Benefits Of Cholesterol Lowering Research Articles

Maximizing cholesterol-lowering benefits of soy protein isolate by glycation with soy soluble polysaccharide

The cholesterol-lowering benefits of two by-products of soybean processing, soy protein isolate (SPI) and soy soluble polysaccharide (SSPS), have been well known in the field, but it remains to be determined whether the combined use of both ingredients can produce synergic benefiting effects. In the work, we reported that the glycation with SSPS with increasing degrees of glycation (DG) progressively improved the potential cholesterol-lowering benefits of SPI. The cholesterol-lowering benefits were evaluated with an in vitro pepsin-trypsin digestion model, by determining the cholesterol-lowering activities (including cholesterol and bile acids binding capacities, and inhibition of micellar cholesterol solubilization) of the gastrointestinal digests. As compared with the conventional heating method (at 60 °C for 7 days under controlled relative humidity conditions), the microwave treatment was much more efficient and effective to form covalent SPI-SSPS conjugates with excellent cholesterol-lowering benefits. An extensive glycation (e.g., with DG values > 40%) significantly inhibited the hydrolysis of the proteins by the proteases, and greatly facilitated the formation of insoluble aggregates during the post digestion. The remarkably improved cholesterol-lowering benefits of the extensively glycated SPIs with SSPS could be largely attributed to the enhanced tendency to form the insoluble aggregates in the digests. In contrast, the improved benefits of the moderately glycated SPIs might be mainly associated with the formation of micelle-like SPI-SSPS conjugate assemblies in the digests. This is the first report to indicate that proteins and polysaccharides may produce synergic cholesterol-lowering benefits. Considering that both SPI and SSPS are important food ingredients, the results may have great implications for the development of plant protein-based functional foods with outstanding cholesterol-lowering benefits. • The glycation with soy soluble polysaccharide greatly improved the cholesterol-lowering activities of SPI. • The microwave-assisted glycation was more effective than the conventional dry heat method. • The improved benefits of SPI were largely due to the facilitated formation of insoluble aggregates. • The synergic cholesterol-lowering effects of proteins and polysaccharides were first reported.

The Impact of Dietary Consumption of Palm Oil and Olive Oil on Lipid Profile and Hepatocyte Injury in Hypercholesterolemic Rats.

A metabolic disease called hypercholesterolemia is connected to both oxidative damage and inflammation. The goal of the current investigation was to determine if olive oil and palm oil could prevent hypercholesterolemia-induced oxidative stress in the liver of rats fed a high-cholesterol diet (HCD). The experimental mice were given HCD for three months while also receiving 0.5 mL/kg of either palm or olive oil. Serum triglycerides, total cholesterol, LDL cholesterol, vLDL cholesterol, and the atherogenic index all significantly increased in HCD-fed rats, while HDL cholesterol significantly dropped. Additionally, HCD caused a notable rise in proinflammatory cytokines and serum transaminases in liver tissue. Additionally, HCD significantly increased the production of nitric oxide and lipid peroxidation in the liver while decreasing antioxidant enzymes. Treatment with palm and olive oils dramatically reduced the levels of pro-inflammatory cytokines and lipid peroxidation, improved antioxidant defenses, and considerably improved liver function indicators. Additionally, the examined oils dramatically decreased the expression of fatty acid synthase (FAS) in the liver of rats receiving HCD. In conclusion, HCD-fed rats exhibit significant antihyperlipidemic and cholesterol-lowering benefits from palm and olive oils. The improved antioxidant defenses, lower inflammation and lipid peroxidation, and altered hepatic FAS mRNA expression were the main mechanisms by which palm and olive oils produced their advantageous effects.

Interactions Between Statins, Exercise, and Health: A Clinical Update

Interactions Between Statins, Exercise, and Health: A Clinical Update

Comparative Effect of Bergamot Polyphenolic Fraction and Red Yeast Rice Extract in Rats Fed a Hyperlipidemic Diet: Role of Antioxidant Properties and PCSK9 Expression.

