Cholesterol-lowering efficacy of plant sterols in low-fat yogurt consumed as a snack or with a meal.

OBJECTIVE: Plant sterols (PS) consumed as a snack may not have the same cholesterol-lowering potential as when consumed with a meal due to poor solubilization. It was hypothesized that the consumption of a single dose, low-fat yogurt rich in PS (1.6 g/d) with a meal over an afternoon snack will lead to favourable changes in plasma lipids, plasma PS concentrations, and cholesterol synthesis without negatively affecting alpha-tocopherol or carotenoids levels. METHODS: Twenty-six hyperlipidemic males and females completed the randomized trial of three phases (control, single PS dose consumed with a meal, or single PS dose as an afternoon snack) while consuming controlled, low-fat diets. Plasma lipids, cholesterol synthesis rates, plasma PS and serum fat-soluble antioxidants were measured at baseline and after 4 weeks. RESULTS: Endpoint total cholesterol (TC) levels after the PS snack phase were decreased (p = 0.04) (5.30 +/- 0.2 mmol/L) compared to the control phase (5.53 +/- 0.2 mmol/L). However, endpoints for TC (5.37 +/- 0.2 mmol/L) for PS dose with a meal were comparable to control phase. Low-density lipoprotein-cholesterol tended to be different (p = 0.06) at the end of the intervention phases (3.51 +/- 0.1, 3.43 +/- 0.1, and 3.33 +/- 0.1 mmol/L; control, meal and snack, respectively). Cholesterol fractional synthesis rates were higher (p = 0.007) by 25.8% and 19.5% at the end of the snack and meal phases, respectively, compared with the control phase. Plasma campesterol and beta-sitosterol concentrations, adjusted for TC, were higher (p < 0.01) in the snack phase (2.30 +/- 0.3 and 0.54 +/- 0.1 micromol/mmol, respectively) and in the meal phase (2.00 +/- 0.3 and 0.51 +/- 0.1 micromol/mmol, respectively) when compared to the control phase (1.81 +/- 0.3 and 0.40 +/- 0.1 micromol/mmol, respectively). No changes in alpha-tocopherol or carotenoids levels were detected after adjusting for TC, for all phases. CONCLUSION: These results indicate that a single dose of PS in low-fat yogurt, provided as a snack, lowers cholesterol levels but does not alter fat-soluble vitamin or carotenoid concentrations in hyperlipidemic participants.

Association between non-responsiveness to plant sterol intervention and polymorphisms in cholesterol metabolism genes: a case-control study.

Plant sterol (PS) consumption decreases low-density lipoprotein cholesterol (LDL-C) levels; however, high variability of responsiveness of lipid levels to PS intervention has been observed. We hypothesized that common single-nucleotide polymorphisms (SNPs) in the genes for the ATP binding cassette proteins G5 (ABCG5) and G8 (ABCG8), Niemann-Pick C1-like 1 (NPC1L1), or other proteins of the cholesterol pathway, would underline inter-individual variations in response to PS. Twenty-six hyperlipidemic subjects completed a randomized trial of 3 PS phases and a control phase. Three non-responders were identified who failed on 3 consecutive occasions to decrease either total cholesterol or LDL-C level vs. control. It was observed that after 3 PS phases compared with a control phase, cholesterol absorption changed to a lesser degree (-7.7% +/- 10.8%) in the non-responders than in the top 3 responders (-22.1% +/- 8.8%); however, cholesterol synthesis rates did not differ between sub-groups. No common polymorphisms in ABCG8, ABCG5, or NPC1L1 were demonstrated between the 3 top responders and the non-responders. Yet, 1 non-responsive subject did demonstrate a rare SNP in NPC1L1. Results indicate PS intake did not decrease cholesterol absorption rates to the same degree in certain subjects, possibly clarifying the inter-individual variability in the cholesterol-lowering effect; hence, this work should be expanded.

Plant sterol-enriched fermented milk enhances the attainment of LDL-cholesterol goal in hypercholesterolemic subjects.

