PLANT STEROL-ENRICHED MARGARINES AND REDUCTION OF PLASMA TOTAL-CHOLESTEROL AND LDL-CHOLESTEROL CONCENTRATIONS IN NORMOCHOLESTEROLEMIC AND MILDLY HYPERCHOLESTEROLEMIC SUBJECTS

Objectives: To compare effects on plasma total-, LDL-, and HDL-cholest erol concentrations of margarines enriched with different vegetable oi l sterols or sitostanol-ester. Design: A randomized double-blind place bo-controlled balanced incomplete Latin square design with five treatm ents and four periods of 3.5 weeks. Margarines enriched with sterols F rom soybean, sheanut or ricebran oil or with sitostanol-ester were com pared to a non-enriched control margarine. Sterol intake was between 1 .5-3.3 g/d. Two thirds of the soybean oil sterols were esterified to f atty acids. Setting: Unilever Research Laboratory, Vlaardingen, The Ne therlands. Subjects: One hundred healthy non-obese normocholesterolaem ic and mildly hypercholesterolaemic volunteers aged 45 +/- 12.8 y, wit h plasma total cholesterol levels below 8 mmol/L at entry. Main outcom e measures: Plasma lipid, carotenoid and sterol concentrations, blood clinical chemistry and haematology, fatty acid composition of plasma c holesterylesters and food intake. Results: Ninety-five volunteers comp leted the study. None of the margarines induced adverse changes in blo od clinical chemistry, serum total bile acids or haematology. Plasma t otal-and LDL-cholesterol concentrations were significantly reduced by 8-13% (0.37-0.44 mmol/L) compared to control for margarines enriched i n soybean oil sterol-esters or sitostanol-ester. No effect on HDL-chol esterol concentrations occurred. The LDL-to HDL-cholesterol ratio was reduced by 0.37 and 0.33 units for these margarines, respectively. Eff ects on blood lipids did not differ between normocholesterolaemic and mildly hypercholesterolaemic subjects. Plasma sitosterol and campester ol levels were significantly higher for the soybean oil sterol margari ne and significantly lower for the sitostanol-ester margarine compared to control Dietary intake was very similar across treatments. The fat ty acid composition of plasma cholesterylesters confirmed the good com pliance to the treatment. All sterol enriched margarines reduced lipid -standardized plasma alpha-plus beta-carotene levels. Plasma lycopene levels were also reduced but this effect was not significant for all p roducts. Conclusions: A margarine with sterol-esters from soybean oil, mainly esters from sitosterol, campesterol and stigmasterol, is as ef fective as a margarine with sitostanol-ester in lowering blood total-a nd LDL-cholesterol levels without affecting HDL-cholesterol concentrat ions. Incorporation in edible fat containing products of such substanc es may substantially reduce the risk of cardiovascular disease in the population. Sponsorship: Unilever Research.