Elevated serum cholesterol levels, either associated or not with increased triglycerides, represent a risk of developing vascular injury, mostly leading to atherothrombosis-related diseases including myocardial infarction and stroke. Natural products have been investigated in the last few decades as they are seen to offer an alternative solution to counteract cardiometabolic risk, due to the occurrence of side effects with the use of statins, the leading drugs for treating hyperlipidemias. Red yeast rice (RYR), a monacolin K-rich natural extract, has been found to be effective in counteracting high cholesterol, being its use accompanied by consistent warnings by regulatory authorities based on the potential detrimental responses accompanying its statin-like chemical charcateristics. Here we compared the effects of RYR with those produced by bergamot polyphenolic fraction (BPF), a well-known natural extract proven to be effective in lowering both serum cholesterol and triglycerides in animals fed a hyperlipidemic diet. In particular, BPF at doses of 10 mg/Kg given orally for 30 consecutive days, counteracted the elevation of both serum LDL cholesterol (LDL-C) and triglycerides induced by the hyperlipidemic diet, an effect which was accompanied by significant reductions of malondialdehyde (MDA) and glutathione peroxidase serum levels, two biomarkers of oxidative stress. Furthermore, the activity of BPF was associated to increased HDL cholesterol (HDL-C) levels and to strong reduction of Proprotein convertase subtilisin/kexin type 9 (PCSK9) levels which were found increased in hyperlipidemic rats. In contrast, RYR at doses of 1 and 3 mg/Kg, produced only significant reduction of LDL-C with very poor effects on triglycerides, HDL-C, glutathione peroxidase, MDA and PCSK9 expression. This indicates that while BPF and RYR both produce serum cholesterol-lowering benefits, BPF produces additional effects on triglycerides and HDL cholesterol compared to RYR at the doses used throughout the study. These additional effects of BPF appear to be related to the reduction of PCSK9 expression and to the antioxidant properties of this extract compared to RYR, thereby suggesting a more complete protection from cardiometabolic risk.

Mild preheating improves cholesterol-lowering benefits of soy protein via enhancing hydrophobicity of its gastrointestinal digests: An in vitro study

Although the cholesterol-lowering benefits of soy proteins have been well recognized for a long time, the importance of protein structural characteristics to their cholesterol-lowering activities is little understood. In the work, we reported that a mild preheating at 95 °C for 20 min could remarkably improve the cholesterol-lowering activities of soy protein isolate (SPI) after an in vitro simulated pepsin-pancreatin digestion, including cholesterol and bile acids binding capacities (CBC and BBC), and inhibition of micellar cholesterol solubility (MCI), while an extensive preheating at 121 °C contrarily impaired its potential. The improvement of the cholesterol-lowering activities of the pepsin-pancreatin digest by the mild preheating was largely associated with the facilitated formation of digestion-induced peptide aggregates with high surface hydrophobicity (Ho) in the digest. The final pepsin-pancreatin digest of the mildly preheated SPI could be fractionated using a gradient ethanol precipitation technique at ethanol concentrations of 20–80% (v/v). The Ho and cholesterol-lowering activities of peptides in the resultant precipitate or supernatant fractions considerably varied. The ethanol-precipitated fractions at ethanol concentrations of 40–80%, with high Ho but low solubility (in water), largely contributed to the CBC of the digest, while all the precipitates obtained at ethanol concentrations of 20–80% dominated the BBC of the digest. In contrast, the soluble peptides in 80% ethanol were mainly responsible for the high potential of the digest to inhibit micellar cholesterol solubilization. In general, a good positive relationship between the CBC (or BBC) and Ho could be well observed for the pepsin-pancreatin digests of SPI, or their fractions. The MCI of the mildly preheated SPI digest was largely ascribed to the action of soluble peptides in 80% ethanol. The results demonstrated that the choice of preheating conditions (especially temperature) is of vital importance for optimal cholesterol-lowering benefits of soy proteins. The findings are also of interest for understanding the molecular mechanisms of the cholesterol-lowering activities of soy proteins.

