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LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies.

Abstract

Phytosterols (PS, comprising plant sterols and plant stanols) have been proven to lower LDL-cholesterol concentrations. The dose-response relationship for this effect has been evaluated in several meta-analyses by calculating averages for different dose ranges or by applying continuous dose-response functions. Both approaches have advantages and disadvantages. So far, the calculation of averages for different dose ranges has not been done for plant sterols and stanols separately. The objective of the present meta-analysis was to investigate the combined and separate effects of plant sterols and stanols when classified into different dose ranges. Studies were searched and selected based on predefined criteria. Relevant data were extracted. Average LDL-cholesterol effects were calculated when studies were categorised by dose, according to random-effects models while using the variance as weighing factor. This was done for plant sterols and stanols combined and separately. In total, 124 studies (201 strata) were included. Plant sterols and stanols were administered in 129 and fifty-nine strata, respectively; the remaining used a mix of both. The average PS dose was 2.1 (range 0.2-9.0) g/d. PS intakes of 0.6-3.3 g/d were found to gradually reduce LDL-cholesterol concentrations by, on average, 6-12%. When plant sterols and stanols were analysed separately, clear and comparable dose-response relationships were observed. Studies carried out with PS doses exceeding 4 g/d were not pooled, as these were scarce and scattered across a wide range of doses. In conclusion, the LDL-cholesterol-lowering effect of both plant sterols and stanols continues to increase up to intakes of approximately 3 g/d to an average effect of 12%.

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  • Authors+Show Affiliations

    ,

    Unilever R&D Vlaardingen,Olivier van Noortlaan 120, PO Box 114,3130 ACVlaardingen,The Netherlands.

    ,

    Division of Human Nutrition, Wageningen University,Bomenweg 2,6703 HDWageningen,The Netherlands.

    Unilever R&D Vlaardingen,Olivier van Noortlaan 120, PO Box 114,3130 ACVlaardingen,The Netherlands.

    Source

    The British journal of nutrition 112:2 2014 Jul 28 pg 214-9

    MeSH

    Adult
    Anticholesteremic Agents
    Cholesterol, LDL
    Dietary Supplements
    Evidence-Based Medicine
    Functional Food
    Humans
    Hypercholesterolemia
    Phytosterols
    Randomized Controlled Trials as Topic

    Pub Type(s)

    Comparative Study
    Journal Article
    Meta-Analysis

    Language

    eng

    PubMed ID

    24780090

    Citation

    Ras, Rouyanne T., et al. "LDL-cholesterol-lowering Effect of Plant Sterols and Stanols Across Different Dose Ranges: a Meta-analysis of Randomised Controlled Studies." The British Journal of Nutrition, vol. 112, no. 2, 2014, pp. 214-9.
    Ras RT, Geleijnse JM, Trautwein EA. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. Br J Nutr. 2014;112(2):214-9.
    Ras, R. T., Geleijnse, J. M., & Trautwein, E. A. (2014). LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. The British Journal of Nutrition, 112(2), pp. 214-9. doi:10.1017/S0007114514000750.
    Ras RT, Geleijnse JM, Trautwein EA. LDL-cholesterol-lowering Effect of Plant Sterols and Stanols Across Different Dose Ranges: a Meta-analysis of Randomised Controlled Studies. Br J Nutr. 2014 Jul 28;112(2):214-9. PubMed PMID: 24780090.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. AU - Ras,Rouyanne T, AU - Geleijnse,Johanna M, AU - Trautwein,Elke A, Y1 - 2014/04/29/ PY - 2014/5/1/entrez PY - 2014/5/2/pubmed PY - 2014/9/3/medline SP - 214 EP - 9 JF - The British journal of nutrition JO - Br. J. Nutr. VL - 112 IS - 2 N2 - Phytosterols (PS, comprising plant sterols and plant stanols) have been proven to lower LDL-cholesterol concentrations. The dose-response relationship for this effect has been evaluated in several meta-analyses by calculating averages for different dose ranges or by applying continuous dose-response functions. Both approaches have advantages and disadvantages. So far, the calculation of averages for different dose ranges has not been done for plant sterols and stanols separately. The objective of the present meta-analysis was to investigate the combined and separate effects of plant sterols and stanols when classified into different dose ranges. Studies were searched and selected based on predefined criteria. Relevant data were extracted. Average LDL-cholesterol effects were calculated when studies were categorised by dose, according to random-effects models while using the variance as weighing factor. This was done for plant sterols and stanols combined and separately. In total, 124 studies (201 strata) were included. Plant sterols and stanols were administered in 129 and fifty-nine strata, respectively; the remaining used a mix of both. The average PS dose was 2.1 (range 0.2-9.0) g/d. PS intakes of 0.6-3.3 g/d were found to gradually reduce LDL-cholesterol concentrations by, on average, 6-12%. When plant sterols and stanols were analysed separately, clear and comparable dose-response relationships were observed. Studies carried out with PS doses exceeding 4 g/d were not pooled, as these were scarce and scattered across a wide range of doses. In conclusion, the LDL-cholesterol-lowering effect of both plant sterols and stanols continues to increase up to intakes of approximately 3 g/d to an average effect of 12%. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/24780090/full_citation L2 - http://journals.cambridge.org/abstract_S0007114514000750 DB - PRIME DP - Unbound Medicine ER -