Hypercholesterolemia Clinical Trial
Official title:
Effect of High Stanol Ester Dose on Serum Lipids, Carotenoids and Fat-soluble Vitamins
The aim was to investigate the effects of the consumption of high doses of plant stanol esters on concentrations of serum lipids, carotenoids and fat soluble vitamins. In addition, we investigated the metabolism of absorbed plant sterols from intestine without and with the consumption of plant stanol esters.
Several studies have shown that 2-3 g of plant stanols as stanol esters reduce serum total
and LDL cholesterol concentrations by 10-15%. There are only a few studies in which
cholesterol-lowering effects of plant stanols have been studied with higher doses than that.
In these studies with the stanol dose of 4 g/d no additional cholesterol-lowering effect has
been reached. However, it would be interesting to know, how effective plant stanols are, if
a dose is very high, or whether there is really a threshold effect in inhibition of
cholesterol absorption. Plant sterols and stanols have been found to reduce serum β-carotene
concentrations. Although they have not been shown to affect serum vitamin A concentrations,
a concern has been aroused about safety of high doses of plant sterol and stanols. This is
not unjustified, because the number of plant sterol and stanol containing products on the
market continues to expand, and therefore, it is possible that the daily intake of plant
sterols and stanols can rise very high.
In humans, the metabolism of plant sterols and stanols is not completely known. Recently, we
showed that plant sterols are esterified in enterocytes as well as cholesterol facilitating
their transport in lipoproteins. However, it is not known, how consumption of high doses of
stanol esters affect the metabolism of plant sterols in enterocytes and their transport.
This is important to know, when new foodstuffs enriched with plant sterols or stanols for
cholesterol-lowering are developed.
In this study, the aim was to investigate the effects of the consumption of high doses of
plant stanol esters on concentrations of serum lipids, carotenoids and fat soluble vitamins.
In addition, we investigated the metabolism of absorbed plant sterols from intestine without
and with the consumption of plant stanol esters.
Altogether 50 subjects with normo- or hypercholesterolemia (total cholesterol 4.5-7.5
mmol/l) were recruited to the study from an announcement in the local newspaper. The study
is carried out with a randomized, double-blind and parallel design. The intervention group
(n=25) consumes spread and oat drink enriched with plant stanol esters (9 g/d stanols) and
the control group (n=25) the same product containing no added stanols for 10 weeks. The
fasting blood samples are taken at weeks 0, 9, 10 and 14 (4 weeks after the end of the test
product consumption). At week 10, an oral postprandial test is performed in 40 subjects in
order to study the postprandial metabolism of plant sterols. From blood samples blood count
and levels of serum liver enzymes (0 and 10 wk), concentrations of serum lipids, squalene
and non-cholesterol sterols, α and β carotenoids, fat soluble vitamins A, E and D (0, 9 and
10 wk) and serum squalene and non-cholesterol sterols (14 wk) will be analyzed.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Supportive Care
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