non-invasive ultrasound was used to measure carotid artery compliance, carotid intima-media thickness and brachial artery flow-mediated endothelial dependent vasodilatation. RESULTS: The carotid artery compliance was non-significantly higher in cases compared with controls, 1.84+/-1.02 vs 1.58+/-0.76 %/10 mm Hg (P=0.13). The difference in compliance became statistically significant (P=0.04) when the unbalance between the groups in family history of coronary artery disease and years of education were taken into account. There was also a significant dose-response relationship between stanol margarine use and carotid compliance, longer use being associated with higher compliance. Serum lipoproteins, blood pressure, flow-mediated dilation and intima-media thickness values did not differ between cases and controls. CONCLUSION: These data raise the possibility that regular stanol ester margarine use may be associated with beneficial changes in arterial compliance. Intervention studies are needed to test this hypothesis and to reveal possible mechanisms.     

Serum and lipoprotein sitostanol and non-cholesterol sterols after an acute dose of plant stanol ester on its long-term consumption

Purpose

Chronic inhibition of cholesterol absorption with large doses of plant stanol esters (staest) alters profoundly cholesterol metabolism, but it is unknown how an acute inhibition with a large staest dose alters the postprandial serum and lipoprotein cholesterol precursor, plant sterol, and sitostanol contents.

Methods

Hypercholesterolemic subjects, randomly and double-blind divided into control (n?=?18) and intervention groups (n?=?20), consumed experimental diet without and with staest (plant stanols 8.8?g/day) for 10?weeks. Next morning after a fasting blood sample (0 h), the subjects had a breakfast without or with staest (4.5?g of plant stanols). Blood sampling was repeated 4?h later. Lipoproteins were separated with ultracentrifugation, and sterols were measured with gas–liquid chromatography.

Results

In 0-h chylomicrons and VLDL, plant sterols were lower in staest than in controls. Postprandially, cholestenol (cholesterol synthesis marker) was reduced in chylomicrons in staest compared with controls (?0.13?±?0.04?μg/dL vs. 0.01?±?0.08?μg/dL, P?P?Conclusions Chronic cholesterol absorption inhibition with large amount of plant stanol esters decreases plant sterols in triglyceride-rich lipoproteins. Acute plant stanol ester consumption increases sitostanol content in triglyceride-rich lipoproteins but suggests to decrease the risk of plant sterol and plant stanol accumulation into vascular wall by chylomicrons.     

Serum plant sterols and their relation to cholesterol absorption

beta-Sitosterol and campesterol were measured in serum lipoproteins of 17 subjects from two families. The serum levels of the two phytosterols were closely correlated with each other (r = 0.974), less consistently with serum cholesterol (r = 0.489), and not at all with serum triglycerides. As compared to cholesterol, serum free and esterified phytosterols tended to be accumulated in HDL where the phytosterol/cholesterol ratios were almost 40% higher than in VLDL and LDL. The serum phytosterol concentrations, the phytosterol/cholesterol ratios, especially in VLDL and LDL, and the fractional absorption of cholesterol were higher in women than in men. The levels of the phytosterols in whole serum and in each lipoprotein were significantly correlated with the percentage absorption of dietary cholesterol but were independent of the amount of dietary cholesterol and plant sterols. Our findings suggest that, in general, serum levels of noncholesterol sterols are effectively determined by the absorption which in turn is proportionate to the fractional absorption of cholesterol.     

Customary use of plant sterol and plant stanol enriched margarine is associated with changes in serum plant sterol and stanol concentrations in humans

The consumption of products enriched with plant sterol or stanol esters lowers serum total and LDL-cholesterol concentrations, thereby most likely reducing the risk of coronary heart disease. However, using plant sterol (not plant stanol) enriched products elevates serum plant sterol concentrations in humans. This may be unwanted because health effects of elevated serum plant sterol concentrations are still controversial. Within postlaunch monitoring of functional foods, we compared serum plant sterol and plant stanol concentrations among users of plant sterol (n = 67) or plant stanol (n = 13) enriched margarines with those of matched nonusers (n = 81) in the ongoing Dutch Doetinchem cohort study. Subjects (aged 29-67 y) were examined in 1994-1998 (before the introduction of enriched margarines) and re-examined in 1999-2003. Serum concentrations of plant sterols and stanols were measured in samples from nonfasting subjects by GLC-MS. Intake of plant sterols was 1.1 +/- 0.6 g/d and was associated with a decrease of serum total cholesterol concentration of 0.25 +/- 0.91 mmol/L (4%, P < 0.05), a change that differed (P < 0.05) from the nonsignificant increase in nonusers (+2%, 0.12 +/- 0.78 mmol/L, P = 0.16). Cholesterol-standardized serum sitosterol and campesterol increased in plant sterol users by 22% (P < 0.0001) and 103% (P < 0.0001), respectively. Cholesterol-standardized serum sitostanol and campestanol increased in plant stanol users by 197% (P = 0.02) and 196% (P = 0.01). To our knowledge, these data are the first to show changes in serum cholesterol, plant sterol, and plant stanol concentrations after (long-term) consumption of plant sterol and stanol enriched margarines in a free-living population in a nonexperimental setting. Whether the increased serum sterol concentrations result in adverse side effects needs to be investigated in future postlaunch monitoring studies.     

