Phytosterols in low- and nonfat beverages as part of a controlled diet fail to lower plasma lipid levels

Dietary phytosterols have been shown to reduce plasma cholesterol concentrations when consumed in different food matrices, but their effectiveness in nonfat or low-fat beverages has not been established. The objective of this study was to examine whether phytosterols alter plasma lipid levels when incorporated into nonfat or low-fat beverages. Fifteen moderately hypercholesterolemic men and women consumed three precisely controlled diets for periods of 21 days each in random order. Diets contained either a nonfat placebo beverage (NF), a beverage that is nonfat with added phytosterols (NFPS), or a beverage that is low in fat with added phytosterols (LFPS). Total cholesterol concentrations were not different between groups at endpoint, decreasing (P < 0.05) equally by 8.5%, 11.6%, and 10.1% with NF, NFPS, and LFPS consumption, respectively. There was no effect of dietary treatment on LDL cholesterol concentrations, which decreased over time (P < 0.05) by 5%, 10.4%, and 8.5% with NF, NFPS, and LFPS, respectively. HDL cholesterol and triacylglycerol concentrations were unaffected by the diets. Provision of phytosterols as part of nonfat and low-fat beverages did not exert any greater hypocholesterolemic effect than a nonfat placebo beverage.These results show that intake of phytosterols in a low-fat beverage format is not efficacious for lipid level modification. Dietary phytosterols have been shown to reduce plasma cholesterol concentrations when consumed in different food matrices, but their effectiveness in nonfat or low-fat beverages has not been established. The objective of this study was to examine whether phytosterols alter plasma lipid levels when incorporated into nonfat or low-fat beverages. Fifteen moderately hypercholesterolemic men and women consumed three precisely controlled diets for periods of 21 days each in random order. Diets contained either a nonfat placebo beverage (NF), a beverage that is nonfat with added phytosterols (NFPS), or a beverage that is low in fat with added phytosterols (LFPS). Total cholesterol concentrations were not different between groups at endpoint, decreasing (P < 0.05) equally by 8.5%, 11.6%, and 10.1% with NF, NFPS, and LFPS consumption, respectively. There was no effect of dietary treatment on LDL cholesterol concentrations, which decreased over time (P < 0.05) by 5%, 10.4%, and 8.5% with NF, NFPS, and LFPS, respectively. HDL cholesterol and triacylglycerol concentrations were unaffected by the diets. Provision of phytosterols as part of nonfat and low-fat beverages did not exert any greater hypocholesterolemic effect than a nonfat placebo beverage. These results show that intake of phytosterols in a low-fat beverage format is not efficacious for lipid level modification. Low-fat diets containing less than 30% of energy as fat and less than 10% as saturated fat have long been promoted for lowering plasma cholesterol concentrations in hypercholesterolemic patients. Recently, the National Cholesterol Education Program Adult Treatment Panel III guidelines have added the inclusion of phytosterols as part of their therapeutic lifestyle changes dietary guidelines (1US Department of Health and Human Services. 2001. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). NIH Publication, Bethesda, MD. 01–3670.Google Scholar) in addition to the traditional recommendations to lower total fat, saturated fat, and cholesterol intakes. Furthermore, in 2000, the US Food and Drug Administration issued a health claim stating that foods containing plant sterol and stanol esters, when consumed in foods low in saturated fat and cholesterol, reduced the risk of coronary heart disease (2Moreau R.A. Whitaker B.D. Hicks K.B. Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses.Prog. Lipid Res. 2002; 41: 457-500Crossref PubMed Scopus (859) Google Scholar). Phytosterols have traditionally been incorporated into margarines, spreads, and other high-fat foods and have been shown to be efficacious in lowering total cholesterol (TC) and LDL cholesterol (3Law M. Plant sterol and stanol margarines and health.BMJ. 2000; 320: 861-864Crossref PubMed Google Scholar, 4Denke M.A. Lack of efficacy of low-dose sitostanol therapy as an adjunct to a cholesterol-lowering diet in men with moderate hypercholesterolemia.Am. J. Clin. Nutr. 1995; 61: 392-396Crossref PubMed Scopus (140) Google Scholar, 5Farquhar J.W. Smith R.E. Dempsey M.E. The effect of beta sitosterol on the serum lipids of young men with arteriosclerotic heart disease.Circulation. 