LDL-Cholesterol Lowering of Plant Sterols and Stanols—Which Factors Influence Their Efficacy?
Unilever R & D Vlaardingen, Olivier van Noortlaan 120, 3133 AT Vlaardingen, The Netherlands
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Nutrients 2018, 10(9), 1262; https://doi.org/10.3390/nu10091262
Received: 15 August 2018 / Revised: 6 September 2018 / Accepted: 6 September 2018 / Published: 7 September 2018
(This article belongs to the Special Issue Plant Sterols/Stanols and Human Health)
The LDL-cholesterol (LDL-C) lowering effect of plant sterols/stanols (PSS) is summarized in several meta-analyses showing a dose-response relationship with intakes of 1.5 to 3 g/day lowering LDL-C by 7.5% to 12%. This review summarizes evidence for the impact of various factors potentially influencing the LDL-C-lowering efficacy of PSS. PSS are efficacious in all food formats and in food supplements. Some factors related to food format, e.g., solid vs. liquid foods, seem to impact efficacy, while there is no difference between free PSS and esters. Compared to multiple daily intakes, once-a-day intake of PSS, especially in the morning with light breakfast, leads to a sub-optimal LDL-C lowering. However, intake frequency seems influenced by intake occasion, i.e., with or without a meal, and time of day. Meal intake is a critical factor for an optimal LDL-C lowering efficacy of PSS. While age has no impact, gender is suggested to influence the LDL-C lowering effect of PSS with greater reductions reported for men than women; but overall evidence is inconclusive and larger studies show no gender by treatment interaction. In conclusion, PSS are efficacious in all foods and food supplements; for optimal efficacy they should be consumed with a (main) meal and twice daily.
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Keywords:
plant sterols; plant stanols; phytosterols; LDL-cholesterol lowering; food format; intake occasion; intake frequency; meal composition; gender; age
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MDPI and ACS Style
Trautwein, E.A.; Vermeer, M.A.; Hiemstra, H.; Ras, R.T. LDL-Cholesterol Lowering of Plant Sterols and Stanols—Which Factors Influence Their Efficacy? Nutrients 2018, 10, 1262.
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