Effects of long-term plant sterol or stanol ester consumption on lipid and lipoprotein metabolism in subjects on statin treatment

Consumption of plant sterol- or stanol-enriched margarines by statin users results in an additional LDL-cholesterol reduction of approximately 10 %, which may be larger than the average decrease of 3-7 % achieved by doubling the statin dose. However, whether this effect persists in the long term is not known. Therefore, we examined in patients already on stable statin treatment the effects of 85 weeks of plant sterol and stanol ester consumption on the serum lipoprotein profile, cholesterol metabolism, and bile acid synthesis. For this, a double-blind randomised trial was designed in which fifty-four patients consumed a control margarine with no added plant sterols or stanols for 5 weeks (run-in period). For the next 85 weeks, seventeen subjects continued with the control margarine and the other two groups with either a plant sterol (n 18) or plant stanol (n 19) (2.5 g/d each) ester-enriched margarine. Blood was sampled at the end of the run-in period and every 20 weeks during the intervention period. Compared with the control group, plant sterol and stanol ester consumption reduced LDL-cholesterol by 0.28 mmol/l (or 8.7 %; P = 0.08) and 0.42 mmol/l (13.1 %; P = 0.006) respectively after 85 weeks. No effects were found on plasma concentrations of oxysterols or 7 alpha-hydroxy-4-cholesten-3-one, a bile acid synthesis marker. We conclude that long-term consumption of both plant sterol and stanol esters effectively lowered LDL-cholesterol concentrations in statin users.     

Serum plant sterols and cholesterol precursors reflect cholesterol absorption and synthesis in volunteers of a randomly selected male population

To investigate the regulation of serum levels of cholesterol precursor sterols and plant sterols, these noncholesterol sterols, fatty acids, and various parameters of cholesterol metabolism were analyzed in 63 volunteers from a randomly selected Finnish male population sample of 100 subjects, aged 50 years, who had normal dietary habits. Serum levels of cholesterol precursors, desmosterol and lathosterol (in terms of micrograms/mg cholesterol), were negatively related to both the fractional and absolute absorption of dietary cholesterol and serum high density lipoprotein (HDL) cholesterol, and positively related to overall cholesterol synthesis and serum very low density lipoprotein (VLDL) cholesterol. Serum levels of the plant sterols, campesterol and sitosterol, exhibited positive correlations with the polyunsaturated/saturated fatty acid ratio of dietary fat, the linoleic acid contents of plasma and dietary lipids, the amount of dietary plant sterols (as indicated by fecal output), fractional and absolute absorption of dietary cholesterol, and HDL cholesterol, but were inversely related to the overall cholesterol synthesis and VLDL cholesterol. Stepwise multiple regression analysis revealed that the serum level of campesterol was associated with fractional cholesterol absorption, dietary plant sterols, and biliary cholesterol secretion, and that of sitosterol with dietary plant sterols, cholesterol synthesis, fractional cholesterol absorption, and biliary cholesterol secretion. Thus, the serum non-cholesterol sterols are significant indicators of cholesterol absorption and synthesis even under basal conditions and, since gas liquid chromatographic determination of these sterols is quite simple, their measurement may be valuable for monitoring cholesterol metabolism in large-scale epidemiologic studies.     

Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on a low-fat diet

OBJECTIVE: To investigate cholesterol-lowering effects of stanol ester (STAEST) and sterol ester (STEEST)-enriched margarines as part of a low-fat diet. DESIGN: According to a Latin square model randomized double-blind repeated measures design with three test margarines and three periods. SETTING: Outpatient clinical trial with free-living subjects. SUBJECTS: Thirty-four hypercholesterolaemic subjects completed the study. Interventions: Subjects consumed three rapeseed oil-based test margarines (STAEST, STEEST and control (no added stanols or sterols)) as part of a low-fat diet each for 4 weeks. RESULTS: Mean daily intake of total plant sterols plus stanols was 2.01-2.04 g during the two test margarine periods. In reference to control, serum total cholesterol was reduced by 9.2 and 7.3% with the STAEST and STEEST margarine, respectively (P<0.001 for both). The respective reductions for low-density lipoprotein (LDL) cholesterol were 12.7 and 10.4% (P<0. 001). The cholesterol-lowering effects of the test margarines did not differ significantly. The presence of apolipoprotein E4 allele had a significant effect on LDL cholesterol response during the STAEST margarine only. Serum sitosterol and campesterol increased by 0.83 and 2.77 mg/l with the STEEST (P<0.001), respectively and decreased by 1.18 and 2.60 mg/l with the STAEST margarine (P<0.001). Increases of serum sitostanol and campestanol were 0.11 and 0.19 mg/l with the STAEST margarine (P<0.001), repsectively. No significant changes were found in serum fat-soluble vitamin and carotenoid concentrations when related to serum total cholesterol. CONCLUSIONS: STAEST and STEEST margarines reduced significantly and equally serum total and LDL cholesterol concentrations as part of a low-fat diet. SPONSORSHIP: Grant to the University of Kuopio by Raisio Benecol Ltd, Raisio, Finland.     

Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment

OBJECTIVE: The present study was designed to examine for the first time, side-by-side, the effects of plant sterol and stanol consumption on lipid metabolism and markers of antioxidant status, oxidative stress, endothelial dysfunction and low-grade inflammation in subjects on stable statin-treatment. DESIGN: Double-blind, randomized, placebo-controlled, intervention trial. SETTING: University. SUBJECTS: Forty-five patients on current statin treatment were recruited via newspaper advertisements. Data of 41 patients were used in statistical analysis. INTERVENTION: Subjects consumed margarine with no added plant sterols or stanols for 4 weeks and were then divided into three groups of 15 subjects. For the next 16 weeks, one group continued with the control margarine and the other two groups with either a plant sterol- or stanol (2.5 g/day)-enriched margarine. Blood was sampled at the end of the run-in and intervention periods. RESULTS: Plant sterol and stanol consumption significantly (P=0.026) reduced low-density lipoprotein (LDL) cholesterol by 0.34 mmol/l (95% confidence interval (CI), -0.67 to -0.04 mmol/l). No effects were shown on enzymatic and non-enzymatic antioxidants and markers of oxidative modification of lipids and DNA. In addition, no effect was found on soluble adhesion molecules, C-reactive protein and monocyte chemotactic protein-1 concentrations. CONCLUSIONS: We conclude that 16 weeks of plant sterol or stanol consumption did not affect markers of antioxidant status, oxidative stress, endothelial dysfunction and low-grade inflammation in patients on stable statin treatment, despite a significant reduction of LDL cholesterol.     

Serum nutrients and habitual dietary intake in colectomized FAP patients in Norway

Background  Patients with familial adenomatous polyposis (FAP) are colectomized in young age in order to avoid development of colorectal cancer. Because colectomy radically changes gastrointestinal physiology, and food avoidance may be present, colectomized patients may be at risk for nutritional deficiency. Aim of the study  to evaluate: (1) serum biochemical levels as compared to reference; (2) dietary intake as compared to the recommendations. Methods  Blood samples, interviews and food frequency questionnaire were collected from 38 colectomized FAP patients with duodenal adenomas (mean age 40 years, range: 24–70). They were recruited from the Norwegian database on FAP. Results  Serum albumin was significantly higher (P ≤ 0.0001), and Mg (P = 0.02), ferritin (P ≤ 0.001), and cholesterol (P = 0.03) significantly lower, than reference levels. Compared to recommendations, a low intake was seen for folate and fiber (<50%), iron, thiamin, riboflavin (<25%), and omega-3 fatty acids (8%). Sugar intake exceeded the recommendation, mainly due to a high intake of soft drinks. Food avoidance was reported by 53%. Conclusions  We would suggest that the nutrient intake among FAP patients should at least meet the recommendations for healthy subjects. Their risk of metachronous cancers should also cause special attention to dietary factors that may prevent nutritional deficiency and carcinogenesis. Disclaimers: None of the authors had any disclaimers.     

