Plant sterol pills significantly lower LDL cholesterol

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Plant sterol pills significantly lower LDL cholesterol



More help for patients already taking cholesterol-lowering statin drugs



By Jim Dryden



March 7, 2006 -- A pill containing plant substances called sterols

can help lower cholesterol, according to researchers at Washington

University School of Medicine in St. Louis.



This image shows a blood vessel that has become narrowed due to the

build-up of cholesterol and other vessel-clogging substances.

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The researchers studied patients who already were eating a heart-

healthy diet and taking statin drugs to control cholesterol. The

addition of plant sterols helped further lower total cholesterol and

contributed to a nearly 10 percent reduction in low-density

lipoprotein (LDL) cholesterol, the so-called " bad " cholesterol.

Results of the study were published in the American Journal of

Cardiology.

The National Cholesterol Education Program recommends that those with

elevated cholesterol eat foods containing plant sterols as a way to

lower cardiovascular risk, but many sterol-containing foods are

inconvenient for some patients.

Structurally similar to cholesterol, plant sterols can reduce the

absorption of cholesterol in the gut by competing with cholesterol to

get absorbed and transported into the body. When consumed in the

diet, sterols are known to lower cholesterol levels, but sterols are

not readily absorbed in the intestine unless they have been dissolved

in something that the intestine can easily absorb. Because sterols

are not water-soluble, past strategies have involved dissolving them

in fat.

Most sterol-containing foods studied so far have been brands of

margarine. Studies have found that a daily intake of one or two

tablespoons of sterol-containing margarine could significantly lower

LDL cholesterol. Some juices and puddings also contain plant sterols.

" One problem is many of our patients already have lowered their

intake of fats and calories and don't use products like margarine on

a regular basis, " says Anne Carol Goldberg, M.D., lead author of the

new study and associate professor of medicine at Washington

University. " In addition, many of these people eat out regularly, and

they can't easily take a particular brand of margarine to a restaurant. "

To deliver the sterols in pill form, the plant compounds were

combined with a substance called lecithin and compressed into

tablets. When mixed with lecithin, the normally insoluble sterols are

able to dissolve in water and get absorbed in the intestine.



Anne Carol Goldberg

Goldberg's team studied 26 patients who were following the American

Heart Association Heart Healthy Diet and taking statin drugs to

control cholesterol. Over six weeks, half were randomly assigned to

take inactive placebo pills while the rest took sterol tablets. All

patients ingested four tablets, twice daily with meals, while

continuing to take statin drugs.

After treatment, those who took the sterol pills averaged a 9 percent

reduction in LDL cholesterol and a 6 percent decline in total

cholesterol. And Goldberg's team found that the higher the LDL before

the study began, the greater the drop in the bad cholesterol.

" Those who started with higher LDL got a bigger response, a bigger

drop in their LDL, when they added plant sterols to their regimen, "

Goldberg says.

The plant sterols appear to provide an effective way to lower

cholesterol levels, especially LDL cholesterol, according to

Goldberg. But she says the sterols probably will work best when given

as an additional therapy, and she recommends they be used in

combination with diet and/or cholesterol-lowering statin drugs.

" This type of treatment would be in addition to dietary changes and

other medication, " she says. " There probably are some people who have

very mild abnormalities in cholesterol who could get by with a sterol

supplement alone, but people with higher cholesterol levels will need

medication, too. They'll take plant sterols in addition to other

therapies and benefit from the additive effect we observed in this

study. "

Goldberg says it would be useful to try and replicate these findings

in larger studies.

" We used a small sample size, but we still saw a significant effect, "

she says.

The sterol pills used in the study are not yet commercially available.

Goldberg AC, Ostlund RE, Bateman JH, Schimmoeller L, McPherson TB,

Spilburg CA. Effect of plant stanol tablets on low-density

lipoprotein cholesterol lowering in patients on statin drugs.

American Journal of Cardiology, vol. 97:3, pp. 376-379, Feb. 2006.

http://mednews.wustl.edu/tips/page/normal/6744.html