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Effects of low-fat hard cheese enriched with plant stanol esters on serum lipids and apolipoprotein B in mildly hypercholesterolaemic subjects

Abstract

Objective:

To investigate the cholesterol-lowering effects of a low-fat cheese enriched with plant stanol esters in mildly hypercholesterolaemic subjects, as part of their normal diet.

Design:

A randomized double-blind parallel-group study.

Setting:

Valio Ltd, Helsinki.

Subjects:

Sixty-seven mildly hypercholesterolaemic volunteers (24 men, 43 women) participated in the study, which all of them completed.

Interventions:

The subjects were randomly assigned to the plant stanol ester group or the control group. During the 5-week intervention, the subjects in the stanol group consumed a cheese enriched with 2 g of plant stanols per day, and the subjects in the control group, a control cheese with no plant stanols.

Results:

In the stanol ester group, as compared to the control group, both serum total and low-density lipoprotein (LDL) cholesterol decreased significantly, that is, by 5.8% (−0.32 mmol/l, 95% CI −0.50 to −0.15 mmol/l, P<0.001) and 10.3% (−0.36 mmol/l, 95% CI −0.53 to −0.18 mmol/l, P<0.001), respectively. There were no significant changes in high-density lipoprotein cholesterol (HDL), triglycerides or apolipoprotein B concentrations between the groups.

Conclusion:

Cheese enriched with 2 g of plant stanol in the form of fatty acid esters decreases serum total and LDL cholesterol significantly.

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References

  • 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, 449–502.

    Google Scholar 

  • Gylling H, Miettinen TA (1994). Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment. Diabetologia 37, 773–780.

    Article  CAS  Google Scholar 

  • Gylling H, Puska P, Vartiainen E, Miettinen TA (1999). Serum sterols during stanol ester feeding in a mildly hypercholesterolemic population. J Lipid Res 40, 593–600.

    CAS  PubMed  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.

    Article  CAS  Google Scholar 

  • Gylling H, Siimes MA, Miettinen TA (1995). Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia. J Lipid Res 36, 1807–1812.

    CAS  PubMed  Google Scholar 

  • Hallikainen M, Sarkkinen E, Wester I, Uusitupa M (2002). Short-term LDL cholesterol-lowering efficacy of plant stanol esters. BMC Cardiovasc Disord 2, 14.

    Article  Google Scholar 

  • Hallikainen MA, Sarkkinen ES, Gylling H, Erkkilä AT, Uusitupa MIJ (2000a). Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesteroleamic subjects on a low-fat diet. Eur J Clin Nutr 54, 715–725.

    Article  CAS  Google Scholar 

  • Hallikainen MA, Sarkkinen ES, Uusitupa MIJ (2000b). Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner. J Nutr 130, 767–776.

    Article  CAS  Google Scholar 

  • Hallikainen MA, Uusitupa MIJ (1999). Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects. Am J Clin Nutr 69, 403–410.

    Article  CAS  Google Scholar 

  • Homma Y (2004). Predictors of atherosclerosis. J Atheroscler Thromb 11, 265–270.

    Article  CAS  Google Scholar 

  • Homma Y, Ikeda I, Ishikawa T, Tateno M, Sugano M, Nakamura H (2003). 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. Nutrition 19, 369–374.

    Article  CAS  Google Scholar 

  • Ikeda I, Tanabe Y, Sugano M (1989). Effects of sitosterol and sitostanol on micellar solubility of cholesterol. J Nutr Sci Vitaminol 35, 361–369.

    Article  CAS  Google Scholar 

  • Mensink RP, Ebbing S, Lindhout M, Plat J, van Heugten MMA (2002). Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 160, 205–213.

    Article  CAS  Google Scholar 

  • Miettinen TA, Puska PP, Gylling H, Vanhanen H, Vartiainen E (1995). Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med 333, 1308–1312.

    Article  CAS  Google 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.

    Article  CAS  Google Scholar 

  • Neil HAW, Meijer GW, Roe LS (2001). Randomised, controlled trial of use by hypercholesterolaemic patients of a vegetable oil sterol-enriched fat spread. Atherosclerosis 156, 329–337.

    Article  CAS  Google Scholar 

  • Nestel P, Cehun M, Pomeroy S, Abbey M, Weldon G (2001). Cholesterol-lowering effects of plant sterol esters and non-esterified stanols in margarine, butter and low-fat foods. Eur J Clin Nutr 55, 1084–1090.

    Article  CAS  Google Scholar 

  • Plat J, Mensink RP (2000). Vegetable oil based versus wood based stanol ester mixtures: effects on serum lipids and hemostatic factors in non-hypercholesterolemic subjects. Atherosclerosis 148, 101–112.

    Article  CAS  Google Scholar 

  • Plat J, van Onselen ENM, van Heugten MMA, Mensink RP (2000). Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur J Clin Nutr 54, 671–677.

    Article  CAS  Google Scholar 

  • Pollak OJ (1985). Effect of plant sterol on serum lipids and atherosclerosis. Pharmacol Ther 31, 177–208.

    Article  CAS  Google Scholar 

  • Stamler J, Daviglus ML, Garside D, Dyer AR, Neaton JD (2000). Relationship of baseline serum cholesterol level in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longvity. JAMA 284, 311–318.

    Article  CAS  Google Scholar 

  • Stamler J, Stamler R, Neaton JD, Wentworth D, Daviglus ML, Garside D et al. (1999). Low risk-factor profile and long-term cardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. JAMA 282, 2012–2018.

    Article  CAS  Google Scholar 

  • Tammi A, Rönnemaa T, Miettinen TA, Gylling H, Rask-Nissilä L, Viikari J et al. (2002). Effects of gender, apolipoprotein E phenotype and cholesterol-lowering by plant stanol esters in children: the STRIP study. Acta Paediatr 91, 1155–1162.

    Article  CAS  Google Scholar 

  • Vanhanen HT, Blomqvist S, Ehnholm C, Hyvönen M, Jauhiainen M, Torstila I et al. (1993). Serum cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic subjects with different apoE phenotypes during dietary sitostanol ester treatment. J Lipid Res 34, 1535–1544.

    CAS  PubMed  Google Scholar 

Download references

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Correspondence to R Korpela.

Additional information

Guarantor: R Korpela.

Contributors: TJ conducted the study and was responsible for the study design, to which PS also contributed. TJ, PS, LN and TP all contributed to the interpretation of the data. TJ and LN were responsible for the actual writing of the manuscript, and TP was responsible for the statistical analyses. RK is the leader of the group and acted as adviser throughout the work.

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Jauhiainen, T., Salo, P., Niittynen, L. et al. Effects of low-fat hard cheese enriched with plant stanol esters on serum lipids and apolipoprotein B in mildly hypercholesterolaemic subjects. Eur J Clin Nutr 60, 1253–1257 (2006). https://doi.org/10.1038/sj.ejcn.1602445

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