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Sterols And Stanols

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Last Updated: 02 July 2021

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General | Latest Info

Certain foods can help lower cholesterol, including fruits, vegetables, legumes, nuts, seeds, and some vegetable oils, because they naturally contain Health Plant Sterols and stanols. Plant sterols and stanols are natural substances that are in the same family as cholesterol but are produced by plants instead of animals, and because they are not normally absorbed by people, they compete and interfere with absorption of animal cholesterol that you eat, explain Ivan V. Pacold, MD, professor of Cardiology at Loyola University's Stritch School of Medicine and director of Cardiology at Gottlieb Memorial Hospital in Chicago. When this happen, your body grabs extra LDL Cholesterol from your bloodstream and sends it to your liver, where it's used to make important digestive juices. This causes your LDL cholesterol and your total cholesterol to go down, while your HDL Cholesterol stays the same. Think of plant sterols as plant's version of animal cholesterol, minus the downside. In fact, adding plant sterols and stanols to your diet is one of the best tips for treating high cholesterol naturally. This is because adding foods rich in plant sterols and stanols to your diet can help lower LDL, or bad cholesterol levels in the blood, according to a review of 59 clinical trials published in August 2008 in Food Nutrition Research. In a trial published in August 2011 in Journal of American Medical Association, people who had a diet that included Cholesterol - lowering foods like nuts, soy, and margarine enriched with Plant Sterols lowed their LDL Cholesterol by 13 percent over a period of six months compared with those on their usual diet. Research has found that having some of these in your diet on a regular basis can help to lower bad cholesterol, agrees Kelly o connor, Nutrition Expert at LifeBridge Health in Baltimore. By adding them to your meals daily, you may start to see results relatively fast. The National Cholesterol Education Program recommends having 2 grams of Plant Sterols and stanols per day in order to reduce LDL Cholesterol, say o connor. If you follow this advice, she say, your bad cholesterol level may drop by 6 percent and sometimes as much as 15 percent over matter of several weeks, she add. This is significant, as most of US want to have lower cholesterol levels without taking medication, if at all possible.

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What's the Evidence?

Phytostanols, sitostanol, cempestanol, stigmastanol, 5 - alpha - stanols, stanol esters, sterols, sterol esters, phytosterols stanols / sterols are compounds found in some types of plants. They have been used to lower cholesterol. Stanols / sterols can be taken by eating soybean oil, margarine spreads, and some salad dressings. They can also be taken as pill. Diabetes is likely to lower total and LDL Cholesterol and raise HDL Cholesterol in people with diabetes A1. High Cholesterol is likely to lower LDL Cholesterol B1 - B10 Editorial Process and description of evidence categories can be found at EBSCO NAT Editorial Process. It is likely safe to take stanols / sterols in small doses for a short time. Not enough studies have been done to say whether they are safe to take for long period. It is also not know whether they are safe to take by women who are pregnant or breastfeeding. Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse. A1 Baker WL, Baker EL, et al. Effect of plant sterols or stanols on lipid parameters in patients with type 2 diabetes: meta - analysis. Diabetes Res Clin Pract. 2009 May; 84: e33 - 7. B1 Scholle JM, Baker WL, et al. Effect of adding plant sterols or stanols to statin therapy in hypercholesterolemic patients: systematic Review and meta - analysis. J AM Coll Nutr. 2009; 28: 517 - 524. B2 Wu T, Fu J, et al. Effects of phytosterols / stanols on blood lipid profiles: systematic Review with meta - analysis. Asia Pac J Clin Nutr. 2009; 18: 179 - 186. B3 Hasani - Ranjbar S, Nayebi N, et al. Efficacy and safety of herbal medicines used in treatment of hyperlipidemia; systematic Review. Curr Pharm Des. 2010; 16: 2935 - 2947. B4 Talati R, Sobieraj DM, et al. Comparative efficacy of plant sterols and stanols on serum lipids: systematic Review and meta - analysis. J AM Diet Assoc. 2010 May; 110: 719 - 726. B5 Musa - Veloso K, Poon, et al. Comparison of LDL - Cholesterol lowering efficacy of plant stanols and plant sterols over continuous dose range: results of meta - analysis of randomize, placebo - control trials. Prostaglandins Leukot Essent Fatty Acids. 2011; 85: 9 - 28. B6 Amir Shaghaghi M, Abumweis SS, et al. Cholesterol - lowering efficacy of plant sterols / stanols provided in capsule and tablet formats: results of systematic Review and meta - analysis. J Acad Nutr Diet. 2013 Nov; 113: 1494 - 503. B7 Castellanos - Jankiewicz, Del Bosque - Plata L, et al. Combined effect of plant sterols and dietary fiber for treatment of hypercholesterolemia. Plant Foods Hum Nutr. 2014 Jun; 69: 93 - 100. B8 Malhortra, Shafiq N, et al. Dietary interventions for familial hypercholesterolaemia. Cochrane Database Syst Rev. 2014;: CD001918. B9 Ras RT, Geleijnse JM, et al. Ldl - Cholesterol - lowering effect of plant sterols and stanols across different dose ranges: meta - analysis of randomise controlled studies. Br J Nutr. 2014; 112: 214 - 219. B10 Han S, Jiao J, et al. Effects of plant stanol or sterol - enrich diets on lipid profiles in patients treated with statins: systematic Review and meta - analysis. Sci Rep. 2016 Aug 19; 6: 31337. Ebsco NAT Review Board Eric Hurwitz, DC 201907 20200327

