Sterole roślinne – zalecenia i aktualna wiedza Artykuł przeglądowy
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Opublikowane:
cze 30, 2013
Słowa kluczowe:
fitosterole, hipercholesterolemia, prewencja chorób układu krążenia
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Abstrakt
Jedną z podstawowych przyczyn zgonów w Polsce i na świecie pozostają wciąż choroby układu sercowo-naczyniowego, wśród których prym wiedzie choroba niedokrwienna serca (ChNS). Dużą rolę wśród głównych czynników ryzyka ChNS odgrywa nieprawidłowe odżywianie, a zwłaszcza nadmierne spożycie tłuszczów pochodzenia zwierzęcego. Badania naukowe wskazują, że niektóre składniki tłuszczów, takie jak: wielonienasycone kwasy tłuszczowe, sterole i stanole roślinne, mogą obniżać stężenie cholesterolu we krwi. Fitosterole występują w błonach komórkowych roślin. Produktem roślinnym najbogatszym w nie są nierafinowane oleje, inne produkty zbożowe, rośliny strączkowe i orzechy. Fitosterole hamują wchłanianie cholesterolu w jelicie. Duża ich podaż powoduje stan względnej hipocholesterolemii w organizmie. Efektem tego stanu jest istotne zwiększenie ekspresji receptorów dla cząsteczek LDL w różnych rodzajach komórek. W rezultacie powoduje to zwiększenie wychwytu cholesterolu LDL i jednoczesne obniżenie jego stężenia we krwi. Podaż fitosteroli jest obecnie uznaną metodą obniżania stężenia LDL w ramach profilaktyki chorób układu sercowo-naczyniowego i pomimo nielicznych działań ubocznych jej rozsądne stosowanie wydaje się obiecującą perspektywą w dietetycznym zapobieganiu hipercholesterolemii.
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Jak cytować
Sobień, B., Tyrka , A., Kopeć , G., & Podolec, P. (2013). Sterole roślinne – zalecenia i aktualna wiedza . Medycyna Faktów , 6(2(19), 15-21. Pobrano z https://journalsmededu.pl/index.php/jebm/article/view/2410
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Bibliografia
1. Pająk A. et al.: Projekt Pol-MONICA Kraków. Przegl. Lek. 1996; 53: 703-846.
2. Rywik S. et al.: Program Pol-MONICA BIS Warszawa. Stan zdrowia ludności Warszawy w roku 2001. Inst. Kardiol., Warszawa 2002.
3. Matyjaszczyk P., Hoffmann K., Bryl W.: Epidemiologia wybranych czynników ryzyka chorób układu krążenia. Przegląd Kardiodiabetologiczny 2011; 6(4): 255-262.
4. Undas A., Szczeklik A.: Miażdżyca. W: Choroby Wewnętrzne. A. Szczeklik (red.). Medycyna Praktyczna, 2005: 135-136.
5. Podolec P., Kopeć G., Pająk A.: Czynniki ryzyka chorób sercowo-naczyniowych. W: Podręcznik Polskiego Forum Profilaktyki. P. Podolec (red.). Medycyna Praktyczna, 2007: 83-87.
6. Batta A.K., Xu G., Honda A. et al.: Stigmasterol reduces plasma cholesterol level and inhibits hepatic synthesis and intestinal absorption in the rat. Metab. Clin. Exp. 2006; 55: 292-299.
7. Moghadasian M.H., Frohlich J.J.: Effect of dietary phytosterols on cholesterol metabolism and atherosclerosis: clinical and experimental evidence. Am. J. Med. 1999; 107: 588-594.
8. Patel M.D., Thompson P.D.: Phytosterols and vascular disease. Atherosclerosis 2006; 186: 12-19.
9. Law M.: Plant sterol and stanol margarines and health. BMJ 2000; 320: 861-864.
10. Lagarda M.J.: Analysis of phytosterols in food. J. Pharm. Biomed. Anal. 2006; 41: 1486-1496.
11. Moreau R.A., Whitaker B.D., Hicks K.B.: Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Prog. Lipid. Res. 2002; 41: 457-500.
12. Thompson G.R., Grundy S.M.: History of development of plant sterol and stanol esters for cholesterol-lowering purposes. Am. J. Cardiol. 2005; 96(supl.): 3D-9D.
