Benecol í baráttunni við kólesteról

Benecol er náttúrulegur mjólkurdrykkur sem ætlaður er þeim sem vilja lækka kólesteról í blóði. Of hátt kólesteról í blóði er einn af helstu áhættuþáttum kransæðasjúkdóma og er því afar mikilvægt að halda kólesterólgildum innan eðlilegra marka. Mataræði er einn þeirra þátta sem hafa hvað mest áhrif á magn kólesteróls í blóði.

Benecol mjólkurdrykkur er seldur í kippum sem innihalda sex 65 ml flöskum og er ein flaska hæfilegur skammtur á dag. Allra nýjustu niðurstöður hafa sýnt fram á að mun betri árangur næst sé Benecols neytt með eða strax eftir máltíð en ef þess er neytt á fastandi maga. Því er mælt með að neyta Benecols í kringum einhverjar af máltíðum dagsins (t.d. morgunverð, hádegisverð eða kvöldverð).

Hvað er kólesteról?
Kólesteról er ein tegund blóðfitu og gegnir ýmsum mikilvægum hlutverkum í líkamanum. Það er framleitt í lifrinni en berst einnig með fæðunni í líkamann. En ef kólesterólmagn í blóði eykst umfram þörf getur það valdið æðakölkun og kransæðasjúkdómum. Algengi of hás kólesteróls eykst með aldri en engu að síður getur þetta vandamál getur herjað á fólk á öllum aldri og í öllum þyngdarflokkum og yfirleitt verður fólk engra einkenna vart. Því er mikilvægt að þeir sem komnir eru á fullorðinsár láti fylgjast með blóðfitunni hjá sér. Æskilegt að heildarkólesteról í blóði sé undir 5 mmól/l og allt yfir 6 mmól/l telst hátt kólesteról.

Hvað er Benecol?
Á undanförnum áratug eða svo hafa komið fjölmörg matvæli á markað víða erlendis undir vöruheitinu Benecol. Benecol er skrásett vörumerki fyrir vörur sem innihalda ákveðna gerð plöntustanólesters, en rannsóknir hafa sýnt að hann hefur áhrif til lækkunar kólesteróls í blóði. Þessi plöntustanólester var framan af einkum notaður í smjörlíki ýmiss konar en nú nýverið hafa einnig komið fram léttari afurðir með plöntustanólester, til að mynda jógúrtdrykkir á borð við þann sem MS hefur nú hafið framleiðslu á undir vörumerkinu Benecol.

Vísindarannsóknir staðfesta virkni Benecols
Fjölmargar vísindarannsóknir hafa verið gerðar á áhrifum plöntustanólesters á kólesteról í blóði. Niðurstöður eru einróma á þá leið að neysla plöntustanólesters lækkar blóðkólesteról, hvort sem um er að ræða klínískar rannsóknir á fólki eða dýratilraunir. Kemur lækkunin yfirleitt fram nokkrum vikum eftir að neysla hefst og er allt að 15% að meðaltali. Sýnt hefur verið fram á að plöntustanólester stuðlar að kólesteróllækkuninni með því að hindra upptöku á kólesteróli úr fæðu í þörmum. Lækkunin er einkum í heildarkólesteróli og hinu svokallaða „vonda kólesteróli“ (LDL), en engar breytingar verða í „góða kólesterólinu“ (HDL). Rannsóknir hafa einnig sýnt að mikilvægt er að neyta vörunnar reglulega til að árangurinn haldist og sé neyslu hætt, fer kólesterólgildi aftur í fyrra horf.

Mataræði og kólesteról
Eins og áður hefur komið fram er mataræði meðal þeirra þátta sem helst hafa áhrif á magn kólesteróls í blóði. Meðal þess sem ráðlagt er til að lækka kólesteról er að stilla fituneyslu í hóf, velja frekar mjúka fitu en harða og neyta grænmetis, ávaxta og grófs kornmetis í ríkum mæli.