Oat and Barley in the Food Supply and Use of Beta Glucan Health Claims.

Beta glucan is a type of soluble dietary fibre found in oats and barley with known cholesterol-lowering benefits. Many countries globally have an approved beta glucan health claim related to lowering blood cholesterol, an important biomarker for cardiovascular disease. However, the use of these claims has not been examined. The aim of this study was to explore the range and variety of oat and barley products in the Australian and global market within a defined range of grain food and beverage categories and examine the frequency of beta glucan health claims. Australian data were collected via a recognised nutrition audit process from the four major Australian supermarkets in metropolitan Sydney (January 2018 and September 2020) and Mintel Global New Product Database was used for global markets where a claim is permitted. Categories included breakfast cereals, bread, savoury biscuits, grain-based muesli bars, flour, noodles/pasta and plant-based milk alternatives and information collected included ingredients lists and nutrition and health claims. Products from Australia (n = 2462) and globally (n = 44,894) were examined. In Australia, 37 products (1.5%) made use of the beta glucan claim (84% related to oat beta glucan and 16% related to barley beta glucan, specifically BARLEYmax®). Of products launched globally, 0.9% (n = 403) displayed beta glucan cholesterol-lowering claims. Despite the number of products potentially eligible to make beta glucan claims, their use in Australia and globally is limited. The value of dietary modification in cardiovascular disease treatment and disease progression deserves greater focus, and health claims are an opportunity to assist in communicating the role of food in the management of health and disease. Further assessment of consumer understanding of the available claims would be of value.

Psyllium

Psyllium is a natural, predominantly soluble isolated fiber that forms a gel when hydrated. The psyllium gel is not fermented and transits the entire gastrointestinal tract intact. In the small intestine, the psyllium gel increases chyme viscosity, which slows the degradation and absorption of nutrients, which significantly improves fasting blood glucose and hemoglobin A1c levels in individuals with metabolic syndrome and type 2 diabetes mellitus (eg, −37 mg/dL). This delay in nutrient absorption prolongs satiety/delays hunger, leading to decreased energy intake and weight loss in overweight and obese patients. In the distal small intestine (terminal ileum), psyllium becomes more concentrated as water is absorbed, and the highly viscous gel interferes with the active reuptake of bile acids, which are captured in the gel and eliminated via stool. This decrease in the bile acid pool stimulates the liver to produce more bile. As cholesterol is a component of bile, the liver expresses low-density lipoprotein (LDL) cholesterol receptors to harvest LDL-cholesterol from the blood, thereby lowering both LDL-cholesterol (up to 24%) and total cholesterol (up to 20%) levels without affecting high-density lipoprotein cholesterol level. The cholesterol-lowering benefit of psyllium is also additive to the effects of statin drugs, with an effect equivalent to doubling the statin dose. In the large intestine, the nonfermented psyllium gel has a paradoxical “stool normalizing” effect: psyllium softens hard stool in constipation, firms loose/liquid stool in diarrhea, and normalizes stool form/reduces symptoms in irritable bowel syndrome. Psyllium is the only fiber recommended for treatment of constipation and irritable bowel syndrome by the American College of Gastroenterology. Taken together, psyllium is the only fiber supplement that provides 5 of the major health benefits identified by the Food and Drug Administration (cholesterol lowering, improved glycemic control, decreased energy intake/weight loss, decreased blood pressure secondary to weight loss, and laxation/regularity). Psyllium has also been shown clinically to be effective in disease states (eg, hypercholesterolemia, type 2 diabetes, obesity, chronic constipation, chronic diarrhea, hemorrhoids, ulcerative colitis, enteral nutrition–induced diarrhea, fecal incontinence, and irritable bowel syndrome). Taken together, the clinical data support the conclusion that “Fiber needs to gel to keep your patients well.”

