Fat type in phytosterol products influence their cholesterol-lowering potential: A systematic review and meta-analysis of RCTs

Prog Lipid Res. 2016 Oct:64:16-29. doi: 10.1016/j.plipres.2016.08.002. Epub 2016 Aug 4.

Abstract

The most common form of phytosterol (PS) fortified foods are fat spreads and dairy products. The predominant fats used are soybean/sunflower (SS) or rapeseed/canola (RC) oils and animal fat (D) in dairy products. This review aimed to investigate whether the carrier fat is a determinant of the hypocholesterolaemic effects of PS fortified foods. Databases were searched using relevant keywords and published RCTs from 1990 investigating the effects of dietary PS intervention (≥1.5g per day) on total cholesterol and LDL-C were included. After methodological quality assessment and data extraction, a total of 32 RCTs (RC, n=15; SS, n=9; D, n=8) were included. As expected, all fat groups significantly reduced TC and LDL-C (p<0.01). When compared across different carrier fats, RC as the main carrier fat, reduced LDL-C significantly more than the SS spreads (p=0.01). Therefore, a combination of monounsaturated fatty acid rich spread with adequate amounts of omega-3 fatty acids (as evident in RC spreads) may be the superior carrier fat for the delivery of PS for optimal blood cholesterol-lowering. The findings of this research provide useful evidence for optimising the hypocholesterolaemic effects of PS and support further investigation into the possible mechanisms behind these findings.

Keywords: Canola; Cholesterol; Dairy; Phytosterols; Rapeseed; Sunflower.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Cardiovascular Diseases / pathology
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol / blood
  • Clinical Trials as Topic
  • Databases, Factual
  • Dietary Fats / therapeutic use
  • Humans
  • Hypolipidemic Agents / chemistry
  • Hypolipidemic Agents / therapeutic use*
  • Phytosterols / chemistry
  • Phytosterols / therapeutic use*
  • Plant Oils / chemistry
  • Plant Oils / metabolism*

Substances

  • Dietary Fats
  • Hypolipidemic Agents
  • Phytosterols
  • Plant Oils
  • Cholesterol