Benecol frá MS er sýrð undanrenna sem inniheldur 5% plöntustanólester, og hentar vel í baráttunni gegn kólesteróli sem hluti af fjölbreyttu mataræði. 

Auglýsingabæklingur í pdf-formi.

Benecol í vörulistanum.

Fjölmargar rannsóknir hafa verið gerðar á áhrifum plöntustanólesters á kólesterólgildi í blóði.

Heimildum er skipt í þrennt, í fyrsta lagi eru klínískar rannsóknir (e. randomized controlled trials, clinical trials), svo aðrar rannsóknir og greinar, og í þriðja lagi yfirlitsgreinar (e. review articles). Þessi heimildaskrá er ekki tæmandi.

Benecol og kólesteról -

    * klínískar rannsóknir (e. randomized controlled trials, clinical trials)

Í öfugri tímaröð.

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2. Homma Y, Ikeda I, Ishikawa T, Tateno M, Sugano M, Nakamura H. Decrease in plasma low-density lipoprotein cholesterol, apolipoprotein B, cholesteryl ester transfer protein, and oxidized low-density lipoprotein by plant stanol ester-containing spread: a randomized, placebo-controlled trial. Nutrition. 2003;19:369-74.

3. Miettinen TA, Gylling H, Lindbohm N, Miettinen TE, Rajaratnam RA, Relas H; Finnish Treat-to-Target Study Investigators. Serum noncholesterol sterols during inhibition of cholesterol synthesis by statins. J Lab Clin Med 2003;141:131-7.

4. Sudhop T, Lutjohann D, Agna M, von Ameln C, Prange W, von Bergmann K. Comparison of the effects of sitostanol, sitostanol acetate, and sitostanol oleate on the inhibition of cholesterol absorption in normolipemic healthy male volunteers. A placebo controlled randomized cross-over study. Arzneimittelforschung 2003;53:708-13.

5. De Graaf J, De Sauvage Nolting PR, Van Dam M, Belsey EM, Kastelein JJ, Haydn Pritchard P, Stalenhoef AF. Consumption of tall oil-derived phytosterols in a chocolate matrix significantly decreases plasma total and low-density lipoprotein-cholesterol levels. Br J Nutr 2002;88:479-88.

6. Tammi A, Ronnemaa T, Miettinen TA, Gylling H, Rask-Nissila L, Viikari J, Tuominen J, Marniemi J, Simell O. Effects of gender, apolipoprotein E phenotype and cholesterol-lowering by plant stanol esters in children: the STRIP study. Special Turku Coronary Risk Factor Intervention Project. Acta Paediatr. 2002;91(11):1155-62.

7. Sudhop T, Sahin Y, Lindenthal B, Hahn C, Luers C, Berthold HK, von Bergmann K. Comparison of the hepatic clearances of campesterol, sitosterol, and cholesterol in healthy subjects suggests that efflux transporters controlling intestinal sterol absorption also regulate biliary secretion. Gut 2002;51:860-3.

8. Ishiwata K, Homma Y, Ishikawa T, Nakamura H, Handa S. Influence of apolipoprotein E phenotype on metabolism of lipids and apolipoproteins after plant stanol ester ingestion in Japanese subjects. Nutrition 2002;18:561-5.

9. Raeini-Sarjaz M, Ntanios FY, Vanstone CA, Jones PJ. No changes in serum fat-soluble vitamin and carotenoid concentrations with the intake of plant sterol/stanol esters in the context of a controlled diet. Metabolism 2002;51:652-6.

10. Plat J, Mensink RP. Effects of plant stanol esters on LDL receptor protein expression and on LDL receptor and HMG-CoA reductase mRNA expression in mononuclear blood cells of healthy men and women. FASEB J. 2002;16:258-60.