Analysis of Omega-3 Fatty Acid Content in Fish Oil Products

Background: Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosehexaenoic acid (DHA), often found in fish oil supplements, have been linked to cardiovascular benefits in proper doses. Objectives: Quantify serving sizes and EPA and DHA content of fish oil products and determine which products contain appropriate amounts of EPA and DHA per serving to lower cholesterol. Methods: Products were identified through the National Institutes of Health’s Dietary Supplement Label Database using the search term “fish oil.” Product labels were reviewed for EPA and DHA content. The number of units, such as capsules, gummies, or milliliters, necessary to obtain a total of at least 2,000 mg of EPA and DHA was also evaluated. Descriptive statistics were used to report findings. Results: Of 493 products identified, 231 products were analyzed. Two (0.9%) products, both of which were liquid formulations, contained at least 2,000 mg of EPA and DHA in the standard serving size listed on the labeling. The total amount of EPA and DHA per serving ranged from 60.2 mg to 2684 mg with an average of 697 mg. The number of servings necessary to achieve 2,000 mg of EPA and DHA ranged from 1 to 34 servings with an average of 5 servings. Conclusions: Serving sizes of fish oil products rarely result in adequate EPA and DHA intake to provide cholesterol-lowering benefit. Instruction by a trained healthcare professional, such as a pharmacist, is important to ensure patients are taking an appropriate serving of fish oil to obtain cardiovascular benefit.

LDL-cholesterol lowering and clinical outcomes in hypercholesterolemic subjects with and without a familial hypercholesterolemia phenotype: Analysis from the secondary prevention 4S trial

Background and aimsTrial evidence for the benefits of cholesterol-lowering is limited for familial hypercholesterolemia (FH) patients, since they have not been the focus of large outcome trials. We assess statin use in coronary artery disease (CAD) subjects with low-density lipoprotein cholesterol (LDL-C) ≥4.9 mmol/L with or without an FH phenotype. MethodsThe 4S trial randomized hypercholesterolemic CAD patients to simvastatin or placebo. We first stratified participants into baseline LDL-C <4.9 and ≥ 4.9 mmol/L; next, based on the DLCN criteria for FH, the latter group was stratified into four subgroups by presence of none, one or both of “premature CAD” and “family history of CAD”. Participants having both are defined as having an FH phenotype. Results2267 and 2164 participants had LDL-C <4.9 and ≥ 4.9 mmol/L, respectively. Mortality endpoints and major coronary events (MCE) were significantly reduced with simvastatin versus placebo in both groups over 5.4 years, but the latter derived greater absolute risk reductions (ARR) (4.1–4.3% for mortality endpoints, versus 2.5–2.8%).LDL-C reductions were similar among the 4 subgroups with levels ≥4.9 mmol/L. Participants with FH phenotype (n = 152) appeared to derive greater relative benefits with simvastatin than the other three subgroups (all-cause death: 84% relative risk reduction, p = 0.046; MCE: 55% reduction, p = 0.0297); statistical interaction was non-significant. Participants with FH phenotype derived greater ARR than any other group with simvastatin versus placebo (all-cause mortality: 6.6% ARR; MCE 13.2%; versus 3.8% and 8.3%, respectively, among participants with LDL-C ≥4.9 mmol/L but without features suggestive of FH). ConclusionsThe FH phenotype appeared to be associated with greater clinical benefits from a given magnitude of LDL-C reduction as compared to individuals without FH phenotype.

Does the Benefit of Cholesterol-Lowering of a Given Magnitude Depend on the Drug Intervention Used?

Does the Benefit of Cholesterol-Lowering of a Given Magnitude Depend on the Drug Intervention Used?

High Molecular Weight Barley β-Glucan Alters Gut Microbiota Toward Reduced Cardiovascular Disease Risk.