1956; 14: 77-82Crossref PubMed Google Scholar, 6Hallikainen M.A. Sarkkinen E.S. Uusitupa M.I.J. Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner.J. Nutr. 2000; 130: 767-776Crossref PubMed Scopus (203) Google Scholar, 7Hendriks H.F.J. Weststrate J.A. van Vliet T. Meijer G.W. Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects.Eur. J. Clin. Nutr. 1999; 53: 319-327Crossref PubMed Scopus (377) Google Scholar, 8Jones P.J.H. Ntanios F.Y. Raeini-Sarjaz M. Vanstone C.A. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men.Am. J. Clin. Nutr. 1999; 69: 1144-1150Crossref PubMed Scopus (221) Google Scholar, 9Jones P.J. Raeini-Sarjaz M. Ntanios F.Y. Vanstone C.A. Feng J.Y. Parsons W.E. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters.J. Lipid Res. 2000; 41: 697-705Abstract Full Text Full Text PDF PubMed Google Scholar, 10Lees A.M. Mok H.Y. Lees R.S. McCluskey M.A. Grundy S.M. Plant sterols as cholesterol-lowering agents: clinical trials in patients with hypercholesterolemia and studies of sterol balance.Atherosclerosis. 1977; 28: 325-338Abstract Full Text PDF PubMed Scopus (296) Google Scholar, 11Miettinen T.A. Puska P. Gylling H. Vanhanen H. Vartainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population.N. Engl. J. Med. 1995; 333: 1308-1312Crossref PubMed Scopus (681) Google Scholar). In a recent meta-analysis, it was reported that consumption of more than 2 g of phytosterols/day reduced LDL cholesterol concentrations by 0.33 to 0.54 mmol/l, depending on the age of the subjects studied, and that intakes of less than 2 g/day led to reductions in LDL cholesterol of at least 0.4 to 0.5 mmol/l (3Law M. Plant sterol and stanol margarines and health.BMJ. 2000; 320: 861-864Crossref PubMed Google Scholar). It is thus generally agreed that phytosterol consumption leads to, on average, a 10% reduction in TC and a 13% reduction in LDL cholesterol concentrations. Phytosterols exert their cholesterol-lowering action by suppressing intestinal cholesterol absorption while partially suppressing cholesterol biosynthesis (9Jones P.J. Raeini-Sarjaz M. Ntanios F.Y. Vanstone C.A. Feng J.Y. Parsons W.E. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters.J. Lipid Res. 2000; 41: 697-705Abstract Full Text Full Text PDF PubMed Google Scholar, 12Ostlund Jr., R.E. Racette S.B. Okeke A. Stenson W.F. Phytosterols that are naturally present in commercial corn oil significantly reduce cholesterol absorption in humans.Am. J. Clin. Nutr. 2002; 75: 1000-1004Crossref PubMed Scopus (183) Google Scholar, 13Plat J. Mensick R.P. Effects of plant sterols and stanols on lipid metabolism and cardiovascular risk.Nutr. Metab. Cardiovasc. Dis. 2001; 11: 31-40PubMed Google Scholar). While they are only partially absorbed into the circulation, phytosterol solubility and incorporation into intestinal micelles is an important aspect of phytosterol cholesterol-lowering efficacy. A previous study using phytosterols-safflower oil (4:1, v/v) in capsules did not show any reduction in cholesterol concentrations, probably due to matrix interference (4Denke M.A. Lack of efficacy of low-dose sitostanol therapy as an adjunct to a cholesterol-lowering diet in men with moderate hypercholesterolemia.Am. J. Clin. Nutr. 1995; 61: 392-396Crossref PubMed Scopus (140) Google Scholar). Phytosterols thus require some fat for solubilization and cholesterol-lowering efficacy. More recently, however, other factors have been found that improve phytosterol solubility. One such factor, lecithin, results in reduced cholesterol absorption at lower phytosterol dosages (14Ostlund R.E. Spilburg C.A. Stenson W.F. Sitostanol administered in lecithin micelles potently reduces cholesterol absorption in humans.Am. J. Clin. Nutr. 1999; 70: 826-831Crossref PubMed Scopus (154) Google Scholar). In the majority of the previous trials, phytosterols have been provided in a fat matrix and fed as part of a regular or low-fat diet containing between 30% and 35% of energy as fat (15Jones P.J. MacDougall D.E. Ntanios F. Vanstone C.A. Dietary phytosterols as cholesterol-lowering in J. 75: PubMed Scopus Google Scholar, Effects of dietary phytosterols on cholesterol metabolism and clinical and J. Med. 1999; Full Text Full Text PDF PubMed Scopus Google Scholar). phytosterols into low-fat foods be more in with a studies have the of phytosterols when provided in low-fat or nonfat foods R.P. M. J. van M. M. A Effects of plant stanol esters in low-fat on serum lipids and sterols and fat 