Dietary lectin lowers serum cholesterol and raises fecal neutral sterols in cholesterol-fed rats

This study examined the influence of a low level of dietary lectin (0.34%), at a dose that did not affect body weight or food intake, on the concentration of serum cholesterol and fecal excretion of neutral sterols in rats fed a diet containing 0.50% cholesterol and 0.13% sodium cholate for 12 d. In experiment 1, rats fed a diet with 0.34% lectin, concanavalin A, had significantly lower concentrations of serum total cholesterol and hepatic cholesterol, a higher ratio of HDL-cholesterol to total cholesterol, enhanced excretion of fecal neutral sterols and reduced apparent cholesterol absorption or digestibility as compared with rats fed a diet without lectin. Fecal excretion of acidic sterols was unaffected by dietary lectin. In contrast, dietary 0.34% lectin had no significant effect on concentrations of serum total protein or glucose. In experiment 2, we examined whether the cholesterol-lowering activity of the lectin was responsibility for its carbohydrate-binding activity. The effect of dietary lectin on concentrations of serum and hepatic cholesterol and excretion of fecal neutral sterols was prevented by simultaneous administration of methyl-alpha-D-mannopyranoside with specific affinity for the carbohydrate-binding sites of the lectin. These results suggest that dietary lectins might reduce concentrations of serum and hepatic cholesterol by a mechanism involving higher excretion of neutral sterols and that these alterations might be associated with the carbohydrate-binding activity of lectin.     

Decrease in plasma low-density lipoprotein cholesterol,apolipoprotein B,cholesteryl ester transfer protein,and oxidized low-density lipoprotein by plant stanol ester-containing spread: a randomized,placebo-controlled trial

OBJECTIVE: The ester of plant stanols significantly reduces plasma levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in Western people. Effects of plant stanol ester-containing spread on plasma levels of TC, LDL-C, and apolipoprotein B (apoB) were studied in a randomized, placebo-controlled trial in Japanese subjects whose diet is low in fat and cholesterol. The effects of plant stanol ester on plasma levels of arteriosclerosis-promoting factors, namely remnants of triacylglycerol (TG)-rich lipoproteins, cholesteryl ester transfer protein (CETP), and oxidized LDL (Ox-LDL), were also studied. The assessment of safety was also made. METHODS: One hundred and five healthy volunteers were assigned randomly to one of three groups: placebo spread (n = 35), 2 g/d of plant stanol (3.4 g of stanol ester; n = 34), and 3 g/d of plant stanol (5.1 g of stanol ester; n = 36). Plasma levels of lipids were measured at start of the study, at 2 and 4 wk (end of trial), and at 8 wk (+4 wk). Plasma apoproteins, cholesterol in remnant-like particles which are equivalent to remnants of TG-rich lipoproteins (RLP-C), CETP mass, and Ox-LDL were measured at the beginning and the end of the trial. Plasma levels of plant steroids and fat-soluble vitamins were also measured for the assessment of safety. RESULTS: Background and dietary composition did not differ among groups. Plasma levels of TC, LDL-C, apoB, apoE, CETP mass, and Ox-LDL were reduced significantly by 6.5%, 9.6%, 8.3%, 4.5%, 6.1%, and 20%, respectively, in the 2 g/d plant stanol group. Plasma levels of TC, LDL-C, apoB, CETP mass, and Ox-LDL were decreased significantly by 5.5%, 7.3%, 5.6%, 3.3%, and 19%, respectively, in the 3 g/d plant stanol group. Plasma levels of plant stanols, plant sterols, retinol, beta-carotene, and alpha-tocopherol did not change in any group, but levels of campestanol increased and alpha-tocopherol decreased slightly in the sitostanol groups. CONCLUSION: Plasma levels of TC and LDL-C were significantly reduced by the plant stanol ester-containing spread. The smaller reduction than in Western studies and the lack of dose dependency in this study might be due to the different basal diets. We concluded that plant stanol ester-containing spread is efficacious in reducing plasma LDL-C, apoB, CETP, and Ox-LDL and that 2 g/d plant stanol is adequate for Japanese people. No significant side effects were observed in any group.     

