Dietary intake of plant sterols in cardiovascular diseases: a population-based study of Polish adults

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology, Warsaw, Poland Introduction. Cardiovascular diseases (CVD) are a major cause of premature mortality and disability in developed countries. Among various risk factors, disorders of lipid metabolism are prevalent. Scientific evidence shows that plant sterols have a positive effect on dyslipidemia. The primary mechanism of hypolipemic effect of plant sterols is inhibition of cholesterol absorption in the small intestine, and this effect depends on the dose. Purpose. The aim of the study was to determine the intake of plant sterols, which was never studied in the Polish population. Methods. In total, 5690 participants of the population-based cross-sectional Polish National Multicenter Health Examination Survey WOBASZ II (2013-2014), aged 20+, were evaluated in the study (1). Nutritional data were collected using a single 24-hour dietary recall method. A dietary plant sterol database was compiled from available experimental data including total and individual plant sterols such as β-sitosterol, campesterol and stigmasterol. Plant sterol intakes were calculated taking into account plant sterol contents in individual food products and the volume of food consumption. Statistical calculations were performed using Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA). Results. The dietary plant sterol intake (DPSI) for the general population, 283 mg/day, was dependent on the age and gender. The intake of sterols among people over 65 years of age (264 mg/day in men and 208 mg/day in women) was lower than in younger age groups (20-44 years) of participants (343 mg/day in men and 259 mg/day in women). The main dietary plant sterol for both genders was β-sitosterol (∼62% of intake), followed by campesterol (∼21%) and stigmasterol (∼9%). Overall, men and women with cardiovascular disease had significantly lower DPSI (p > 0.002) than men and women without cardiovascular disease, 298.6 and 237.8 vs. 326.1 and 255.9 mg/d, respectively, and men but not women with diabetes had significantly (p > 0.04) lower DPSI than men without diabetes, 301.7 vs. 323.3, respectively. Conclusions. In the view of current recommendations to lower cholesterol, this research confirms findings for other populations, that the dietary intake of plant sterols in the Polish population is insufficient to beneficially modulate lipid metabolism, especially in CVD and diabetic patients.