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Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment

Abstract

Objective:

The present study was designed to examine for the first time, side-by-side, the effects of plant sterol and stanol consumption on lipid metabolism and markers of antioxidant status, oxidative stress, endothelial dysfunction and low-grade inflammation in subjects on stable statin–treatment.

Design:

Double-blind, randomized, placebo-controlled, intervention trial.

Setting:

University.

Subjects:

Forty-five patients on current statin treatment were recruited via newspaper advertisements. Data of 41 patients were used in statistical analysis.

Intervention:

Subjects consumed margarine with no added plant sterols or stanols for 4 weeks and were then divided into three groups of 15 subjects. For the next 16 weeks, one group continued with the control margarine and the other two groups with either a plant sterol- or stanol (2.5 g/day)-enriched margarine. Blood was sampled at the end of the run-in and intervention periods.

Results:

Plant sterol and stanol consumption significantly (P=0.026) reduced low-density lipoprotein (LDL) cholesterol by 0.34 mmol/l (95% confidence interval (CI), −0.67 to −0.04 mmol/l). No effects were shown on enzymatic and non-enzymatic antioxidants and markers of oxidative modification of lipids and DNA. In addition, no effect was found on soluble adhesion molecules, C-reactive protein and monocyte chemotactic protein-1 concentrations.

Conclusions:

We conclude that 16 weeks of plant sterol or stanol consumption did not affect markers of antioxidant status, oxidative stress, endothelial dysfunction and low-grade inflammation in patients on stable statin treatment, despite a significant reduction of LDL cholesterol.

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Acknowledgements

We thank Mirjam Heinen for dietary support, Frank Cox and Maurice Kunen for technical support and Marjolijn Bragt for performing the ELISAs and LDL-receptor analyses. We also thank Arnold Kester for support on the statistical analyses. We thank Raisio Group (Raisio, Finland) for kindly providing us with all the margarines.

This work was sponsored by the Netherlands Organization for Health Research and Development (Program Nutrition: Health, Safety and Sustainability, Grant 014-12-010).

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Correspondence to R P Mensink.

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Guarantor: J Plat.

Contributors: AJ conducted the study and statistically analysed the data. RPM and JP designed and supervised the study. AB was responsible for the analyses of the enzymatic antioxidants and MDA. RWLG conducted the 8-oxo-dG analysis. SB was responsible for the analysis of 15-PDGH. All authors contributed to the writing of the paper.

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De Jong, A., Plat, J., Bast, A. et al. Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment. Eur J Clin Nutr 62, 263–273 (2008). https://doi.org/10.1038/sj.ejcn.1602733

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