11. Noakes M, Clifton P, Ntanios F, Shrapnel W, Record I, McInerney J. An increase in dietary carotenoids when consuming plant sterols or stanols is effective in maintaining plasma carotenoid concentrations. Am J Clin Nutr 2002;75:79-86.

12. Mensink RP, Ebbing S, Lindhout M, Plat J, van Heugten MM. Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 2002;160:205-13.

13. Nestel P, Cehun M, Pomeroy S, Abbey M, Weldon G. Cholesterol-lowering effects of plant sterol esters and non-esterified stanols in margarine, butter and low-fat foods. Eur J Clin Nutr 2001;55:1084-90.

14. Plat J, Mensink RP. Effects of diets enriched with two different plant stanol ester mixtures on plasma ubiquinol-10 and fat-soluble antioxidant concentrations.

Metabolism 2001;50:520-9.

15. Tammi A, Ronnemaa T, Gylling H, Rask-Nissila L, Viikari J, Tuominen J, Pulkki K, Simell O. Plant stanol ester margarine lowers serum total and low-density lipoprotein cholesterol concentrations of healthy children: the STRIP project. Special Turku Coronary Risk Factors Intervention Project. J Pediatr 2000;136:503-10.

16. Hallikainen MA, Sarkkinen ES, Gylling H, Erkkila AT, Uusitupa MI. Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on a low-fat diet. Eur J Clin Nutr 2000;54:715-25.

17. Plat J, van Onselen EN, van Heugten MM, Mensink RP. Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur J Clin Nutr 2000;54:671-7.

18. Blair SN, Capuzzi DM, Gottlieb SO, Nguyen T, Morgan JM, Cater NB. Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am J Cardiol 2000;86:46-52.

19. Jones PJ, Raeini-Sarjaz M, Ntanios FY, Vanstone CA, Feng JY, Parsons WE. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters. J Lipid Res 2000;41:697-705.

20. Normen L, Dutta P, Lia A, Andersson H. Soy sterol esters and beta-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am J Clin Nutr 2000;71:908-13.

21. Relas H, Gylling H, Miettinen TA. Effect of stanol ester on postabsorptive squalene and retinyl palmitate. Metabolism 2000;49:473-8.

22. Hallikainen MA, Sarkkinen ES, Uusitupa MI. Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner. J Nutr 2000;130:767-76.

23. Vuorio AF, Gylling H, Turtola H, Kontula K, Ketonen P, Miettinen TA. Stanol ester margarine alone and with simvastatin lowers serum cholesterol in families with familial hypercholesterolemia caused by the FH-North Karelia mutation. Arterioscler Thromb Vasc Biol 2000;20:500-6.

24. Plat J, Mensink RP. Vegetable oil based versus wood based stanol ester mixtures: effects on serum lipids and hemostatic factors in non-hypercholesterolemic subjects.

Atherosclerosis 2000;148:101-12.

25. Williams CL, Bollella MC, Strobino BA, Boccia L, Campanaro L. Plant stanol ester and bran fiber in childhood: effects on lipids, stool weight and stool frequency in preschool children. J Am Coll Nutr 1999;18:572-81.

26. Hallikainen MA, Sarkkinen ES, Uusitupa MI. Effects of low-fat stanol ester enriched margarines on concentrations of serum carotenoids in subjects with elevated serum cholesterol concentrations. Eur J Clin Nutr 1999;53:966-9.

27. Nguyen TT, Dale LC, von Bergmann K, Croghan IT. Cholesterol-lowering effect of stanol ester in a US population of mildly hypercholesterolemic men and women: a randomized controlled trial. Mayo Clin Proc 1999;74:1198-206.

28. Gylling H, Miettinen TA. Cholesterol reduction by different plant stanol mixtures and with variable fat intake. Metabolism 1999;48:575-80.

29. Gylling H, Puska P, Vartiainen E, Miettinen TA. Serum sterols during stanol ester feeding in a mildly hypercholesterolemic population. J Lipid Res 1999;40:593-600.

