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Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread

European Journal of Clinical Nutrition volume 58, pages 1612–1620 (2004)Cite this article

Abstract

Objective: To study the compliance and changes in plasma lipids, plant sterols, fat-soluble vitamins and carotenoids in children and parents with familial hypercholesterolemia (FH) consuming a plant sterol ester-enriched (PSE) spread.

Design: A 26-week open-label follow-up of children who had previously been studied in a controlled cross-over design. The parents were also included in the open-label arm of the study.

Setting: Outpatient clinic for treatment of hyperlipidemia.

Subjects: A total of 37 children (7–13 y) and 20 parents (32–51 y) diagnosed with ‘definite’ or ‘possible’ heterozygous FH. In all, 19 of the parents, but no children, used statins. All were patients at the Lipid Clinic, National Hospital in Oslo.

Interventions: Subjects were recommended to eat 20 g/day of PSE spread as part of their lipid-lowering diet.

Results: The mean intake of PSE spread was 13.7 and 16.5 g/days in the children and parents, respectively, corresponding to 1.2 and 1.5 g of plant sterols. Plasma total cholesterol decreased by 9.1% in both children (P<0.001) and parents (P=0.002). The corresponding decreases in LDL cholesterol were 11.4% (P<0.001) and 11.0% (P=0.012). Increases in serum lathosterol, campesterol and sitosterol, adjusted for total cholesterol, were observed in the children (31, 96, 48%, respectively, P<0.001) at the end of the controlled cross-over period. In the parents, serum campesterol and sitosterol, adjusted for total cholesterol, increased by 92 and 39%, respectively (P< 0.001). Lipid-adjusted serum α- and β-carotene decreased by 17.4% (P=0.008) and 10.9% (P=0.018), respectively, in the children at the end of the controlled PSE period, but increased again during the follow-up. In the parents, serum α- and β-carotene concentrations were unchanged, while serum lutein and lycopene decreased by 7.3% (P=0.037) and 14.6% (P=0.044), respectively.

Conclusions: Sustained efficacy of cholesterol reduction and long-term compliance of PSE intake were demonstrated in this study.

Sponsorship: Unilever Research and Development, Vlaardingen, The Netherlands.

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Acknowledgements

We are especially grateful to all children and enthusiastic parents participating in the study. We acknowledge all those involved in the conduction of the study at the Lipid Clinic. We also acknowledge Stabburet, Oslo, Mills DA, Oslo, Brødfakta, Oslo and Tine BA, Oslo, for the contribution of breakfast products to the study participants.

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Authors and Affiliations

  1. Lipid Clinic, National Hospital, Oslo, Norway

    Å L Amundsen & L Ose

  2. Institute for Nutrition Research, University of Oslo, Norway

    Å L Amundsen

  3. Unilever Health Institute, Unilever Research and Development, Vlaardingen, The Netherlands

    F Ntanios & N van der Put

Authors
  1. Å L Amundsen
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  2. F Ntanios
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  3. N van der Put
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  4. L Ose
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Contributions

Guarantor: Å L Amundsen.

Contributors: ÅLA: study coordinator, main author. FN: contact person from Unilever, revised the manuscript. NvdP: revised the manuscript, LO: head of the Lipid Clinic, responsible for the study.

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Correspondence to Å L Amundsen.

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Amundsen, Å., Ntanios, F., Put, N. et al. Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread. Eur J Clin Nutr 58, 1612–1620 (2004). https://doi.org/10.1038/sj.ejcn.1602015

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