2002; Full Text Full Text PDF PubMed Scopus Google Scholar, P. M. M. Cholesterol-lowering of plant sterol esters and stanols in and low-fat J. Clin. Nutr. 2001; PubMed Scopus Google Scholar, P. J. J. H. of a diet on low-fat foods enriched with plant sterols and on serum J. 2001; Full Text Full Text PDF PubMed Scopus Google Scholar, A. F. Effects of enriched with plant sterols on serum lipids in patients with moderate J. Nutr. 2001; PubMed Google Scholar). These trials have found reductions in TC and LDL cholesterol with consumption of low-fat foods containing plant however, in study the efficacy of or nonfat foods enriched with phytosterols in plasma lipid concentrations. In no study has the hypocholesterolemic of beverages. The objective of this was thus to whether when provided in a low-fat or nonfat a hypocholesterolemic in mildly hypercholesterolemic subjects with a diet in which were provided The was that be no in plasma lipid or plant sterol concentrations the three diets. Fifteen subjects to were to in this of three were on for LDL cholesterol between and mmol/l, HDL cholesterol mmol/l, triacylglycerol concentrations mmol/l, and between and were they were or phytosterols to to in the to or days to subjects were they were with or or a of or a of or or heart or in the to The study was and by the Human of the of and of The and were to each to the of the and subjects were to of treatment treatment was of 21 days and by a Treatment were controlled periods only in the of beverage either nonfat placebo (NF), nonfat with phytosterols (NFPS), or low-fat fat by with phytosterols (LFPS). The nonfat beverages contained less than fat, and of the nonfat beverages provided The low-fat beverage contained the and but contained fat and provided g The LFPS and were by plant sterol into beverages using a consumed three g The mixture of phytosterols provided in the beverages was oil and contained as as some sitostanol and with an phytosterol of Diets were controlled and contained 35% of energy as fat, as and as and and and Diets were provided as three and were with the treatment beverage in were by the of the of energy intake was using the A for energy in J. Clin. Nutr. PubMed Scopus Google Scholar) with an of is for in moderately subjects P.J.H. J. of energy for clinical Res. Scopus Google Scholar). were to foods provided and In were consumed at the and the other was for subjects to of the were at and at the of the study to the of or were at the and of each treatment A was the study in subjects blood were on and 21 of each treatment for of plasma lipid and phytosterol concentrations. was blood of at g and at HDL cholesterol, and were in using a and commercial HDL cholesterol concentrations were of the with and J. for of 28: PubMed Scopus Google Scholar). LDL cholesterol concentrations were using the of the of cholesterol in of the PubMed Scopus Google Scholar). phytosterol concentrations were in by of the plasma as reported F. P.J.H. Effects of dietary sitostanol concentrations on plasma lipid and phytosterol metabolism in PubMed Scopus Google Scholar). 0.5 of plasma was with 0.5 at for and the with was as the were into a with a and a and were at and respectively. were at were by with lipid concentrations were using with and dietary treatment as effect were as in the of and were found for diet were to treatment were to and between each dietary phytosterol concentrations were using with and treatment as was to and for plasma phytosterol and dietary treatment A of was as are reported as subjects the study the was subjects consumed at the and reported of the other and beverages. were the and was no between dietary on subjects reported a total of of which the and three the LFPS of the were and to study The majority were or The were a and a and as as were not significantly by were between treatment groups and not different at and 21 days of consumption of diets with and are NFPS, nonfat with LFPS, low-fat with are in a NF, NFPS, nonfat with LFPS, low-fat with and concentrations as as changes in LDL cholesterol, HDL cholesterol, and concentrations over the 21 periods are shown in There was no in TC and LDL cholesterol concentrations treatment groups at TC concentrations at were and mmol/l with NF, NFPS, and LFPS respectively. These to reductions in TC concentrations a of 8.5%, 11.6%, and 10.1% for NF, NFPS, and LFPS, respectively. LDL cholesterol concentrations were not significantly different between at LDL cholesterol concentrations NF, NFPS, and LFPS consumption were and mmol/l, respectively. These