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Plant sterol-enriched spread enhances the cholesterol-lowering potential of a fat-reduced diet

Abstract

Objective: To determine the effect of a plant sterol-enriched spread on plasma cholesterol concentrations when replacing butter or a standard polyunsaturated spread in a diet containing 30% of energy fat.

Design: Parallel butter phase followed by double-blind, randomized, cross-over polyunsaturated spread phases.

Setting: General community.

Subjects: Volunteer sample of 50 free-living men and women with mean age (s.d.) 46.7 y (10.5), moderately elevated plasma total cholesterol 5.95 mmol/l (0.78), and body mass index 26.0 (3.9) kg/m2.

Intervention: Participants ate a moderately low-fat diet (30% of energy) for the 11-week intervention. During the first 3 weeks the diet included 20 g per day of butter. Participants were then randomized to replace the butter with 25 g of polyunsaturated spread with or without 2 g of plant sterols for 4 weeks, crossing over in the last 4 weeks to the alternate spread.

Main outcome measures: Plasma cholesterol and fatty acids.

Results: Replacing butter with a standard polyunsaturated fat spread reduced mean plasma total cholesterol concentrations by 4.6% (from 6.09 (0.82) to 5.81 (0.77) mmol/l, P<0.01) and low-density lipoprotein cholesterol by 5.5% (from 3.98 (0.76) to 3.76 (0.74) mmol/l, P<0.05). Replacing butter with a polyunsaturated spread containing plant sterols reduced plasma total cholesterol by 8.9% (from 6.09 (0.82) to 5.55 (0.76) mmol/l, P<0.01) and low density lipoprotein cholesterol by 12.3% (from 3.98 (0.76) to 3.49 (0.72) mmol/l, P<0.01). Plasma high density lipoprotein cholesterol concentration was the same on the three diets.

Conclusion: In people with moderately raised plasma cholesterol concentrations consuming reduced-fat diets the reduction in plasma total and low-density lipoprotein cholesterol concentrations achieved by replacing butter with a polyunsaturated spread is enhanced by addition of plant sterols.

Sponsorship: Partially funded by a grant to the University of Otago from Unilever Research.

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Acknowledgements

The authors would like to thank Margaret Waldron and Linda Henry for blood collection and help with the participants and Ashley Duncan and Michelle Harper for assistance with laboratory methods. We would also like to thank the people who took part in the study.

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Correspondence to C M Skeaff.

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Cleghorn, C., Skeaff, C., Mann, J. et al. Plant sterol-enriched spread enhances the cholesterol-lowering potential of a fat-reduced diet. Eur J Clin Nutr 57, 170–176 (2003). https://doi.org/10.1038/sj.ejcn.1601531

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