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      Efeitos terapêuticos dos fitosteróis e fitostanóis na colesterolemia

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          Abstract

          Os ésteres de esterol e estanóis vegetais são reconhecidos como componentes "funcionais" dos alimentos por apresentarem propriedades hipocolesterolêmicas. Os fitosteróis são compostos esteróis osbtidos de óleos vegetais. Neste estudo foi realizado uma análise críticarevisão de estudos experimentais e clínicos recentes, publicados em base de dados Medline e Lilacs, abordando a ação farmacológica dos fitoesteróis e fitoestanóis na colesterolemia. Os efeitos hipocolesterolemiantes são observados pela ingestão de doses maciças, em dose única ou múltipla, de até 2,5 g/dia destes compostos. O consumo diário por durante quatro semanas tem evidenciado a redução dos níveis sanguíneos de colesterol total (CT) e LDL-colesterol (LDL-c) em cerca de 10%. O mecanismo de ação na diminuição da colesterolemia se deve, possivelmente, à sua semelhança estrutural com o colesterol, o que favorece uma competição na absorção intestinal, entre ésteres de esterol e/ou estanol e o colesterol. Efeitos adversos da suplementação de fitosteróis e fitostanóis ocasionaram a diminuição da absorção de algumas vitaminas e antioxidantes lipossolúveis.

          Translated abstract

          Therapeutic effects of phytosterols and phytostanols in cholesterolemia. Plant sterol and stanol esters are called "functional" compounds due to their hypocholesterolemic properties. The objective of this review is to update recent findings concerning the effect of phytosterols in the blood cholesterol, emphasizing the results from experimental and human studies. The hypocholesterolemic effect is observed with the intake of 2.5g/day of phytosterols or phytostanols. Daily intake, usually of stanols, for 4 weeks has shown to to be effective in lowering blood total- as well as LDL-cholesterol by about 10%. The mechanism of action in lowering blood cholesterol comes from their structural similarity to cholesterol, hence they act by competing with cholesterol at the luminal absorption site. The adverse effects of a high intake of phytosterols and phytostanols are the lower absorption of some liposoluble vitamins and antioxidants.

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          Most cited references57

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          Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population.

          Dietary plant sterols, especially sitostanol, reduce serum cholesterol by inhibiting cholesterol absorption. Soluble sitostanol may be more effective than a less soluble preparation. We tested the tolerability and cholesterol-lowering effect of margarine containing sitostanol ester in a population with mild hypercholesterolemia. We conducted a one-year, randomized, double-blind study in 153 randomly selected subjects with mild hypercholesterolemia. Fifty-one consumed margarine without sitostanol ester (the control group), and 102 consumed margarine containing sitostanol ester (1.8 or 2.6 g of sitostanol per day). The margarine containing sitostanol ester was well tolerated. The mean one-year reduction in serum cholesterol was 10.2 percent in the sitostanol group, as compared with an increase of 0.1 percent in the control group. The difference in the change in serum cholesterol concentration between the two groups was -24 mg per deciliter (95 percent confidence interval, -17 to -32; P < 0.001). The respective reductions in low-density lipoprotein (LDL) cholesterol were 14.1 percent in the sitostanol group and 1.1 percent in the control group. The difference in the change in LDL cholesterol concentration between the two groups was -21 mg per deciliter (95 percent confidence interval, -14 to -29; P < 0.001). Neither serum triglyceride nor high-density lipoprotein cholesterol concentrations were affected by sitostanol. Serum campesterol, a dietary plant sterol whose levels reflect cholesterol absorption, was decreased by 36 percent in the sitostanol group, and the reduction was directly correlated with the reduction in total cholesterol (r = 0.57, P < 0.001). Substituting sitostanol-ester margarine for part of the daily fat intake in subjects with mild hypercholesterolemia was effective in lowering serum total cholesterol and LDL cholesterol.
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            Phytosterols as anticancer dietary components: evidence and mechanism of action.

            Phytosterols (PS) or plant sterols are structurally similar to cholesterol. The most common PS are beta-sitosterol, campesterol and stigmasterol. Epidemiologic and experimental studies suggest that dietary PS may offer protection from the most common cancers in Western societies, such as colon, breast and prostate cancer. This review summarizes the findings of these studies and the possible mechanisms by which PS offer this protection. These include the effect of PS on membrane structure and function of tumor and host tissue, signal transduction pathways that regulate tumor growth and apoptosis, immune function of the host and cholesterol metabolism by the host. In addition, suggestions for future studies to fill the gaps in our knowledge have been given.
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              Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters.

              To examine in humans the effects on serum lipids, lipoproteins and fat-soluble antioxidants of a daily consumption of 2.5 g plant stanols, consumed either once per day at lunch or divided over the three meals. A randomized, double-blind, placebo-controlled, cross-over design. Thirty-nine healthy normocholesterolemic or mildly hypercholesterolemic subjects participated. Each subject consumed in random order; no plant stanols; 2.5 g plant stanols at lunch; and 2.5 g plant stanols divided over the three meals (0.42 g at breakfast, 0.84 g at lunch and 1.25 g at dinner, which is proportional to dietary cholesterol intake). Each period lasted 4 weeks. Plant stanols were esterified with fatty acids from low erucic rapeseed oil (LEAR) and incorporated into margarines or shortenings. Consumption of 2.5 g plant stanols at lunch results in a similar low-density lipoprotein (LDL)-cholesterol-lowering efficacy compared to consumption of 2.5 g plant stanols divided over the three meals (-0. 29 mmol/l compared with the control period (P<0.001; 95% CI, -0.19 to -0.39 mmol/l) for the once per day diet and -0.31 mmol/l (P<0. 001; 95% CI, -0.20 to -0.41 mmol/l)) for the three times per day period). High-density Lipoprotein (HDL) cholesterol and triacylglycerol concentrations did not change. After standardization for LDL cholesterol, the sum of the most lipophylic hydrocarbon carotenoids (ie alpha-carotene, beta-carotene and lycopene) in particular was slightly, though not significantly, lowered by -0. 017+/-0.018 micromol/mmol LDL cholesterol (P=0.307) after the once per day period and by -0.032+/-0.016 micromol/mmol LDL cholesterol (P=0.049) after the three times per day period. Our findings suggest that for lowering LDL cholesterol concentrations it is not necessary to consume products rich in plant stanol ester at each meal or simultaneously with dietary cholesterol. Raisio Group, Raisio, Finland.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                alan
                Archivos Latinoamericanos de Nutrición
                ALAN
                Sociedad Latinoamericana de Nutrición (Caracas )
                0004-0622
                September 2004
                : 54
                : 3
                : 257-263
                Affiliations
                [1 ] Universidade de Brasília
                [2 ] Fundaçao de Ensino e Pesquisa em Ciencias da Saude Brasil
                Article
                S0004-06222004000300001
                b3457556-73e7-4c51-8170-9d1062b54b5d

                http://creativecommons.org/licenses/by/4.0/

                History
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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0622&lng=en
                Categories
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                Pphytosterols,phytostanols,blood cholesterol,Fitosteróis,fitostanóis,colesterolemia

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