A low-fat spread with added plant sterols and fish omega-3 fatty acids lowers serum triglyceride and LDL-cholesterol concentrations in individuals with modest hypercholesterolaemia and hypertriglyceridaemia

Wendy A M Blom,Hubert Scharnagl,Tatjana Stojakovic,Harry Hiemstra,Elke A Trautwein,Wieneke P Koppenol

doi:10.1007/s00394-018-1706-1

Wendy A M Blom, Hubert Scharnagl + Show 4 more

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https://doi.org/10.1007/s00394-018-1706-1

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Abstract

PurposeThe primary and secondary objectives were to investigate the triglyceride (TG) and LDL-cholesterol (LDL-C) lowering effects of a spread with added plant sterols (PS) and fish oil as compared to a placebo spread.MethodsThis study had a randomized, double-blind, placebo-controlled, parallel group design with two intervention arms. Following a 2-week placebo run-in period, 260 healthy individuals with modestly elevated blood TG (≥ 1.4 mmol/L) and LDL-C (≥ 3.4 mmol/L) concentrations consumed either the placebo or intervention spread for 4 weeks. The intervention spread contained 2.0 g/day PS and 1.0 g/day eicosapentaenoic acid (EPA) + docosahexanoic acid (DHA) from fish oil. Fasting serum lipids and apolipoproteins (Apo) (exploratory) were measured at the end of the run-in and intervention phases.ResultsFour-week consumption of the intervention spread resulted in significantly lower TG (− 10.6%, 95% CI − 16.0 to − 4.9%; P < 0.001) and LDL-C concentrations (− 5.2%; 95% CI − 7.8 to − 2.4%) as compared to placebo. Total cholesterol (− 3.9%; 95% CI − 6.1 to − 1.5%), non-HDL-C (− 5.4%; 95% CI − 8.1 to − 2.7%), remnant-cholesterol (− 8.1%; 95% CI − 3.4 to − 12.5%), ApoAII (− 2.9%; 95% CI − 5.5 to − 0.2%), ApoCIII (− 7.7%; 95% CI − 12.1 to − 3.1%) and ApoB (− 3.2%; 95% CI − 5.9 to − 0.4%) concentrations were also significantly lower, as compared to placebo. No significant treatment effects were found for HDL-cholesterol, ApoAI, ApoCII, Apo E or ApoB/ApoAI.ConclusionsFour-week consumption of the intervention spread led to significant and clinically relevant decreases in serum TG, LDL-C and other blood lipid concentrations. The study was registered at clinicaltrials.gov (NCT 02728583).

Highlights

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally; 17.7 million of people die each year of CVD [1]
TG triglyceride, low-density lipoprotein-cholesterol (LDL-C) low-density lipoprotein cholesterol, HDL-C high-density lipoprotein cholesterol, TC total cholesterol, apo apolipoprotein, LS least square. This intervention study showed that consumption of a lowfat spread delivering 1.0 g/day of eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) from fish oil together with 2.0 g/day of plant sterols (PS) significantly lowered serum TG as well as serum LDL-C, TC, non-HDL-C and remnant-C concentrations, as compared to placebo, in a population with elevated LDL-C and borderline-high to high TG concentrations
Our findings confirm that consumption of a spread containing a recommended dose of PS and low doses of EPA + DHA can help lower both TG and LDL-C concentrations confirming that this dietary approach can contribute to maintaining low TG and LDL-C concentrations and to reducing the risk of developing CVD

Summary

Introduction

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally; 17.7 million of people die each year of CVD [1]. The most common types are cerebrovascular disease, coronary heart disease (CHD) and peripheral artery disease, many of which are related to atherosclerosis, i.e. the building up of plaque in the walls of the arteries. Elevated blood low-density lipoprotein-cholesterol (LDL-C) is the most important blood lipid risk factor of atherosclerosis [2, 3]. An emerging risk factor for the development of atherosclerosis are elevated blood triglycerides (TG). Though an association of lowering TG and reduced CVD risk is still under debate, the evidence for a causal role of

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