de Jong N, Zuur A, Wolfs M C J, Wendel-Vos G C W, van Raaij J M A, Schuit A J
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Eur J Clin Nutr. 2007 Dec;61(12):1407-15. doi: 10.1038/sj.ejcn.1602660. Epub 2007 Feb 14.
Studies on effectiveness of phytosterol/-stanol-enriched margarines in the community have received low priority. For postlaunch monitoring purposes including risk-benefit analyses, it is needed to investigate both exposure and effectiveness of these margarines.
To study the use and effectiveness of phytosterol/-stanol-enriched margarine.
DESIGN, SETTING AND SUBJECTS: The study population consisted of 2379 subjects that participated in a community intervention study ('Hartslag Limburg') aged 28-76 years. In 1998 and 2003, blood samples for total and high-density lipoprotein (HDL) cholesterol were obtained. A general questionnaire and food frequency questionnaire (FFQ) were administered. From 1999 onwards, phytosterol/-stanol-enriched margarines were introduced on the Dutch market. On the basis of 2003 data, subjects were classified in users of (a) phytosterol/-stanol-enriched margarine, (b) cholesterol-lowering drugs, (c) the combination (both enriched margarine and drugs) and (d) neither enriched margarines nor cholesterol-lowering drugs.
Mean (+/-s.d.) daily intake of phytosterol-enriched margarine (n=99) and phytostanol-enriched margarine (n=16) was 14+/-9 g. From 1998 to 2003, total serum cholesterol concentration changed significantly different among the four groups: in the combination users -2.04+/-1.50 mmol/l (-29%), in cholesterol-lowering drug users -1.09+/-1.17 mmol/l (-17%), in the enriched margarine users -0.24+/-0.75 mmol/l (-4%) and in non-users +0.10+/-0.72 mmol/l (+2%)(P<0.05).
Recommended doses are not consumed, but phytosterol/-stanol-enriched margarines can modestly reduce serum total cholesterol in the community. These margarines cannot equal the effect of cholesterol-lowering drugs, but may act additively. Further investigation of the health effects that may occur during simultaneous cholesterol lowering drugs and phytosterol-or -stanol-enriched margarines usage is important, as well as community education about the cholesterol lowering foods and drugs.
Netherlands Organization for Health Research and Development (ZonMW) (data collection of Hartslag Limburg and further data- analyses).
关于富含植物甾醇/甾烷醇的人造黄油在社区中的有效性研究未得到足够重视。为了进行上市后监测，包括风险效益分析，需要调查这些人造黄油的摄入量和有效性。
研究富含植物甾醇/甾烷醇的人造黄油的使用情况和有效性。
设计、地点和研究对象：研究人群包括2379名年龄在28 - 76岁之间、参与社区干预研究（“哈特斯拉格林堡”）的受试者。在1998年和2003年采集了总胆固醇和高密度脂蛋白（HDL）胆固醇的血样。发放了一份一般问卷和食物频率问卷（FFQ）。从1999年起，富含植物甾醇/甾烷醇的人造黄油在荷兰市场推出。根据2003年的数据，受试者被分为以下几类：（a）富含植物甾醇/甾烷醇的人造黄油使用者；（b）降胆固醇药物使用者；（c）两者都使用（富含植物甾醇/甾烷醇的人造黄油和药物）；（d）既不使用富含植物甾醇/甾烷醇的人造黄油也不使用降胆固醇药物。
富含植物甾醇的人造黄油（n = 99）和富含植物甾烷醇的人造黄油（n = 16）的平均（±标准差）每日摄入量为14±9克。从1998年到2003年，四组受试者的血清总胆固醇浓度变化有显著差异：联合使用者降低了2.04±1.50 mmol/l（-29%），降胆固醇药物使用者降低了1.09±1.17 mmol/l（-17%），富含植物甾醇/甾烷醇的人造黄油使用者降低了0.24±0.75 mmol/l（-4%），非使用者升高了0.10±0.72 mmol/l（+2%）（P < 0.05）。
未达到推荐剂量，但富含植物甾醇/甾烷醇的人造黄油可适度降低社区人群的血清总胆固醇。这些人造黄油的效果不及降胆固醇药物，但可能具有相加作用。进一步研究同时使用降胆固醇药物和富含植物甾醇/甾烷醇的人造黄油可能产生的健康影响以及对社区进行有关降胆固醇食物和药物的教育很重要。
荷兰卫生研究与发展组织（ZonMW）（“哈特斯拉格林堡”的数据收集及进一步数据分析）
