Randomised controlled trial of the effect of phytosterol-enriched low-fat milk on lipid profile in Chinese.

Abstract

INTRODUCTION: Phytosterols found naturally in plants are known to reduce cholesterol absorption in the gut. The Chinese diet typically contains many vegetables and not much meat. Therefore, we aimed to test if phytosterols are effective in reducing cholesterol absorption in the Chinese population. METHOD: There were 221 (41 men, 180 women; aged 24-79 years) subjects who consented to participate in the study; the protocol of which was approved by the Institutional Review Board of the University of Hong Kong/ Hospital Authority Hong Kong West Cluster. Subjects were randomised to double-blind intake of a phytosterol-enriched low-fat milk or a conventional low-fat milk for 3 weeks. Every day before breakfast and lunch, they had a 273-mL serving. Active treatment contained 1.5 g of phytosterol per day. Blood samples were taken from fasting subjects before and at the end of the study for the measurement of lipid profile. Body weight, waist circumference, and blood pressure were also measured. RESULTS: Low-density lipoprotein (LDL)–cholesterol level decreased from 3.22 ± 0.08 to 3.06 ± 0.08 mmol/L in the phystosterol group and increased from 3.08 ± 0.08 to 3.20 ± 0.08 mmol/L in controls. Comparing treatment with control, the decrease in LDL-cholesterol was 9.5 ± 2.0% (P < 0.001). There were no significant changes in high-density lipoprotein–cholesterol, triglycerides, body weight, or blood pressure. Five subjects (2.3%; 4 in treatment group) withdrew. CONCLUSION: Consumption of a phytosterol-enriched low-fat milk led to a significant fall in LDL-cholesterol. This can be recommended as part of a healthy diet for people with mildly elevated cholesterol levels and not at high cardiovascular risk. Statins and ezetimibe remain the treatment of choice for those with high cholesterol levels or high cardiovascular risk.