Abstract
BackgroundMany studies showed a moderate cholesterol-lowering effect of plant sterols (PS), but increased circulating PS might be atherogenic. We evaluated the associations between natural dietary intake of PS and carotid intima–media thickness (IMT) and serum lipids.Methodology/Principal FindingsThis community-based cross-sectional study included 1160 men and 2780 women aged 31–75 years. Dietary intakes were assessed using a food-frequency questionnaire. The IMTs at the common, bifurcation and internal carotid artery segments, and fasting serum total (TC), LDL (LDLc) and HDL (HDLc) cholesterol, and triglycerides (TG) were determined. After adjusting for potential covariates, multivariate analysis showed a dose-dependent inverse association of total PS intake with serum TC, LDLc, non-HDLc in women (P<0.001) and in men (P<0.05). As compared to the lowest quartile of PS intake (<206 mg/d), the multivariate-adjusted means of TC, LDLc and non-HDLc in the highest quartile of PS intake (447 mg/d) decreased by 5.0%, 6.2% and 6.5% in women (P<0.005), and by 6.4%, 7.1% and 6.7% (P>0.05) in men. Although the IMTs tended to be lower with greater intake of dietary PS, only small differences in the left internal IMT between the highest and lowest groups were observed among men (−7.6%) and women (−5.1%) (P<0.05). The multivariate analysis showed no significant mean differences among the PS groups in HDLc, TG and IMTs at other studied sites among men and women (all P>0.05).ConclusionsGreater PS consumption from natural diets is associated with lower serum total, LDL, non-HDL cholesterol and with thinner left internal IMT in women and men.
Highlights
Low-density lipoprotein (LDL) is the major atherogenic lipoprotein
Greater plant sterols (PS) consumption from natural diets is associated with lower serum total, LDL, non-HDL cholesterol and with thinner left internal intima–media thickness (IMT) in women and men
A recent meta-analysis including 84 randomized controlled trials (RCTs) suggests that 2.15 g/d PS added in fat matrices lowers LDL cholesterol (LDLc) concentration by 8.8% [2]
Summary
Low-density lipoprotein (LDL) is the major atherogenic lipoprotein. It is the primary target in the reduction of serum cholesterol and in the prevention of cardiovascular diseases (CVD) [1]. A reduction in LDL cholesterol (LDLc) of 10% would reduce the incidence of coronary heart disease (CHD) by 10–20% [1]. Plant sterols (PS) are a group of non-nutritive but bioactive compounds naturally present in all plant origin foods. They are structurally similar to cholesterol and can inhibit cholesterol absorption. Many studies showed a moderate cholesterol-lowering effect of plant sterols (PS), but increased circulating PS might be atherogenic. We evaluated the associations between natural dietary intake of PS and carotid intima–media thickness (IMT) and serum lipids
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