Plant sterol consumption frequency affects plasma lipid levels and cholesterol kinetics in humans

Background/Objectives: To compare the efficacy of single versus multiple doses of plant sterols on circulating lipid level and cholesterol trafficking. Subjects/Methods: A randomized, placebo-controlled, three-phase (6 days/phase) crossover, supervised feeding trial was conducted in 19 subjects. Subjects were provided (i) control margarine with each meal; (ii) 1.8 g/day plant sterols in margarine with breakfast (single-BF) and control margarine with lunch and supper or (iii) 1.8 g/day plant sterols in margarine divided equally at each of the three daily meals (three times per day). Results: Relative to control, end point plasma low-density lipoprotein (LDL) cholesterol concentrations were lower (P < 0.05) after consuming plant sterols three times per day but were not different when consumed once per day (3.43 +/- 0.62, 3.22 +/- 0.58 and 3.30 +/- 0.65 mmol/l,control, three times per day and single-BF, respectively). Relative to the control, end point LDL level was 0.21 +/- 0.27 mmol/l (6%) lower (P < 0.05) at the end of the three times per day phase. Cholesterol fractional synthesis rate was highest (P < 0.05) after the three times per day phase (0.0827 +/- 0.0278, 0.0834 +/- 0.0245 and 0.0913 +/- 0.0221 pool/day, control, single-BF and three times per day, respectively). Cholesterol-absorption efficiency decreased (P < 0.05) by 36 and 39% after the three times per day and single-BF phase, respectively, relative to control. Conclusions: Present data indicate that to obtain optimal cholesterol-lowering impact, plant sterols should be consumed as smaller doses given more often, rather than one large dose. European Journal of Clinical Nutrition (2009) 63, 747-755; doi:10.1038/ejcn.2008.36; published online 4 June 2008