Relationship between phytosterol intake and cardiovascular disease in the adult Polish population

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Plant sterols are compounds with multiple biological functions, mainly cholesterol-reducing. Although phytosterols lower LDL-cholesterol, their relationship to cardiovascular risk is unclear. Purpose To assess dietary total phytosterol, β-sitosterol, campesterol and stigmasterol and to determine the relationship between total plant sterols and the chance of cardiovascular disease (CVD) in the adult Polish population. Methods Within the frame of the National Multicenter Health Survey (WOBASZ II), a random sample of the whole Polish population aged 20 years and above was screened during the years 2013-2014. Dietary habits and an interview of a history of CVD were assessed in 2554 men and 3136 women. The international food databases were used to develop a database on plant sterols in the products consumed in Poland. Plant sterols were calculated from the amount of food consumed by the participants combined with the phytosterol content of the food. The subjects were divided according to the tertiles of total phytosterol intake – 1st tertile (mean [mg/day]); 153 (men 174; women 141); 2nd tertile – 257 (293; 233 respectively), and 3rd tertile 439 (496; 383). The logistic regression method was used to calculate the odds ratio (OR) of the occurrence of CVD in phytosterol tertiles after adjustment for age, BMI and consumption of lipid-lowering drugs, fiber, and alcohol. Results The average total plant sterol intake [mg/day] was significantly lower in subjects with CVD than in subjects without CVD (men 299 vs 326, p= 0.0016 and women 238 vs 256, p= 0.0016); β-sitosterol (186 vs 201, p= 0.0062 and 149 vs 160 p= 0.0016 respectively), campesterol (63.2 vs 70.6; p=0.0044 and 46.8 vs 51.9 p= 0.0015) and stigmasterol (24.2 vs 26.9; p=0.0017; 20.7 vs 23.1 p=0.0023). In the whole group there was a significantly lower OR=0.695 (0.528-0.916) of developing CVD in the third tertile compared to the first. In men, the odds ratios of CVD were significantly lower in the second tertile OR=0.637 (95%CI 0.445-0.911) and in the third tertile OR=0.581 (95%CI 0.372-0.907) compared to the first tertile. In women, the trends were similar, although no significant differences were shown – in the second tertile OR = 0.927 (95% CI 0.695-1.237) and in the third tertile OR=0.843 (95%CI 0.600-1.184). In addition, there was a better overall quality of nutrition in people in the third tertile of phytosterol intake compared to the first tertile. Conclusion The content of phytosterols in the diet may determine the chance of developing CVD, especially in men.