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A Caveat From Some Experts

Research aside, some experts say people are better off getting their nutrients from whole foods. Whole foods offer a complex combination of nutrients that work together in ways we don't fully understand. Getting nutrients from whole foods is the best way to go, say ADA spokeswoman Keecha Harris, DrPH,. Supplements that are fortified with sterols do not offer as many benefits as getting sterols and stanols as they naturally occur. The American Heart Association doesn't recommend sterol and stanol - fortified foods for everyone. Instead, it suggests that only people who need to lower their cholesterol or who have had heart attack should use them.

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Article Info

Table

Product nameServing sizeCalories per servingTotal fat per serving (g)Saturated fat per serving (g)Plant sterol or stanol per serving (g)
Blue Bonnet: Plant Sterols1 pill0000.5
Centrum Specialist Heart dietary supplement2 tabletsn/an/an/a0.8
GNC Preventive Nutrition CardioAid1 pilln/an/an/a0.8
Nature Made CholestOff2 tabletsn/an/an/a0.9

Plant sterols and plant stanols are normal components of plants, which are not synthesize in humans, so they are derived from dietary sources. They have gained a lot of interest during the last two decades after foods and supplements with added plant sterols / stanols were launched as effective and safe non - pharmacologic hypocholesterolemic agents, and also after mechanisms of intestinal absorption and hepatic excretion of cholesterol and plant sterols / stanols were unraveled. Even though there is ample available research on plant sterols / stanols, there are items not clarified in detail or which are scattered in original publications. Metabolism of plant sterols / stanols in humans and their role and possible clinical consequencies in parenteral nutrition are examples of topics welcome to gather available information at moment. The main clinical effects of plant sterols / stanols are on circulating lipids, but there is also information on their effects on other atherosclerotic risk factors such as inflammation and fatty liver, so that topic of dyslipidemia, metabolic syndrome, and fatty liver deals with their role in preventing atherosclerosis. Finally, effect of dietary fat on the interplay of cholesterol and plant sterols / stanols in the intestine is important and has practical consequencies, but is very little dealt with in literature, and whether plant sterols / stanols accumulate in human tissues and whether they have atherogenic potential are important clinical issues which need objective and detailed examinations. To this end, you are cordially invited to submit proposals for manuscripts that fir objectives and topics of this Special Issue. Submit manuscripts should not have been published previously, nor be under consideration for publication elsewhere. All manuscripts are thoroughly refereed through a single - blind peer - review process. A Guide for Authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer - review open - access monthly journal published by MDPI. Please visit Instructions for Authors page before submitting manuscript. The Article Processing Charge for publication in this open access journal is 2000 CHF. Submit papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.


