Hyperlipidemias: Patch CS

Patch CS, Tapsell LC, Williams PG, Gordon M. · National Centre of Excellence in Functional Foods, Northfields Avenue, University of Wollongong, New South Wales, Australia. · Vasc Health Risk Manag. · Pubmed #17319460 links to  free full text

Abstract: Plant sterol-enriched foods are an effective dietary adjuvant in reducing cardiovascular risk by lowering total cholesterol and low density lipoprotein-cholesterol (LDL-C) in serum by up to approximately 15%. The mechanism of action of plant sterols is different from those of 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) and thus their effect is additive. Combining plant sterols with other dietary components known to reduce cholesterol in a portfolio approach has proven to be most effective for reduction of hypercholesterolemia and provide an alternative treatment option for clinicians. Plant sterol-enriched foods provides clinicians with a relatively cheap, safe, and effective way to help patients manage their cardiovascular risk.

Patch CS, Tapsell LC, Williams PG. · Smart Foods Centre, University of Wollongong, NSW 2522, Australia. · J Am Diet Assoc. · Pubmed #15635344 No free full text.

Abstract: OBJECTIVE: To determine the effectiveness of prescribing 2 g plant sterols/stanols per day as an addition to standard practice in a dietary outpatient clinic. DESIGN: A randomized parallel design of comparative 12-week interventions. SUBJECTS/SETTING: Patients referred by a general practitioner to a dietary outpatient clinic for the management of hyperlipidemia were eligible. Twenty-five patients (15 women and 10 men) completed the study. INTERVENTION: Counseling regarding diet for hyperlipidemia was based on the National Cholesterol Education Program guidelines. The intervention group was instructed to incorporate approximately 25 g/day of margarine, containing plant sterols/stanols, which delivered approximately 2 g plant sterols/stanols. MAIN OUTCOME MEASURE: Changes in diet, body weight, and serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides were measured. STATISTICAL ANALYSIS PERFORMED: Changes in dietary and biochemical outcomes were assessed using Student's t test. For nonnormally distributed data, Wilcoxon signed rank test was used, and Mann-Whitney U tests were conducted to determine the proportion of subjects reaching defined goals. The number needed to treat index was used to report effectiveness of the intervention. RESULTS: Five of 14 subjects in the intervention group compared with 0 of 11 in the control group achieved a reduction in serum cholesterol of >/=15% ( P <.05). Using the number needed to treat index, for each 2.8 patients counseled with routine prescription of plant sterols/stanols, one additional patient would obtain a reduction in cholesterol by >/=15% compared with conventional management. This was achieved without any detrimental effects on the dietary fatty acid profile. CONCLUSIONS: Routine prescription of margarine containing plant sterol/stanol is an effective strategy in the management of hypercholesterolemic patients in the clinical setting.

Patch CS, Tapsell LC, Mori TA, Meyer BJ, Murphy KJ, Mansour J, Noakes M, Clifton PM, Puddey IB, Beilin LJ, Annison G, Howe PR. · National Centre of Excellence in Functional Foods, University of Wollongong, New South Wales, Australia. · J Am Diet Assoc. · Pubmed #16321598 No free full text.

Abstract: OBJECTIVE: To evaluate the effect of consuming a variety of foods enriched in long-chain n-3 fatty acids in low fish eaters. DESIGN: Evaluation of reported dietary intakes in a 6-month, double-blind, randomized, controlled parallel design trial. SUBJECTS/SETTING: Eighty-five men and women with overweight and mildly elevated triglyceride levels who have a low habitual intake of fish. INTERVENTION: Subjects were randomized to consume foods either enriched in long-chain n-3 fats or control foods (not enriched). Subjects were asked to consume eight portions per day (equivalent to approximately 1 g/day long-chain n-3 fatty acid if randomized to the intervention). MAIN OUTCOME MEASURE: Reported energy, macronutrient, and fatty acid intakes were measured by diet history, 3-day food records, and body weight. STATISTICAL ANALYSES: Repeated measures analysis of variance, Kruskall-Wallis test, Pearson's correlation coefficient, and Bland-Altman plots were conducted. RESULTS: The two groups did not differ in mean dietary intake of long-chain n-3 fatty acid intake at baseline (258 mg and 313 mg for the intervention and control groups, respectively). At 6 months the intervention group members increased their intake of long-chain n-3 fats 4.5-fold compared with baseline and with the control group (P<.001). The data from the diet histories correlated well with the food records for all reported macronutrient and fatty acid values. Food pattern analysis showed that milk (13.8%), cereal (12.1%), and bread (11.3%) contributed the most to the overall long-chain n-3 fatty acid intake in the intervention group. CONCLUSIONS: This long-term study in free-living subjects indicates that population intakes of long-chain n-3 fatty acids could be substantially increased through the availability of a variety of n-3 fatty acid-enriched processed foods.