Lipid-altering effects of a dietary supplement tablet containing free plant sterols and stanols in men and women with primary hypercholesterolaemia: a randomized,placebo-controlled crossover trial

This randomized, placebo-controlled, crossover trial assessed the lipid-altering efficacy of a dietary supplement (tablet form) providing 1.8 g/day free (non-esterified) plant sterols and stanols versus placebo for 6 weeks as part of a therapeutic lifestyle changes (TLC) diet in 32 men and women with primary hypercholesterolaemia. Mean ± SE baseline (end of a 5-week TLC diet lead-in) lipid concentrations (mmol/l) were total cholesterol (TC), 5.88 ± 0.08; non-high-density lipoprotein cholesterol (non-HDL-C), 4.71 ± 0.09; low-density lipoprotein cholesterol (LDL-C), 4.02 ± 0.08; HDL-C, 1.17 ± 0.06 and triglycerides (TGs), 1.51 ± 0.12. Differences from control in responses (plant sterol/stanol ? control) were significant (p < 0.05) for LDL-C ( ? 4.9%), non-HDL-C ( ? 3.6%) and TC ( ? 2.8%). HDL-C and TG responses were not significantly different between treatment conditions. These results indicate that 1.8 g/day free plant sterols/stanols administered in a tablet produced favourable lipoprotein lipid changes in men and women with hypercholesterolaemia.     

Efficacy of fish oil supplementation for treatment of moderate elevation of serum cholesterol

A study was performed to determine the efficacy and feasibility of using fish oil capsules for treatment of moderate hypercholesterolemia. Thirty-three subjects, randomized to fish or olive oil, took two 1-g capsules with each meal for 12 weeks. Each subject crossed over to the alternate treatment at 12 weeks. Patients maintained usual levels of exercise and diet for 24 weeks. Eight subjects dropped out. For the group starting fish oil (n = 13), the average baseline cholesterol level was 6.336 mmol/L (245.0 mg/dL) and was 6.341 mmol/L (245.2 mg/dL) after 12 weeks. High-density lipoprotein cholesterol (HDL-C) and calculated low-density lipoprotein cholesterol (LDL-C) baseline levels were 1.459 mmol/L (56.4 mg/dL) and 4.332 mmol/L (167.5 mg/dL); 1.474 mmol/L (57.0 mg/dL) and 4.479 mmol/L (173.2 mg/dL), respectively, after fish oil supplementation. In the group that began with olive oil (n = 12), baseline total cholesterol level was 6.274 mmol/L (242.6 mg/dL); HDL-C and calculated LDL-C baseline levels were 1.386 mmol/L (53.6 mg/dL) and 3.988 mmol/L (154.2 mg/dL). When mean baseline levels were compared with post-fish-oil values for the entire population, no significant change in total cholesterol or LDL-HDL ratio was obtained. Triglyceride responses to fish oil were variable. Values after olive oil treatment were neither significantly different from baseline nor different from fish oil. It was concluded that fish oil in manufacturer's recommended dosage does not appear to lower moderately elevated cholesterol levels.     

Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials

BACKGROUND/OBJECTIVES

Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors.

MATERIALS/METHODS

We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP).

RESULTS

The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively.

CONCLUSIONS

This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.     

A Softgel Dietary Supplement Containing Esterified Plant Sterols and Stanols Improves the Blood Lipid Profile of Adults with Primary Hypercholesterolemia: A Randomized,Double-Blind,Placebo-Controlled Replication Study

