Intake occasion affects the serum cholesterol lowering of a plant sterol-enriched single-dose yoghurt drink in mildly hypercholesterolaemic subjects

Objective: To determine the impact of intake occasion ( with or without a meal), and product fat level on the cholesterol-lowering efficacy of a plant sterol ( PS)-enriched ( 3 g/day) single-dose yoghurt drink. Design: Double-blind, randomized, placebo-controlled, parallel study with a 4 weeks run-in and 4 weeks intervention period. Setting: Subjects recruited from the general community. Subjects: A total of 184 moderate hypercholesterolaemic subjects ( 81 men and 103 women) ( age 5772 years) completed the study. Interventions: The study product was a 100-g single-dose yoghurt drink with or without added PS in the form of PS esters. The subjects were randomly assigned to one of five 4-week treatments: (i) drink A (0.1% dairy fat, 2.2% total fat) with a meal, (ii) drink A without a meal, (iii) drink B (1.5% dairy fat, 3.3% total fat) with a meal, (iv) drink B without a meal and ( v) placebo drink with a meal. Results: LDL-cholesterol (LDL-C) was significantly lowered when the single-dose drink was taken with a meal independent of its fat content ( drink A: - 9.5% (P<0.001, 95% CI: - 13.8 to - 5.2); drink B: - 9.3% ( P<0.001, 95% CI: - 13.7 to - 4.9)) as compared to placebo. When consumed without a meal, LDL-C was also significantly decreased ( drink A: - 5.1% (P<0.05, 95% CI: - 9.4 to - 0.8); drink B: - 6.9% (P<0.01, 95% CI: - 11.3 to - 2.5) as compared to placebo, however the effect was significantly smaller as compared to the intake with a meal. Conclusion: These results indicate that a PS-ester-enriched single-dose yoghurt drink effectively reduces LDL-C irrespective of the fat content of the product. A substantially larger decrease in serum cholesterol concentration was achieved when the single-dose drink was consumed with a meal emphasizing the importance of the intake occasion for optimal cholesterol-lowering efficacy.