Effects of a Stanol-Enriched Yogurt on Plasma Cholesterol Levels

Abstract

Plant stanols have been recommended in combination with individualized dietary interventions to reduce plasma cholesterol concentrations. Even though yogurt is consumed in high quantities in Turkey, it is unclear whether yogurts with plant stanols will reduce high cholesterol levels in a Turkish population. We designed this study to settle this issue. We investigated the effect of plant stanols in yogurt, combined with the traditional Mediterranean diet (TMD), in subjects with high lipid levels. 100 patients were included: 50 in the intervention group and 50 in the control group. Neither the subjects nor the control group were taking any medication for cholesterol. The intervention group received 100 mls of stanol-enriched yogurt, while the control group received the same amount of yogurt without plant stanols. All subjects maintained TMD. Total cholesterol and LDL cholesterol levels decreased significantly in the stanol group (12.9%, 14.9%, respectively). In the control group, a slight decrease in LDL cholesterol (3.3%) was observed. The changes in total and LDL cholesterol between the two groups were significantly different (p=0.01). Intensive dietary intervention with the addition of plant stanols results in a clinically relevant reduction of total and LDL cholesterol in patients with high lipid levels.

Keywords

• Cholesterol, diet, stanol, Turkey, yogurt

Effects of a Stanol-Enriched Yogurt on Plasma Cholesterol Levels

Abstract

Plasma kolesterol seviyesini düşürmek için kişiselleştirilmiş diyet uygulamaları ile birlikte bitkisel stanoller tavsiye edilir. Türkiye'de yoğurt tüketimi çok fazla miktarda olmasına rağmen stanollü yoğurtların Türk milletinde yüksek kolesterol değerini düşürüp düşürmediği net belli değildir. Bu konuyu ortaya çıkarmak amacıyla bu çalışma planlanmıştır. Yüksek lipid seviyeli bireylerde, geleneksel akdeniz diyeti ile beraber bitkisel stanollü yoğurt kombinasyonun etkilerini araştırdık. 50 kişi çalışma grubu 50 kişi kontrol grubu olmak üzere 100 hasta çalışmaya dahil edildi. Ne çalışma grubu ne de kontrol grubu kolesterol tedavisi için ilaç almıyordu. Çalışma grubu 100ml stanollü yoğurt alırken kontrol grubu stanolsüz yoğurt aldı. Bütün bireyler akdeniz diyeti yaptı. Stanol grubunda total kolesterol ve LDL kolesterol seviyesi bariz olarak düştü. (%12.9, %14.9 sırasıyla). Kontrol grubunda LDL kolesterolde hafifçe düşme görüldü (%3.3). İki grup arasında Total ve LDL kolesterol deki değişimler oldukça farklıydı (p=0.01). Yüksek lipid seviyeli hastalarda yoğun diyet tedavisine bitkisel stanollerin eklenmesi Total ve LDL kolesterol seviyelerinde düşmeye neden olur

Keywords

• Kolesterol, diyet, stanol, Türkiye, yoğurt

References

1. 1. Steinberg D, Gotto AM. Preventing coronary artery disease by lowering cholesterol levels: Fifty years from bench to bedside. JAMA 1999; 282: 2043–50.
2. 2. Ballantyne CM. Current and future aims of lipid-lowering therapy: Changing paradigms and lessons from the Heart Protection Study on standards of efficacy and safety. Am J Cardiol 2003; 92: 3-9
3. 3. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Final Report. Circulation 2002;106:3143–21.
4. 4. Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti Stresa R, workshop participants. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 2003;78: 965–78.
5. 5. De Jong A, Plat J, Mensink RP. Metabolic effects of plant sterols and stanols. J Nutr Biochem 2003; 14: 362–9.
6. 6. Castro Cabezas M. Postprandial lipaemia in familial combined hyperlipidaemia. Biochem Soc Trans 2003; 31:1090– 3.
7. 7. Blair SN, Capuzzi DM, Gottlieb SO, Nguyen T, Morgan JM, Cater NB. Incremental reduction of serum total cholesterol and low density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am J Cardiol 2000; 86: 46-52
8. 8. Feunekes GI, Van Staveren WA, De Vries JH, Burema J, Hautvast JG. Relative and biomarker-based validity of a food-frequency questionnaire estimating intake of fats and cholesterol. Am J Clin Nutr 1993; 58:489–96.

9. 9. Snel YEM, Brummer RJM, Doerga ME, Zelissen PMJ, Koppeschaar HPF. Validation of extracellular water determination by bioelectrical impedance analysis in growthhormone deficient adults. Ann Nutr Metab 1995; 39: 242–50.
10. 10. Krauss RM, Eckel RH, Howard B, et al. AHA dietary guidelines: revision 2000: a statement for healthcare professionals from Nutrition Committee of the American Heart Association. Circulation 2000; 102: 2284-99.
11. 11. Van Oostrom AJ, Van Dijk H,Verseyden C, et al. Addition of glucose to an oral fat load reduces postprandial free fatty acids and prevents the postprandial increase of complement component 3. Am J Clin Nutr 2004; 79: 510–5.
12. 12. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of lowdensity lipoprotein cholesterol in plasma without use of the preparative ultracentrifugation. Clin Chem 1972; 18: 499–502.
13. 13. Miettinen TA, Gylling H. Plant stanol and sterol esters in prevention of cardiovascular diseases. Ann Med 2004; 36: 126–34.
14. 14. Gotto AM. Management of dyslipidemia. Am J Med suppl 8A 2002; 112: 10–8.
15. 15. Sudhop T, Lutjohann D, Kodal A, et al. Inhibition of intestinal cholesterol absorption by ezetimibe in humans. Circulation 2002; 106: 1943–8.
16. 16. De Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999; 99: 779–85.
17. 17. Seppo L, Jauhiainen T, Nevala R, Poussa T, Korpela R. Plant stanol esters in low-fat milk products lower serum total and LDL cholesterol. Eur J Nutr 2007; 46: 111-7.
18. 18. Algorta PJ, Chinchetru RMJ, Aquirre AJ, Francisco TS. Hypocholesteremic effectiveness of a yogurt cantaining plant stanol ester. Rev Clin Esp 2005; 205: 63-6.