13. Miettinen T.A., Gylling H.: Vascular effects of diets, especially plant sterol ester consumption. J. Am. Coll. Cardiol. 2008; 51: 1562-1563.
14. Kopeć A., Nowacka E., Piątkowska E. et al.: Charakterystyka i prozdrowotne właściwości steroli roślinnych. Żywność. Nauka. Technologia. Jakość 2011; 3(76): 5-14.
15. Weihrauch J.L., Gardner J.M.: Sterol content of foods of plant origin. JADA 1978; 73: 39-47.
16. Cater N.B.: Plant sterol ester. Review of cholesterol-lowering efficacy and implications for coronary heart disease risk reduction. Prev. Cardiol. 2000; 3: 121-131.
17. Patel M.D., Thompson P.D.: Phytosterols and vascular disease. Atherosclerosis 2006; 186: 12-19.
18. Szeligowska J., Mamcarz A.: Sterole roślinne w prewencji chorób układu sercowo-naczyniowego. Medycyna Faktów 2012; 5(3): 1-6.
19. Blair S.N., Capuzzi D.M., Gottlieb S.O. et al.: Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am. J. Cardiol. 2000; 86: 46-52.
20. Halliday J.: Cholesterol-lowering sterols to enter new food categories. 2006 [online: www.foodnavigartor.com].
21. Salen G., Ahrens Jr. E.H., Grundy S.M.: Metabolism of beta-sitosterol in man. J. Clin. Invest. 1970; 49: 952-67.
22. Gould R.G., Jones R.J., LeRoy G.V. et al.: Absorbability of beta-sitosterol in humans. Metabolism 1969; 18: 652-62.
23. Kudchodkar B.J., Sodhi H.S., Horlick L.: Absorption of dietary cholesterol in man. Metabolism 1973; 22: 155-63.
24. Sudhop T., Sahin B., Lindenthal B. et al.: Comparison of the hepatic clearances of campesterol, sitosterol and cholesterol in healthy subjects suggests that efflux transporters controlling intestinal sterol absorption also regulate biliary secretion. Gut 2002; 51: 860-3.
25. Heinemann T., Axtmann G., von Bergmann K.: Comparison of intestinal absorption of cholesterol with different plant sterols in man. Eur. J. Clin. Invest. 1993; 23: 827-31.
26. Ostlund Jr R.E., McGill J.B., Zeng C.M. et al.: Gastrointestinal absorption and plasma kinetics of soy Δ5-phytosterols and phytostanols in humans. Am. J. Physiol. Endocrinol. Metab. 2002; 282: E911-6.
27. Altmann S.W., Davis Jr H.R., Zhu L.J. et al.: Niemann-Pick C1 Like 1 protein is critical for intestinal cholesterol absorption. Science 2004; 303: 1201-4.
28. Berge K.E., Tian H., Graf G.A. et al.: Accumulation of dietary cholesterol in sitosterolemia caused by mutations in adjacent ABC transporters. Science 2000; 290: 1771-5.
29. Ntanios F.Y., Jones P.J., Frohlich J.J.: Dietary sitostanol reduces plaque formation but not lecithin cholesterol acyl transferase activity in rabbits. Atherosclerosis 1998; 138: 101-10.
30. Miettinen T.A., Vuoristo M., Nissinen M. et al.: Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine. Am. J. Clin. Nutr. 2000; 71: 1095-102.
31. Peterson D.W.: Plant sterols and tissue cholesterol levels. Am. J. Clin. Nutr. 1958; 6: 644-9.
32. Lees A.M., Mok H.Y., Lees R.S. et al.: Plant sterols as cholesterol-lowering agents: clinical trials in patients with hypercholesterolemia and studies of sterol balance. Atherosclerosis 1977; 28: 325-38.
33. Weststrate J.A., Meijer G.W.: Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur. J. Clin. Nutr. 1998; 52: 334-43.
34. Hendriks H.F., Weststrate J.A., van Vliet T. et al.: Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur. J. Clin. Nutr. 1999; 53: 319-27.
35. Plat J., van Onselen E.N., van Heugten M.M. et al.: Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur. J. Clin. Nutr. 2000; 54: 671-7.
36. Mensink R.P., Ebbing S., Lindhout M. et al.: Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 2002; 160: 205-13.
37. Miettinen T.A., Vuoristo M., Nissinen M. et al.: Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine. Am. J. Clin. Nutr. 2000; 71: 1095-102.