Sitosterolemia

Once gene defects were identify, it became possible to dissect pathophysiology, using in vitro as well as animal modelling methodology. Absence of ABCG5, ABCG8 or both results in elevation of plant sterols in tissues and blood and failure to excrete sterols into bile 24 - 31. Over expression of ABCG5 and ABCG8 in mice transgenic for human genes led to super saturation of cholesterol in bile and protected animals against atherosclerosis. Careful studies in ABCG8 knockout mice show that there was increased intestinal absorption of both cholesterol and non - cholesterol sterols. Together with failure to excrete cholesterol, even when force, loss of sterolins shows that these proteins are cholesterol and non - cholesterol transporters for excretion at intestinal and biliary level. Interestingly, mice heterozygous for ABCG8 loss show an intermediate phenotype for biliary sterol excretion. To investigate whether humans who are heterozygous for mutations in ABCG8 12 heterozygotes were fed diets low in fat and cholesterol or enriched with plant sterols or stanols 32. Blood levels of plant sterols increase significantly in heterozygotes while on an enriched diet, and LDL - cholesterol levels decrease significantly while on a low fat diet. These studies confirm earlier smaller studies by Salen and colleagues suggesting that heterozygous individuals may have subtle phenotype 33.

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How do plant sterols work?

Plant sterols are compound that help block your body from absorbing cholesterol. While plant sterols help lower LDL cholesterol, they do appear to affect your levels of HDL cholesterol or triglycerides. One Canadian study concluded that plant sterols are the most effective natural treatments for high cholesterol. Fruits, vegetables, vegetable oils, wheat bran and wheat germ cereals, legumes nuts, all of these foods contain low levels of plant sterols, though. So eating these foods may not make big impact on your cholesterol level. The easier way to get enough plant sterols to lower your cholesterol level is through eating fortified foods. Plant sterols are added to certain foods, including some kinds of orange juice, yogurt, and margarine. To reap cholesterol - lowering benefits, you need to consume at least 2 grams of plant sterols per day. This equals about two 8 - ounce glasses of Sterol - fortified orange juice per day. As for how effective plant sterols are, one study examined people with high cholesterol who use margarine that contains plant sterols instead of regular margarine. A study found that these people were able to lower their LDL cholesterol levels by 14 percent in one year.


What do plant stanols and sterols do?

One concern with plant stanols and stanols is that they may reduce absorption of fat - soluble vitamins. However, in general, any reduction in fat soluble vitamins can be compensated for by making sure you eat a diet that is rich in fruit and vegetables. As consumption of plant sterols and stanols can interfere with absorption of beta - carotene, it is important to choose at least one fruit or vegetable high in beta - carotene daily. It is unlikely that people with normal levels of cholesterol will benefit from including plant stanols and sterols fortify foods. As cholesterol is essential for normal growth, these products are not recommended for children or women who are pregnant or breastfeeding unless on advice of a doctor or dietitian.


Sitosterolemia

A 22 - year - old woman present at the orthopedic clinic complaining of pain in both her heels and knees. She had tendon xanthomas with a history of hand xanthomas beginning at age 8 years, which progressed to patellar, plantar, and Achilles tendon involvement. The patient has a sister who has a similar phenotype. This combination of arthralgia and tendon xanthomas is associated with the diagnosis of familial hypercholesterolemia. Familial hypercholesterolemia is characterized by hypercholesterolemia, tendon xanthoma, arthralgia and a family history of premature heart disease. It is relatively common and occurs in 1 in 200 to 500 of the general population. Diagnosis is typically confirmed by the lipid panel, which reveals LDL - cholesterol level of > 200 mg / dL accompanied by positive family history of premature heart disease and hypercholesterolemia. In two sisters, total cholesterol levels were borderline high at 195 mg / dL and 206 mg / dL. Serum triglyceride levels were 81 mg / dL and 63 mg / dL. Their parents had tendon xanthomas, but were otherwise normal with no family history of hyperlipidemia or cardiovascular disease for the previous two generations. Absence of family history is not consistent with diagnosis of familial hypercholesterolemia. The original description of rare disorder - sitosterolemia and xanthomatosis was reported by Bhattacharyya and Connor in 1974 6. Sitosterolemia or phytosterolemia is autosomal recessive disorder 7. It is an exceedingly rare disorder that affects fewer than 1 patient per 1 million population, with about 20 cases reported so far in the US. Underlying pathophysiology is increased absorption of dietary sterols, loss of discrimination between cholesterol and non - cholesterol sterols and reduced excretion of sterols into bile 8 9. Sitosterolemia is associated with tendon xanthomas, increased coronary atherosclerosis, and hemolysis 7. Include in differential diagnosis is cerebrotendinous xanthomatosis. Laboratory testing reveals elevated plasma levels of phytosterols that are typically > 10mg / dL, of which sitosterol is major species. Segregation analysis in the larger Amish family show that sitosterolemia was inherited as autosomal recessive disease, suggesting a single locus was defective 10. This locus is thus responsible for determining dietary sterol discrimination, cholesterol absorption, and biliary cholesterol secretion. In healthy individuals, mechanisms exist that permit the body to distinguish between sterols. In sitosterolemia, either absorption of sterols is increased or excretion is decreased, resulting in markedly elevated plasma non - cholesterol levels. Major consequence of sitosterolemia is an increased risk of cardiovascular disease 11. Although the prevalence of premature atherosclerotic disease in patients with sitosterolemia has not been fully defined because of the rarity of condition, it is estimated that more than half of patients have documented coronary artery disease. Greater understanding of mechanisms involved in metabolism of cholesterol might result in better treatment options for sitosterolemia, but also could provide better understanding of cholesterol absorption and excretion.