to reductions in LDL cholesterol concentrations of 5%, 10.4%, and 8.5% for NF, NFPS, and LFPS, respectively. in (P < 0.05) in TC and LDL cholesterol over time lipid concentrations with dietary with and are cholesterol different each < different each < different each < cholesterol different each < different each < different each < cholesterol different each < different each < are different each < in a HDL cholesterol and concentrations were not significantly different between dietary with concentrations to mmol/l for HDL cholesterol and between to mmol/l for The and a (P < 0.05) of 8.5% and in HDL cholesterol concentrations of LDL cholesterol were by dietary as by and with NF, NFPS, and LFPS consumption, concentrations (P < with consumption of LFPS diet versus and at were (P < to with consumption of the LFPS plasma sitosterol concentrations (P < with LFPS with and concentrations were (P < than for and sitosterol concentrations with dietary with and different and < different and LFPS < different and < different and < different and < different and LFPS < in a is the study to examine the of phytosterols provided in the of a beverage. Furthermore, it is of the trials to the efficacy of nonfat and low-fat foods or beverages in lowering plasma lipid concentrations. The results show that consumption of phytosterols at a level of g/day not to reductions in TC and LDL cholesterol concentrations when in the of a nonfat or low-fat beverage with a placebo not containing the plant sterol on the foods and results show that previous cholesterol-lowering efficacy of plant sterols in and low-fat not be to phytosterol It is that the of efficacy of the beverages was due to in study Diets were controlled and in Furthermore, of with the study is subjects consumed at the and thus at least of the total phytosterol was In the of in that subjects consumed of the food provided and is a that subjects study foods for In that only g of phytosterols have been level of plant sterols or lower has been shown to reductions in plasma LDL cholesterol concentrations Lipid to incorporated into a National Cholesterol Education Program J. Clin. Nutr. 2001; PubMed Scopus Google Scholar, F. A diet moderately enriched in phytosterols plasma cholesterol concentrations in Nutr. Metab. 1995; PubMed Scopus Google Scholar, E. P. P.J. M. J.A. of a and diet on serum lipids and 2001; Full Text PDF PubMed Scopus Google Scholar). of phytosterols is not beverage provided g of phytosterols for a total of a by P.J.H. Ntanios F.Y. Raeini-Sarjaz M. Vanstone C.A. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men.Am. J. Clin. Nutr. 1999; 69: 1144-1150Crossref PubMed Scopus (221) Google Scholar, 9Jones P.J. Raeini-Sarjaz M. Ntanios F.Y. Vanstone C.A. Feng J.Y. Parsons W.E. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters.J. Lipid Res. 2000; 41: 697-705Abstract Full Text Full Text PDF PubMed Google Scholar, P.J.H. of an oil of and cardiovascular risk in Full Text Full Text PDF PubMed Scopus Google Scholar, C.A. Raeini-Sarjaz M. Parsons W.E. P.J.H. plant sterols and stanols lower cholesterol levels in hypercholesterolemic J. Clin. Nutr. 2002; PubMed Scopus Google Scholar) and (3Law M. Plant sterol and stanol margarines and health.BMJ. 2000; 320: 861-864Crossref PubMed Google Scholar, 6Hallikainen M.A. Sarkkinen E.S. Uusitupa M.I.J. Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner.J. Nutr. 2000; 130: 767-776Crossref PubMed Scopus (203) Google Scholar, 7Hendriks H.F.J. Weststrate J.A. van Vliet T. Meijer G.W. Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects.Eur. J. Clin. Nutr. 1999; 53: 319-327Crossref PubMed Scopus (377) Google Scholar, 11Miettinen T.A. Puska P. Gylling H. Vanhanen H. Vartainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population.N. Engl. J. Med. 1995; 333: 1308-1312Crossref PubMed Scopus (681) Google Scholar) to be to a hypocholesterolemic level of consumption of plant when in a fat has been shown to reduce TC and LDL cholesterol concentrations by an of 10% and Effects of dietary phytosterols on cholesterol metabolism and clinical and J. Med. 1999; Full Text Full Text PDF PubMed Scopus Google Scholar). Lack of to a between groups is on previous a of mmol/l in LDL cholesterol concentrations have been between the diets and the diet P.J.H. Ntanios F.Y. Raeini-Sarjaz M. Vanstone C.A. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men.Am. J. Clin. Nutr. 1999; 69: 1144-1150Crossref PubMed Scopus (221) Google Scholar). the in this previous was to a of mmol/l with and It be that a greater have of between treatment The in HDL cholesterol concentrations with and NFPS, but not LFPS, was previous studies have not shown any effect of plant sterol or stanol consumption on HDL cholesterol concentrations P.J.H. Ntanios F.Y. Raeini-Sarjaz M. Vanstone C.A. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men.Am. J. Clin. Nutr. 1999; 69: 1144-1150Crossref PubMed Scopus (221) Google Scholar, 9Jones P.J. Raeini-Sarjaz M. Ntanios F.Y. Vanstone C.A. Feng J.Y. Parsons W.E. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters.J. Lipid Res. 2000; 41: 697-705Abstract Full Text Full Text PDF PubMed Google Scholar, 11Miettinen T.A. Puska P. Gylling H. Vanhanen H. Vartainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population.N. Engl. J. Med. 1995; 333: 1308-1312Crossref PubMed Scopus (681) Google Scholar, C.A. Raeini-Sarjaz M. Parsons W.E. P.J.H. plant sterols and stanols lower cholesterol levels in hypercholesterolemic J. Clin. Nutr. 2002; PubMed Scopus Google Scholar). in changes in concentrations between diets be for this and reductions in LFPS reduced by recent studies to examine the of phytosterols incorporated into a fat or trials have shown that phytosterol consumption TC and LDL cholesterol concentrations by to for TC and to for LDL cholesterol M.A. Sarkkinen E.S. Uusitupa M.I.J. Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner.J. Nutr. 2000; 130: 767-776Crossref PubMed Scopus (203) Google Scholar, 7Hendriks H.F.J. Weststrate J.A. van Vliet T. Meijer G.W. Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects.Eur. J. Clin. Nutr. 1999; 53: 319-327Crossref PubMed Scopus (377) Google Scholar, 8Jones P.J.H. Ntanios F.Y. Raeini-Sarjaz M. Vanstone C.A. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men.Am. J. Clin. Nutr. 1999; 69: 1144-1150Crossref PubMed Scopus (221) Google Scholar, 9Jones P.J. Raeini-Sarjaz M. Ntanios F.Y. Vanstone C.A. Feng J.Y. Parsons W.E. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters.J. Lipid Res. 2000; 41: 697-705Abstract Full Text Full Text PDF PubMed Google Scholar, Cholesterol-lowering of enriched with plant sterols in hypercholesterolemic subjects.Eur. J. Nutr. 2001; PubMed Scopus Google Scholar, P. Effects of phytosterol margarine on plasma in to moderately are to cholesterol and fat 2002; Full Text PDF PubMed Scopus Google Scholar). trials have been to whether incorporation of phytosterols into low-fat and results in cholesterol concentrations. Lipid to incorporated into a National Cholesterol Education Program J. Clin. Nutr. 2001; PubMed Scopus Google Scholar) have reported lowering of TC concentrations by and with a fat g or g with a and LDL cholesterol lowering of and in a the of g phytosterols/day in a versus g phytosterols/day in a fat and g phytosterols/day provided in and E. and of phytosterols administered in and to men and Nutr. 2001; Scopus Google was no in cholesterol concentrations in any of the three groups with to by E. and of phytosterols administered in and to men and Nutr. 2001; Scopus Google Scholar) been when using as a for phytosterol T.A. Vanhanen H. Dietary sitostanol to and serum level of cholesterol in different Full Text PDF PubMed Scopus Google Scholar, J. H. T.A. absorption and of cholesterol of dietary sitostanol esters in hypercholesterolemic PubMed Scopus Google Scholar). These studies show a high degree of in to phytosterols incorporated into reduced fat More recent studies have the of phytosterols on plasma lipid concentrations when were incorporated into low-fat or nonfat the studies to Effects of dietary phytosterols on cholesterol metabolism and clinical and J. Med. 1999; Full Text Full Text PDF PubMed Scopus Google Scholar, R.P. M. J. van M. M. A Effects of plant stanol esters in low-fat on serum lipids and sterols and fat 2002; Full Text Full Text PDF PubMed Scopus Google Scholar, P. M. M. Cholesterol-lowering of plant sterol esters and stanols in and low-fat J. Clin. Nutr. 2001; PubMed Scopus Google Scholar, P. J. J. H. of a diet on low-fat foods enriched with plant sterols and on serum J. 2001; Full Text Full Text PDF PubMed Scopus Google Scholar, A. F. Effects of enriched with plant sterols on serum lipids in patients with moderate J. Nutr. 2001; PubMed Google have shown reductions in plasma lipid concentrations. The results of studies that the of foods that be with phytosterols as a of lowering cholesterol concentrations be to low-fat food in study In the study by P. M. M. Cholesterol-lowering of plant sterol esters and stanols in and low-fat J. Clin. Nutr. 2001; PubMed Scopus