DOI: 10.1017/S0007114514000750
Rouyanne T. Ras1, Johanna M. Geleijnse2 and Elke A. Trautwein1
1Unilever R&D Vlaardingen, Olivier van Noortlaan 120, PO Box 114, 3130 AC Vlaardingen, The Netherlands 2Division of Human Nutrition, Wageningen University, Bomenweg 2, 6703 HD Wageningen, The Netherlands
Abstract
Phytosterols (PS, comprising plant sterols and plant stanols) have been proven to lower LDL-cholesterol concentrations. The dose–response relationship for this effect has been evaluated in several meta-analyses by calculating averages for different dose ranges or by applying continuous dose–response functions. Both approaches have advantages and disadvantages. So far, the calculation of averages for different dose ranges has not been done for plant sterols and stanols separately. The objective of the present meta-analysis was to investigate the combined and separate effects of plant sterols and stanols when classified into different dose ranges. Studies were searched and selected based on predefined criteria. Relevant data were extracted. Average LDL-cholesterol effects were calculated when studies were categorised bydose,accordingtorandom-effectsmodelswhileusingthevarianceasweighingfactor.Thiswasdoneforplantsterolsandstanols combined and separately. In total, 124 studies (201 strata) were included. Plant sterols and stanols were administered in 129 and fifty-nine strata, respect-ively; the remaining used a mix of both. The average PS dose was 2·1 (range 0·2–9·0)g/d. PS intakes of 0·6–3·3g/d were found to gradually reduce LDL-cholesterol concentrations by, on average, 6–12%. When plant sterols and stanols were analysed separately, clear and comparable dose–response relationships were observed. Studies carried out with PS doses exceeding 4g/d were not pooled, as these were scarce and scattered across a wide range of doses. In conclusion, the LDL-cholesterol-lowering effect of both plant sterols and stanols continues to increase up to intakes of approximately 3g/d to an average effect of 12%.
Key words: Plant sterols, Plant stanols, LDL-cholesterol, Dose–response methods, Meta-analyses