38. Miettinen T.A., Puska P., Gylling H. et al.: Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N. Engl. J. Med. 1995; 333: 1308-12.
39. Katan M.B., Grundy S.M., Jones P. et al.: Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin. Proc. 2003; 78: 965-78.
40. Grundy S.M.: Absorption, metabolism of dietary cholesterol. Annu. Rev. Nutr. 1983; 3: 71-96.
41. Normen L., Dutta P., Lia A., Andersson H.: Soy sterol esters and betasitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am. J. Clin. Nutr. 2000; 71: 908-13.
42. Christiansen L., Karjalainen N., Serimaa A. et al.: Phase behaviour of b-sitosterol-cholesterol and bsitostanol-cholesterol co-precipitates. Stp. Pharma. Sci. 2001; 11: 167-73.
43. Ikeda I., Sugano M.: Some aspects of mechanism of inhibition of cholesterol absorption by b-sitosterol. Biochim. Biophys. Acta 1993; 732: 651-8.
44. Plat J., van Onselen E.N., van Heugten M.M. et al.: Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur. J. Clin. Nutr. 2000; 54: 671-7.
45. Quílez J., García-Lorda P., Salas-Salvadó J.: Potential uses and benefits of phytosterols in diet: present situation and future directions. Clin. Nutr. 2003; 22: 343-51.
46. Rodwell V.W., Nordstrom J.L., Mitschelen J.J.: Regulation of HMGCoA reductase. Adv. Lipid Res. 1976; 14: 1-74.
47. Trautwein E.A., Duchateau G.S.M.J.E., Lin Y. et al.: Proposed mechanisms of cholesterol-lowering action of plant sterols. Eur. J. Lipid. Sci. Technol. 2003; 105: 171-85.
48. Plat J., Mensink R.P.: Effects of plant stanol esters on LDL receptor protein expression and on LDL receptor and HMG-CoA reductase mRNA expression in mononuclear blood cells of healthy men and women. FASEB J. 2002; 16: 258-60.
49. Mensink R.P., Ebbing S., Lindhout M. et al.: Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 2002; 160: 205-13.
50. Quílez J., Rafecas M., Brufau G. et al.: Bakery products enriched with phytosterol esters, atocopherol and b-carotene decrease LDL-cholesterol and maintain plasma b-carotene concentrations in normocholesterolemic men and women. J. Nutr. 2003; 133: 3103-9.
51. Gylling H., Miettinen T.A.: Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment. Diabetologia 1994; 37: 773-80.
52. Lau V.W.Y., Journoud M., Jones P.J.H.: Plant sterols are efficacious in lowering plasma LDL and non-HDL cholesterol in hypercholesterolemic type 2 diabetic and nondiabetic persons. Am. J. Clin. Nutr. 2005; 81: 1351-8.
53. Vanhanen H.T., Blomqvist S., Ehnholm C. et al.: Serum-cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic subjects with different apoE phenotypesduring dietary sitostanol ester treatment. J. Lipid. Res. 1993; 34: 1535-44.
54. Blair S.N., Capuzzi D.M., Gottlieb S.O. et al.: Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester–containing spread to statin therapy. Am. J. Cardiol. 2000; 86: 46-52.
55. Nigon F., Serfaty-Lacrosnière C., Beucler I. et al.: Plant sterol-enriched margarine lowers plasma LDL in hyperlipidemic subjects with low cholesterol intake: effect of fibrate treatment. Clin. Chem. Lab. Med. 2001; 39: 634-40.
56. Gylling H., Miettinen T.A.: LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects. Nutr. Metab. Cardiovasc. Dis. 2002; 12: 19-23.
57. Plat J., Mensink R.P.: Vegetable oil based versus wood based stanol ester mixtures: effects on serum lipid and hemostatic factors in non-hypercholesterolemic subjects. Artherosclerosis 2000; 148: 101-112.
58. Lagarda M.J.: Analysis of phytosterols in food. J. Pharm. Biomed. Anal. 2006; 41: 1486-1496.
59. Woyengo T.A., Ramprasath V.R., Jones P.J.: Anticancer effects of phytosterols. Eur. J. Clin. Nutr. 2009; 63: 813-820.
