12 January - 20 June 2016

Effect of phytosterols and inulin-enriched soymilk on LDL-cholesterol in Thai subjects

2 December 2015

A high level of low-density lipoprotein cholesterol (LDL-c) is a risk factor for cardiovascular diseases (CVD). According to a recent Thai study this risk could be lowered by consuming phytosterols which are found in plants (e.g. nuts, legumes and seeds). At present the phytosterol intake in the Thai as well as western diets are inadequate (< 2g/day) and the way to raise the levels of phytosterols in diets could be by consuming phytosterols-enriched soymilk, suggest Thai researchers in the recent Journal of Lipids in Health and Disease. The researchers conducted a double blinded randomized controlled trial to study the effect of phytosterols and inulin-enriched soymilk on cholesterol levels. In the study, 240 subjects (≥ 18 years old) with baseline LDL-c of 130mg/dl or higher were consuming either 1g of phytosterols twice a day and 5g of soymilk with inulin twice a day (study group) or standard soymilk (control group). In previous studies it was reported that phytosterols have a neutral effect on triglyceride (TG) or high density lipoprotein cholesterol (HDL-c) but they have an ability to inhibit the absorption of cholesterol. Inulin has the capability to reduce TGs and though still controversial TG may be linked to CVD.

Based on regular measurement of participants’ lipid profile (every 2 weeks for 8 weeks) Kietsiriroje et al. could conclude that phytosterols significant reduce LDL-c. There was a significant reduction of LDL-c in both groups, however stronger reduction (10 %) was observed in people consuming phytosterols and inulin-enriched soymilk than in those who drunk standard soymilk (1.3%). In the study group the median LDL-c dropped from 165 mg/dl to 150 mg/dl and in the control group from 165 to 159. The study group also had stronger reduction in TC (6.6%) than the control group (1.76%). There was no significant difference in TG and HDL-c between the groups.

“The effect of phytosterols may be influenced by the types of food carriers” the authors highlight. For example the effect may be dependent on what food phytosterols are served with be it high fat cheese or low fat yogurt. There is evidence for both high fat and low fat foods to be preferential as a phytosterol carrier. The authors of this study chose soymilk that also proved to be a good carrier of phytosterols. Kietsiriroje et al. warns that the study is not free from limitations because it doesn’t determine the synergistic effect of phytosterols and statin, it was a short term study that didn’t show the effect on CVD though it did show the effect on lipid profile; and finally the participants were lean and healthy thus it didn’t show effects on subjects with diabetes and/or metabolic syndrome.

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