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Source(s)

Table 1. Total Phytosterol Content of Selected Foods

FoodServingPhytosterols (mg)
Soybeans, mature seeds, rawcup149
Peas, green, mature seeds, rawcup133
Sesame oil1 tablespoon (14 g)118
Kidney beans, mature seeds, rawcup117
Pistachio nuts1 ounce (49 kernels)61
Safflower oil1 tablespoon (14 g)60
Lentils, pink or red, mature seeds, rawcup54
Cashew nuts1 ounce45
Soybeans, green, cooked, boiledcup45
Cottonseed oil1 tablespoon (14 g)44
Orange, raw1 fruit34
Macadamia nuts1 ounce (10-12 kernels)33
Almonds, blanched1 ounce32
Olive oil1 tablespoon (14 g)30
Banana, raw1 large24
Brussels sprouts, raw1 cup21

Almost everyone has eaten cholesterol - lowering foods like walnuts, salmon, and oatmeal. But what's plant Sterol or stanol? And do you really want to eat it? Most experts say yes. Eating Sterol and stanol - containing foods is an easy way to lower your LDL cholesterol, which helps reduce the risk of heart disease, said Ruth Frechman, spokeswoman for the American Dietetic Association. Plant sterols and stanols are substances that occur naturally in small amounts in many grains, vegetables, fruits, legumes, nuts, and seeds. Since they have powerful cholesterol - lowering properties, manufacturers have started adding them to foods. You can now get stanols or sterols in margarine spreads, orange juice, cereals, and even granola bars.

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6. Soya foods

If you have been told you need to reduce your cholesterol levels, there are four foods you could try to eat every day. Soluble fibre, plant stanols and sterols, soy protein and nuts are known to lower cholesterol. This is according to research by the British Heart Foundation. Eating these four as part of your healthy diet can lower your cholesterol level by up to 24%, as much as low - dose statin. However, you must not stop taking your prescribed medication. Porridge is a great way to start the day - for more reasons than one. Eating 70g bowl of porridge a day is equal to consuming 3g of beta glucan. 3 grams is regarded as the optimum amount of beta glucans to reduce bad low - density lipoprotein cholesterol. Other rich sources of soluble fibre are barley, oat bran and wholegrains, such as wholegrain cereals, breads, brown rice and whole wheat pasta. Other good sources of soluble fibre are fruit and vegetables. Some options are: apples, citrus fruits, strawberries, prunes, plums, avocados, aubergines, carrots, broccoli, okra, sweet potatoes and onions. Pulses are also excellent sources: kidney beans, soya beans, peas, lentils or chickpeas. According to cholesterol charity Heart UK, plant sterols and stanols - used in brands such as Flora ProActiv and Benecol - can lower cholesterol. Stenols and stanols are found naturally in plants and absorb bad LDL cholesterol. This reduces LDL levels by up to 10% when you eat 2g a day regularly as part of a healthy, balanced diet. Soya is a great source of vegetable protein, low in saturated fat and high in fibre. Soya also includes special proteins that appear to influence how the body regulates cholesterol. Swap cow milk for soya milk or try soya yogurts as snacks. Other sources include soya beans or mince as well as tofu. Some studies show that by eating 15g of soya protein a day you can lower your cholesterol by around 6%. If you opt for unsalted, unsweetened varieties, 30g of nuts a day are great addition to your diet. Nuts contain healthy unsaturated fats and soluble fibre. This can help to lower cholesterol by up to 7. 5%. Almonds, cashews, hazelnuts, natural peanuts and pistachios are all excellent choices. For more information on lowering your cholesterol, see Heart UK and British Heart Foundation.

