23.08.2011 Copyright® Raisio

Effect of a plant stanol ester-containing spread, placebo spread, or Mediterranean diet on estimated cardiovascular risk and lipid, inflammatory and haemostatic factors

Athyros et al. Nutr Metab Cardiovasc Dis 2011; 21(3): 213-221.

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 2

Methods I

Parallel, randomized, placebo-controlled study

N=150, mildly hypercholesterolaemic (5,2–6,4 mmol/l) subjects 4-week run-in with a NCEP Step I diet, intervention for 16 weeks

Placebo spread; NCEP Step I diet Plant stanol ester containing spread (2 g plant

stanols/d); NCEP Step I diet Mediterranean diet

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 3

Methods II

Outcome measures:

Individual risk factors: changes in lipids and lipoproteins (TC, LDL-C, HDL-C,

TG, apo B, apo A1) blood pressure haemostatic factors (plasma fibrinogen & PAI-1

activity) inflammatory marker (hsCRP)

Estimated CVD risk (Framingham, PROCAM & Raynolds risk engines)

Percentage of patients at NCEP Total Cholesterol target (< 5.2 mmol/l)

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 4

Results I

Effect of intervention on risk factors:

Placebo: no significant effect on any of the risk factors

Plant stanol ester: TC ↓, LDL ↓ and hsCRP ↓ (statistically significant change in all)

Mediterranean diet: TC ↓, LDL ↓, TG ↓, blood pressure ↓, hsCRP and thrombotic markers ↓; HDL ↑(statistically significant change in all)

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 55

* * * *

*

Plant Stanol Ester effectively lowers LDL-cholesterol

Control spread n=50

Mediterraneandiet n=50

Plant stanol ester spread (plant stanol 2 g/d) n=50

% CHANGE IN LDL-CHOLESTEROL

*

*

%

months

** *

*p <0.01 vs. control

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 6

Results II

Estimated cardiovascular disease risk:

• Placebo: no effect on estimated disease risk

• Plant stanol ester: eCVD risk reduction of 26–30 % in 1 month with all risk engines used, sustained the 4 months intervention

• Mediterranean diet: eCVD risk reduction of 24–32% in 4 months with all risk engines used

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 7

Effective reduction in the estimated risk of cardiovascular diseases with use of Plant Stanol Ester

EFFECTIVE REDUCTION IN THE ESTIMATED RISK OF CORONARY ARTERY DISEASE (CAD)

Control spread n=50A change in the estimated CAD risk during the following 10 years (Framingham risk engine)

Mediterraneandiet n=50

Plant stanolester spread(2 g of plantstanols / day) n=50

Months

*

*

**

*

*=p<0.05 vs. control

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 8

Results III

Percentage of subjects meeting target level for total cholesterol (<5.2 mmol/L) by the end of the study:

• Placebo: 14 %• Plant stanol ester: 80 %• Mediterranean diet: 46 %

Athyros et al. Nutr Metab Cardiovasc Dis 2011. 9

Conclusions

Mediterranean diet was efficient in reducing the estimated CVD risk by several mechanisms but the change was fully seen only after 4 months

Plant stanol ester reduced the estimated risk of CVD as effectively already after 1 month

The use of plant stanol ester products is especially beneficial for those individuals who are unable to adopt Mediterranean diet

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Thank You!