Google of the phytosterol was provided in and the incorporated in in and g phytosterols/day has been shown to be to a hypocholesterolemic T.A. Vanhanen H. Dietary sitostanol to and serum level of cholesterol in different Full Text PDF PubMed Scopus Google Scholar, J. H. T.A. absorption and of cholesterol of dietary sitostanol esters in hypercholesterolemic PubMed Scopus Google Scholar, P.J.H. Raeini-Sarjaz M. Plant sterols and their the of 2001; PubMed Scopus Google it is that the margarine cholesterol-lowering with the other low-fat foods not to the reductions In the study by P. J. J. H. of a diet on low-fat foods enriched with plant sterols and on serum J. 2001; Full Text Full Text PDF PubMed Scopus Google the fat of the foods in which phytosterols were incorporated were not In a A. F. Effects of enriched with plant sterols on serum lipids in patients with moderate J. Nutr. 2001; PubMed Google reductions in TC and LDL cholesterol concentrations of and to were with consumption of a low-fat fat by enriched with g of is no of the results of a between the and the which a lowering of and in TC and LDL cholesterol concentrations, respectively. More in TC and LDL cholesterol concentrations of and to were by Mensick R.P. M. J. van M. M. A Effects of plant stanol esters in low-fat on serum lipids and sterols and fat 2002; Full Text Full Text PDF PubMed Scopus Google Scholar) when g/day of stanols in low-fat stanols were it is whether results be using In the present consumption of sterols in and nonfat beverages did not to reductions in TC and LDL cholesterol concentrations to the beverage. A previous report E. M. P. M.E. A. Effects of stanols in in hypercholesterolemic J. Nutr. 2002; 41: PubMed Scopus Google Scholar) decreased cholesterol absorption with consumption of g/day stanols in beverage however, the of the to be efficacy in lowering plasma cholesterol concentrations. There is thus some the efficacy of nonfat and low-fat foods enriched in plant sterols in plasma lipid concentrations. In the present phytosterols were incorporated into beverages containing either no fat or g of of fat not have been to It has been shown that are not as in cholesterol absorption as (14Ostlund R.E. Spilburg C.A. Stenson W.F. Sitostanol administered in lecithin micelles potently reduces cholesterol absorption in humans.Am. J. Clin. Nutr. 1999; 70: 826-831Crossref PubMed Scopus (154) Google Scholar). of phytosterols is thus an important of of plant sterol efficacy. the of a as for phytosterols not be for their incorporation into of of a is more than for B.D. P.J. of the and oil of a in and patients with J. Clin. 28: PubMed Scopus Google Scholar). is not by the of foods or in the of the oil is by the and of dietary B.D. P.J. of the and oil of a in and patients with J. Clin. 28: PubMed Scopus Google Scholar). plant sterols consumed in foods have more time to be with which in to micelles in the of only the LFPS but not in in plasma plant sterol concentrations in the present previous controlled it have been that diets plasma plant sterol concentrations P.J.H. Ntanios F.Y. Raeini-Sarjaz M. Vanstone C.A. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men.Am. J. Clin. Nutr. 1999; 69: 1144-1150Crossref PubMed Scopus (221) Google Scholar, C.A. Raeini-Sarjaz M. Parsons W.E. P.J.H. plant sterols and stanols lower cholesterol levels in hypercholesterolemic J. Clin. Nutr. 2002; PubMed Scopus Google Scholar). was no in plasma phytosterol concentrations with consumption, it is that fat have been to absorption of In the of the LFPS the fat some phytosterol but at a level low to that lower cholesterol a level for phytosterol absorption to cholesterol which was not with and nonfat phytosterol In this study that when provided in low-fat and nonfat not to greater reductions in TC and LDL cholesterol with a The cholesterol-lowering of phytosterols thus previous into a fat matrix and on the of the be for the cholesterol-lowering action of phytosterols when they are incorporated into this show changes in plasma phytosterol incorporation of plant sterols in a beverage format is not in cholesterol reductions with a beverage. It is important that previous the cholesterol-lowering efficacy of plant sterols not be to phytosterol is thus to the efficacy of such The the of the for and the for the The Vanstone for in blood lipid concentrations, and Parsons for the the the for their was by the of low-fat with phytosterols nonfat placebo nonfat with phytosterols total cholesterol

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