Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations


      Oil-based products enriched with plant stanol esters can lower low-density lipoprotein (LDL) cholesterol concentrations by 10–14%. Effectiveness of low-fat products, however, has never been evaluated, although such products fit into a healthy diet. We therefore examined the effects of plant stanol esters emulsified into low-fat yoghurt (0.7% fat) on fasting concentrations of plasma lipids and lipid-soluble antioxidants, which may also change by plant stanol consumption. Sixty non-hypercholesterolemic subjects first consumed daily three cups (3×150 ml) of placebo yoghurt for 3 weeks. For the next 4 weeks, 30 subjects continued with the placebo yoghurt, while the other 30 subjects received three cups of experimental yoghurt. Each cup provided 1 g of plant stanols (0.71 g sitostanol plus 0.29 g campestanol) as its fatty acid ester. LDL cholesterol (mean±S.D.) increased by 0.06±0.21 mmol/l in the placebo group, but decreased by −0.34±0.30 mmol/l in the experimental group. The difference in changes between the two groups of 0.40 mmol or 13.7% was highly significant (P<0.001; 95% confidence interval for the difference, −0.26–−0.53 mmol/l). Effects were already maximal after 1 week. HDL cholesterol and triacylglycerol concentrations did not change. Total tocopherol levels increased by 1.43 μmol/mmol LDL cholesterol (14.0%, P=0.015). β-carotene levels, however, decreased by −0.02 μmol/mmol LDL cholesterol (−14.4%, P=0.038). Decreases in absolute β-carotene concentrations were found in all apoB-containing lipoproteins. LDL-cholesterol standardised phytofluene levels decreased by 21.4±25.7% (P<0.001), while other plasma carotenoid (lutein/zeaxanthin, β-cryptoxanthin, lycopene and α-carotene) levels did not change significantly. We conclude that low-fat yoghurt enriched with plant stanol esters lowers within 1 week LDL cholesterol to the same extent as oil-based products. LDL-cholesterol standardised concentrations of tocopherol increased. The observed decrease in β-carotene levels, as found in many other studies, appears not to be limited to the LDL fraction.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Law M.
        Plant sterol and stanol margarines and health.
        Br. Med. J. 2000; 320: 861-864
        • Tammi A.
        • Rönnemaa T.
        • Gylling H.
        • et al.
        Plant stanol ester margarine lowers serum total and low-density lipoprotein cholesterol concentrations of healthy children: The STRIP project.
        J. Pediatr. 2000; 136: 503-510
        • Blair S.N.
        • Capuzzi D.M.
        • Gottlieb S.O.
        • Nguyen T.
        • Morgan J.M.
        • Cater N.B.
        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
        • Hallikainen M.A.
        • Uusitupa M.I.
        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: 403-410
        • Heinemann T.
        • Kullak-Ublick G.A.
        • 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: 59-63
        • Mattson F.H.
        • Grundy S.M.
        • Crouse J.R.
        Optimizing the effect of plant sterols on cholesterol absorption in man.
        Am. J. Clin. Nutr. 1982; 35: 697-700
        • Plat J.
        • Kerckhoffs D.A.J.M.
        • Mensink R.P.
        Therapeutic potential of plant sterols and stanols.
        Curr. Opinion Lipid. 2000; 11: 571-576
        • Terpstra A.H.M.
        • Woodward J.H.
        • Sanchez-Muniz F.J.
        Improved techniques for the separation of serum lipoproteins by density ultracentrifugation—visualization by prestaining and rapid eparation of serum lipoproteins from small volumes of serum.
        Anal. Biochem. 1981; 111: 149-157
        • Friedewald W.T.
        • Levy R.I.
        • Fredrickson D.S.
        Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of the preparative ultracentrifugation.
        Clin. Chem. 1972; 18: 499-502
        • Plat J.
        • Mensink R.P.
        Effects of diets enriched with two different plant stanol ester mixtures on plasma ubiquinol-10 and fat soluble antioxidant concentrations.
        Metabolism. 2001; 50: 520-529
        • Plat J.
        • van Onselen E.N.M.
        • van Heugten M.M.A.
        • Mensink R.P.
        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: 671-677
      1. Statview (for the Macintosh) manual. Berkeley, CA: Abacus Concepts, Statview Abacus Concepts Inc., 1992.

        • Ostlund R.E.
        • Spilburg C.A.
        • Stenson W.F.
        Sitostanol administered in lecithin micelles potently reduces cholesterol absorption in humans.
        Am. J. Clin. Nutr. 1999; 70: 826-831
        • Gylling H.
        • Radhakrishnan R.
        • Miettinen T.A.
        Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine.
        Circulation. 1997; 96: 4226-4231
        • Plat J.
        • Mensink R.P.
        Consumption of plant stanol esters increase LDL receptor expression in mononuclear cells from non-hypercholesterolemic subjects.
        Atherosclerosis. 2000; 151 (Abstract): 86
        • Weststrate J.A.
        • Meijer G.W.
        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: 334-343
        • Hu X.
        • Jandacek R.J.
        • White W.S.
        Intestinal absorption of beta-carotene ingested with a meal rich in sunflower oil or beef tallow: postprandial appearance in triacylglycerol-rich lipoproteins in women.
        Am. J. Clin. Nutr. 2000; 71: 1170-1180