30. Hallikainen MA, Uusitupa MI. Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects. Am J Clin Nutr 1999;69:403-10.

31. Ostlund RE Jr, Spilburg CA, Stenson WF. Sitostanol administered in lecithin micelles potently reduces cholesterol absorption in humans. Am J Clin Nutr 1999;70:826-31.

32. Jones PJ, Ntanios FY, Raeini-Sarjaz M, Vanstone CA. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men. Am J Clin Nutr 1999;69:1144-50.

33. Weststrate JA, Meijer GW. Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr 1998;52:334-43.

34. Jones PJ, Howell T, MacDougall DE, Feng JY, Parsons W. Short-term administration of tall oil phytosterols improves plasma lipid profiles in subjects with different cholesterol levels. Metabolism 1998;47:751-6.

35. Gylling H, Radhakrishnan R, Miettinen TA. Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine: women and dietary sitostanol. Circulation 1997;96:4226-31.

36. Gylling H, Miettinen TA. Effects of inhibiting cholesterol absorption and synthesis on cholesterol and lipoprotein metabolism in hypercholesterolemic non-insulin-dependent diabetic men. J Lipid Res 1996;37:1776-85.

37. Miettinen TA, Puska P, Gylling H, Vanhanen H, Vartiainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med 1995;333:1308-12.

38. Gylling H, Siimes MA, Miettinen TA. Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia. J Lipid Res 1995;36:1807-12.

39. Denke MA. Lack of efficacy of low-dose sitostanol therapy as an adjunct to a cholesterol-lowering diet in men with moderate hypercholesterolemia. Am J Clin Nutr 1995;61:392-6.

40. Gylling H, Miettinen TA. Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment. Diabetologia 1994;37:773-80.

41. Vanhanen HT, Kajander J, Lehtovirta H, Miettinen TA. Serum levels, absorption efficiency, faecal elimination and synthesis of cholesterol during increasing doses of dietary sitostanol esters in hypercholesterolaemic subjects. Clin Sci (Lond) 1994;87:61-7.

42. Miettinen TA, Vanhanen H. Dietary sitostanol related to absorption, synthesis and serum level of cholesterol in different apolipoprotein E phenotypes. Atherosclerosis 1994;105:217-26.

43. Vanhanen HT, Blomqvist S, Ehnholm C, Hyvonen M, Jauhiainen M, Torstila I, Miettinen TA. Serum cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic subjects with different apoE phenotypes during dietary sitostanol ester treatment. J Lipid Res 1993;34:1535-44.

44. Heinemann T, Kullak-Ublick GA, Pietruck B, von Bergmann K. Mechanisms of action of plant sterols on inhibition of cholesterol absorption. Comparison of sitosterol and sitostanol. Eur J Clin Pharmacol 1991;40 Suppl 1:S59-63.

    * aðrar rannsóknir og greinar

Í öfugri tímaröð.

1. Field FJ, Born E, Mathur SN. Dietary stanol esters decrease plasma cholesterol independently of changes in gene expression of intestinal ABC sterol transporters and Niemann-Pick C1 Like 1 protein in hamster. J Lipid Res 2004 [Epub ahead of print].

2. O´Neill FH, Brynes A, Mandeno R, Rendell N, Taylor G, Seed M, Thompson GR. Comparison of the effects of dietary plant sterol and stanol esters on lipid metabolism.

Nutr Metab Cardiovasc Dis 2004;14:133-42.

3. Noakes M, Clifton PM, Doornbos AM, Trautwein EA. Plant sterol ester-enriched milk and yoghurt effectively reduce serum cholesterol in modestly hypercholesterolemic subjects. Eur J Nutr 2004 [Epub ahead of print].

4. De Jong N, Pijpers L, Bleeker JK, Ocke MC. Potential intake of phytosterols/-stanols: results of a simulation study. Eur J Clin Nutr 2004;58:907-19.

