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Nutrients
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Plant Sterols/Stanols and Human Health
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Plant Sterols/Stanols and Human Health

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (1 November 2018) | Viewed by 34437

Special Issue Editor

Prof. Helena Gylling

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Guest Editor
University of Helsinki and Helsinki University Hospital, Internal Medicine, Helsinki, Finland
Interests: Plant sterol/stanol metabolism in humans; Plant sterils/stanols and cholesterol interplay in humans; Plant sterols/stanols in dyslipidemias; Plant sterols/stanols in atherosclerosis and in cardiovascular diseases

Special Issue Information

Dear Colleagues,

Plant sterols and plant stanols are normal components of plants, which are not synthesized in the humans, so that they are derived from dietary sources. They have gained a lot of interest during the last two decades after foods and supplements with added plant sterols/stanols were launched as effective and safe non-pharmacologic hypocholesterolemic agents, and also after the mechanisms of intestinal absorption and hepatic excretion of cholesterol and plant sterols/stanols were unraveled. Even though ample available research on plant sterols/stanols, there are items not clarified in detail or which are scattered in the original publications. The metabolism of plant sterols/stanols in humans and their role and possible clinical consequencies in parenteral nutrition are examples of topics welcomed to gather the available information scattered at the moment. The main clinical effects of plant sterols/stanols are on circulating lipids, but there is also information on their effects on other atherosclerotic risk factors such as inflammation and fatty liver, so that the topic of dyslipidemias, metabolic syndrome, and fatty liver deals with their role in preventing atherosclerosis. Finally, the effect of dietary fat on the interplay of cholesterol and plant sterols/stanols in intestine is important and has practical consequencies, but is very little dealt with in the literature, and whether plant sterols/stanols accumulate in human tissues and whether they have atherogenic potential are important clinical issues which need objective and detailed examinations. To this end, you are cordially invited to submit proposals for manuscripts that fir the objectives and topics of this Special Issue.

Prof. Helena Gylling
Guest Editor

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Keywords

  • LDL cholesterol
  • HDL cholesterol
  • Metabolic syndrome
  • Dietary fat
  • Plant sterol absorption
  • Plant stanol absorption
  • Cholesterol
  • Coronary artery disease
  • Atherosclerosis
  • Parenteral nutrition

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Published Papers (4 papers)

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Research

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9 pages, 217 KiB  
Article
Modifying Serum Plant Sterol Concentrations: Effects on Markers for Whole Body Cholesterol Metabolism in Children Receiving Parenteral Nutrition and Intravenous Lipids
by Jogchum Plat, Sabine Baumgartner, Anita C.E. Vreugdenhil, Maurice C. J. M. Konings, Kara L. Calkins and Ronald P. Mensink
Nutrients 2019, 11(1), 120; https://doi.org/10.3390/nu11010120 - 8 Jan 2019
Cited by 9 | Viewed by 3163
Abstract
Background: Non-cholesterol sterols are validated markers for fractional intestinal cholesterol absorption (cholestanol) and endogenous cholesterol synthesis (lathosterol). This study’s objective was to evaluate markers for cholesterol synthesis and absorption in children exposed to two different intravenous lipid emulsions that rapidly change serum plant [...] Read more.
Background: Non-cholesterol sterols are validated markers for fractional intestinal cholesterol absorption (cholestanol) and endogenous cholesterol synthesis (lathosterol). This study’s objective was to evaluate markers for cholesterol synthesis and absorption in children exposed to two different intravenous lipid emulsions that rapidly change serum plant sterol concentrations as part of their parenteral nutrition (PN). Methods: Serum samples from two different studies were used: (1) nine PN-dependent children with intestinal failure associated liver disease (IFALD) whose soy-based, plant sterol-rich lipid (SO) was replaced with a fish-based, plant sterol-poor (FO) lipid; and (2) five neonates prescribed SO after birth. In the first study, samples were collected at baseline (prior to FO initiation) and after 3 and 6 months of FO. In study 2, samples were collected at 1 and 3 weeks of age. Results: In study 1, a 7-fold reduction in campesterol, a 12-fold reduction in sitosterol, and a 15-fold reduction in stigmasterol was observed 6 months after switching to FO. Serum cholesterol concentrations did not change, but cholesterol-standardized lathosterol increased (3-fold) and cholesterol-standardized cholestanol decreased (2-fold). In study 2, after 3 weeks of SO, sitosterol and campesterol concentrations increased 4-5 fold. At the same time, cholesterol-standardized lathosterol increased 69% and cholesterol-standardized cholestanol decreased by 29%. Conclusion: Based on these finding we conclude that changes in serum plant sterol concentrations might have direct effects on endogenous cholesterol synthesis, although this needs to be confirmed in future studies. Moreover, we speculate that this changed synthesis subsequently affects intestinal cholesterol absorption. Full article
(This article belongs to the Special Issue Plant Sterols/Stanols and Human Health)