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Results

Plant sterol containing products decrease LDL levels by 0. 31 mmol / L compared with placebo. Between trials, heterogeneity was evident, indicating that observe differences between trial results were unlikely to have been caused by chance. Reductions in LDL levels were greater in individuals with high baseline LDL levels compared with those with normal to borderline baseline LDL levels. Reductions in LDL were greater when plant sterols were incorporated into fat spreads, mayonnaise and salad dressing, milk and yoghurt compared with other food products such as croissants and muffins, orange juice, non - fat beverages, cereal bars, and chocolate. Plant sterols consumed as single morning dose do not have significant effect on LDL cholesterol levels. Dietary incorporation of plant sterols and stanols is recommended for blood cholesterol reduction. Berger et al. Review clinical trials on the efficacy of plant sterols as cholesterol lowering agents and report that consumption of plant sterols / stanols has been reported to reduce low density lipoprotein cholesterol levels by 5 - 15%. Reasons for such large variations need to be investigate. Earlier studies that have tested the efficacy of plant sterols / stanols as cholesterol lowering agents incorporate plant sterols / stanols into either regular or low fat spreads. Since it appears counterintuitive to use high fat food products to deliver cholesterol lowering agent,ss clinical trials have been conducted to test the efficacy of plant sterols / stanols incorporated into low fat products. A number of clinical trials have tested the efficacy of plant sterols / stanols incorporated into low fat foods, including low fat milk, low fat yoghurt, bakery products, orange juice, cereal bars and low and non - fat beverages. However, although plant sterols / stanols that are incorporated into low fat food have been shown to reduce blood cholesterol, same food carrier tested in different trials gave different magnitude in LDL cholesterol reduction. Plant sterol / stanol enriched yoghurt and milk drinks have resulted in LDL cholesterol reduction in the range of 5 - 14% in various clinical trials. Study by Clifton et al. Compare the effect of plant stanol esterify to fatty acids and incorporated in a number of food matrices, including bread, breakfast cereal, milk and yoghurt on plasma lipids. Plant stanol esters in low fat milk were almost three times more effective than in bread and cereal in lowering plasma cholesterol levels. Whether all plant sterols / stanols enrich low fat food matrices are efficacious as plant sterol / stanol enrich spread carrier in lowering blood cholesterol has not been studied thoroughly. It remains to be determined which food matrices are viable carriers to deliver effective doses of plant sterols / stanols. The optimal number of servings per day of plant sterol / stanol containing products was addrest in only one study. Plat et al. Show that 2. 5 g of plant stanols in margarines and shortenings consumed for four weeks once per day at lunch or divided over three meals, lowers LDL cholesterol levels to a similar extent, about 10%. Intake of single dose of plant sterol / stanol enriched products is thought to increase consumers compliance and add convenience.

