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Potential intake of phytosterols/-stanols: results of a simulation study

European Journal of Clinical Nutrition volume 58, pages 907–919 (2004)Cite this article

Abstract

Background: Different doses of phytosterols/-stanols up to a maximum of 4.0 g/day have been used in human safety studies, whereas only one small-scale study investigated some detailed clinical information about consumption levels exceeding 8.6 g/day.

Objective: To determine which population groups are likely to be at risk of excessive intakes if liberal enrichment of foods with phytosterols/-stanols will be allowed.

Design and subjects: Cross-sectional study among a representative sample (n=23 106) of the Dutch population, aged 20–60 y (MORGEN-project, 1993–1997). Phytosterol/-stanol intake was assessed with virtual replacement of one to four ordinary foods in the diet with enriched products. Percentile values were used to describe the distribution in simulated intake for different groups in the population, varying in sociodemographic and health characteristics. Multiple linear regression was used to describe the contribution of the different population characteristics to the simulated phytosterol/-stanol intake.

Results: If three commonly consumed products (margarine, cheese, yoghurt) were completely replaced, the median daily phytosterol/-stanol intake will be about 5.5 g in men and 4.6 g in women. In males, the intake above the 90th percentile will exceed 8.6 g/day. Women will approach this level. Especially, age, body mass index, socioeconomic status, subjective health, smoking behaviour, alcohol consumption, pregnancy (women) and high cholesterol level (men) contributed to the variance in the simulated intake (P<0.05), although the total explained variance was low (1–3%).

Conclusions: If liberal phytosterol/-stanol fortification is allowed, the daily intake might exceed the recommended intake level as well as our ‘cutoff’ level of 8.6 g/day. Postlaunch monitoring to identify consumers and real intake levels, refinement of scenario buiding, as well as human safety studies for levels above 8.6 g/day are necessary.

Sponsorship: The Monitoring Project on Risk Factors for Chronic Diseases (MORGEN study) was financially supported by the Ministry of Health, Welfare and Sport of the Netherlands and the National Institute of Public Health and the Environment. As part of the EPIC project, the MORGEN study was also financially supported by the Europe Against Cancer Programme of the European Union. The Netherlands Organisation for Health Research and Development (NWO) supported the first author.

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Acknowledgements

The Monitoring Project on Risk Factors for Chronic Diseases (MORGEN study) was part of the EPIC project and was financially supported by the Europe Against Cancer Programme of the European Union, the Ministry of Health, Welfare and Sport of the Netherlands, and the National Institute of Public Health and the Environment. We thank the epidemiologists and field workers of the Municipal Health Services in Amsterdam, Doetinchem and Maastricht for their important contribution to the data collection for this study. The project steering committee consisted of Dr HB Bueno de Mesquita, Dr HA Smit, Dr WMM Verschuren and Dr JC Seidell. We acknowledge the Netherlands Organisation for Health Research and Development (NWO) for supporting N De Jong.

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Authors and Affiliations

  1. Centre for Nutrition and Health, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

    N De Jong, L Pijpers & M C Ocké

  2. Department of Human Nutrition and Epidemiology, Wageningen University and Research Centre, Wageningen, The Netherlands

    L Pijpers & J K Bleeker

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  1. N De Jong
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  2. L Pijpers
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  3. J K Bleeker
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  4. M C Ocké
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Contributions

Guarantor: N de Jong.

Contributors: N DJ is a nutrition scientist, and MO is a nutrition epidemiologist, both working at the Centre for Nutrition and Health, the National Institute of Public Health and the Environment, the Netherlands. They were both responsible for the concept of the paper, the finalising of the data analyses and the writing process. LP was at the time of study a master's degree candidate who assisted with the analyses and the writing. JB was at the time of the study an assistant professor at the Department of Human Nutrition and Epidemiology, Wageningen University and Research Centre, the Netherlands and participated in the data analysis process and commented on the manuscript.

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Correspondence to N De Jong.

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De Jong, N., Pijpers, L., Bleeker, J. et al. Potential intake of phytosterols/-stanols: results of a simulation study. Eur J Clin Nutr 58, 907–919 (2004). https://doi.org/10.1038/sj.ejcn.1601912

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