60. Wolfreys A.M., Hepburn P.A.: Safety evaluation of phytosterol esters. Part 7. Assessment of mutagenic activity of phytosterols, phytosterol esters and the cholesterol derivative, 4-cholesten-3-one. Food Chem. Toxicol. 2002; 40: 461-470.
61. Hepburn P.A., Horner S.A., Smith M.: Safety evaluation of phytosterol esters. Part 2. Subchronic 90-day oral toxicity study on phytosterol esters – a novel functional food. Food Chem. Toxicol. 1999; 37: 521-532.
62. Rozporządzenie Komisji (WE) nr 608/2004 z dnia 31 marca 2004 r. dotyczące etykietowania żywności oraz składników żywności z dodatkiem fitosteroli, estrów fitosteroli, fitostanoli i/lub estrów fitostanoli – Dz. Urz. UE 287; L 97/44.
63. Bartnikowska E.: Wpływ fitosteroli na gospodarkę lipidową. Tłuszcze Jadalne 2007; 42: 21-24.
64. Hicks K.B., Moreau R.A.: Phytosterols and phytostanols: functional food cholesterol busters. Food Technol. 2001; 55: 63-69.
65. Judd J.T., Baer D.J., Chen S.C. et al.: Plant sterol esters lower plasma lipids and most carotenoids in mildly hypercholesterolemic adults. Lipids 2002; 37: 33-42.
66. Batta A.K., Xu G., Honda A. et al.: Stigmasterol reduces plasma cholesterol level and inhibits hepatic synthesis and intestinal absorption in the rat. Metab. Clin. Exp. 2006; 55: 292-299.
67. Patel M.D., Thompson P.D.: Phytosterols and vascular disease. Atherosclerosis 2006; 186: 2-19.
68. Lin D.S., Steiner R.D., Pappu A.S. et al.: The effects of sterol structure upon sterol esterification. Atherosclerosis 2010; 208: 155-160.
2. Rywik S. et al.: Program Pol-MONICA BIS Warszawa. Stan zdrowia ludności Warszawy w roku 2001. Inst. Kardiol., Warszawa 2002.
3. Matyjaszczyk P., Hoffmann K., Bryl W.: Epidemiologia wybranych czynników ryzyka chorób układu krążenia. Przegląd Kardiodiabetologiczny 2011; 6(4): 255-262.
4. Undas A., Szczeklik A.: Miażdżyca. W: Choroby Wewnętrzne. A. Szczeklik (red.). Medycyna Praktyczna, 2005: 135-136.
5. Podolec P., Kopeć G., Pająk A.: Czynniki ryzyka chorób sercowo-naczyniowych. W: Podręcznik Polskiego Forum Profilaktyki. P. Podolec (red.). Medycyna Praktyczna, 2007: 83-87.
6. Batta A.K., Xu G., Honda A. et al.: Stigmasterol reduces plasma cholesterol level and inhibits hepatic synthesis and intestinal absorption in the rat. Metab. Clin. Exp. 2006; 55: 292-299.
7. Moghadasian M.H., Frohlich J.J.: Effect of dietary phytosterols on cholesterol metabolism and atherosclerosis: clinical and experimental evidence. Am. J. Med. 1999; 107: 588-594.
8. Patel M.D., Thompson P.D.: Phytosterols and vascular disease. Atherosclerosis 2006; 186: 12-19.
9. Law M.: Plant sterol and stanol margarines and health. BMJ 2000; 320: 861-864.
10. Lagarda M.J.: Analysis of phytosterols in food. J. Pharm. Biomed. Anal. 2006; 41: 1486-1496.
11. Moreau R.A., Whitaker B.D., Hicks K.B.: Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Prog. Lipid. Res. 2002; 41: 457-500.
12. Thompson G.R., Grundy S.M.: History of development of plant sterol and stanol esters for cholesterol-lowering purposes. Am. J. Cardiol. 2005; 96(supl.): 3D-9D.
13. Miettinen T.A., Gylling H.: Vascular effects of diets, especially plant sterol ester consumption. J. Am. Coll. Cardiol. 2008; 51: 1562-1563.
14. Kopeć A., Nowacka E., Piątkowska E. et al.: Charakterystyka i prozdrowotne właściwości steroli roślinnych. Żywność. Nauka. Technologia. Jakość 2011; 3(76): 5-14.
