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Objective Intake of plant sterol (PS)-enriched foods effectively lowers plasma total- and LDL-cholesterol concentrations while increasing plasma PS concentrations. The magnitude of this increase has not been systematically assessed. This study aimed to investigate the effect of PS-enriched foods on plasma PS concentrations by performing a meta-analysis of randomized controlled studies. Methods Published PS intervention studies reporting plasma PS concentrations were searched through June 2012. Studies were selected that fulfilled pre-defined in- and exclusion criteria. Data were extracted, particularly on campesterol, sitosterol, total- and LDL-cholesterol. Random-effects models were used to calculate net effects while weighing each study by the inverse of its variance. Potential sources of heterogeneity were investigated. Results The meta-analysis included data from 41 studies (55 strata) with in total 2084 subjects. The average dose of PS from enriched foods was 1.6 g/d (range: 0.3–3.2 g/d). Plasma sitosterol and campesterol concentrations were increased by on average 2.24 μmol/L (31%) and 5.00 μmol/L (37%), respectively, compared to control. Total- and LDL-cholesterol were reduced by on average 0.36 mmol/L (5.9%) and 0.33 mmol/L (8.5%), respectively. The increase in sitosterol and campesterol was impacted by the dose of PS, the baseline PS concentration and the PS composition of the test products. In the highest PS dose category (2.0–3.2 g/d), increases in sitosterol and campesterol were on average 3.56 and 7.64 μmol/L, respectively. Conclusion Intake of PS-enriched foods increases plasma sitosterol and campesterol concentrations. However, total PS remain below 1% of total sterols circulating in the blood.

The citrus flavonoids hesperidin and naringin have been suggested to lower blood total (TC) and LDL-cholesterol (LDL-C) both in animal models and humans. However, the evidence from previous studies in humans is not convincing. This study evaluated the LDL-C-lowering efficacy of pure hesperidin and naringin in moderately hypercholesterolemic individuals. A total of 204 healthy men and women with a serum TC concentration of 5.0-8.0 mmol/L participated in a randomized, placebo-controlled, parallel trial with 3 groups. A 4-wk preintervention period during which participants refrained from consuming hesperidin and naringin sources preceded the intervention. During the 4-wk intervention, the participants applied the same dietary restrictions and consumed 4 capsules/d providing either placebo (cellulose) or a daily dose of 800 mg hesperidin or 500 mg naringin. Blood samples to measure serum lipids were taken on 2 consecutive days at the beginning and end of the intervention phase. One hundred ninety-four participants completed the study. They maintained their prestudy body weights (mean changes lt 0.2 kg in all groups). In all groups, the mean consumption of scheduled capsules was gt 99%. Hesperidin and naringin did not affect TC or LDL-C, with endpoint LDL-C concentrations (adjusted for baseline) of 4.00 +/- 0.04, 3.99 +/- 0.04, and 3.99 +/- 0.04 mmol/L for control, hesperidin, and naringin groups, respectively. These citrus flavonoids also did not affect serum HDL-cholesterol and triglyceride concentrations. In conclusion, pure hesperidin and naringin consumed in capsules at mealtime do not lower serum TC and LDL-C concentrations in moderately hypercholesterolemic men and women.

We compared the effects of eicosapentaenoic acid (EPA) and oleic acid (OA) on glycerolipid and apolipoprotein B (apoB) metabolism in primary human hepatocytes, HepG2 cells and primary rat hepatocytes. Cells were incubated for 1 to 5 h with 0.25 mM bovine serum albumin in the absence (control) or presence of 1 mM of EPA or OA. Synthesis and secretion of [3H]glycerolipid were determined after 1 h incubation with [3H]glycerol. Cellular and medium apoB abundance was semi-quantitatively estimated in human cells by Western blotting. The following observations were made. (1) Compared to control, OA induced a 7-fold increase in [3H]triacylglycerol (TG) synthesis in human hepatocytes and a 4-fold increase in rat hepatocytes and HepG2 cells. EPA enhanced [3H]TG synthesis about 2-fold in all three cell types although it stimulated [3H]diacylglycerol (DG) synthesis to an extent (i.e., 2.5- to 5-fold) similar to OA. (2) In contrast to OA, which stimulated VLDL-associated [3H]TG secretion 2.5- to 3-fold in the three cell types relative to control, EPA did not alter [3H]TG secretion in HepG2 and rat hepatocytes and suppressed [3H]TG secretion by 75% in primary human hepatocytes. (3) In primary human hepatocytes, both OA and EPA did not alter cellular apoB abundance but EPA decreased apoB secretion by 44% as compared to control. In contrast, both EPA and OA increased cellular and medium apoB abundance 2- to 2.5-fold in HepG2 cells, although medium apoB tended to be lower in EPA-treated cells.(ABSTRACT TRUNCATED AT 250 WORDS)