Consumption of plant sterols in Belgium: consumption patterns of plant sterol-enriched foods in Flanders, Belgium

The present study describes the consumption of foods enriched with plant sterols (PS) and supplements containing PS, and evaluates PS intakes via the current consumption and for specific consumption scenarios. A market inventory was performed to collate different PS-enriched food items and supplements available in Belgium. An FFQ was developed to investigate the consumption of PS-enriched foods and supplements. A total of 139 pre-school children (2·5-7 years old) and 569 adults (308 women and 261 men) living in Flanders (the northern, Dutch-speaking part of Belgium) participated in the study. Of these, 21 % (Flemish pre-school children) and 28·5 % (Flemish adults) consume PS-enriched food products, leading to a mean PS intake in the consumer group of 0·70 (sd 0·61) g/d for pre-school children and 1·51 (sd 1·42) g/d for adults. Of the adult PS consumers, 23·2 % did not suffer from elevated blood cholesterol levels; 50 % of them had a PS intake less than or equal to 1 g/d and 16·4 % had a PS intake above 3 g/d and 7·8 % even had an intake above 4 g/d. Scenario studies assessed the intake when all Belgian adults would consume PS-enriched margarines without (scenario 1) or with (scenario 2) a daily consumption of a PS-enriched yoghurt drink. This resulted in an intake above 3 g/d in 17 % (women) and 29 % (men) for scenario 1 and 40 % (women) and 53 % (men) for scenario 2. The results indicate that PS-enriched food products are also consumed by the non-target group. Efficient communication tools are needed to inform consumers better about the target group of PS-enriched products, the advised dose per day and alternative dietary strategies to lower the blood cholesterol level.     

Rapeseed oil, olive oil, plant sterols, and cholesterol metabolism: an ileostomy study

OBJECTIVE: To study whether olive oil and rapeseed oil have different effects on cholesterol metabolism. DESIGN: Short-term experimental study, with controlled diets. SETTING: Outpatients at a metabolic-ward kitchen. SUBJECTS: A total of nine volunteers with conventional ileostomies. INTERVENTIONS: Two 3-day diet periods; controlled diet including 75 g of rapeseed oil or olive oil. MAIN OUTCOME MEASURES: Cholesterol absorption, ileal excretion of cholesterol, and bile acids. Serum levels of cholesterol and bile acid metabolites. Differences between diets evaluated with Wilcoxon's signed rank sum test. RESULTS: Rapeseed oil diet contained 326 mg more plant sterols than the olive oil diet. Rapeseed oil tended to decrease cholesterol absorption by 11% (P = 0.050), and increased excretion of cholesterol, bile acids, and their sum as sterols by 9% (P = 0.021), 32% (P = 0.038), and 51% (P = 0.011) compared to olive oil. A serum marker for bile acid synthesis (7alpha-hydroxy-4-cholesten-3-one) increased by 28% (P = 0.038) within 10 h of consumption, and serum cholesterol levels decreased by 7% (P = 0.024), whereas a serum marker for cholesterol synthesis (lathosterol) as well as serum levels of plant sterols remained unchanged. CONCLUSIONS: Rapeseed oil and olive oil have different effects on cholesterol metabolism. Rapeseed oil, tends to decrease cholesterol absorption, increases excretion of cholesterol and bile acids, increases serum marker of bile acid synthesis, and decreases serum levels of cholesterol compared to olive oil. This could in part be explained by different concentrations of natural plant sterols. SPONSORSHIP: Supported by the G?teborg Medical Society, the Swedish Medical Society, the Swedish Board for Agricultural Research (SJFR) grant 50.0444/98 and by University of G?teborg.     

Effects of low-fat stanol ester enriched margarines on concentrations of serum carotenoids in subjects with elevated serum cholesterol concentrations

OBJECTIVE: To investigate the effects of low-fat stanol ester margarines on concentrations of serum carotenoids. DESIGN: A randomized parallel double-blind study design consisting of a 4-week run-in (high-fat diet) and an 8-week experimental (low-fat, low-cholesterol diet) period. During the experimental diet period subjects consumed low-fat wood stanol ester (WSEM), vegetable oil stanol ester (VOSEM) or control (no stanol esters) margarine daily. The daily mean total stanol intake was 2.31 and 2.16 g in the WSEM and VOSEM groups, respectively. SETTING: Outpatient clinical trial with free-living subjects. SUBJECTS: Altogether, 60 hypercholesterolaemic subjects were selected for the study out of 91 originally screened. The study was completed by 55 subjects. MAIN OUTCOMES MEASURES: Serum alpha- and beta-carotene and lycopene determined by the HPLC. RESULTS: Serum alpha-carotene concentration did not change significantly in either of the experimental groups, whereas beta-carotene concentration decreased significantly in the WSEM and VOSEM groups (P<0.01), and the change differed significantly (P<0.05 and P <0.01, respectively) from that of the control group. Decrease in alpha+beta-carotene concentration was significantly greater (P <0.05) in both experimental groups than in the control group. However, the change in alpha-, beta- or alpha+beta-carotene/total cholesterol ratio did not differ significantly among the groups. No significant changes were found in serum lycopene or lycopene/total cholesterol ratio in both experimental groups. CONCLUSIONS: Low-fat stanol ester margarines appeared to have little effect on serum concentrations of alpha-, beta- or alpha + beta-carotene, or lycopene. SPONSORSHIP: Grant to the University of Kuopio by Raisio Benecol Ltd, Raisio, Finland.     

