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Intake of dietary plant sterols is inversely related to serum cholesterol concentration in men and women in the EPIC Norfolk population: a cross-sectional study


Objective: We examined the relation between intake of natural dietary plant sterols and serum lipid concentrations in a free-living population.

Design, setting and participants: Cross-sectional population-based study of 22 256 men and women aged 39–79 y resident in Norfolk, UK, participating in the European Prospective Investigation into Cancer (EPIC-Norfolk).

Main exposure and outcome measures: Plant sterol intake from foods and concentrations of blood lipids.

Results: Mean concentrations of total cholesterol and low-density lipoprotein cholesterol, adjusted for age, body mass index and total energy intake, decreased with increasing plant sterol intake in men and women. Mean total serum cholesterol concentration for men in the highest fifth of plant sterol intake (mean intake 463 mg daily) was 0.25 mmol/l lower and for low-density lipoprotein cholesterol 0.14 mmol/l lower than those in the lowest fifth of plant sterol consumption (mean intake 178 mg daily); the corresponding figures in women were 0.15 and 0.13 mmol/l. After adjusting for saturated fat and fibre intakes, the results for total cholesterol and low-density lipoprotein cholesterol were similar, although the strength of the association was slightly reduced.

Conclusions: In a free-living population, a high intake of plant sterols is inversely associated with lower concentrations of total and low-density lipoprotein serum cholesterol. The plant sterol content of foods may partly explain diet-related effects on serum cholesterol concentration.

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We thank the participants and general practitioners who took part in EPIC-Norfolk. We also thank Mitra Ravand for technical assistance in the plant sterol analyses. EPIC-Norfolk is supported by programme grants from the Cancer Research Campaign and Medical Research Council with additional support from the Stroke Association, British Heart Foundation, Food Standards Agency, Department of Health and Wellcome Trust. The phytosterol analyses were supported by a grant from the Swedish government under the LUA agreement and the Swedish Cancer Foundation. There are no competing interests.

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Guarantor: K-T Shaw.

Contributors: K-TK and SB are principal investigators in the EPIC-Norfolk population study. AW and SB are responsible for the nutritional analyses. SA developed the phytosterol nutrient databases with HA and LE. AM prepared the phytosterol data set in the EPIC cohort. JS conducted the statistical analyses with assistance from SA and K-TK. SA wrote the paper with contributions from coauthors.

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Correspondence to K-T Shaw.

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Andersson, S., Skinner, J., Ellegård, L. et al. Intake of dietary plant sterols is inversely related to serum cholesterol concentration in men and women in the EPIC Norfolk population: a cross-sectional study. Eur J Clin Nutr 58, 1378–1385 (2004).

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  • phytosterols
  • cholesterol
  • lipids
  • diet
  • population


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