A well-controlled clinical trial previously demonstrated the efficacy of a novel softgel dietary supplement providing 1.8 g/day esterified plant sterols and stanols, as part of the National Cholesterol Education Program Therapeutic Lifestyle Changes diet, to improve the fasting lipid profile of men and women with primary hypercholesterolemia (fasting low-density lipoprotein [LDL] cholesterol ≥130 and <220 mg/dL [≥3.37 and <5.70 mmol/L]). The purpose of this randomized, double blind, placebo-controlled crossover study (conducted July 2011 to January 2012) was to support these previous findings in a similar, but independent, sample with a different lead investigator and research site. Repeated measures analysis of covariance was used to compare outcomes for sterol/stanol and placebo treatment conditions using the baseline value as a covariate. Forty-nine subjects were screened and 30 (8 men and 22 women) were randomized to treatment (all completed the trial). Baseline (mean±standard error of the mean) plasma lipid concentrations were: total cholesterol 236.6±4.2 mg/dL (6.11±0.11 mmol/L), high-density lipoprotein (HDL) cholesterol 56.8±3.0 mg/dL (1.47±0.08 mmol/L), LDL cholesterol 151.6±3.3 mg/dL (3.92±0.09 mmol/L), non-HDL cholesterol 179.7±4.6 mg/dL (4.64±0.12 mmol/L), and triglycerides 144.5±14.3 mg/dL (1.63±0.16 mmol/L). Mean placebo-adjusted reductions in plasma lipid levels were significant (P<0.01) for LDL cholesterol (–4.3%), non-HDL cholesterol (–4.1%), and total cholesterol (–3.5%), but not for triglycerides or HDL cholesterol. These results support the efficacy of 1.8 g/day esterified plant sterols/stanols in softgel capsules, administered as an adjunct to the National Cholesterol Education Program Therapeutic Lifestyle Changes diet, to augment reductions in atherogenic lipid levels in individuals with hypercholesterolemia.     

Oral Supplement Containing Hydroxytyrosol and Punicalagin Improves Dyslipidemia in an Adult Population without Co-Adjuvant Treatment: A Randomized,Double-Blind,Controlled and Crossover Trial

Hydroxytyrosol (HT) and punicalagin (PC) exert cardioprotective and antiatherosclerotic effects. This study evaluated the effect of an oral supplement containing HT and PC (SAx) on dyslipidemia in an adult population. A randomized, double-blind, controlled, crossover trial was conducted over a 20-week period. SAx significantly reduced the plasma levels of triglycerides (TG) in subjects with hypertriglyceridemia (≥150 mg/dL) (from 200.67 ± 51.38 to 155.33 ± 42.44 mg/dL; p < 0.05), while no such effects were observed in these subjects after the placebo. SAx also significantly decreased the plasma levels of low-density lipoprotein cholesterol (LDL-C) in subjects with high plasma levels of LDL-C (≥160 mg/dL) (from 179.13 ± 16.18 to 162.93 ± 27.05 mg/dL; p < 0.01), while no such positive effect was observed with the placebo. In addition, the placebo significantly reduced the plasma levels of high-density lipoprotein cholesterol (HDL-C) in the total population (from 64.49 ± 12.65 to 62.55 ± 11.57 mg/dL; p < 0.05), while SAx significantly increased the plasma levels of HDL-C in subjects with low plasma levels of HDL-C (<50 mg/dL) (from 44.25 ± 3.99 to 48.00 ± 7.27 mg/dL; p < 0.05). In conclusion, the supplement containing HT and PC exerted antiatherosclerotic and cardio-protective effects by considerably improving dyslipidemia in an adult population, without co-adjuvant treatment or adverse effects.     

Lipid effects of a dietary supplement softgel capsule containing plant sterols/stanols in primary hypercholesterolemia

