The comparative efficacy of plant sterols and stanols on serum lipids: A systematic review and meta-analysis

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The comparative efficacy of plant sterols and stanols on serum lipids: A systematic review and meta-analysis
454 inform July 2010, Vol. 21 (7)







Extracts & 95% CI –1.18 to 0.62, P = 0.54), or tri-

glycerides (WMD –1.80 mg/dL [–0.0203

mmol/L], 95% CI –6.80 to 3.21, P = 0.48).

lowering. Plant sterols/stanols exert benefi-

cial effects on other lipid variables, such as

apolipoprotein (apo) B/apoAI ratio and, in





Distillates

Plant sterols and plant stanols do not have some studies, high-density lipoprotein cho-

statistically or clinically relevant differing lesterol (HDL-C) and triglycerides (TG).

effects on total cholesterol, low-density lipo- Plant sterols/stanols may also affect inflam-

protein cholesterol, high-density lipopro- matory markers and coagulation parameters,

tein cholesterol, or triglyceride levels. The as well as platelet and endothelial function.

selection of plant sterols vs. plant stanols Evidence also exists about a beneficial effect

The comparative efficacy of should then be based on potential differ- on oxidative stress, but this does not seem

plant sterols and stanols on ences in safety parameters and further study to be of greater degree than that expected

serum lipids: A systematic is required to elucidate such differences. from the LDL-C lowering. Many of these

effects have been demonstrated in vitro and

review and meta-analysis animal models. Some in vitro effects cannot

Talati, R., et al., J. Am. Diet. Assoc. 110:719–

Role of very-long-chain fatty

be seen in vivo or in humans at usual doses.

726, 2010. acids in plant development, The epidemiological studies that evaluated

Plant sterols and stanols are plant ste- when chain length does matter the association of plasma PS concentration

roids with a similar chemical structure and with cardiovascular disease (CVD) risk do

Bach, L., and J.D. Faure, Comptes Rend.

cellular function to human cholesterol, and not provide a definitive answer. Long-term

Biol. 333:361–370, 2010.

are recommended as dietary modifiers of randomized placebo-controlled studies are

Very long chain fatty acids (VLCFA) are

serum lipids. Plant sterols have a higher required to clarify the effects of supplemen-

essential components for eukaryotes. They

degree of absorption than plant stanols, tation with PS on CVD risk and progression

are elongated by the elongase complex in the

suggesting differential efficacy between the of atherosclerosis.

endoplasmic reticulum and are incorporated

two. A meta-analysis of randomized con-

into four major lipid pools (triacylglycerols,

trolled trials was performed to summa- Stereospecific analysis of

waxes, phospholipids, complex sphingolip-

rize direct comparisons between the effect

of plant sterols vs. plant stanols on serum

ids). Functional analysis of several compo- triacylglycerols as a useful

nents of the elongase complex demonstrated

lipid levels in healthy patients and patients

the essential role of VLCFA in plants, inver-

means to evaluate genuineness

with hypercholesterolemia. A systematic

tebrates, and vertebrates. Although VLCFA of pumpkin seed oils: Lesson

literature search of MEDLINE, EMBASE,

Cochrane CENTRAL, and the Natural Med-

changes in the triacylglycerol pool have no fr

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