Increased plant sterol and stanol levels in brain of Watanabe rabbits fed rapeseed oil derived plant sterol or stanol esters

Foods containing plant sterol or stanol esters can be beneficial in lowering LDL-cholesterol concentration, a major risk factor for CVD. The present study examined whether high dietary intake of rapeseed oil (RSO) derived plant sterol and stanol esters is associated with increased levels of these components in brain tissue of homozygous and heterozygous Watanabe rabbits, an animal model for familial hypercholesterolemia. Homozygous animals received either a standard diet, RSO stanol or RSO sterol ester while heterozygous animals were additionally fed with 2 g cholesterol/kg to the respective diet form for 120 d (n 9 for each group). Concentrations of cholesterol, its precursor lathosterol, plant sterols and stanols in brain and additionally in liver and plasma were determined by highly sensitive GC-MS. High-dose intake of RSO derived plant sterols and stanols resulted in increased levels of these components in plasma and liver. In brain a limited uptake of plant sterols and stanols was proven, indicating that these compounds passed the blood-brain barrier and may be retained in the brain tissue of Watanabe rabbits. Plant stanol ester feeding lowered plant sterol levels in brain, liver, and plasma. Cholesterol synthesis in brain, indicated by lathosterol, a local surrogate cholesterol synthesis marker, does not seem to be affected by plant sterol or stanol ester feeding. We conclude that high dose intake of plant sterol and stanol esters in Watanabe rabbits results in elevated concentrations of these components not only in the periphery but also in the central nervous system.     

Serum cholesterol, fat intake, and breakfast consumption in the United States adult population

Morgan et al demonstrated that adults who consumed ready-to-eat cereals had significantly lower fat and cholesterol intakes than those who ate other foods at breakfast. Not discussed in that study was the effect of breakfast consumption habits on serum cholesterol levels. The NHANES II study of 11,864 adults was used to both verify the Morgan et al results with a different sample and to extend that research by including serum cholesterol. The analysis disclosed that serum cholesterol levels are lowest among adults eating a breakfast that includes ready-to-eat cereal and highest among breakfast skippers.     

Influence of apolipoprotein E phenotype on metabolism of lipids and apolipoproteins after plant stanol ester ingestion in Japanese subjects

OBJECTIVE: We investigated the effect of apolipoprotein E phenotype on changes in plasma levels of lipids and apoproteins by plant stanol ester (PSE) ingestion in Japanese subjects whose diet is low in fat and cholesterol. METHODS AND RESULTS:The effect of PSE-containing spread was studied in a randomized, placebo-controlled trial. One hundred five healthy volunteers were enrolled for this study. Apolipoprotein E phenotyping was done in 96 of 105 subjects. We compared plasma levels at the start and end of the test period (4 wk). The daily ingestion of 2 g of plant stanols from the PSE spread significantly reduced plasma levels of low-density lipoprotein cholesterol by 8.9 +/- 6.6% (mean +/- standard deviation) in the E(3) group and 10.4 +/- 8.0% in the E(4) group. The daily ingestion of 2 g of plant stanols from the PSE spread significantly decreased plasma levels of apoprotein B by 5.4 +/- 7.9% in the E(3) group and 8.9 +/- 7.0% in the E(4) group. No further reductions of low-density lipoprotein cholesterol and apoprotein B were observed with 3 g/d of plant stanols from the PSE spread. CONCLUSION: The ingestion of PSE spread significantly reduced plasma levels of total cholesterol, low-density lipoprotein cholesterol, and apoprotein B. However, the response to PSE ingestion was not influenced by apolipoprotein E phenotype.