ObjectiveThis randomized, placebo-controlled, crossover trial assessed the lipid-altering efficacy of a softgel capsule dietary supplement, providing esterified plant sterols/stanols 1.8 g/d, in 28 participants (～75% women) with primary hypercholesterolemia (fasting low-density lipoprotein cholesterol [LDL-C] levels ≥130 and <220 mg/dL), a mean age of 58.4 y, and a mean body mass index of 27.9 kg/m².MethodsAfter a 5-wk National Cholesterol Education Program (NCEP) Therapeutic Lifestyle Changes (TLC) diet and a single-blinded placebo lead-in, subjects received double-blinded placebo or sterol/stanol softgel capsules for 6 wk and then crossed over to the opposite product for 6 wk while continuing the TLC diet. Fasting lipids were assessed in duplicate at the end of the diet lead-in (baseline) and the end of each treatment.ResultsThe mean baseline lipid concentrations (milligrams per deciliter) were 223 for total cholesterol (TC), 179 for non–high-density lipoprotein cholesterol (non-HDL-C), 154 for low-density lipoprotein cholesterol, 44 for HDL-C, 125 for triacylglycerols, and 5.2 for TC/HDL-C. Differences from the control responses (plant sterol/stanol minus control) in the per-protocol sample were significant (P < 0.05) for LDL-C (?9.2%), non-HDL-C (?9.0%), TC (?7.4%), TC/HDL-C (?5.4%), and triacylglycerols (?9.1%). The HDL-C responses were not significantly different between treatments.ConclusionThe incorporation of softgel capsules providing esterified plant sterols/stanols 1.8 g/d into the NCEP TLC diet produced favorable changes in atherogenic lipoprotein cholesterol levels in these subjects with hypercholesterolemia.     

Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial.

BACKGROUND: Effects of diet on blood lipids are best known in white men, and effects of type of carbohydrate on triacylglycerol concentrations are not well defined. OBJECTIVE: Our goal was to determine the effects of diet on plasma lipids, focusing on subgroups by sex, race, and baseline lipid concentrations. DESIGN: This was a randomized controlled outpatient feeding trial conducted in 4 field centers. The subjects were 436 participants of the Dietary Approaches to Stop Hypertension (DASH) Trial [mean age: 44.6 y; 60% African American; baseline total cholesterol: < or = 6.7 mmol/L (< or = 260 mg/dL)]. The intervention consisted of 8 wk of a control diet, a diet increased in fruit and vegetables, or a diet increased in fruit, vegetables, and low-fat dairy products and reduced in saturated fat, total fat, and cholesterol (DASH diet), during which time subjects remained weight stable. The main outcome measures were fasting total cholesterol, LDL cholesterol, HDL cholesterol, and triacylglycerol. RESULTS: Relative to the control diet, the DASH diet resulted in lower total (-0.35 mmol/L, or -13.7 mg/dL), LDL- (-0.28 mmol/L, or -10.7 mg/dL), and HDL- (-0.09 mmol/L, or -3.7 mg/dL) cholesterol concentrations (all P < 0.0001), without significant effects on triacylglycerol. The net reductions in total and LDL cholesterol in men were greater than those in women by 0.27 mmol/L, or 10.3 mg/dL (P = 0.052), and by 0.29 mmol/L, or 11.2 mg/dL (P < 0.02), respectively. Changes in lipids did not differ significantly by race or baseline lipid concentrations, except for HDL, which decreased more in participants with higher baseline HDL-cholesterol concentrations than in those with lower baseline HDL-cholesterol concentrations. The fruit and vegetable diet produced few significant lipid changes. CONCLUSIONS: The DASH diet is likely to reduce coronary heart disease risk. The possible opposing effect on coronary heart disease risk of HDL reduction needs further study.     

原发性肾病综合征患儿血清低密度脂蛋白胆固醇理论预测值与实测值的差异

目的:比较原发性肾病综合征(primary nephrotic syndrome,PNS)患儿血清低密度脂蛋白胆固醇(low densitylipoprotein-cholesterol,LDL-C)理论预测值与实测值之间的差异。方法:78例PNS患儿,血清甘油三酯(triglyeride,TG)浓度均小于4.5 mmol/L,根据血清总胆固醇(total cholesterol,TC)水平,将其分成TC<6.21mmol/L组(29例)和TC≥6.21 mmol/L组(49例);液体双试剂法直接检测血清LDL-C浓度,并与Friedewald公式及Planella公式计算结果进行比较。结果:①PNS患儿LDL-C浓度三种测算方法之间存在显著性差异(P<0.05);②TC≥6.21 mmol/L时,Friedewald公式预测值与实测值之间未见显著性差异(P>0.05);③两种公式预测值与实测值均存在显著正相关,当TC≥6.21 mmol/L时,Friedewald公式预测值与实测值相关性最明显(R=0.79,P=0.00)。结论:当TC≥6.21 mmol/L且TG<4.5 mmol/L时,Friedewald公式预测值与实测值最为接近,可以为临床评价PNS患儿血清LDL-C水平提供参考。     

Long-term blood cholesterol-lowering effects of a dietary fiber supplement.

