De Graaf Jacqueline, De Sauvage Nolting Pernette R W, Van Dam Marjel, Belsey Elizabeth M, Kastelein John J P, Haydn Pritchard P, Stalenhoef Anton F H
Department of General Internal Medicine, University Medical Centre Nijmegen, The Netherlands.
Br J Nutr. 2002 Nov;88(5):479-88. doi: 10.1079/BJN2002690.
In a randomized, double-blind, placebo-controlled trial we evaluated the effect of dietary chocolates enriched with a wood-based phytosterol-phytostanol mixture, containing 18 % (w/w) sitostanol, compared with placebo dietary chocolates in seventy subjects with primary hypercholesterolaemia (total cholesterol levels below 8 mmol/l). For 4 weeks, participants consumed three servings of the phytosterol-enriched chocolate/d that provided 1.8 g unesterified phytosterols/d or a placebo chocolate in conjunction with a low-fat, low-cholesterol diet. Plasma total and LDL-cholesterol levels were statistically significantly reduced by 6.4 % (-0.44 mmol/l) and 10.3 % (-0.49 mmol/l), respectively, after 4 weeks of phytosterol-enriched-chocolate treatment. Plasma HDL-cholesterol and triacylglycerol levels were not affected. Consumption of phytosterol-enriched chocolates significantly increased plasma lathosterol concentration (+20.7 %), reflecting an increased endogenous cholesterol synthesis in response to phytosterol-induced decreased intestinal cholesterol absorption. Furthermore, the chocolates enriched with phytosterols significantly increased both plasma sitosterol (+95.8 %) and campesterol (+64.1 %) levels, compared with the placebo chocolate group. However, the absolute values of plasma sitosterol and campesterol remained within the normal range, that is, below 10 mg/l. The chocolates with phytosterols were palatable and induced no clinical or biochemical side effects. These findings indicate that dietary chocolate enriched with tall oil-derived phytosterols (1.8 g/d) is effective in lowering blood total and LDL-cholesterol levels in subjects with mild hypercholesterolaemia and thus may be helpful in reducing the risk of CHD in these individuals.
在一项随机、双盲、安慰剂对照试验中，我们评估了富含木基植物甾醇 - 植物甾烷醇混合物（含18%（w/w）谷甾烷醇）的膳食巧克力与安慰剂膳食巧克力对70名原发性高胆固醇血症患者（总胆固醇水平低于8 mmol/l）的影响。在4周时间里，参与者每天食用三份富含植物甾醇的巧克力，每份提供1.8 g未酯化植物甾醇，或食用一份安慰剂巧克力，并搭配低脂、低胆固醇饮食。经过4周富含植物甾醇巧克力治疗后，血浆总胆固醇和低密度脂蛋白胆固醇水平分别在统计学上显著降低了6.4%（-0.44 mmol/l）和10.3%（-0.49 mmol/l）。血浆高密度脂蛋白胆固醇和三酰甘油水平未受影响。食用富含植物甾醇的巧克力显著提高了血浆羊毛甾醇浓度（+20.7%），这反映出因植物甾醇诱导肠道胆固醇吸收减少，内源性胆固醇合成增加。此外，与安慰剂巧克力组相比，富含植物甾醇的巧克力显著提高了血浆甾醇（+95.8%）和菜油甾醇（+64.1%）水平。然而，血浆甾醇和菜油甾醇的绝对值仍在正常范围内，即低于10 mg/l。含植物甾醇的巧克力口感良好，未引发临床或生化副作用。这些研究结果表明，富含妥尔油衍生植物甾醇（1.8 g/d）的膳食巧克力对降低轻度高胆固醇血症患者的血液总胆固醇和低密度脂蛋白胆固醇水平有效，因此可能有助于降低这些个体患冠心病的风险。