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Discussion

Phytosterols, comprising both plant sterols and plant stanols, are compounds that naturally occur in all foods of plant origin, such as vegetable oils, nuts, seeds, grain products, fruits and vegetables. The Intake of naturally occurring PS from general diet is about 200 - 400 mg / d. Higher PS intakes can be achieved by consuming vegetable - base diets such as vegetarian diets for which PS intakes are almost double, or by consuming food products enriched with PS. Ps - enriching foods are well known for their total cholesterol - and especially LDL - cholesterol - lowering properties. Having elevated LDL - cholesterol concentrations is one of the most important risk factors for CVD. Ps - enrich foods are considered a valuable option as part of a healthy diet and lifestyle changes in management of hypercholesterolaemia. Since the 1950 s, abundant research into the LDL - cholesterol - lowering effect of PS has been carried out and this wealth of evidence has been summarise in several meta - analyses. In these meta - analyses, dose - response relationship for LDL - cholesterol - lowering efficacy of PS has been investigate. Meta - analyses carried out by Law, katan et al. And Abumweis et al. Describe dose - response relationship based on calculation of average LDL - cholesterol - lowering effects for different categories of PS doses. More recently, Demonty et al. Have investigate continuous dose - response relationship, as determined by first - order elimination function based on the assumption that processes involved in cholesterol transport and absorption are saturable. Musa - Veloso et al. Subsequently, established similar continuous dose - response curves, but this time for plant sterols and stanols separately. Overall, these analyses conclude that with increasing dose of PS, LDL - cholesterol - lowering effect increases, but that this effect tapers off at doses of 2 - 3 g / d. Applied approaches used to study dose - response relationship differ between showing average effects for ranges of doses and establishing continuous dose - response functions. Both approaches have advantages and disadvantages. Establishing a continuous dose - response relationship has the advantage that IT allows predicting effects for give dose of PS. However, shape of curve largely depends on distribution of studies across an entire range of doses; if this distribution is not balance, this type of analysis may become vulnerable to over - or underestimation of estimated effects at certain doses. For example, in meta - analysis carried out by Musa - Veloso et al., Depict plant sterol curve clearly underestimated the effects of plant sterols at doses of 27 - 33 g / d. As a result, it was suggested that a larger maximum lowering effect exists for plant stanols than for plant sterols. Calculation of average effects for predefined ranges of PS doses is less sensitive to potential over - or underestimation, but this approach does not allow predicting effects over a continuous range of doses. So far, calculation of weighing averages for different dose ranges has not been done for plant sterols and stanols separately. Such analysis would provide useful insights into the comparison of LDL - cholesterol - lowering efficacy of these two types of PS for which some debate exists.


How the intervention might work

Three shortterm trials of adults with FH were included in this intervention group. In the 2005 Ketomaki trial, adults with FH receiving hypolipidaemic drugs were randomise to receive either plant sterols or stanols. The Trial was of crossover design and does not allow comparison of addition of plant sterols or stanols supplementation to drug treatment. In another trial by Ketomaki, 16 out of 23 children had FH. Data from these children were not reported separately and authors were contacted for this information. This trial compared plant sterol and sterol ester spread added to a lowfat diet given to all participants. The third trial was of parallel design with three separate treatment groups: plant sterols versus lowdose plant stanols versus highdose plant stanols. This trial had 69 FH participants who were included alongside unaffected individuals. Authors do provide data for 69 individuals with FH. However, these data were not in format which could be used for analysis; percentage changes in lipid levels were given instead of actual values.

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Materials and Methods

Sediment cores were retrieved using Glew & Smol shallow - water push corer and section into 0. 5 cm intervals using Glew extruder. For all eight sediment cores, freeze - dried sediments were dated using 210 Pb and 137 Cs radiometric dating techniques, with radioisotopic activity measure using Ortec High - purity germanium gamma spectrometer. Sediment chronologies were calculated using the Constant Rate of Supply model with S cien T issi M E software. Radioisotope activities and dating profiles for East Brother, Pigeon, Main Duck and False Duck have been previously published by Stewart et al. For sediment records from ponds Gull, Calf, High Bluff and Little Gallo, approximately 10 intervals evenly space through each core were analyse for total Pb concentrations using inductively couple plasma mass spectrometry at SGS Canada, certified by Canadian Association for Laboratory Accreditation Inc. In the Great Lakes region, there were steady increases in atmospheric Pb emissions owing to industrialization since 1830s, as well as onset of leaded gasoline in 1920s. Atmospheric Pb deposition subsequently decreased with the discontinuation of leaded gasoline in the 1970s. Here, we confirm the accuracy of our total Pb profiles by matching trends with those of 1991 core from eastern Lake Ontario. Sediment chronologies were used when verified total Pb trends had reasonable agreement with CRS - derive dates and timing of historical deposition. To examine whether modern - day sterol composition within sediments differs from past sterol composition, we use a palaeolimnological approach that compares two discrete time intervals across spatial gradient. These types of regional assessments can efficiently address broad - scale questions about environmental change. Bottom samples provide integrated samples of sterols and stanols present in pre - impact or pre - bird environment. By contrast, top surface sediment samples provide integrated samples of sterols and stanols present in modern - day aquatic habitats. Additionally, for one reference site and two impact sites, we completed sterol and stanol analysis at higher temporal resolution. For 15 N analysis, freeze - dried sediments were weighed into tin capsules with two parts tungsten trioxide, with analytical details provided in electronic supplementary material. The Organic matter content of sediment samples was determined using the Loss - on - Ignition method. In addition to analysing sterols and stanols in sediment cores, total of three guano samples were collected from cormorants, ring - bill gulls and herring gulls that defaecated while being handled by ornithologists, and analyse independently for sterol and stanol composition. Nine sterols and stanols that were examined in all samples include: coprostanol, epicoprostanol, coprostanone, cholesterol, 5 - cholestanol, cholestanone, stigmastanol, and sitosterol. Analytical methods for analysing sterols and stanols in sediments were modified by Birk et al. And Cheng et al. And detail in electronic supplementary material,s along with detection limits and quality assurance / quality control measures. Use of different ratios for determining the range of waterbird's influence on different ponds was explored both spatially and temporally.