The physiological cholesterol-lowering benefits of β-glucan have been well documented, however, whether modulation of gut microbiota by β-glucan is associated with these physiological effects remains unknown. The objectives of this study were therefore to determine the impact of β-glucan on the composition of gut microbiota in mildly hypercholesterolemic individuals and to identify if the altered microbiota are associated with bioactivity of β-glucan in improving risk factors of cardiovascular disease (CVD). Using a randomized, controlled crossover study design, individuals received for 5-week either a treatment breakfast containing 3 g high molecular weight (HMW), 3 g low molecular weight (LMW), 5 g LMW barley β-glucan, or wheat and rice. The American Heart Association (AHA) diet served as the background diet for all treatment groups. Phases were separated by 4-week washout periods. Fecal samples were collected at the end of each intervention phase and subjected to Illumina sequencing of 16S rRNA genes. Results revealed that at the phylum level, supplementation of 3 g/d HMW β-glucan increased Bacteroidetes and decreased Firmicutes abundances compared to control (P < 0.001). At the genus level, consumption of 3 g/d HMW β-glucan increased Bacteroides (P < 0.003), tended to increase Prevotella (P < 0.1) but decreased Dorea (P < 0.1), whereas diets containing 5 g LMW β-glucan and 3 g LMW β-glucan failed to alter the gut microbiota composition. Bacteroides, Prevotella, and Dorea composition correlated (P < 0.05) with shifts of CVD risk factors, including body mass index, waist circumference, blood pressure, as well as triglyceride levels. Our data suggest that consumption of HMW β-glucan favorably alters the composition of gut microbiota and this altered microbiota profile associates with a reduction of CVD risk markers. Together, our study suggests that β-glucan induced shifts in gut microbiota in a MW-dependent manner and that might be one of the underlying mechanisms responsible for the physiological benefits of β-glucan.

Low dose chromium-polynicotinate or policosanol is effective in hypercholesterolemic children only in combination with glucomannan

ObjectiveA low-fat, fiber-rich diet is the first step in the management for hypercholesterolemic children. Glucomannan (GM) is a natural fiber that has been demonstrated to lower total and LDL-cholesterol. The use of high-dose chromium-polynicotinate (CP) and policosanol (PC) has also shown cholesterol-lowering benefits. We aimed at investigating the effects of low-dose CP or PC and their GM combination in hypercholesterolemic children. MethodsA double-blind trial was conducted in 120 children (60 M, 60 F, 9 ± 4 years, median 9.6 years, range: 3–16 years) randomly assigned to 5 neutraceutical and 1 placebo (only resistant starch) 8-week treatment groups. Fasting blood glucose (FBG), total cholesterol (CholT), triglycerides (TG), HDL and LDL cholesterol were considered. ResultsGM combination of low-dose CP or PC reduced CholT and LDL without changing HDL, TG and FBG. The highest post-treatment changes were seen after GM combination with CP (CholT 85 ± 3% and LDL 85 ± 5%, of pretreatment) which was significantly (p < 0.01) less than with low-dose CP or PC and starch. When GM was associated with starch, there was no lipid lowering effect, which was an unexpected finding as compared to previous data with GM and no starch. No adverse effects were reported. ConclusionThis is the first report to show the cholesterol-lowering efficacy of GM combined treatment with low-dose CP or PC. Further studies are needed to investigate the best combinations and doses of nutraceutics to be added to the standard GM treatment. The potential negative association of GM and nutraceutics with starch is clearly shown.

Beneficios dietéticos asociados a la ingesta habitual de dosis moderadas de fitoesteroles presentes de forma natural en los alimentos

BackgroundRecently it has been shown that the regular intake of moderate amounts of naturally-occurring phytosterols affects whole-body cholesterol metabolism giving rise to lower serum levels. The aim of the study was to describe the dietary pattern of a population from the region of Aragon (Spain) with a moderate consumption of phytosterols, to identify the major food groups involved, and to investigate the relationship between phytosterol intake and several dietary factors related to cardiovascular health. MethodsA total of 85 healthy volunteers were studied as regards their dietary habits (using a validated food frequency questionnaire). Subjects were classified into tertiles of phytosterol intake and differences regarding foods, nutrients and other dietary components affecting cardiovascular health consumption as well as the adherence degree to the Mediterranean diet pattern were assessed. ResultsA higher phytosterols intake was associated with a higher consumption of fresh fruits and nuts, vegetables and vegetable oils, and lower in meat and pre-cooked meals. Furthermore, it was associated with higher level of unsaturated fat, total fibre intake, antioxidant capacity of the diet and phytosterols/cholesterol ratio, as well as a lower of cholesterol intake and cholesterol-saturated fat index. Finally, phytosterols intake correlated positively with the degree of adherence to the Mediterranean diet. ConclusionThe regular intake of moderate amounts of naturally-occurring phytosterols, besides having cholesterol lowering benefits per se, is associated with other dietetic factors related to the prevention of cardiovascular disease. The recommendation of increasing the regular intake of phytosterols source foods is completely justified.

