Lipids

, Volume 40, Issue 2, pp 169–174 | Cite as

Effects of a diet high in plant sterols, vegetable proteins, and viscous fibers (dietary portfolio) on circulating sterol levels and red cell fragility in hypercholesterolemic subjects

  • Peter J. Jones
  • Mahmoud Raeini-Sarjaz
  • David J. A. Jenkins
  • Cyril W. C. Kendall
  • Edward Vidgen
  • Elke A. Trautwein
  • Karen G. Lapsley
  • Augustine Marchie
  • Stephen C. Cunnane
  • Philip W. Connelly
Articles

Abstract

Plant sterols, soy proteins, viscous fibers, and nuts are advised for cholesterol reduction, but their combined effect on plant sterol absorption has never been tested. We assessed their combined action on serum sterols in hyperlipidemic subjects who were following low-saturated fat diets before starting the study and who returned to these diets post-test. The 1-mon test (combination) diet was high in plant sterols (1 g/1,000 kcal), soy protein (23 g/1,000 kcal), viscous fiber (9 g/1,000 kcal), and almonds (14 g/1000 kcal). Fasting blood was obtained for serum lipids and sterols, and erythrocytes were obtained for fragility prior to and at 2-wk intervals during the study. The combination diet raised serum campesterol concentrations by 50% and β-sitosterol by 27%, although these changes were not significant after Bonferroni correction; near-maximal rises were found by the end of the first week, but no change was found in red cell fragility despite a 29% reduction in the LDL cholesterol level. No significant associations were observed between changes in red cell fragility and blood lipids or sterols. We conclude that plant sterols had a minimal impact on serum sterol concentrations or red cell fragility in hyperlipidemic subjects on diets that greatly reduced their serum lipids.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Jones, P.J., Ntanios, F.Y., Raeini-Sarjaz, M., and Vanstone, C.A. (1999) Cholesterol-Lowering Efficacy of a Sitostanol-Containing Phytosterol Mixture with a Prudent Diet in Hyperlipidemic Men, Am. J. Clin. Nutr. 69, 1144–1150.PubMedGoogle Scholar
  2. 2.
    Miettinen, T.A., Puska, P., Gylling, H., Vanhanen, H., and Vartiainen, E. (1995) Reduction of Serum Cholesterol with Sitostanol-Ester Margarine in a Mildly Hypercholesterolemic Population, N. Engl. J. Med. 333, 1308–1312.PubMedCrossRefGoogle Scholar
  3. 3.
    Lees, A.M., Mok, H.Y., Lees, R.S., McCluskey, M.A., and Grundy, S.M. (1977) Plant Sterols as Cholesterol-Lowering Agents: Clinical Trials in Patients with Hypercholesterolemia and Studies of Sterol Balance, Atherosclerosis 28, 325–338.PubMedCrossRefGoogle Scholar
  4. 4.
    Law, M. (2000) Plant Sterol and Stanol Margarines and Health, Br. Med. J. 320, 861–864.CrossRefGoogle Scholar
  5. 5.
    Ratnayake, W.M., L'Abbe, M.R., Mueller, R., Hayward, S., Plouffe, L., Hollywood, R., and Trick, K. (2000) Vegetable Oils High in Phytosterols Make Erythrocytes Less Deformable and Shorten the Life Span of Stroke-Prone Spontaneously Hypertensive Rats, J. Nutr. 130, 1166–1178.PubMedGoogle Scholar
  6. 6.
    Jenkins, D.J., Kendall, C.W., Faulkner, D., Vidgen, E., Trautwein, E.A., Parker, T.L., Marchie, A., Koumbridis, G., Lapsley, K.G., Josse, R.G., et al. (2002) A Dietary Portfolio Approach to Cholesterol Reduction: Combined Effects of Plant Sterols, Vegetable Proteins, and Viscous Fibers in Hypercholesterolemia, Metabolism 51, 1596–1604.PubMedCrossRefGoogle Scholar
  7. 7.
    Jenkins, D.J., Kendall, C.W., Marchie, A., Faulkner, D.A., Wong, J.M., de Souza, R., Emam, A., Parker, T.L., Vidgen, E., Lapsley, K.G., et al. (2003) Effects of a Dietary Portfolio of Cholesterol-Lowering Foods vs Lovastatin on Serum Lipids and C-Reactive Protein, JAMA 290, 502–510.PubMedCrossRefGoogle Scholar
  8. 8.
    Jenkins, D.J., Wolever, T.M., Rao, A.V., Hegele, R.A., Mitchell, S.J., Ransom, T.P., Boctor, D.L., Spadafora, P.J., Jenkins, A.L., and Mehling, C. (1993) Effect on Blood Lipids of Very High Intakes of Fiber in Diets Low in Saturated Fat and Cholesterol, N. Engl. J. Med. 329, 21–26.PubMedCrossRefGoogle Scholar
  9. 9.
    U.S. Food and Drug Administration (1998) Food Labeling: Health Claims: Soluble Fiber from Certain Foods and Coronary Heart Disease, FDA, Rockville, MD, Docket No. 96P-0338.Google Scholar
  10. 10.
    Anderson, J.W., Allgood, L.D., Lawrence, A., Altringer, L.A., Jerdack, G.R., Hengehold, D.A., and Morel, J.G. (2000) Cholesterol-Lowering Effects of Psyllium Intake Adjunctive to Diet Therapy in Men and Women with Hypercholesterolemia: Meta-analysis of 8 Controlled Trials, Am. J. Clin. Nutr. 71, 472–479.PubMedGoogle Scholar
  11. 11.
    Brown, L., Rosner, B., Willett, W.W., and Sacks, F.M. (1999) Cholesterol-Lowering Effects of Dietary Fiber: A Meta-analysis, Am. J. Clin. Nutr. 69, 30–42.PubMedGoogle Scholar
  12. 12.
    Anderson, J.W., Johnstone, B.M., and Cook-Newell, M.E. (1995) Meta-analysis of the Effects of Soy Protein Intake on Serum Lipids, N. Engl. J. Med. 333, 276–282.PubMedCrossRefGoogle Scholar
  13. 13.
    U.S. Food and Drug Administration. (1999) FDA Final Rule for Food Labelling: Health Claims: Soy Protein and Coronary Heart Disease, Fed. Regist. 64, 57699–57733.Google Scholar
  14. 14.
    Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), JAMA 285, 2486–2497.CrossRefGoogle Scholar
  15. 15.
    Lipid Research Clinics (1982) Population Studies Data Book. Volume II: The Prevalence Study-Nutrient Intake, U.S. Government Printing Office, Washington, DC, U.S. Department of Health and Human Services Publication no. (NIH) 82-2014.Google Scholar
  16. 16.
    Jones, P.J., Raeini-Sarjaz, M., Ntanios, F.Y., Vanstone, C.A., Feng, J.Y., and Parsons, W.E. (2000) Modulation of Plasma Lipid Levels and Cholesterol Kinetics by Phytosterol Versus Phytostanol Esters, J. Lipid Res. 41, 697–705.PubMedGoogle Scholar
  17. 17.
    Lipid Research Clinics (1982) Manual of Laboratory Operations: Lipid and Lipoprotein Analysis, revised, U.S. Government Printing Office, Washington, DC, U.S. Department of Health and Human Services Publication no. (NIH) 75-678.Google Scholar
  18. 18.
    Warnick, G.R., Benderson, J., and Albers, J.J. (1982) Dextran Sulfate-Mg2+ Precipitation Procedure for Quantitation of High-Density-Lipoprotein Cholesterol, Clin. Chem. 28, 1379–1388.PubMedGoogle Scholar
  19. 19.
    Friedewald, W.T., Levy, R.I., and Fredrickson, D.S. (1972) Estimation of the Concentration of Low-Density Lipoprotein Cholesterol in Plasma, Without Use of the Preparative Ultracentrifuge, Clin. Chem. 18, 499–502.PubMedGoogle Scholar
  20. 20.
    Fink, P.C., Romer, M., Haeckel, R., Fateh-Moghadam, A., Delanghe, J., Gressner, A.M., and Dubs, R.W. (1989) Measurement of Proteins with the Behring Nephelometer. A Multicentre Evaluation, J. Clin. Chem. Biochem. 27, 261–276.Google Scholar
  21. 21.
    Naito, Y., Konishi, C., and Ohara, N. (2000) Blood Coagulation and Osmolar Tolerance of Erythrocytes in Stroke-Prone Spontaneously Hypertensive Rats Given Rapeseed Oil or Soybean Oil as the Only Dietary Fat, Toxicol. Lett. 117, 209–215.CrossRefGoogle Scholar
  22. 22.
    The Agricultural Research Service (1992) Composition of Foods, Agriculture Handbook No. 8. U.S. Department of Agriculture, Washington, DC.Google Scholar
  23. 23.
    Association of Official Analytical Chemists (1980) AOAC Official Methods of Analysis, AOAC, Washington, DC.Google Scholar
  24. 24.
    Cunnane, S.C., Hamadeh, M.J., Liede, A.C., Thompson, L.U., Wolever, T.M., and Jenkins, D.J. (1995) Nutritional Attributes of Traditional Flaxseed in Healthy Young Adults, Am. J. Clin. Nutr. 61, 62–68.PubMedGoogle Scholar
  25. 25.
    Anderson, J.W., and Bridges, S.R. (1988) Dietary Fiber Content of Selected Foods, Am. J. Clin. Nutr. 47, 440–447.PubMedGoogle Scholar
  26. 26.
    SAS Institute (1997) SAS/STAT User's Guide, edn. 6.12, SAS Institute, Cary, NC.Google Scholar
  27. 27.
    U.S. Food and Drug Administration (2001) Food Labeling: Health Claims; Soluble Fiber from Whole Oats and Risk of Coronary Heart Disease, pp. 15343–15344, FDA, Rockville, MD, Docket No. 95P-0197.Google Scholar
  28. 28.
    Olson, B.H., Anderson, S.M., Becker, M.P., Anderson, J.W., Hunninghake, D.B., Jenkins, D.J., LaRosa, J.C., Rippe, J.M., Roberts, D.C., Stoy, D.B., et al. Psyllium-Enriched Cereals Lower Blood Total Cholesterol and LDL Cholesterol, but Not HDL Cholesterol, in Hypercholesterolemic Adults: Results of a Meta-analysis, J. Nutr. 127, 1973–1980.Google Scholar
  29. 29.
    Jenkins, D.J., Kendall, C.W., Marchie, A., Parker, T.L., Connelly, P.W., Qian, W., Haight, J.S., Faulker, D., Vidgen, E., Lapsley, K.G., and Spiller, G.A. (2002) Dose Response of Almonds on Coronary Heart Disease Risk Factors: Blood Lipids, Oxidized Low-Density Lipoproteins, Lipoprotein(a), Homocysteine, and Pulmonary Nitric Oxide: A Randomized, Controlled, Crossover Trial, Circulation 106, 1327–1332.PubMedCrossRefGoogle Scholar
  30. 30.
    Spiller, G.A., Jenkins, D.A., Bosello, O., Gates, J.E., Cragen, L.N., and Bruce, B. (1998) Nuts and Plasma Lipids: An Almond-Based Diet Lowers LDL-C While Preserving HDL-C, J. Am. Coll. Nutr. 17, 285–290.PubMedGoogle Scholar
  31. 31.
    Jenkins, D.J., Kendall, C.W., Popovich, D.G., Vidgen, E., Mehling, C.C., Vuksan, V., Ransom, T.P., Rao, A.V., Rosenberg-Zand, R., Tariq, N., et al. (2001) Effect of a Very-High-Fiber Vegetable, Fruit, and Nut Diet on Serum Lipids and Colonic Function, Metabolism 50, 494–503.PubMedCrossRefGoogle Scholar
  32. 32.
    International Committee for Standardization in Haematology (1971) Recommended Methods for Radioisotope Red-Cell Survival Studies. A Report by the ICSH Panel on Diagnostic Applications of Radioisotopes in Haematology, Br. J. Haematol. 21, 241–250.Google Scholar
  33. 33.
    Goodman, J.W., and Smith, L.H. (1961) Erythrocyte Life Span in Normal Mice and in Radiation Bone Marrow Chimeras, Am. J. Physiol. 200, 764–770.PubMedGoogle Scholar
  34. 34.
    Ketomaki, A.M., Gylling, H., Antikainen, M., Siimes, M.A., and Miettinen, T.A. (2003) Red Cell and Plasma Plant Sterols Are Related During Consumption of Plant Stanol and Sterol Ester Spreads in Children with Hypercholesterolemia, J. Pediatr. 142, 524–531.PubMedCrossRefGoogle Scholar
  35. 35.
    Young, L.E., Izzo, M.J., and Platzer, R.F. (1951) Hereditary Spherocytosis, I. Clinical, Hematologic and Genetic Features in 28 Cases, with Particular Reference to the Osmotic and Mechanical Fragility of Incubated Erythrocytes, Blood 6, 1073.PubMedGoogle Scholar