15. Weihrauch J.L., Gardner J.M.: Sterol content of foods of plant origin. JADA 1978; 73: 39-47.
16. Cater N.B.: Plant sterol ester. Review of cholesterol-lowering efficacy and implications for coronary heart disease risk reduction. Prev. Cardiol. 2000; 3: 121-131.
17. Patel M.D., Thompson P.D.: Phytosterols and vascular disease. Atherosclerosis 2006; 186: 12-19.
18. Szeligowska J., Mamcarz A.: Sterole roślinne w prewencji chorób układu sercowo-naczyniowego. Medycyna Faktów 2012; 5(3): 1-6.
19. Blair S.N., Capuzzi D.M., Gottlieb S.O. et al.: Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am. J. Cardiol. 2000; 86: 46-52.
20. Halliday J.: Cholesterol-lowering sterols to enter new food categories. 2006 [online: www.foodnavigartor.com].
21. Salen G., Ahrens Jr. E.H., Grundy S.M.: Metabolism of beta-sitosterol in man. J. Clin. Invest. 1970; 49: 952-67.
22. Gould R.G., Jones R.J., LeRoy G.V. et al.: Absorbability of beta-sitosterol in humans. Metabolism 1969; 18: 652-62.
23. Kudchodkar B.J., Sodhi H.S., Horlick L.: Absorption of dietary cholesterol in man. Metabolism 1973; 22: 155-63.
24. Sudhop T., Sahin B., Lindenthal B. et al.: Comparison of the hepatic clearances of campesterol, sitosterol and cholesterol in healthy subjects suggests that efflux transporters controlling intestinal sterol absorption also regulate biliary secretion. Gut 2002; 51: 860-3.
25. Heinemann T., Axtmann G., von Bergmann K.: Comparison of intestinal absorption of cholesterol with different plant sterols in man. Eur. J. Clin. Invest. 1993; 23: 827-31.
26. Ostlund Jr R.E., McGill J.B., Zeng C.M. et al.: Gastrointestinal absorption and plasma kinetics of soy Δ5-phytosterols and phytostanols in humans. Am. J. Physiol. Endocrinol. Metab. 2002; 282: E911-6.
27. Altmann S.W., Davis Jr H.R., Zhu L.J. et al.: Niemann-Pick C1 Like 1 protein is critical for intestinal cholesterol absorption. Science 2004; 303: 1201-4.
28. Berge K.E., Tian H., Graf G.A. et al.: Accumulation of dietary cholesterol in sitosterolemia caused by mutations in adjacent ABC transporters. Science 2000; 290: 1771-5.
29. Ntanios F.Y., Jones P.J., Frohlich J.J.: Dietary sitostanol reduces plaque formation but not lecithin cholesterol acyl transferase activity in rabbits. Atherosclerosis 1998; 138: 101-10.
30. Miettinen T.A., Vuoristo M., Nissinen M. et al.: Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine. Am. J. Clin. Nutr. 2000; 71: 1095-102.
31. Peterson D.W.: Plant sterols and tissue cholesterol levels. Am. J. Clin. Nutr. 1958; 6: 644-9.
32. Lees A.M., Mok H.Y., Lees R.S. et al.: Plant sterols as cholesterol-lowering agents: clinical trials in patients with hypercholesterolemia and studies of sterol balance. Atherosclerosis 1977; 28: 325-38.
33. Weststrate J.A., Meijer G.W.: Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur. J. Clin. Nutr. 1998; 52: 334-43.
34. Hendriks H.F., Weststrate J.A., van Vliet T. et al.: Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur. J. Clin. Nutr. 1999; 53: 319-27.
35. Plat J., van Onselen E.N., van Heugten M.M. et al.: Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur. J. Clin. Nutr. 2000; 54: 671-7.
36. Mensink R.P., Ebbing S., Lindhout M. et al.: Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 2002; 160: 205-13.
37. Miettinen T.A., Vuoristo M., Nissinen M. et al.: Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine. Am. J. Clin. Nutr. 2000; 71: 1095-102.
38. Miettinen T.A., Puska P., Gylling H. et al.: Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N. Engl. J. Med. 1995; 333: 1308-12.
39. Katan M.B., Grundy S.M., Jones P. et al.: Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin. Proc. 2003; 78: 965-78.
40. Grundy S.M.: Absorption, metabolism of dietary cholesterol. Annu. Rev. Nutr. 1983; 3: 71-96.
41. Normen L., Dutta P., Lia A., Andersson H.: Soy sterol esters and betasitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am. J. Clin. Nutr. 2000; 71: 908-13.