Lipid-lowering drugs and control of hypercholesterolemia in Poland: recent evidence

The role of hypercholesterolemia as a risk factor for cardiovascular disease has been well-documented. Hypercholesterolemia is the most prevalent modifiable risk factor in Poland. Despite the fact that the benefits of cholesterol lowering have been known for a long time, the therapeutic goals recommended by guidelines are still often not attained in clinical practice. Only 3% of Poles with hypercholesterolemia achieve recommended cholesterol levels, and the rate of reaching recommended goals among patients receiving lipid-lowering drugs is low, approximately 30%. Control of hypercholesterolemia is not satisfactory also in patients with ischemic heart disease. The introduction of new statins, use of higher statin doses, and the evidence pointing to the effectiveness of combination therapy have provided us with effective tools whose broad application in everyday practice may lead to a significant improvement in the control of hypercholesterolemia in Poland.

Phytosterols differentially influence ABC transporter expression, cholesterol efflux and inflammatory cytokine secretion in macrophage foam cells

Phytosterol supplements lower low-density lipoprotein (LDL) cholesterol, but accumulate in vascular lesions of patients and limit the anti-atherosclerotic effects of LDL lowering in apolipoprotein E (Apo E)-deficient mice, suggesting that the cholesterol-lowering benefit of phytosterol supplementation may not be fully realized. Individual phytosterols have cell-type specific effects that may be either beneficial or deleterious with respect to atherosclerosis, but little is known concerning their effects on macrophage function. The effects of phytosterols on ABCA1 and ABCG1 abundance, cholesterol efflux and inflammatory cytokine secretion were determined in cultured macrophage foam cells. Among the commonly consumed phytosterols, stigmasterol increased expression of ABCA1 and ABCG1 and increased efflux of cholesterol to apolipoprotein (Apo) AI and high-density lipoprotein (HDL). Campesterol and sitosterol had no effect on ABCA1 or ABCG1 levels. Sitosterol had no effect on cholesterol efflux to Apo AI or HDL, whereas campesterol had a modest but significant reduction in cholesterol efflux to HDL in THP-1 macrophages. Whereas stigmasterol blunted aggregated LDL (agLDL) induced increases in tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-1β secretion, sitosterol exacerbated these effects. The presence of campesterol had no effect on agLDL-induced inflammatory cytokine secretion from THP-1 macrophages. In conclusion, the presence of stigmasterol in modified lipoproteins promoted cholesterol efflux and suppressed inflammatory cytokine secretion in response to lipid loading in macrophage foam cells. While campesterol was largely inert, the presence of sitosterol increased the proinflammatory cytokine secretion.

Purified black tea theaflavins and theaflavins/catechin supplements did not affect serum lipids in healthy individuals with mildly to moderately elevated cholesterol concentrations