5. Vuorio AF, Kovanen PT, Gylling H. Hypolipidemic treatment of heterozygous familial hypercholesterolemia: a lifelong challenge. Expert Rev Cardiovasc Ther 2004;2:405-15.

6. Ketomaki A, Gylling H, Miettinen TA. Removal of intravenous Intralipid in patients with familial hypercholesterolemia during inhibition of cholesterol absorption and synthesis. Clin Chim Acta 2004;344:83-93.

7. Ketomaki A, Gylling H, Miettinen TA. Effects of plant stanol and sterol esters on serum phytosterols in a family with familial hypercholesterolemia including a homozygous subject. J Lab Clin Med 2004;143:255-62.

8. Mel´nikov SM, Seijen ten Hoorn JW, Eijkelenboom AP. Effect of phytosterols and phytostanols on the solubilization of cholesterol by dietary mixed micelles: an in vitro study. Chem Phys Lipids 2004;127:121-41.

9. Duan LP, Wang HH, Wang DQ. Cholesterol absorption is mainly regulated by the jejunal and ileal ATP-binding cassette sterol efflux transporters Abcg5 and Abcg8 in mice. J Lipid Res 2004;45:1312-23.

10. Charest A, Desroches S, Vanstone CA, Jones PJ, Lamarche B. Unesterified plant sterols and stanols do not affect LDL electrophoretic characteristics in hypercholesterolemic subjects. J Nutr 2004;134:592-5.

11. Mel´nikov SM, Seijen ten Hoorn JW, Bertrand B. Can cholesterol absorption be reduced by phytosterols and phytostanols via a cocrystallization mechanism?

Chem Phys Lipids 2004;127:15-33.

12. Ratnayake WM, Plouffe L, L´Abbe MR, Trick K, Mueller R, Hayward S. Comparative health effects of margarines fortified with plant sterols and stanols on a rat model for hemorrhagic stroke. Lipids 2003;38:1237-47.

13. Vorlat A, Conraads VM, Vrints CJ. Regular use of margarine-containing stanol/sterol esters reduces total and low-density lipoprotein (LDL) cholesterol and allows reduction of statin therapy after cardiac transplantation: preliminary observations. J Heart Lung Transplant 2003;22:1059-62.

14. Pritchard PH, Li M, Zamfir C, Lukic T, Novak E, Moghadasian MH. Comparison of cholesterol-lowering efficacy and anti-atherogenic properties of hydrogenated versus non-hydrogenated (Phytrol) tall oil-derived phytosterols in apo E-deficient mice. Cardiovasc Drugs Ther 2003;17:443-9.

15. Mezine I, Zhang H, Macku C, Lijana R. Analysis of plant sterol and stanol esters in cholesterol-lowering spreads and beverages using high-performance liquid chromatography-atmospheric pressure chemical ionization-mass spectroscopy. J Agric Food Chem 2003;51:5639-46.

16. Naumann E, Plat J, Mensink RP. Changes in serum concentrations of noncholesterol sterols and lipoproteins in healthy subjects do not depend on the ratio of plant sterols to stanols in the diet. J Nutr 2003;133:2741-7.

17. Ketomaki AM, Gylling H, Antikainen M, Siimes MA, Miettinen TA. Red cell and plasma plant sterols are related during consumption of plant stanol and sterol ester spreads in children with hypercholesterolemia. J Pediatr 2003;142:524-31.

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26. Plat J, Mensink RP. Relationship of genetic variation in genes encoding apolipoprotein A-IV, scavenger receptor BI, HMG-CoA reductase, CETP and apolipoprotein E with cholesterol metabolism and the response to plant stanol ester consumption. Eur J Clin Invest 2002;32:242-50.

27. Gylling H, Miettinen TA. Baseline intestinal absorption and synthesis of cholesterol regulate its response to hypolipidaemic treatments in coronary patients. Atherosclerosis 2002;160:477-81.

