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  • Original Article
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Exposure and effectiveness of phytosterol/-stanol-enriched margarines

European Journal of Clinical Nutrition volume 61, pages 1407–1415 (2007)Cite this article

Abstract

Background:

Studies on effectiveness of phytosterol/-stanol-enriched margarines in the community have received low priority. For postlaunch monitoring purposes including risk–benefit analyses, it is needed to investigate both exposure and effectiveness of these margarines.

Objective:

To study the use and effectiveness of phytosterol/-stanol-enriched margarine.

Design, setting and subjects:

The study population consisted of 2379 subjects that participated in a community intervention study (‘Hartslag Limburg’) aged 28–76 years. In 1998 and 2003, blood samples for total and high-density lipoprotein (HDL) cholesterol were obtained. A general questionnaire and food frequency questionnaire (FFQ) were administered. From 1999 onwards, phytosterol/-stanol-enriched margarines were introduced on the Dutch market. On the basis of 2003 data, subjects were classified in users of (a) phytosterol/-stanol-enriched margarine, (b) cholesterol-lowering drugs, (c) the combination (both enriched margarine and drugs) and (d) neither enriched margarines nor cholesterol-lowering drugs.

Results:

Mean (±s.d.) daily intake of phytosterol-enriched margarine (n=99) and phytostanol-enriched margarine (n=16) was 14±9 g. From 1998 to 2003, total serum cholesterol concentration changed significantly different among the four groups: in the combination users −2.04±1.50 mmol/l (−29%), in cholesterol-lowering drug users −1.09±1.17 mmol/l (−17%), in the enriched margarine users −0.24±0.75 mmol/l (−4%) and in non-users +0.10±0.72 mmol/l (+2%)(P<0.05).

Conclusion:

Recommended doses are not consumed, but phytosterol/-stanol-enriched margarines can modestly reduce serum total cholesterol in the community. These margarines cannot equal the effect of cholesterol-lowering drugs, but may act additively. Further investigation of the health effects that may occur during simultaneous cholesterol lowering drugs and phytosterol-or –stanol-enriched margarines usage is important, as well as community education about the cholesterol lowering foods and drugs.

Sponsorship:

Netherlands Organization for Health Research and Development (ZonMW) (data collection of Hartslag Limburg and further data- analyses).

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Acknowledgements

The data collection in Maastricht was financially supported by The Netherlands Organization for Health Research and Development (ZonMW). We thank the field workers of the Municipal Health Service in Maastricht for their contribution to the data collection of this study, in particular R Veldkamp and J de Vreede. Project leader was Dr AJ Schuit, project coordination was performed by GCW Wendel-Vos. Data management was performed by A Blokstra, logistic support by PE Vissink and E Goddijn and secretarial assistance was provided by T van den Brink. Finally, we would like to thank ZonMW for supporting M Wolfs (grant number 014-12-010).

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Authors and Affiliations

  1. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    N de Jong, A Zuur, M C J Wolfs, G C W Wendel-Vos, J M A van Raaij & A J Schuit

  2. Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    A Zuur & J M A van Raaij

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  1. N de Jong
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  2. A Zuur
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  3. M C J Wolfs
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  4. G C W Wendel-Vos
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  5. J M A van Raaij
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  6. A J Schuit
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Correspondence to N de Jong.

Additional information

Guarantor: N de Jong.

Contributors: NdJ and JMAvR are nutrition scientists, MCJW, a human health scientist, who are working at the Centre for Nutrition and Health, the National Institute of Public Health and the Environment (RIVM), The Netherlands. They were responsible for the concept of the paper, the finalising of the data analyses and the writing process. AZ was at the time of the study a master's degree candidate who performed the analyses and wrote main parts of the paper. GCWW-V and AJS are both epidemiologists and working at the Centre for Prevention and Health Services Research (RIVM), The Netherlands. They were study manager and study director of the HL study, respectively, and participated in the data analysis process and commented on the manuscript.

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de Jong, N., Zuur, A., Wolfs, M. et al. Exposure and effectiveness of phytosterol/-stanol-enriched margarines. Eur J Clin Nutr 61, 1407–1415 (2007). https://doi.org/10.1038/sj.ejcn.1602660

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