Ingestion of tea flavonoids found in both green and black tea is linked to cardiovascular health benefits such as lowering serum lipids. Evidence for a cholesterol-lowering benefit of green or black tea consumption from human intervention studies is, however, conflicting and active components responsible for the effect have not yet been clearly identified. In a randomized, double-blind, placebo-controlled, parallel design study the effects of ingesting a purified black tea theaflavins (TFs) powder alone or in combination with catechin (TFs/catechins) on lowering serum total (TC) and LDL-cholesterol (LDL-c) were assessed. In total, 102 mildly to moderately hypercholesterolemic (TC and LDL-c: 5.70 +/- 0.74 and 3.97 +/- 0.61 mmol/L, respectively) subjects (67 men and 35 women) were randomly assigned to consume once daily one capsule of one of the 3 treatments: TFs (providing 77.5 mg), TFs/catechins (providing 75.0 mg TFs plus 150.0 mg catechins and 195.0 mg of other polyphenols), or placebo (cellulose). Serum TC and LDL-c concentrations did not differ significantly among the 3 treatments as assessed at 4, 8, and 11 weeks using analysis of covariance (p = 0.1187 and p = 0.1063, respectively). Although changes over time from baseline to week 11 were significant for TC and LDL-c (p = 0.0311 and p = 0.0269, respectively), this decrease over time was seen in the TFs and placebo groups. In this human intervention study, no statistically significant LDL-c lowering effect was seen with either TFs alone or the TFs/catechins combination as compared to placebo. Based on these findings it cannot be concluded that tea flavonoids such as theaflavins and catechins are responsible for a putative cholesterol-lowering effect of black tea, at least not with the daily dose applied in the present study.

Lipoprotein effects of combined ezetimibe and colesevelam hydrochloride versus ezetimibe alone in hypercholesterolemic subjects: a pilot study

Two drug classes act in the intestine to lower cholesterol. Ezetimibe inhibits cholesterol absorption, whereas bile acid–binding resins enhance cholesterol excretion via enhanced conversion to bile acids. Combining these 2 classes may be beneficial, but cholestyramine binds ezetimibe, and the combined effect of colesevelam hydrochloride and ezetimibe was little studied. The aim of the study was to determine if adding colesevelam HCl to ezetimibe provides additional lowering of low-density lipoprotein– and apolipoprotein B–containing lipoproteins or alters ezetimibe levels. Twenty subjects with low-density lipoprotein cholesterol (LDL-C) levels of 130 mg/dL or higher were enrolled and taught a National Cholesterol Education Program Step I diet. At a second baseline visit, lipoproteins were measured and subjects were randomly allocated to (1) ezetimibe 10 mg daily with placebo colesevelam HCl twice daily (E) or (2) ezetimibe 10 mg daily with 1.875 g colesevelam HCl twice daily (E + C). Lipoproteins were measured 6 and 12 weeks after initiating treatment. Baseline characteristics (mean ± SD) were statistically indistinguishable in E vs E + C: LDL-C (mg/dL), 167 ± 26 and 158 ± 27; triglyceride, 134 ± 75 and 140 ± 67; and BMI, 29.4 ± 4.9 and 27.8 ± 6.6 kg/m 2, respectively. Percent changes after 12 weeks in E vs E + C were as follows: LDL-C, −24 ± 12 vs −30 ± 11 ( P = .102); triglyceride, −19 ± 34 vs 36 ± 85 ( P = .054; at 6 weeks, P = .009); total cholesterol, −19 ± 9 vs −15 ± 8 ( P = .50); non–high-density lipoprotein cholesterol, −25 ± 10 vs −21 ± 11 ( P = .70); apolipoprotein B, −31 ± 14 vs −22 ± 14 ( P = .41). Plasma ezetimibe levels at 12 weeks were 21% lower in E + C vs E, a nonsignificant difference ( P = .54). In conclusion, in the short term, colesevelam HCl may not consistently add cholesterol-lowering benefit to ezetimibe. This observation requires confirmation.