28. Cunninghan E, Marcason W. Should my clients include plant stanol/sterol esters into their diets to help lower cholesterol? J Am Diet Assoc 2002;102:81.

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32. Volger OL, Mensink RP, Plat J, Hornstra G, Havekes LM, Princen HM. Dietary vegetable oil and wood derived plant stanol esters reduce atherosclerotic lesion size and severity in apoE*3-Leiden transgenic mice. Atherosclerosis 2001;157:375-81.

33. Volger OL, van der Boom H, de Wit EC, van Duyvenvoorde W, Hornstra G, Plat J, Havekes LM, Mensink RP, Princen HM. Dietary plant stanol esters reduce VLDL cholesterol secretion and bile saturation in apolipoprotein E*3-Leiden transgenic mice. Arterioscler Thromb Vasc Biol 2001;21:1046-52.

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38. Wasan KM, Holtorf L, Subramanian R, Cassidy SM, Pritchard PH, Stewart DJ, Novak E, Moghadasian MH. Assessing plasma pharmacokinetics of cholesterol following oral coadministration with a novel vegetable stanol mixture to fasting rats.

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58. Lutjohann D, Meese CO, Crouse JR 3rd, von Bergmann K. Evaluation of deuterated cholesterol and deuterated sitostanol for measurement of cholesterol absorption in humans. J Lipid Res 1993;34:1039-46.

59. Becker M, Staab D, Von Bergmann K. Treatment of severe familial hypercholesterolemia in childhood with sitosterol and sitostanol. J Pediatr 1993;122:292-6.

60. Vanhanen HT, Miettinen TA. Effects of unsaturated and saturated dietary plant sterols on their serum contents. Clin Chim Acta 1992;205:97-107.

61. Habiger RG, Cassal JM, Kempen HJ, Seelig J. Influence of stigmastanol and stigmastanyl-phosphorylcholine, two plasma cholesterol lowering substances, on synthetic phospholipid membranes. A 2H- and 31P-NMR study. Biochim Biophys Acta 1992;1103:69-76.

62. Ikeda I, Tanabe Y, Sugano M. Effects of sitosterol and sitostanol on micellar solubility of cholesterol. J Nutr Sci Vitaminol (Tokyo) 1989;35:361-9.

63. Heinemann T, Pietruck B, Kullak-Ublick G, von Bergmann K. Comparison of sitosterol and sitostanol on inhibition of intestinal cholesterol absorption. Agents Actions Suppl 1988;26:117-22.

64. Nes WR, Dhanuka IC. Inhibition of sterol synthesis by delta 5-sterols in a sterol auxotroph of yeast defective in oxidosqualene cyclase and cytochrome P-450.

J Biol Chem 1988;263:11844-50.

65. Myher JJ, Kuksis A. Facile gas-liquid chromatographic resolution of saturated and unsaturated sterols using a polar capillary column. J Biochem Biophys Methods 1987;15:111-21.

66. Heinemann T, Leiss O, von Bergmann K. Effect of low-dose sitostanol on serum cholesterol in patients with hypercholesterolemia. Atherosclerosis 1986;61:219-23.

67. Ikeda I, Kawasaki A, Samezima K, Sugano M. Antihypercholesterolemic activity of beta-sitostanol in rabbits. J Nutr Sci Vitaminol (Tokyo) 1981;27:243-51.

68. Hassan AS, Rampone AJ. Effect of beta-sitostanol (5 alpha-stigmastan-3 beta-ol) on cholesterol absorption from micellar solutions in jejunal loops in situ. Steroids 1980;36:731-41.

69. Sugano M, Morioka H, Ikeda I. A comparison of hypocholesterolemic activity of beta-sitosterol and beta-sitostanol in rats. J Nutr 1977;107:2011-9.

·         yfirlitsgreinar (e. review articles)

Í öfugri tímaröð.

