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The effects of phytosterols present in natural food matrices on cholesterol metabolism and LDL-cholesterol: a controlled feeding trial

European Journal of Clinical Nutrition volume 64, pages 1481–1487 (2010)Cite this article

Subjects

Abstract

Background/Objectives:

Extrinsic phytosterols supplemented to the diet reduce intestinal cholesterol absorption and plasma low-density lipoprotein (LDL)-cholesterol. However, little is known about their effects on cholesterol metabolism when given in native, unpurified form and in amounts achievable in the diet. The objective of this investigation was to test the hypothesis that intrinsic phytosterols present in unmodified foods alter whole-body cholesterol metabolism.

Subjects/Methods:

In all, 20 out of 24 subjects completed a randomized, crossover feeding trial wherein all meals were provided by a metabolic kitchen. Each subject consumed two diets for 4 weeks each. The diets differed in phytosterol content (phytosterol-poor diet, 126 mg phytosterols/2000 kcal; phytosterol-abundant diet, 449 mg phytosterols/2000 kcal), but were otherwise matched for nutrient content. Cholesterol absorption and excretion were determined by gas chromatography/mass spectrometry after oral administration of stable isotopic tracers.

Results:

The phytosterol-abundant diet resulted in lower cholesterol absorption (54.2±2.2% (95% confidence interval 50.5%, 57.9%) vs 73.2±1.3% (69.5%, 76.9%), P<0.0001) and 79% higher fecal cholesterol excretion (1322±112 (1083.2, 1483.3) vs 739±97 mg/day (530.1, 930.2), P<0.0001) relative to the phytosterol-poor diet. Plasma lathosterol/cholesterol ratio rose by 82% (from 0.71±0.11 (0.41, 0.96) to 1.29±0.14 μg/mg (0.98, 1.53), P<0.0001). LDL-cholesterol was similar between diets.

Conclusions:

Intrinsic phytosterols at levels present in a healthy diet are biologically active and have large effects on whole-body cholesterol metabolism not reflected in circulating LDL. More work is needed to assess the effects of phytosterol-mediated fecal cholesterol excretion on coronary heart disease risk in humans.

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Acknowledgements

This work was supported by NIH grants R01 HL050420, MO1 RR-00036, RR-00954, P60-DK020579-30 and P30 DK056341. We thank Robin Fitzgerald and Michele Burton for excellent technical assistance.

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Author notes

  1. M Lefevre

    Present address: 5Current address: Center for Advanced Nutrition, Utah State University, 4715 Old Main Hill, Logan, UT 84322-4715, USA.,

  2. M Most

    Present address: 6Current address: Department of Human Nutrition & Food, School of Human Ecology, Louisiana State University, Baton Rouge, LA 70803, USA.,

Authors and Affiliations

  1. Division of Endocrinology, Department of Medicine, Metabolism and Lipid Research, Washington University School of Medicine, St Louis, MO, USA

    X Lin, S B Racette, L Ma & R E Ostlund Jr

  2. Program in Physical Therapy, Washington University School of Medicine, St Louis, MO, USA

    S B Racette

  3. Pennington Biomedical Research Center, Baton Rouge, LA, USA

    M Lefevre & M Most

  4. Center for Applied Research Sciences, Washington University School of Medicine, St Louis, MO, USA

    C A Spearie

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  1. X Lin
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Correspondence to R E Ostlund Jr.

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Competing interests

Washington University and Dr Ostlund have a financial interest in Lifeline Technologies, Inc., a startup company commercializing emulsified phytosterols. (Emulsified phytosterols and Lifeline products were not used in this work.) The remaining authors declare no conflict of interest.

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Lin, X., Racette, S., Lefevre, M. et al. The effects of phytosterols present in natural food matrices on cholesterol metabolism and LDL-cholesterol: a controlled feeding trial. Eur J Clin Nutr 64, 1481–1487 (2010). https://doi.org/10.1038/ejcn.2010.180

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  • DOI: https://doi.org/10.1038/ejcn.2010.180

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