BACKGROUND: The study evaluated the blood cholesterol-lowering effects of a dietary supplement of water-soluble fibers (guar gum, pectin) and mostly non-water-soluble fibers (soy fiber, pea fiber, corn bran) in subjects with mild to moderate hypercholesterolemia (LDL cholesterol, 3.37-4.92 mmol/L). METHODS: After stabilization for 9 weeks on a National Cholesterol Education Program Step 1 Diet, subjects were randomly assigned to receive 20 g/d of the fiber supplement (n = 87) or matching placebo (n = 82) for 15 weeks and then receive the fiber supplement for 36 weeks. The efficacy analyses included the 125 subjects (58 fiber; 67 placebo) who were treatment and diet compliant. One hundred two (52 fiber; 50 placebo) completed the 15-week comparative phase. Of these subjects 85 (45 fiber; 40 placebo) elected to continue in the 36-week noncomparative extension phase. RESULTS: The mean decreases during the 15-week period for LDL cholesterol (LDL-C), total cholesterol (TC), and LDL-C/HDL-C ratio were greater (P < 0.001) in the fiber group. The mean changes from pre-treatment values in LDL-C, TC, and LDL-C/HDL-C ratio for subjects in the fiber group were -0.51 mmol/L (-12.1%), -0.53 mmol/L (-8.5%), and -0.30 (-9.4%), respectively. The corresponding changes in the placebo group were -0.05 mmol/L (-1.3%), -0.05 mmol/L (-0.8%), and 0.05 (1.5%), respectively. The fiber supplement had no significant effects (P > 0.05) on HDL cholesterol (HDL-C), triglyceride, iron, ferritin, or vitamin A or E levels. Similar effects were seen over the subsequent 36-week noncomparative part of the study. CONCLUSIONS: The fiber supplement provided significant and sustained reductions in LDL-C without reducing HDL-C or increasing triglycerides over the 51-week treatment period.     

Cardiovascular risk reduction and dietary compliance with a home-delivered diet and lifestyle modification program

Lack of adherence to diet contributes to ineffective dietary responsiveness and elevated cardiovascular risk factors in coronary heart disease (CHD) patients. Our purpose was to determine if home-delivered, heart-healthy meals and snacks, combined with telephone diet education, would be efficacious in improving dietary compliance, quality of life, and cardiovascular risk factors (primarily low-density lipoprotein [LDL] cholesterol and body weight) in CHD patients. Participants were 35 free-living subjects (21 men, 14 postmenopausal women) with a mean age of 62 (ranging from 40 to 79 years) in an 8-week diet intervention. A registered dietitian provided diet education over the telephone and weekly menus averaging 67% carbohydrate, 16% protein, 17% fat, 4% saturated fat, 5% monounsaturated fat, 128 mg cholesterol, and 25 g fiber. Lipid profiles, anthropometric measures, food records, and quality of diet, and life questionnaires were obtained at baseline, week 4, and week 8. Mean compliance-defined as percentage of prepared food energy consumed divided by percentage of prepared food energy provided-was 91% at 4 weeks and 88% at 8 weeks. After 8 weeks, significant reductions in weight (-3.7 kg), waist circumference (-2.0 in), hip circumference (-1.3 in), body mass index (-1.21 kg/m2), total cholesterol (-0.17 mmol/dL, -7.0 mg/dL), and LDL cholesterol (-0.19 mmol/dL, -7.5 mg/dL) (P<.05) were achieved without significant changes in high-density lipoprotein cholesterol (0.00 mmol/dL, 0.0 mg/dL) or triglycerides (+0.06 mmol/dL, +2.5 mg/dL). Significant improvements in quality of life and quality of diet (P < .05) were also demonstrated. This program could be a useful additive component to traditional medical nutrition therapy to improve dietary adherence.     

Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients

This study evaluated the association of the serum total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) with mortality in incident peritoneal dialysis (PD) patients. We performed a multi-center, prospective cohort study of 630 incident PD patients from 2008 to 2015 in Korea. Participants were stratified into quintiles according to baseline TC, HDL-C, LDL-C and TC/HDL-C. The association between mortality and each lipid profile was evaluated using multivariate Cox regression analysis. During a median follow-up period of 70.3 ± 25.2 months, 185 deaths were recorded. The highest TC/HDL-C group had the highest body mass index, percentage of diabetes and serum albumin level. Multivariate analysis demonstrated that the highest quintile of TC/HDL-C was associated with increased risk of all-cause mortality (hazard ratio 1.69, 95% confidence interval 1.04–2.76; p = 0.036), whereas TC, HDL-C and LDL-C were not associated with mortality. Linear regression analysis showed a positive correlation between TC/HDL-C and body mass index. Increased serum TC/HDL-C was an independent risk factor for mortality in the subgroup of old age, female, cardiovascular disease and low HDL-C. The single lipid marker of TC or HDL-C was not able to predict mortality in PD patients. However, increased serum TC/HDL-C was independently associated with all-cause mortality in PD patients.     

Effects of Egg Consumption on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Background: It is widely agreed that egg consumption only modestly influences serum lipid concentrations. However, there is no meta-analysis summarizing existing randomized controlled trials.

Objective: The purpose of this study was to conduct a meta-analysis of published randomized controlled trials to explore the quantitative effect of egg consumption on serum lipid concentrations.

Design: Online databases including MEDLINE, Proquest and Google Scholar were systematically searched. Studies that were published after 2000 and compared serum lipids concentrations in egg-consumers and non egg-consumers were included. The data were obtained from 28 studies. Weighted mean differences were calculated as the ultimate effect using random effects model.

Results: Overall, egg consumption increased total cholesterol (TC) by 5.60 mg/dL (95% CI: 3.11, 8.09; P<0.0001), low density lipoprotein-cholesterol (LDL-C) by 5.55 mg/dL (95% CI: 3.14, 7.69; P<0.0001) and high density lipoprotein-cholesterol (HDL-C) by 2.13 mg/dL (95% CI: 1.10, 3.16; P<0.0001) compared with the control group. Heterogeneity found between studies was explained partly by study design and participant response to dietary cholesterol. No effect of increased egg consumption on LDL-C:HDL-C and TC:HDL-C ratios, and triglyceride (TG) concentrations were found. No association was observed between number of eggs consumed per day or study duration and any of the serum lipid markers.

Conclusion: Consumption of egg increases total cholesterol, LDL-C and HDL-C, but not LDL-C:HDL-C, TC:HDL-C and TG compared with low egg control diets. To assess the risk of coronary events, future studies should focus on the postprandial effect of egg consumption and effects on coronary risk.     

Lipid-altering effects of a dietary supplement tablet containing free plant sterols and stanols in men and women with primary hypercholesterolaemia: a randomized, placebo-controlled crossover trial

This randomized, placebo-controlled, crossover trial assessed the lipid-altering efficacy of a dietary supplement (tablet form) providing 1.8?g/day free (non-esterified) plant sterols and stanols versus placebo for 6 weeks as part of a therapeutic lifestyle changes (TLC) diet in 32 men and women with primary hypercholesterolaemia. Mean?±?SE baseline (end of a 5-week TLC diet lead-in) lipid concentrations (mmol/l) were total cholesterol (TC), 5.88?±?0.08; non-high-density lipoprotein cholesterol (non-HDL-C), 4.71?±?0.09; low-density lipoprotein cholesterol (LDL-C), 4.02?±?0.08; HDL-C, 1.17?±?0.06 and triglycerides (TGs), 1.51?±?0.12. Differences from control in responses (plant sterol/stanol?-?control) were significant (p?相似文献   

Maternal and paternal family history of type 2 diabetes differently influence lipid parameters in young nondiabetic Japanese women

Objectives

We assessed the association of family history of type 2 diabetes (T2D) with parameters used for health checkups in young Japanese women.

