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Assessment
(2005) How might the consumption of carotenoid-rich fruits or vegetables alter plasma carotenoid levels when also consuming sterols?
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Conclusion
(2005)
Preliminary research suggests that consuming one extra carotenoid rich fruit or vegetable per day has been shown to maintain plasma carotenoid levels when also consuming sterol-enriched spreads.
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Grade: III
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
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Conclusion
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Intervention
(2005) Can plant stanols further reduce LDL cholesterol and total cholesterol even for people receiving statin therapy?
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Conclusion
For patients receiving statin therapy, plant stanols further reduce LDL cholesterol and total cholesterol.
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Grade: I
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
(2005) Can statin dose be reduced through the use of stanols and sterols?-
Conclusion
Data regarding whether the dose of statins can be reduced by the use of stanols and sterols are needed.
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Grade: V
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
(2005) How are the effects of stanols and sterols on cholesterol levels altered when eaten as part of a cholesterol lowering diet?-
Conclusion
The total cholesterol and LDL cholesterol lowering effects of stanols and sterols are evident even when sterols and stanols are consumed as part of a cholesterol lowering diet.
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Grade: I
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
(2005) How do esterified and nonesterified forms of stanols and sterols compare in terms of their cholesterol lowering ability?-
Conclusion
Nonesterified and esterified forms of sterols and stanols are equally effective. Consumption of 2-3 g of nonesterified sterols and stanols reduce TC by 4-11% and LDL-C by 8-15% and esterified sterols and stanols reduce TC by 6-10% and LDL-C by 7-15%.
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Grade: III
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
(2005) What effect does the intake of plant sterols and stanols have on total cholesterol and LDL cholesterol?-
Conclusion
Plant sterols and stanols are potent hypocholesterolemic agents and a daily consumption of 2 - 3 g (through margarine, lowfat yogurt, orange juice, breads, and cereals) lowers TC concentrations in a dose dependent manner by 4 – 11% and LDL cholesterol concentrations by 7 – 15% without changing HDL cholesterol or triacylglycerol concentrations.
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Grade: I
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
(2006) How do sterols and stanols compare in terms of their efficacy in lowering cholesterol?-
Conclusion
The cholesterol loweing effects are similarly caused by sterols and stanols. Sterols lowered TC by 6-11% and LDL-C by 7-15%. Stanols lowered TC by 4-10% and LDL-C by 7-14%. Although the reduction in TC and LDL-C are similar, two high-quality randomized controlled trials in hypercholesterolemic adults report slightly greater though non-significant effects with consumption of stanols compared to sterols.
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Grade: II
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
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Conclusion
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Monitoring and Evaluation
(2005) Are there any unintended adverse effects when consuming stanols and sterols?
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Conclusion
It is unclear whether there are unintended adverse effects when consuming stanols and sterols. Some studies have observed no significant differences in plasma carotenoid concentrations, including alpha-carotene and lycopene and vitamins A, D and E, but other studies have found that alpha-tocopherol, alpha- and beta-carotene plasma concentrations decrease after consumption of sterols and stanols, even after adjusting for changes in plasma lipid levels.
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Grade: V
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
(2005) What does the research indicate about the safety of stanol and sterol intake?-
Conclusion
At an intake of 2 - 3 g of plant sterols and stanols per day generally appears to be safe.
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Grade: II
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
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Conclusion