Background Dietary plant sterols, especially sitostanol, reduceserum cholesterol by inhibiting cholesterol absorption. Solublesitostanol may be more effective than a less soluble preparation.We tested the tolerability and cholesterol-lowering effect ofmargarine containing sitostanol ester in a population with mildhypercholesterolemia.
Methods We conducted a one-year, randomized, double-blind studyin 153 randomly selected subjects with mild hypercholesterolemia.Fifty-one consumed margarine without sitostanol ester (the controlgroup), and 102 consumed margarine containing sitostanol ester(1.8 or 2.6 g of sitostanol per day).
Results The margarine containing sitostanol ester was well tolerated.The mean one-year reduction in serum cholesterol was 10.2 percentin the sitostanol group, as compared with an increase of 0.1percent in the control group. The difference in the change inserum cholesterol concentration between the two groups was -24mg per deciliter (95 percent confidence interval, -17 to -32;P<0.001). The respective reductions in low-density lipoprotein(LDL) cholesterol were 14.1 percent in the sitostanol groupand 1.1 percent in the control group. The difference in thechange in LDL cholesterol concentration between the two groupswas -21 mg per deciliter (95 percent confidence interval, -14to -29; P<0.001). Neither serum triglyceride nor high-densitylipoprotein cholesterol concentrations were affected by sitostanol.Serum campesterol, a dietary plant sterol whose levels reflectcholesterol absorption, was decreased by 36 percent in the sitostanolgroup, and the reduction was directly correlated with the reductionin total cholesterol (r = 0.57, P<0.001).
Conclusions Substituting sitostanol-ester margarine for partof the daily fat intake in subjects with mild hypercholesterolemiawas effective in lowering serum total cholesterol and LDL cholesterol.
Source Information
From the Department of Medicine, Division of Internal Medicine, University of Helsinki (T.A.M., H.G., H.V.), and the Department of Epidemiology and Health Promotion, National Public Health Institute (P.P., E.V.) — both in Helsinki, Finland.
Address reprint requests to Dr. Miettinen at the Department of Medicine, Division of Internal Medicine, University of Helsinki, Haartmaninkatu 4, FIN-00290 Helsinki, Finland.
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