Plant sterols and stanols

Sterols are an essential component of cell membranes, and both animals and plants produce them. Sterol ring is common to all sterols; differences are in the side chain. Cholesterol is exclusively animal sterol. Over 40 plant sterols have been identified. But - sitosterol, campesterol, and stigmasterol are most abundant. These three sterols are structurally similar to cholesterol: they are all 4 - desmethyl sterols. Stanols are saturate sterols. Stanols are less abundant in nature than sterols. Plant stanols are produced by hydrogenating sterols. The term sterol is sometimes used as a generic term to include unsaturated sterols and saturated stanols, but it is used here to refer specifically to unsaturated compounds. It was realised in the 1950s that plant sterols lower serum concentrations of cholesterol 15; they do this by reducing absorption of cholesterol from the gut by competing for limited space for cholesterol in mixed micelles. 6 11 16 - 18 in Europe, average consumption of butter or margarine is 25 g per person each day, and fortified margarines contain 2 g of plant sterols or stanols per daily portion. About 0. 25 g of plant sterols and 0. 3 g of cholesterol occurs naturally in daily diet; amount of plant sterols consumed daily is twice as high in vegetarian diet. Add plant sterols or stanols in fortified margarine reduces absorption of cholesterol in the gutboth, dietary and endogenous, by about half, from a normal proportion of about half of total cholesterol to one quarter. This reduced absorption lowers serum cholesterol despite a compensatory increase in cholesterol synthesis which occurs in the liver and other tissues. 6 11 Plant sterols are potentially atherogenic like cholesterol 19, but atherogenesis does not occur because so little of plant sterols are absorb. 16 use of plant sterols as cholesterol lowering drugs has been limit: initially the market was small and later greater efficacy of statins was evident. In the 1980s, however, it was realised that as naturally occurring substances plant sterols and stanols could be added to foods. Because fats are needed to solubilise sterols, margarines are ideal vehicle for them, although cream cheese, salad dressing, and yoghurt are also used. Esterification of plant sterols and stanols with long chain fatty acids increases their lipid solubility and facilitates their incorporation into these foods. Benecol was the first fortified margarine, and stanols were added because evidence suggests that they had greater potential to lower cholesterol than sterols and the amount absorbed from the gut is negligible. 16 18 20 21

