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Stanol-heavy diet lowers cholesterol

Adding plant stanol-enriched foods to the diet of people taking maximum-dose statins has clinical relevance for cardiovascular health, reports research from Holland into a population of patients not previously studied for such dietary interventions. High cholesterol levels have had a long association with many diseases, particularly cardiovascular disease.

Numerous controlled clinical trials have reported that daily consumption of 1.5 to 3 grams of phytosterols/stanols can reduce total cholesterol levels by eight to 17 per cent, representing a significant reduction in the risk of cardiovascular disease. Whether plant stanol interventions in people already getting optimal statin treatments could impact cholesterol levels remains unknown and requires further study.

The new research, published in the October issue of the Journal of the American Dietetic Association, recruited 20 hypercholesterolaemic patients at the outpatient clinic of the Department of Vascular Medicine of the University Medical Center Utrecht. All the patients had been receiving the optimal daily dose of statins without change for six months. The single-blinded, randomized study assigned subjects to receive either a plant stanol-enriched margarine or a comparable stanol-free margarine for six weeks. The fat content for each margarine was the same.

The subjects' daily intake of the margarines was between 30 and 35 grams, providing the stanol group with the recommended daily stanol intake of three grams. The researchers reported the stanol group had lower plasma cholesterol and LDL cholesterol at the end of the intervention period. Levels of the apolipoprotein B (ApoB) also decreased by 10.8 percent. ApoB is the main apolipoprotein of LDL cholesterol and is responsible for the transport of cholesterol to tissues. In high concentrations it has been linked to plaque formation in the blood vessels, although the mechanism behind this is not clear.

The control group (patients consuming stanol-free margarine and taking high-dose statins) only had reductions in LDL-cholesterol levels and not total cholesterol levels. No difference in triglyceride levels was observed and the researchers state the differences between the LDL-cholesterol and ApoB levels was not statistically significant between the groups.