23.08.2011 copyright® raisio effect of a plant stanol ester-containing spread, placebo spread, or...
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23.08.2011 Copyright® Raisio
Effect of a plant stanol ester-containing spread, placebo spread, or Mediterranean diet on estimated cardiovascular risk and lipid, inflammatory and haemostatic factors
Athyros et al. Nutr Metab Cardiovasc Dis 2011; 21(3): 213-221.
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 2
Methods I
Parallel, randomized, placebo-controlled study
N=150, mildly hypercholesterolaemic (5,2–6,4 mmol/l) subjects 4-week run-in with a NCEP Step I diet, intervention for 16 weeks
Placebo spread; NCEP Step I diet Plant stanol ester containing spread (2 g plant
stanols/d); NCEP Step I diet Mediterranean diet
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 3
Methods II
Outcome measures:
Individual risk factors: changes in lipids and lipoproteins (TC, LDL-C, HDL-C,
TG, apo B, apo A1) blood pressure haemostatic factors (plasma fibrinogen & PAI-1
activity) inflammatory marker (hsCRP)
Estimated CVD risk (Framingham, PROCAM & Raynolds risk engines)
Percentage of patients at NCEP Total Cholesterol target (< 5.2 mmol/l)
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 4
Results I
Effect of intervention on risk factors:
Placebo: no significant effect on any of the risk factors
Plant stanol ester: TC ↓, LDL ↓ and hsCRP ↓ (statistically significant change in all)
Mediterranean diet: TC ↓, LDL ↓, TG ↓, blood pressure ↓, hsCRP and thrombotic markers ↓; HDL ↑(statistically significant change in all)
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 55
* * * *
*
Plant Stanol Ester effectively lowers LDL-cholesterol
Control spread n=50
Mediterraneandiet n=50
Plant stanol ester spread (plant stanol 2 g/d) n=50
% CHANGE IN LDL-CHOLESTEROL
*
*
%
months
** *
*p <0.01 vs. control
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 6
Results II
Estimated cardiovascular disease risk:
• Placebo: no effect on estimated disease risk
• Plant stanol ester: eCVD risk reduction of 26–30 % in 1 month with all risk engines used, sustained the 4 months intervention
• Mediterranean diet: eCVD risk reduction of 24–32% in 4 months with all risk engines used
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 7
Effective reduction in the estimated risk of cardiovascular diseases with use of Plant Stanol Ester
EFFECTIVE REDUCTION IN THE ESTIMATED RISK OF CORONARY ARTERY DISEASE (CAD)
Control spread n=50A change in the estimated CAD risk during the following 10 years (Framingham risk engine)
Mediterraneandiet n=50
Plant stanolester spread(2 g of plantstanols / day) n=50
Months
*
*
**
*
*=p<0.05 vs. control
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 8
Results III
Percentage of subjects meeting target level for total cholesterol (<5.2 mmol/L) by the end of the study:
• Placebo: 14 %• Plant stanol ester: 80 %• Mediterranean diet: 46 %
Athyros et al. Nutr Metab Cardiovasc Dis 2011. 9
Conclusions
Mediterranean diet was efficient in reducing the estimated CVD risk by several mechanisms but the change was fully seen only after 4 months
Plant stanol ester reduced the estimated risk of CVD as effectively already after 1 month
The use of plant stanol ester products is especially beneficial for those individuals who are unable to adopt Mediterranean diet
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Thank You!