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Cholesterol-lowering effects of plant sterol esters and non-esterified stanols in margarine, butter and low-fat foods


Objectives: To determine the efficacy on plasma cholesterol-lowering of plant sterol esters or non-esterified stanols eaten within low-fat foods as well as margarine.

Design: Randomised, controlled, single-blind study with sterol esters and non-esterified plant stanols provided in breakfast cereal, bread and spreads. Study 1 comprised 12 weeks during which sterol esters (2.4 g) and stanol (2.4 g) -containing foods were eaten during 4 week test periods of cross-over design following a 4 week control food period. In Study 2, in a random order cross-over design, a 50% dairy fat spread with or without 2.4 g sterol esters daily was tested.

Subjects: Hypercholesterolaemic subjects; 22 in study 1 and 15 in study 2.

Main outcome measures: Plasma lipids, plasma sterols, plasma carotenoids and tocopherols.

Results: Study 1—median LDL cholesterol was reduced by the sterol esters (−13.6%; P<0.001 by ANOVA on ranks; P<0.05 by pairwise comparison) and by stanols (−8.3%; P=0.003, ANOVA and <0.05 pairwise comparison). With sterol esters plasma plant sterol levels rose (35% for sitosterol, 51% for campesterol; P<0.001); plasma lathosterol rose 20% (P=0.03), indicating compensatory increased cholesterol synthesis. With stanols, plasma sitosterol fell 22% (P=0.004), indicating less cholesterol absorption. None of the four carotenoids measured in plasma changed significantly. In study 2, median LDL cholesterol rose 6.5% with dairy spread and fell 12.2% with the sitosterol ester fortified spread (P=0.03 ANOVA and <5% pairwise comparison).

Conclusion: 1. Plant sterol esters and non-esterified stanols, two-thirds of which were incorporated into low-fat foods, contributed effectively to LDL cholesterol lowering, extending the range of potential foods. 2. The LDL cholesterol-raising effect of butter fat could be countered by including sterol esters. 3. Plasma carotenoids and tocopherols were not reduced in this study.

Sponsorship: Meadow Lea Foods, Australia.

European Journal of Clinical Nutrition (2001) 55, 1084–1090


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We acknowledge the assistance of Dr Ron Bowrey, Donna Ross and Adam Mayne (from Meadow Lea Foods, Sydney), Sean Westcott (Uncle Toby's Company, Rutherglen, Victoria), and Greg Ponting (Milling & Baking, Goodman Fielder, Sydney) for preparing the test foods. We thank Mr Mark Mano and Mr Ben Brinkman for assistance in measuring plasma plant sterols.

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Correspondence to P Nestel.

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Nestel, P., Cehun, M., Pomeroy, S. et al. 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 (2001).

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  • sterolesters
  • sitostanol
  • low-fat foods
  • cholesterol

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