BACKGROUND: The number of hypercholesterolemic individuals who do not meet their cholesterol recommended targets is inappropriately high. The use of plant sterol-enriched foods could help in this clinical setting. AIM OF THE STUDY: To evaluate the efficacy and side effects of plant sterol-enriched fermented milk in reducing LDL-cholesterol and increasing the number of patients who attain their therapeutic targets. METHODS: This was a multicentre, randomised, double-blind, placebo-controlled, parallel clinical trial. Eighty-three hypercholesterolemic patients that were not at therapeutic goals were studied. The patients received one 100 ml serving of either plain (control) low-fat or phytosterol enriched (1.6 g of free sterol equivalents) drinkable yogurt per day along with the main meal for 42 days. The principal variables were variation on LDL cholesterol (LDL-C) concentration and the number of patients achieving therapeutic goals after intervention. RESULTS: Patients on phytosterols attained an average LDL-C reduction of more than 10% (12.2% after 3 weeks; 10.6% after 6 weeks) (P = 0.001; 95% CI: 4.03-19.00) regardless of statin therapy compared to the control group. About 50% of the subjects on phytosterols, as compared to 20% of controls, attained their LDL-C target values (<3.3 or <2.6 mmol/l for primary and secondary prevention, respectively) at the end of the study (P < 0.001). HDL-cholesterol (HDL-C) did not change and triglycerides (TG) were decreased by 14% (P < 0.018). The plasma sterols/total cholesterol ratio increased. CONCLUSIONS: Plant sterol-enriched fermented milk significantly reduced LDL-C and increased the number of moderately hypercholesterolemic patients achieving therapeutic targets.

Effect of low-fat, fermented milk enriched with plant sterols on serum lipid profile and oxidative stress in moderate hypercholesterolemia.

BACKGROUND: Plant sterol (PS)-enriched foods have been shown to reduce plasma LDL-cholesterol concentrations. In most studies, however, PSs were incorporated into food products of high fat content. OBJECTIVE: We examined the effect of daily consumption of PS-supplemented low-fat fermented milk (FM) on the plasma lipid profile and on systemic oxidative stress in hypercholesterolemic subjects. DESIGN: Hypercholesterolemic subjects (LDL-cholesterol concentrations >or=130 and

Lyophilized carrot ingestion lowers lipemia and beneficially affects cholesterol metabolism in cholesterol-fed C57BL/6J mice.

BACKGROUND: Several lines of evidence indicate that diet rich in fruit and vegetable can protect against cardiovascular diseases by acting on cholesterol metabolism and on oxidative stress. AIM OF THE STUDY: The aim of this study was to assess whether daily carrot consumption (provided as lyophilized powder) could differentially influence the consequences of cholesterol supplementation on lipid metabolism and oxidative stress in C57BL/6J mice. METHODS: Fourteen mice were randomized in four groups. Mice were fed either control diets (without or with 0.25% cholesterol added) or lyophilized carrot enriched diets (20% wt/wt without or with 0.25 % cholesterol added) for 4 weeks. Cholesterol and triglycerides in plasma and in liver were measured at the end of the experimental period. Fecal excretion of sterols was evaluated. Vitamin E and carotenoid concentrations were also determined. Several biomarkers relative to oxidative stress such as FRAP (Ferric Reducing Ability of Plasma) and isoprostanes were investigated. RESULTS: Feeding the carrot diet resulted in a decrease of cholesterol (-41%) and triglycerides (-49 %) in plasma and in the liver (-41% and -39%, respectively) in animals fed cholesterol-supplemented diets. Carrot diet induced an increase of total neutral sterols fecal excretion, which inhibits digestive cholesterol absorption. Carrot diet increased antioxidant status in cholesterol-fed mice as related by the 16% higher FRAP values. Although vitamin E was not affected by carrot diet, vitamin E/TG ratio was significantly higher in animals fed carrot diets. The carrot diet induced an increase of vitamin E in the heart in both cholesterol-free and cholesterol-supplemented mice suggesting a higher protection of this tissue. CONCLUSION: This study shows that carrot ingestion decreases lipemia and improves antioxidant status in mice. Such results suggest that carrot intake may exert a protective impact against CVD linked to atherosclerosis. It is likely that these effects could be due to the synergistic effect of fiber and associated antioxidants.

Health effect of vegetable-based diet: lettuce consumption improves cholesterol metabolism and antioxidant status in the rat.

BACKGROUND & AIMS: It is often assumed that fruits and vegetables contribute to protect against degenerative pathologies such as cardiovascular diseases. Besides epidemiological observations, scientific evidences for their mechanism of action are scarce. In the present study, we investigated the mean term and post-prandial effects of lettuce ingestion on lipid metabolism and antioxidant protection in the rat. RESULTS: Feeding rats a 20% lettuce diet for 3 weeks resulted in a decrease cholesterol LDL/HDL ratio and a marked decrease of liver cholesterol levels (-41%). Concurrently, fecal total steroid excretion increased (+44%) and apparent absorption of dietary cholesterol was significantly depressed (-37%) by the lettuce diet. Lettuce diet also displayed an improvement of vitamin E/TG ratio in plasma and limited lipid peroxidation in heart as evidenced by TBARS. In post-prandial experiment, lettuce intake significantly increased both ascorbic acid and alpha-tocopherol plasma levels which contribute to improve plasma antioxidant capacity within 2 h of consumption. Other lipid-soluble antioxidants (lutein and vitamin E) may also improve the plasma antioxidant capacity. CONCLUSION: Lettuce consumption increases the total cholesterol end-products excretion and improves antioxidant status due to the richness in antioxidants (vitamins C, E and carotenoids). In our model, lettuce clearly shows a beneficial effect on lipid metabolism and on tissue oxidation. Therefore regular consumption of lettuce should contribute to improve protection against cardiovascular diseases.