Copyright information

© AOCS Press 2005

Authors and Affiliations

  • Peter J. Jones
    • 1
  • Mahmoud Raeini-Sarjaz
    • 1
  • David J. A. Jenkins
    • 2
    • 3
    • 4
    • 5
  • Cyril W. C. Kendall
    • 2
    • 4
  • Edward Vidgen
    • 2
    • 4
  • Elke A. Trautwein
    • 8
  • Karen G. Lapsley
    • 9
  • Augustine Marchie
    • 2
    • 4
  • Stephen C. Cunnane
    • 2
  • Philip W. Connelly
    • 3
    • 6
    • 7
  1. 1.School of Dietetics and Human NutritionMcGill UniversityMontréalCanada
  2. 2.Clinical Nutrition & Risk Factor Modification CenterSt. Michael's HospitalTorontoCanada
  3. 3.Department of Medicine Division of Endocrinology and MetabolismSt. Michael's HospitalTorontoCanada
  4. 4.Department of Nutritional SciencesUniversity of TorontoTorontoCanada
  5. 5.Department of MedicineUniversity of TorontoTorontoCanada
  6. 6.Department of BiochemistryUniversity of TorontoTorontoCanada
  7. 7.Department of Laboratory Medicine and Pathobiology, Faculty of MedicineUniversity of TorontoTorontoCanada
  8. 8.Univer Health InstituteUnilever R&DVlaardingenThe Netherlands
  9. 9.The Almond Board of CaliforniaModesto
  10. 10.Clinical Nutrition and Risk Factor Modification CenterSt. Michael's HospitalTorontoCanada

Personalised recommendations