Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, 305C Medical Science Building, University of Newcastle, Callaghan, NSW 2308, Australia.
Food Funct. 2019 May 22;10(5):2515-2527. doi: 10.1039/c8fo02512f.
We previously demonstrated that the combination of phytosterols (PS) and curcumin administered as dietary supplements significantly lowers LDL-cholesterol (LDL-C) more than either treatment alone. The aim of this study was to investigate the effects of this combination in a novel food (bread) on plasma lipid profiles in hypercholesterolaemic individuals. In a double-blinded, placebo-controlled, 2 × 2 factorial trial, participants were randomised to receive bread fortified with placebo (PL), 2.3 g PS (PS), 228 mg curcumin (CC) or a combination of 2.3 g PS and 228 mg CC (PS-CC) daily for four weeks. Primary outcomes were fasting plasma lipids [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG)] and secondary outcomes were plasma LDL-particle (LDL-P) profile: LDL-P number and LDL-P size. Cardiovascular disease (CVD) risk (Framingham Risk Algorithm) was also explored. There was no significant difference between PL and CC or PS and PS-CC on blood lipids or CVD risk; therefore, groups were pooled for final analysis: the PL and CC group (PL-C, n = 36) and the PS and PS-CC group (PS-C, n = 39). PS-C significantly lowered TC (-0.52 mmol L-1, p < 0.0001), LDL-C (-0.49 mmol L-1, p < 0.0001) and CVD risk (-1.1 absolute %, p = 0.0005) compared to the PL-C group. Reductions from baseline in the PS-C group compared to that in the PL-C group were 7.6% and 10.6% for TC and LDL-C, respectively, and statistically significant (p < 0.0001). CVD-risk in the PS-C group reduced significantly (-12.7%) compared to that in the PL-C group (p = 0.0005). HDL-C and TG remained unchanged. The LDL-P number significantly decreased in the PS-C group by 124.33 nmol L-1 compared to that in the PL-C group (p = 0.005) and both groups showed a significant decrease in LDL-P size (p < 0.01); however, the absolute nm change in LDL-P size did not differ between groups and the percent change in LDL-P size in the PS-C group was borderline significant (-0.89%, p = 0.05) compared to that in the PL-C group. Regular consumption of PS-enriched bread with or without curcumin lowers blood cholesterol; however, curcumin alone did not influence blood lipids. Bread may be a convenient means of delivering PS with greater compliance for reducing the blood cholesterol concentration.
我们之前的研究表明，植物甾醇（PS）和姜黄素联合作为膳食补充剂使用，降 LDL-胆固醇（LDL-C）的效果明显优于单独使用任何一种[1]。本研究旨在探讨该联合制剂在一种新型食品（面包）中的应用对高胆固醇血症个体的血浆脂质谱的影响。采用双盲、安慰剂对照、2×2 析因试验，参与者被随机分为接受安慰剂（PL）强化面包、2.3 g PS（PS）、228 mg 姜黄素（CC）或 2.3 g PS 和 228 mg CC 的组合（PS-CC）的治疗组，每天服用 4 周。主要终点为空腹血脂[总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）]，次要终点为 LDL 颗粒（LDL-P）谱：LDL-P 数量和 LDL-P 大小。还探讨了心血管疾病（CVD）风险（Framingham 风险算法）。PL 和 CC 或 PS 和 PS-CC 之间的血脂或 CVD 风险没有显著差异；因此，将各组合并进行最终分析：PL 和 CC 组（PL-C，n=36）和 PS 和 PS-CC 组（PS-C，n=39）。与 PL-C 组相比，PS-C 显著降低了 TC（-0.52 mmol/L，p<0.0001）、LDL-C（-0.49 mmol/L，p<0.0001）和 CVD 风险（-1.1%，p=0.0005）。与 PL-C 组相比，PS-C 组的 TC 和 LDL-C 分别降低了 7.6%和 10.6%，且具有统计学意义（p<0.0001）。与 PL-C 组相比，PS-C 组的 CVD 风险降低了 12.7%（p=0.0005）。HDL-C 和 TG 保持不变。与 PL-C 组相比，PS-C 组的 LDL-P 数量减少了 124.33 nmol/L（p=0.005），且两组 LDL-P 大小均显著降低（p<0.01）；然而，两组 LDL-P 大小的绝对 nm 变化无差异，PS-C 组 LDL-P 大小的百分比变化有边缘显著意义（-0.89%，p=0.05），与 PL-C 组相比。经常食用富含 PS 的面包（无论是否含有姜黄素）可降低血胆固醇；然而，姜黄素单独使用并不影响血脂。面包可能是一种方便的提供 PS 的方法，具有更高的顺应性，可降低血胆固醇浓度。