Methods

The subjects were 497 nondiabetic women aged 19–39 years. Among them, the mothers of 34 subjects and fathers of 50 had T2D (MD group and PD group, respectively). The subjects were assessed for levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG).

Results

TC and LDL-C level showed a tendency to increase in the MD group compared with subjects without family history of T2D. LDL-C/HDL-C ratio ≥2.14 was found in 32.4 and 18.0 % of subjects in the MD and PD groups, respectively. When adjusted for differences in age, body mass index, smoking status, and drinking habits, the MD group was found to have a higher risk of abnormal TC and LDL-C levels than the PD group. LDL-C/HDL-C ratio was independently associated with maternal family history but not with paternal family history (odds ratio 3.44 [99 % confidence interval 1.11–10.6] and 1.21 [0.38–3.89], respectively). There was no association between TG/HDL-C ratio and family history type of T2D.

Conclusions

Maternal family history of T2D had a more pronounced effect on the lipid parameters generally evaluated during health checkups than did paternal family history of T2D. Therefore, we recommend systematic screening for early detection and appropriate healthcare guidance for Japanese women, particularly those with maternal family history of T2D.     

A spread enriched with plant sterol-esters lowers blood cholesterol and lipoproteins without affecting vitamins A and E in normal and hypercholesterolemic Japanese men and women

The objective of the study was to investigate whether different initial baseline cholesterol levels modulate the efficacy of a spread enriched with plant sterol-esters (PS) in lowering blood cholesterol in a Japanese population consuming their usual diet. Healthy adults with a mean age of 45 y and mean plasma total cholesterol (TC) level of 6.5 mmol/L were recruited to participate in a double-blind trial comprised of a run-in period of 1 wk, followed by two intervention periods of 3 wks in a 2 x 2 crossover design and a post-trial follow-up of 3 wk. Volunteers consumed two spreads, one enriched with PS (12 g/100 g plant sterols) and a control spread not fortified with PS. Recommended spread intake was 15 g/d. Effects on plasma lipids, lipoproteins, beta-carotene and vitamins A and E were assessed. Plasma TC and LDL cholesterol (LDL-C) concentrations were 5.8 and 9.1% lower, respectively, when subjects consumed the PS spread than when they consumed the control spread (P < 0.001). Subjects were divided into two groups [normal and mildly cholesterolemic (TC <5.7 mmol/L) and hypercholesterolemic (TC >/= 5.7 mmol/L)]. Reductions (P < 0.001) in TC and LDL-C due to treatment in the former group were 4.9 and 7.9%, respectively. In the hypercholesterolemic group, the reductions (P < 0.001) were 7.1 and 10.6%, respectively. The decreases did not differ between normal/mildly cholesterolemic and hypercholesterolemic subjects. Plasma apolipoprotein B (apoB) and remnant-like particle (RLP) cholesterol (RLP-C) concentrations were lower when subjects consumed the PS spread (44.3 g/L) than the control spread (49.7 g/L). Plasma beta-carotene concentration was lower (P < 0.001) in subjects consuming the PS spread than in the control. Changes in plasma vitamins A and E levels did not differ after intake of the PS and control spreads. In conclusion, consumption of a PS-enriched spread effectively lowered plasma TC, LDL-C, apoB and RLP-C regardless of baseline plasma TC at an intake of 1.8 g/d of plant sterols.     

