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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.

European Journal of Clinical Nutrition (2000) 54, 715–725

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Guarantor: MIJ Uusitupa.

Contributors: MAH was responsible for the study design, gave nutrition counselling, analysed and interpreted the data and wrote the manuscript. MIJU and ESS contributed to the planning of study design and diets, interpreting the data and writing the manuscript. HG analysed serum cholesterol precursors and plant sterols, and ATE analysed fatty acid composition of serum lipids and, in addition, both also contributed to interpreting the data and writing the manuscript.

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Correspondence to MA Hallikainen.

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Hallikainen, M., Sarkkinen, E., Gylling, H. et al. 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. Eur J Clin Nutr 54, 715–725 (2000).

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  • cholesterol-lowering diet
  • hypercholesterolaemic
  • plant sterols
  • plant stanols
  • carotenoids
  • vitamins
  • apolipoprotein E

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