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Author information

In the present study, mean intake of PS among nonusers of PS - enriched products was 363 mg / d for men and 286 mg / d for women, whereas mean intake of PS among users was 2. 2 g / d for men and 1. 6 g / d for women. It seems that dietary intake of naturally occurring plant sterols has slightly increased when compared with estimated intakes according to FINDIET 1997 Survey by Valsta et al., 2 in which means PS intake was 305 mg / d for men and 237 mg / d for women. By contrast, cholesterol intake has slightly decreased in comparison with intake in the 1997 study. Intake of plant sterols among users of PS - enrich products has not been assessed earlier in the Finnish population. Plant stanol ester - enriching products were brought to market in Finland in 1995, and some years later, products with plant sterol enrichment were introduced to Finnish consumers. During data collection in 2007, several PS - enrich commercial products were on the market in Finland, including plant sterol - and plant stanol ester - enriched margarines, yoghurt drinks, milk, sour milk, pasta and cheese - like products. As the LDL - clowering effect of plant sterols and stanols is well establish, use of PS - enrich products has become an increasingly popular treatment for lowering high serum LDL - C levels. According to data collected in Finland between 1996 and 2000, plant stanol ester margarine was used as bread spread by 4. 5% of subjects. 13 Almost half of plant stanol ester margarine users and one - fourth of nonusers report having cardiovascular disease. 13 in the national FINRISK 2002 Study, 6% of subjects use plant sterol - or plant stanol ester - enrich bread spread, and almost 80% of users report having high or elevated blood cholesterol levels. 14 present data from the FINDIET 2007 Survey demonstrate that 9. 5% of subjects use some PS - enrich food product, including both plant sterol - and plant stanol ester - enrich products. Use of PS - enrich foods was more common in older people and among subjects with cholesterol - lowering medication than in subjects without medication. However, most people on cholesterol - lowering medication do not consume PS - enriching foods. Use of PS - enriched foods was more common in subjects with higher educational level; in general, people with higher educational level are more health conscious and tend to follow healthy diets than those less educated. 15 16 Among users of PS - enrich foods, contribution of fat, saturated fat and monounsaturated fat to energy was lower than in nonusers even after adjusting for age, education and use of cholesterol - lowering medication and / or cholesterol - lowering diet. This may be partly explained by the fat composition of PS - enrich margarines, which are low in their fat and saturated fat content; However, users and nonusers may also differ with respect to other dietary behaviour. As a matter of fact, intake of cholesterol was lower in user men than in nonuser men, and the difference became significant in women after adjusting for cholesterol - lowering medication and / or diet.


Sitosterolemia

The case was reported of a 19 - year - old male who presented with chronic active liver disease and after extensive evaluation was found to have sitosterolemia 34. Liver disease has not been reported to be a feature in sitosterolemia. In contrast, diagnosis of idiopathic cirrhosis is not an uncommon diagnosis in people presenting with progressive liver failure. Since sitosterolemia requires analyses of blood by GC or HPLC for these sterols, it is possible that such cases are not diagnose. Interestingly, our patient underwent orthotopic liver transplantation, which reduced his plant sterols to near - normal values, suggesting that restoration of normal sterolin activity in the liver alone is sufficient to effect cure 34. Rees and colleagues report five pedigrees with Mediterranean stomatocytosis or Mediterranean macrothrombocytopenia, which combine stomatocytic hemolysis with the presence of very large platelets 35. All patients had grossly elevated plasma levels of phytosterols and all showed mutations in ABCG5 and ABCG8 transporters. Authors conclude that Mediterranean stomatocytosis / macrothrombocytopenia is caused by excess of phytosterols, that phytosterolemia can be diagnosed based on distinctive hematology findings including unexplained hemolysis and macrothrombocytopenia, and that phytosterolemia should be considered in differential diagnosis of all patients with large platelets 35. Subsequent follow up study of one of these families show that sitosterolemia was also associated with adrenal and ovarian failure, suggesting that build up of non - cholesterol sterols can lead to disruption of steroid hormone pathway synthesis, although it should be emphasized that these features are not classically present in most cases of sitosterolemia 36.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

1. Introduction

Throughout much of human evolution, it is likely that large amounts of plant foods have been consume. In addition to being rich in fiber and plant protein, diets of our ancestors were also rich in phytosterols plant - derive compounds that are structurally very similar to cholesterol. There is increasing evidence to suggest that reintroduction of plant foods providing phytosterols into modern diets could improve serum lipid profiles and help reduce the risk of cardiovascular disease. Cholesterol in human blood and tissues is derived from diet, as well as from endogenous cholesterol synthesis. In contrast, all phytosterols in human blood and tissues are derived from diet because humans cannot synthesize phytosterols. While cholesterol is the predominant sterol in animals, including humans, variety of sterols are found in plants. Nutritionists recognize two classes of phytosterols: plant sterols have double bond in sterol ring. The most abundant sterols in plants and human diet are - sitosterol, campesterol, and stigmasterol. Plant stanols lack double bond in sterol ring. Stanols, especially sitostanol and campestanol, comprise only about 10% of total dietary phytosterols.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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