Hypocholesterolemic Action of Fermented Brown Rice Supplement in Cholesterol‐Fed Rats: Cholesterol‐lowering Action of Fermented Brown Rice

ABSTRACT:Fermented rice products have been implicated in vascular injury and atherosclerosis in recent animal and human studies. In the current study, whether consumption of differently processed brown rice diets may change the cholesterol metabolism was evaluated in male Spraque Dawley (SD) rats after 28 d of treatment with diets containing 1% cholesterol. The experimental diets include corn starch alone as control diet (CO) or a diet containing a 50% substitute of CO; uncooked brown rice (UB), cooked brown rice (CB), lactic acid bacteria (LAB), brown rice mixed with LAB (BLAB), and fermented‐brown rice by LAB (FB), respectively. Among them, FB group elicited significantly lower levels of plasma and hepatic triglycerides, plasma total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), and very low‐density lipoprotein cholesterol (VLDL‐C) by 33% to 50%, whereas higher levels of HDL‐C were elicited by 227% compared with the CO group (P &lt; 0.05). These amelioration action on lipid profile in FB group appeared to correspondent to the higher excretions of fecal weight, triglyceride (TG), total cholesterol (TC), and bile acid (P &lt; 0.05). Furthermore, sensory properties such as flavor liking, taste liking, and overall acceptability of the diet were significantly improved by the addition of fermented brown rice. Conclusively, fermented‐brown rice may have a potent cholesterol‐lowering benefits with sensory quality improvement of the diet.

Cholesterol-Lowering Benefits of Oat-Containing Cereal in Hispanic Americans

This randomized, controlled trial of cholesterol lowering by an oat bran cereal containing beta glucan vs a corn cereal without soluble fiber in Hispanic Americans was conducted for 11 weeks. One-hundred fifty-two men and women, ages 30 to 70 years, with baseline low-density lipoprotein cholesterol (LDL-C) levels between 120 and 190 mg/dL and triglycerides <400 mg/dL were included. After eating a National Cholesterol Education Program Step 1 diet for 5 weeks, subjects were randomly assigned to the corn or the oat cereal for the next 6 weeks. The daily dose of beta glucan was 3 g. Consumption of oat cereal was associated with a reduction in plasma levels of both total cholesterol (−10.9±21.6 mg/dL; –4.5%) and LDL-C (−9.4±20.3 mg/dL; −5.3%). Consumption of corn cereal did not affect either total cholesterol (+1.2±18.3 mg/dL; 1.1%) or LDL-C (+1.2±17.5 mg/dL; 2.2%). Differences between the effects of the two cereals on total cholesterol and LDL-C were significant, P=.0003 and P=.0007, respectively.

The Influence of Recruitment Training on Serum Lipid Shifts

We followed 930 healthy men who did not alter their habit of smoking cigarettes or ingesting alcohol for 3 months in a recruitment-training course. Lipid profiles were checked on two separate occasions 3 months apart. Smokers had lower high-density lipoprotein (HDL) cholesterol levels then nonsmokers before initiating the recruitment training. The average amount of exercise increased mildly by the evaluation of Borg score (p = 0.0004). There was a statistically significant difference in body weight reduction from 65.3 +/- 11.2 kg to 64.7 +/- 10.1 kg (p < 0.0001). In univariate analysis, there was an 8.7% decrease of the serum level of total cholesterol (TC; from 167.3 +/- 30.8 mg/dL to 152.7 +/- 26.9 mg/dL). There was a 15.2% decrease of the serum level of low-density lipoprotein cholesterol (from 104.1 +/- 28.3 mg/dL to 88.2 +/- 22.1 mg/dL). A 13.4% decrease of the serum level of apoprotein B (from 74.7 +/- 22.05 mg/dL to 64.7 +/- 17.0 mg/dL) was also noted. The TC/HDL cholesterol decreased from 1.18 +/- 0.24 to 1.08 +/- 0.24 in natural logarithm scales. All of the declines were statistically significantly different, with p less than 0.0001. The shift of HDL was not statistically significant (from 51.8 +/- 11.5 mg/dL to 52.4 +/- 12.5 mg/dL, p = 0.14). With a multivariate analysis, weight reduction was the most important factor contributing to the cholesterol-lowering effect. With a mild increase of exercise intensity, alcohol demostrated benefits to reduce serum cholesterol levels. Smoking would countervail the cholesterol-lowering benefits of alcohol use. It was evident that the serum levels of TC, low-density lipoprotein cholesterol, and the apoprotein B levels were increased in alcoholic smokers after exercise, but were decreased in alcoholic nonsmokers.