1. Miettinen TA, Gylling H. Plant stanol and sterol esters in prevention of cardiovascular diseases. Ann Med. 2004;36:126-34.

2. Thompson PD. What´s new in lipid management? Pharmacotherapy 2003;23:34S-40S.

3. Carson JA. Nutrition therapy for dyslipidemia. Curr Diab Rep 2003 Oct;3(5):397-403.

4. de Jong A, Plat J, Mensink RP. Metabolic effects of plant sterols and stanols (Review). J Nutr Biochem. 2003 Jul;14(7):362-9.

5. Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R; Stresa Workshop Participants. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 2003;78:965-78.

6. Miettinen TA, Gylling H. Non-nutritive bioactive constituents of plants: phytosterols. Int J Vitam Nutr Res. 2003 Mar;73(2):127-34.

7. Gylling H, Miettinen TA. Combination therapy with statins.

Curr Opin Investig Drugs. 2002;3:1318-23.

8. Stone NJ, Van Horn L. Therapeutic lifestyle change and Adult Treatment Panel III: evidence then and now. Curr Atheroscler Rep 2002;4:433-43.

9. Ntanios FY, Duchateau GS. A healthy diet rich in carotenoids is effective in maintaining normal blood carotenoid levels during the daily use of plant sterol-enriched spreads. Int J Vitam Nutr Res 2002;72:32-9.

10. The new margarines: can they help your heart? Harv Mens Health Watch 2002;6:1-4.

11. Spreading your way to lower cholesterol? Harv Heart Lett 2002;12:1-3.

12. Cater NB. Plant stanol ester: review of cholesterol-lowering efficacy and implications for coronary heart disease risk reduction. Prev Cardiol 2000;3:121-130.

13. Platt R. Current concepts in optimum nutrition for cardiovascular disease.

Prev Cardiol 2000;3:83-87.

14. Miettinen TA. Cholesterol absorption inhibition: a strategy for cholesterol-lowering therapy. Int J Clin Pract 2001;55:710-6.

15. Stone NJ. The optimal dietary strategy to manage risk associated with various dyslipidemias. Curr Cardiol Rep 2001;3:391-400.

16. Avery JK. Making the most of cholesterol-lowering margarines. Cleve Clin J Med 2001;68:194-6.

17. Plat J, Kerckhoffs DA, Mensink RP. Therapeutic potential of plant sterols and stanols. Curr Opin Lipidol 2000;11:571-6.

18. Ntanios F, Meijer G, Hepburn P. Comments on the review by Nguyen et al. (1999). The cholesterol-lowering action of plant stanol esters. J Nutr 2000;130:2390-2.

19. Law MR. Plant sterol and stanol margarines and health. West J Med 2000;173:43-7.

20. Nguyen TT. The cholesterol-lowering action of plant stanol esters. J Nutr 1999;129:2109-12.

21. Miettinen TA, Gylling H. Regulation of cholesterol metabolism by dietary plant sterols. Curr Opin Lipidol 1999;10:9-14.

22. Wang HX, Ng TB. Natural products with hypoglycemic, hypotensive, hypocholesterolemic, antiatherosclerotic and antithrombotic activities. Life Sci 1999;65:2663-77.

23. Wikstrom AC. [Is the Finnish healthy margarine food or medicine? Addition of plant sterols can lower cholesterol levels]. Lakartidningen 1998;95:5146-8. Swedish.

24. Jones PJ, Ntanios F. Comparable efficacy of hydrogenated versus nonhydrogenated plant sterol esters on circulating cholesterol levels in humans. Nutr Rev 1998;56:245-8.

25. Gylling H, Miettinen TA. Treatment of lipid disorders in non-insulin-dependent diabetes mellitus. Curr Opin Lipidol 1997;8:342-7.

  1. Jones PJ, MacDougall DE, Ntanios F, Vanstone CA. Dietary phytosterols as cholesterol-lowering agents in humans. Can J Physiol Pharmacol 1997;75:217-27.

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