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Phytosterol Intake and Dietary Fat Reduction are Independent and Additive in their Ability to Reduce Plasma LDL Cholesterol



We studied the interrelationship of diet and plant sterols (PS) on plasma lipids, lipoproteins and carotenoids. Mildly hypercholesterolemic men (n = 13) and postmenopausal women (n = 9) underwent four randomized, crossover, double-blind, controlled feeding periods of 23 days each. The design consisted of two levels of PS (0 and 3.3 g/day) and two background diets having fat content either typical of the American diet (total and saturated fat at 33.5 and 13.2% of energy, respectively), or a Step 1 type of diet (total and saturated fat at 26.4 and 7.7% of energy, respectively). Plasma total cholesterol (TC), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, Apo A1 and Apo B were 4.3, 5.3, 4.5, 2.8 and 2.5% lower, respectively (≤ 0.0001; <0.0001, 0.0016, 0.0006, and 0.0069), with the Step 1 diet than with the typical American diet. Diet had no effect on TC/HDL cholesterol (= 0.1062). Plant sterol intake lowered TC, LDL cholesterol, and Apo B by 9.0, 12.4 and 6.1% and TC/HDLC by 9.6% (P ≤ 0.0001 for all), respectively, without affecting HDL cholesterol and Apo A1 (P = 0.2831 and 0.732). The PS effect in lowering plasma TC and LDL cholesterol was independent of and additive to the effect due to dietary fat reduction. Responses of plasma carotenoids to PS intake were consistent with the literature.

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Apo A1:

Apolipoprotein A1

Apo B:

Apolipoprotein B


Beltsville Human Nutrition Research Center


High density lipoprotein


High-performance liquid chromatography


Hormone-replacement therapy


Low density lipoprotein


National Cholesterol Education Program


Plant sterols


Standard error of the mean


Saturated fatty acid


Typical American Diet


Total cholesterol




US Department of Agriculture


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This paper is dedicated to our late mentor, colleague, and friend, David Kritchevsky, Ph.D. We are grateful to Elke Trautwein, Ph.D., of the Unilever Food and Health Research Institute for helpful discussions; Richard A. Muesing, Ph.D., of George Washington University for determining plasma concentrations of lipids, apoproteins, and lipoprotein cholesterols. Supported in part through a Research Support Agreement between the Agricultural Research Service, US Department of Agriculture, and Unilever US, Englewood Cliffs, NJ.

Conflict of interest statement

J.T. Judd, M. Kramer, B.A. Clevidence, and D.J. Baer, no conflicts of interest. S.C. Chen was an employee of Unilever Foods, NA at the time the dietary portion of the study was conducted. G.W. Meijer is an employee of Unilever.

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Correspondence to David J. Baer.

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Mention of trade names or commercial products in this article is solely for the purpose of providing specific information and does not imply recommendation or endorsement by the US Department of Agriculture.

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Chen, S.C., Judd, J.T., Kramer, M. et al. Phytosterol Intake and Dietary Fat Reduction are Independent and Additive in their Ability to Reduce Plasma LDL Cholesterol. Lipids 44, 273–281 (2009).

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