Review

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31 pages, 445 KiB  
Review
Non-Cholesterol Sterol Concentrations as Biomarkers for Cholesterol Absorption and Synthesis in Different Metabolic Disorders: A Systematic Review
by Sultan Mashnafi, Jogchum Plat, Ronald P. Mensink and Sabine Baumgartner
Nutrients 2019, 11(1), 124; https://doi.org/10.3390/nu11010124 - 9 Jan 2019
Cited by 30 | Viewed by 5487
Abstract
Non-cholesterol sterols are validated biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis. However, their use in metabolic disturbances has not been systematically explored. Therefore, we conducted a systematic review to provide an overview of non-cholesterol sterols as markers for cholesterol metabolism in [...] Read more.
Non-cholesterol sterols are validated biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis. However, their use in metabolic disturbances has not been systematically explored. Therefore, we conducted a systematic review to provide an overview of non-cholesterol sterols as markers for cholesterol metabolism in different metabolic disorders. Potentially relevant studies were retrieved by a systematic search of three databases in July 2018 and ninety-four human studies were included. Cholesterol-standardized levels of campesterol, sitosterol and cholestanol were collected to reflect cholesterol absorption and those of lathosterol and desmosterol to reflect cholesterol synthesis. Their use as biomarkers was examined in the following metabolic disorders: overweight/obesity (n = 16), diabetes mellitus (n = 15), metabolic syndrome (n = 5), hyperlipidemia (n = 11), cardiovascular disease (n = 17), and diseases related to intestine (n = 16), liver (n = 22) or kidney (n = 2). In general, markers for cholesterol absorption and synthesis displayed reciprocal patterns, showing that cholesterol metabolism is tightly regulated by the interplay of intestinal absorption and endogenous synthesis. Distinctive patterns for cholesterol absorption or cholesterol synthesis could be identified, suggesting that metabolic disorders can be classified as ‘cholesterol absorbers or cholesterol synthesizers’. Future studies should be performed to confirm or refute these findings and to examine whether this information can be used for targeted (dietary) interventions. Full article
(This article belongs to the Special Issue Plant Sterols/Stanols and Human Health)
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10 pages, 886 KiB  
Review
Decreasing the Cholesterol Burden in Heterozygous Familial Hypercholesterolemia Children by Dietary Plant Stanol Esters
by Alpo Vuorio and Petri T. Kovanen
Nutrients 2018, 10(12), 1842; https://doi.org/10.3390/nu10121842 - 1 Dec 2018
Cited by 8 | Viewed by 5359
Abstract
This review covers the current knowledge about plant stanol esters as a dietary treatment option for heterozygous familial hypercholesterolemia (he-FH) children. The current estimation of the prevalence of he-FH is about one out of 200–250 persons. In this autosomal dominant disease, the concentration [...] Read more.
This review covers the current knowledge about plant stanol esters as a dietary treatment option for heterozygous familial hypercholesterolemia (he-FH) children. The current estimation of the prevalence of he-FH is about one out of 200–250 persons. In this autosomal dominant disease, the concentration of plasma low-density lipoprotein cholesterol (LDL-C) is strongly elevated since birth. Quantitative coronary angiography among he-FH patients has revealed that stenosing atherosclerotic plaques start to develop in he-FH males in their twenties and in he-FH females in their thirties, and that the magnitude of the plaque burden predicts future coronary events. The cumulative exposure of coronary arteries to the lifelong LDL-C elevation can be estimated by calculating the LDL-C burden (LDL-C level × years), and it can also be used to demonstrate the usefulness of dietary stanol ester treatment. Thus, when compared with untreated he-FH patients, the LDL-C burden of using statin from the age of 10 is 15% less, and if he-FH patients starts to use dietary stanol from six years onwards and a combination of statin and dietary stanol from 10 years onwards, the LDL-C burden is 21% less compared to non-treated he-FH patients. We consider dietary stanol treatment of he-FH children as a part of the LDL-C-lowering treatment package as safe and cost-effective, and particularly applicable for the family-centered care of the entire he-FH families. Full article
(This article belongs to the Special Issue Plant Sterols/Stanols and Human Health)
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15 pages, 966 KiB  
Review
LDL-Cholesterol Lowering of Plant Sterols and Stanols—Which Factors Influence Their Efficacy?
by Elke A. Trautwein, Mario A. Vermeer, Harry Hiemstra and Rouyanne T. Ras
Nutrients 2018, 10(9), 1262; https://doi.org/10.3390/nu10091262 - 7 Sep 2018
Cited by 72 | Viewed by 19701
Abstract
The LDL-cholesterol (LDL-C) lowering effect of plant sterols/stanols (PSS) is summarized in several meta-analyses showing a dose-response relationship with intakes of 1.5 to 3 g/day lowering LDL-C by 7.5% to 12%. This review summarizes evidence for the impact of various factors potentially influencing [...] Read more.
The LDL-cholesterol (LDL-C) lowering effect of plant sterols/stanols (PSS) is summarized in several meta-analyses showing a dose-response relationship with intakes of 1.5 to 3 g/day lowering LDL-C by 7.5% to 12%. This review summarizes evidence for the impact of various factors potentially influencing the LDL-C-lowering efficacy of PSS. PSS are efficacious in all food formats and in food supplements. Some factors related to food format, e.g., solid vs. liquid foods, seem to impact efficacy, while there is no difference between free PSS and esters. Compared to multiple daily intakes, once-a-day intake of PSS, especially in the morning with light breakfast, leads to a sub-optimal LDL-C lowering. However, intake frequency seems influenced by intake occasion, i.e., with or without a meal, and time of day. Meal intake is a critical factor for an optimal LDL-C lowering efficacy of PSS. While age has no impact, gender is suggested to influence the LDL-C lowering effect of PSS with greater reductions reported for men than women; but overall evidence is inconclusive and larger studies show no gender by treatment interaction. In conclusion, PSS are efficacious in all foods and food supplements; for optimal efficacy they should be consumed with a (main) meal and twice daily. Full article
(This article belongs to the Special Issue Plant Sterols/Stanols and Human Health)
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