Phytosterols/stanols lower cholesterol concentrations in familial hypercholesterolemic subjects: a systematic review with meta-analysis

BACKGROUND: To-date, reviews regarding the cholesterol lowering capacity of phytosterols/stanols have focused on normo- and hypercholesterolemic (HC) subjects. Familial hypercholestrolemia (FH) is characterized by very high low-density lipoprotein cholesterol (LDL-C) concentrations and is considered a world public health problem due to the high incidence of premature coronary heart disease (CHD) in these patients. OBJECTIVE: To conduct a systematic review that investigates the efficacy of phytosterols/stanols in lowering total cholesterol (TC) and LDL-C concentrations in FH subjects. DESIGN: Randomized controlled intervention trials with the primary objective to investigate the effects of phytosterols/stanols on lipid concentrations in FH subjects were identified through selected international journal databases and reference lists of relevant publications. Two researchers extracted data from each identified trial and only trials of sufficient quality (e.g. controlled, randomized, double-blind, good compliance, sufficient statistical power) were included in the review. The main outcome measures were differences between treatment and control groups for LDL-C, TC, high-density lipoprotein cholesterol (HDL-C) and triacylglycerol (TG). RESULTS: Six out of 13 studies were of sufficient quality. Two were excluded from the meta-analysis because the sterols were administered in the granulate form at very high dosages (12 g/day and 24 g/day) compared to the other studies that used fat spreads as vehicle with dosages ranging from 1.6-2.8 g/day. The subjects were heterozygous, aged 2-69 years with baseline TC and LDL-C concentrations of +/-7 mmol/L and +/-5.4 mmol/L, respectively. The duration of the studies ranged from 4 weeks to 3 months. Fat spreads enriched with 2.3 +/- 0.5 g phytosterols/stanols per day significantly reduced TC from 7 to 11% with a mean decrease of 0.65 mmol/L [95% CI -0.88, -0.42 mmol/L], p < 0.00001 and LDL-C from 10-15% with a mean decrease of 0.64 mmol/L [95% CI -0.86, -0.43 mmol/L], p < 0.00001 in 6.5 +/- 1.9 weeks compared to control treatment, without any adverse effects. TG and HDL-C concentrations were not affected. CONCLUSION: Phytosterols/stanols may offer an effective adjunct to the cholesterol lowering treatment strategy of FH patients.     

Combined extractives of red yeast rice,bitter gourd,chlorella, soy protein,and licorice improve total cholesterol,low-density lipoprotein cholesterol,and triglyceride in subjects with metabolic syndrome

In this study, we aimed to examine the effects of a plant-extractive compound on lipid profiles in subjects with metabolic syndrome. We hypothesized that extractives from red yeast rice, bitter gourd, chlorella, soy protein, and licorice have synergistic benefits on cholesterol and metabolic syndrome. In this double-blinded study, adult subjects with metabolic syndrome were randomized to receive a plant-extractive compound or a placebo treatment for 12 weeks. Both total cholesterol (5.4 ± 0.8 to 4.4 ± 0.6 mmol/L, P < .001) and low-density lipoprotein cholesterol (3.4 ± 0.7 to 2.7 ± 0.5 mmol/L, P < .001) were significantly reduced after treatment with the plant extractives, and the magnitudes of reduction were significantly greater than in the placebo group (−1.0 ± 0.6 vs 0.0 ± 0.6mmol/L, P < .001; −0.7 ± 0.6 vs 0.0 ± 0.6 mmol/L, P < .001). The reduction in the fasting triglycerides level was significantly greater in the plant-extractive group than in the placebo group (−0.5 ± 0.8 vs −0.2 ± 1.0 mmol/L, P = .039). There was also a significantly greater reduction in the proportion of subjects with hypertensive criteria in the plant-extractive group than in the placebo group (P = .040). In conclusion, the plant extractives from red yeast rice, bitter gourd, chlorella, soy protein, and licorice were effective in reducing total and low-density lipoprotein cholesterol. The plant extractives also showed potential for reducing triglyceride and normalizing blood pressure.     

