Isocaloric substitution of plant sterol-enriched fat spread for carbohydrate-rich foods in a low-fat, fibre-rich diet decreases plasma low-density lipoprotein cholesterol and increases high-density lipoprotein concentrations

Oct 12, 2005Nutrition, metabolism, and cardiovascular diseases : NMCD

Replacing carbs with plant sterol-enriched fat in a low-fat, high-fiber diet lowers bad cholesterol and raises good cholesterol

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Abstract

Mean plasma low-density lipoprotein cholesterol concentration decreased by 20% on the plant sterol diet compared to a 12% decrease on the carbohydrate diet.

Replacing a plant sterol-enriched fat spread with carbohydrate-rich foods may lead to less favorable changes in cholesterol levels.
Plasma low-density lipoprotein cholesterol levels were significantly lower on the plant sterol diet compared to both the carbohydrate diet and the high saturated fat diet.
The cholesterol-lowering fiber-rich diet with plant sterols resulted in a greater reduction in low-density lipoprotein cholesterol than the same diet with carbohydrates.
High-density lipoprotein cholesterol levels decreased slightly on the carbohydrate diet but remained unchanged with the plant sterol diet.

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BACKGROUND AND AIM: The aim of the study was to determine the effects on plasma cholesterol of replacing a plant sterol-enriched fat spread with carbohydrate-rich foods relative to a diet high in saturated fat.

METHODS AND RESULTS: Twenty-nine men and women, from the general community, with mean age (SD) 48 (14)y, body mass index 29.0 (6.2)kg/m(2), and plasma total cholesterol concentration 6.48 (0.97)mmol/L completed the randomised, crossover dietary intervention. There were three diets: New Zealand diet (NZ diet) high in total (34%kJ) and saturated (15%kJ) fat, a cholesterol-lowering fibre-rich diet reduced in total (30%kJ) and saturated fat (8%kJ) but including a plant sterol spread (PS diet), and the same cholesterol-lowering diet with the plant sterol spread isocalorically replaced with carbohydrate (CHO diet); total fat, 26%kJ; saturated fat 7%kJ. All foods were provided and each diet was followed for four weeks. Mean (SD) plasma low-density lipoprotein cholesterol concentration declined from 4.68 (0.91)mmol/L on the high saturated fat diet to 4.12 (0.83)mmol/L (P<0.001) on the carbohydrate diet and 3.76 (0.84)mmol/L (P<0.001) on the plant sterol diet. The 20% decrease on the plant sterol diet was significantly greater (P<0.001) than the 12% decrease on the carbohydrate diet. Relative to the NZ diet, mean (95% CI) plasma high-density lipoprotein cholesterol concentration changed by -0.11 (-0.16, -0.06)mmol/L on the CHO diet but was not different at the end of the PS diet, -0.03 (-0.09, 0.02).

CONCLUSION: Including a plant sterol-enriched fat spread in a cholesterol-lowering diet produces a more favourable plasma lipid profile than the same diet made lower in total and saturated fat by replacing the spread with carbohydrate-rich foods.

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Isocaloric substitution of plant sterol-enriched fat spread for carbohydrate-rich foods in a low-fat, fibre-rich diet decreases plasma low-density lipoprotein cholesterol and increases high-density lipoprotein concentrations

Abstract

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