Low-Fat Nondairy Minidrink Containing Plant Stanol Ester Effectively Reduces LDL Cholesterol in Subjects with Mild to Moderate Hypercholesterolemia as Part of a Western Diet
The cholesterol-lowering efficacy of plant stanol ester (STAEST) added to fat- or milk-based products is well documented. However, their efficacy when added to nondairy liquid drinks is less certain. Therefore, we have investigated the cholesterol-lowering efficacy of STAEST added to a soymilk-based minidrink in the hypercholesterolemic subjects. In a randomized, double-blind, placebo-controlled parallel study, the intervention group ( ) consumed 2.7？g/d of plant stanols as the ester in soymilk-based minidrink (65？mL/d) with the control group ( ) receiving the same drink without added plant stanols once a day with a meal for 4 weeks. Serum total, LDL, and non-HDL cholesterol concentrations were reduced by 8.0, 11.1, and 10.2% compared with controls ( for all). Serum plant sterol concentrations and their ratios to cholesterol declined by 12–25% from baseline in the STAEST group while the ratio of campesterol to cholesterol was increased by 10% in the controls ( for all). Serum precursors of cholesterol remained unchanged in both groups. In conclusion, STAEST-containing soymilk-based low-fat minidrink consumed once a day with a meal lowered LDL and non-HDL cholesterol concentrations without evoking any side effects in subjects consuming normal Western diet. The clinical trial registration number is NCT01716390. 1. Introduction It is known that the best way to reduce the risk of coronary artery disease (CAD) is to lower the low-density lipoprotein (LDL) cholesterol level. It has been estimated that each 1% reduction in LDL cholesterol achieves a 1% reduction in the risk of CAD [1]. Phytosterols have attracted considerable interest as cholesterol-lowering agents since the 1950s [2] due to their ability to reduce the serum LDL cholesterol level by interfering with cholesterol absorption. In a recent meta-analysis, LDL cholesterol values were reduced by 9% with a 2？g daily dose of plant stanols, and furthermore increasing the daily intake of plant stanols was found to dose-dependently reduce LDL cholesterol [3]. Most of the studies included in the plant stanol ester (STAEST) meta-analysis have been performed with solid food format, and only in four studies out of 61 has the plant stanol been in liquid dairy and one in a nondairy form [3]. The EFSA NDA Panel concluded in its heath claim dossier that STAEST at a daily intake of 3？g plant stanols (range of 2.7？g to 3.3？g) in matrices approved by Regulation (EC) No 376/2010 (yellow fat spreads, dairy products, mayonnaise, and salad dressings) can lower LDL cholesterol by 11.4% (95% CI: 9.8–13.0) and STAEST added
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