Effects of a phytosterol-enriched dairy product on lipids, sterols and 8-isoprostane in hypercholesterolemic patients: A multicenter Italian study

Background and aims: Plant sterols, added to several food sources, lower serum cholesterol concentrations. Plant sterol-induced cholesterol Lowering is paralleled by a mild decrease in plasma Levels of the antioxidant beta-carotene, the amount of this decrease being considered clinically non-significant. Whether the effect on lipid profile of daily consumption of plant sterol-enriched tow-fat fermented milk (FM) is paralleled by a concomitant variation in a reliable marker of the oxidative burden like plasma isoprostane levels is unresolved. Methods and results: The effect of plant sterol consumption on plasma lipid and isoprostane levels of hypercholesterolemic patients was evaluated in a multicenter, randomized double blind study. Hypercholesterolemic patients consumed a FM daily for 6 weeks. Subjects were randomized to receive either 1.6 g of plant sterol-enriched FM (n = 60) or control FM product (n = 56). After 6 weeks of plant sterol-enriched FM consumption, LDL cholesterol was reduced from 166.2 +/- 2.0 to 147.4 +/- 2.8 mg/dL (p = 0.01). A significant reduction was observed for total cholesterol (from 263.5 +/- 2.6 to 231.0 +/- 3.2 mg/dL, p = 0.01). There was greater LDL cholesterol towering among hypercholesterolemic patients with higher LDL cholesterol at baseline. We found a reduction of plasma 8-isoprostane in patients taking plant sterol-enriched FM (from 43.07 +/- 1.78 to 38.04 +/- 1.14 pg/ml, p = 0.018) but not in patients taking the control product (from 42.56 +/- 2.12 to 43.19 +/- 2.0 pg/ml, p = NS). Campesterol and beta-sitosterol levels were not influenced by phytosterol consumption. Conclusions: Daily consumption of tow-fat plant sterol dairy product favourably changes lipid profile by reducing LDL-cholesterol, and may also have an anti-oxidative effect through a reduction of plasma isoprostanes. (C) 2008 Elsevier B.V. All rights reserved.