A Combination of Lactoplantibacillus plantarum Strains CECT7527, CECT7528, and CECT7529 Plus Monacolin K Reduces Blood Cholesterol: Results from a Randomized,Double-Blind,Placebo-Controlled Study

Background: Dietary supplements have been proposed to help manage blood cholesterol, including red yeast rice (RYR) extracts, plant sterols and stanols, beta-glucans, and some probiotics. This study was conducted to evaluate the efficacy of RYR (containing 10 mg of monacolin K) combined with 10⁹ CFU of three Lactoplantibacillus plantarum strains (CECT7527, CECT7528, and CECT7529). Methods: A 12-week randomized, double-blinded, placebo-controlled clinical trial was conducted. In total, 39 adult patients were enrolled, having total cholesterol (TC) ≥200 mg/dL, and being statin-naïve or having recently stopped statin treatment because of intolerance. Active product or placebo were taken once daily, and subjects were evaluated at baseline, 6, and 12 weeks. Results: Study groups were comparable at baseline, except for history of recent hypercholesterolemia treatment (81% in active vs. 22% in placebo). Changes in LDL cholesterol and TC became significant compared to placebo (mean difference between groups and standard error of the mean = 23.6 ± 1.5 mg/dL, p = 0.023 and 31.4 ± 1.9 mg/dL, p = 0.011, respectively) upon adjusting for the baseline imbalance in hypercholesterolemia treatment. No adverse effects were noted during the study. Conclusion: This combination of 10 mg of monacolin K and L. plantarum strains was well tolerated and achieved a statistically significant greater reduction in LDL-C and TC in the intervention group compared to the placebo, once adjusting for recent history of hypercholesterolemia treatment.     

A controlled study on the effect of beta-glucan-rich oat bran on serum lipids in hypercholesterolemic subjects: relation to apolipoprotein E phenotype.

The effects of beta-glucan-rich oat bran on serum lipids and lipoproteins were examined in a randomized 8-week study. After a 4-week run-in phase, subjects with mild to moderate hypercholesterolemia [serum total cholesterol (TC) 5.5-8.5 mmol/l] on cholesterol-lowering diets were randomly allocated to an oat bran (10.3 g beta-glucan/day) or wheat bran group. Thirty-six subjects (20 in the oat bran group, 16 in the wheat bran group) completed the study. The diet was identical in both groups during the trial and no significant changes in body weight were found. Serum TC and low-density lipoprotein cholesterol (LDL-C) significantly declined in the oat bran group during the first 4 weeks from 7.03 +/- 0.81 to 6.72 +/- 0.97 (p = 0.028) and from 4.90 +/- 0.69 to 4.61 +/- 0.89 mmol/l (p = 0.038), respectively, but at 8 weeks the values were not significantly different from baseline. Changes in serum TC were mainly confined to those who ate at least two-thirds of the planned daily dose of oat bran. In wheat bran group no changes were observed in serum TC or LDL-C levels. Apolipoprotein A1 and B did not change significantly in either group. Only subjects with apolipoprotein E 3/3 phenotype (n = 12) had hypocholesterolemic response to oat bran at 4 weeks, but no change was found in those with apolipoprotein E 4/4 or 4/3 (n = 7).(ABSTRACT TRUNCATED AT 250 WORDS)     

男性青年饮用牛奶和豆浆后血脂血糖变化的研究

目的研究饮用牛奶或豆浆后健康男性青年血脂血糖的变化情况。方法 30名男性健康大学生随机分入牛奶组、豆浆组和纯净水组,每天饮用相应饮品1L,连续饮用4周。测定干预前后血浆中甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、葡萄糖(GLU)水平的变化。结果干预后牛奶组的LDL-C水平从(2.28±0.33)mmol/L下降至(1.95±0.41)mmol/L(P﹤0.05),豆浆组从(2.23±0.27)mmol/L下降至(1.94±0.37)mmol/L(P﹤0.05)。与纯净水对照组比较,牛奶组和豆浆组降LDL-C作用更为明显(P﹤0.01)。另外豆浆组的TG水平也明显降低(P﹤0.05)。各组的TC、GLU水平未见明显变化。结论饮用牛奶或豆浆对血糖没有明显影响但有一定降血脂作用,可以预防动脉粥样硬化等心血管疾病。