42. Christiansen L., Karjalainen N., Serimaa A. et al.: Phase behaviour of b-sitosterol-cholesterol and bsitostanol-cholesterol co-precipitates. Stp. Pharma. Sci. 2001; 11: 167-73.
43. Ikeda I., Sugano M.: Some aspects of mechanism of inhibition of cholesterol absorption by b-sitosterol. Biochim. Biophys. Acta 1993; 732: 651-8.
44. Plat J., van Onselen E.N., van Heugten M.M. et al.: Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur. J. Clin. Nutr. 2000; 54: 671-7.
45. Quílez J., García-Lorda P., Salas-Salvadó J.: Potential uses and benefits of phytosterols in diet: present situation and future directions. Clin. Nutr. 2003; 22: 343-51.
46. Rodwell V.W., Nordstrom J.L., Mitschelen J.J.: Regulation of HMGCoA reductase. Adv. Lipid Res. 1976; 14: 1-74.
47. Trautwein E.A., Duchateau G.S.M.J.E., Lin Y. et al.: Proposed mechanisms of cholesterol-lowering action of plant sterols. Eur. J. Lipid. Sci. Technol. 2003; 105: 171-85.
48. Plat J., Mensink R.P.: Effects of plant stanol esters on LDL receptor protein expression and on LDL receptor and HMG-CoA reductase mRNA expression in mononuclear blood cells of healthy men and women. FASEB J. 2002; 16: 258-60.
49. Mensink R.P., Ebbing S., Lindhout M. et al.: Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 2002; 160: 205-13.
50. Quílez J., Rafecas M., Brufau G. et al.: Bakery products enriched with phytosterol esters, atocopherol and b-carotene decrease LDL-cholesterol and maintain plasma b-carotene concentrations in normocholesterolemic men and women. J. Nutr. 2003; 133: 3103-9.
51. Gylling H., Miettinen T.A.: Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment. Diabetologia 1994; 37: 773-80.
52. Lau V.W.Y., Journoud M., Jones P.J.H.: Plant sterols are efficacious in lowering plasma LDL and non-HDL cholesterol in hypercholesterolemic type 2 diabetic and nondiabetic persons. Am. J. Clin. Nutr. 2005; 81: 1351-8.
53. Vanhanen H.T., Blomqvist S., Ehnholm C. et al.: Serum-cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic subjects with different apoE phenotypesduring dietary sitostanol ester treatment. J. Lipid. Res. 1993; 34: 1535-44.
54. Blair S.N., Capuzzi D.M., Gottlieb S.O. et al.: Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester–containing spread to statin therapy. Am. J. Cardiol. 2000; 86: 46-52.
55. Nigon F., Serfaty-Lacrosnière C., Beucler I. et al.: Plant sterol-enriched margarine lowers plasma LDL in hyperlipidemic subjects with low cholesterol intake: effect of fibrate treatment. Clin. Chem. Lab. Med. 2001; 39: 634-40.
56. Gylling H., Miettinen T.A.: LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects. Nutr. Metab. Cardiovasc. Dis. 2002; 12: 19-23.
57. Plat J., Mensink R.P.: Vegetable oil based versus wood based stanol ester mixtures: effects on serum lipid and hemostatic factors in non-hypercholesterolemic subjects. Artherosclerosis 2000; 148: 101-112.
58. Lagarda M.J.: Analysis of phytosterols in food. J. Pharm. Biomed. Anal. 2006; 41: 1486-1496.
59. Woyengo T.A., Ramprasath V.R., Jones P.J.: Anticancer effects of phytosterols. Eur. J. Clin. Nutr. 2009; 63: 813-820.
60. Wolfreys A.M., Hepburn P.A.: Safety evaluation of phytosterol esters. Part 7. Assessment of mutagenic activity of phytosterols, phytosterol esters and the cholesterol derivative, 4-cholesten-3-one. Food Chem. Toxicol. 2002; 40: 461-470.
61. Hepburn P.A., Horner S.A., Smith M.: Safety evaluation of phytosterol esters. Part 2. Subchronic 90-day oral toxicity study on phytosterol esters – a novel functional food. Food Chem. Toxicol. 1999; 37: 521-532.
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