Dietary lignins are precursors of mammalian lignans in rats.

The mammalian lignans enterolactone (ENL) and enterodiol, commonly found in human plasma and urine, are phytoestrogens that may contribute to the prevention of breast cancer and coronary heart disease. They are formed by the conversion of dietary precursors such as secoisolariciresinol and matairesinol lignans by the colonic microflora. The identification of lignins, cell-wall polymers structurally related to lignans, as precursors of mammalian lignans is reported here for the first time. In study 1, rats were fed rye or wheat bran (15% diet) for 5 d. Untreated brans and brans extracted with solvents to remove lignans were compared. ENL was estimated in urine samples collected for 24 h by time-resolved fluoroimmunoassay. ENL urinary excretion was reduced from 18.6 to 5.3 nmol/d (n=8; P<0.001) when lignans were removed from rye bran and from 30.5 to 6.2 nmol/d (P<0.001) when they were removed from wheat bran. These results suggest that lignins, embedded in the cell wall and retained in the bran during solvent extraction, account for 26-32% of the ENL formed from cereal brans. In study 2, rats were fed a deuterated synthetic lignin (0.2% diet) together with wheat bran (15%) for 3 d. The detection of deuterated ENL by LC-tandem MS in urine (20 nmol/d) clearly confirms the conversion of lignin into mammalian lignans. More research is warranted to determine the bioavailability of lignins in the human diet.

Effect of carrot intake on cholesterol metabolism and on antioxidant status in cholesterol-fed rat.

BACKGROUND: Vegetables are major dietary sources of fibers and antioxidants such as carotenoids, polyphenols and vitamin C which contribute to explain their protective effects against cardiovascular diseases. AIM OF THE STUDY: We investigated in the rat the effects of a 3-week supplementation of the diet with carrot (15% dry matter) on lipid metabolism and antioxidant status. RESULTS: A significant decrease of cholesterol level in liver (-44%; P= 0.0007) was observed together with a reduction of the level of liver triglycerides (-40%; P= 0.0005). Fecal total steroids excretion increased by 30% upon feeding the carrot diet as compared to the control. The secretion of bile acids was maintained, whereas the cholesterol apparent absorption was reduced in rats fed carrot diet. Carrot consumption also improved the antioxidant status. It significantly decreased the urinary excretion of thiobarbituric acid reactive substances (TBARS), reduced the TBARS levels in heart, increased the vitamin E plasmatic level and tended to increase the ferric reducing ability of plasma (FRAP) as compared to the controls. The carrot diet provided carotenoid antioxidants: 5.1 mg beta-carotene, 1.6 mg alpha-carotene and 0.25mg lutein per 100 g diet. No carotenoids were found in plasma whereas the three carotenoids were detected in the plasma of the rats fed the carrot diet at 125, 41, 43 nmol/L respective concentrations. beta-Carotene was also detected in liver and heart. CONCLUSION: Carrot consumption modifies cholesterol absorption and bile acids excretion and increases antioxidant status and these effects could be interesting for cardiovascular protection.

Mammalian lignan formation in rats fed a wheat bran diet.

The dietary origin of lignan phytoestrogens is still poorly understood more than 20 years after their discovery in human urine. Their level in urine has been associated with the consumption of dietary fiber. This paper reports the study of the excretion of enterolactone, assayed by a time-resolved fluoroimmunoassay, in rats fed a diet supplemented with 15% wheat bran, one of the main sources of fiber in Western countries. Enterolactone excretion regularly increased during the two weeks of the diet to reach a value of 45 nmol/day. The level of excretion also increased upon preadaptation to ferulic acid, structurally related to secoisolariciresinol, an established precursor of enterolactone in flaxseeds, and decreased upon preadaptation to potato starch rich in fiber. These results show that the formation of lignans from wheat bran is influenced by the diet, possibly because of an adaptation of the colonic microflora.