1. 23.08.2011 Copyright® Raisio Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects Hallikainen MA & Uusitupa MIJ Am J Clin Nutr 1999

2. Hallikainen & Uusitupa, 19992 Objective To investigate the cholesterol-lowering effects of two low-fat plant stanol ester containing margarines as a part of a low-fat diet recommended for hypercholesterolemic subjects (resembling that of the National Cholesterol Education Program’s Step II diet)

3. Hallikainen & Uusitupa, 19993 Methods I Double-blind, parallel, randomized study N=60, TC 5.4–7.5 mmol/L 4-week run-in diet (high-fat) 8-week experimental period (low-fat and low-ch) Control margarine Wood stanol ester margarine (~2,31 g/d plant stanols) Vegetable oil stanol ester margarine (~2,16 g/d plant stanols)

4. Hallikainen & Uusitupa, 19994 Methods II week Run-in Low-fat diet; randomization to study groups 0248 Fasting blood samples; TC, LDL, HDL, VLDL, TAG, β- carotene, fat-soluble vitamins, apo A, apo B, plant sterols -4

5. Hallikainen & Uusitupa, 19995 Results Adherence to low-fat diet was very good: Mean energy intake: 26 E-% from fat 7 E-% SAFA 20 mg/MJ chol

6. Hallikainen & Uusitupa, 199966 Effective as part of different kind of diets – strict cholesterol-lowering diet example EFFECTIVE AS PART OF A STRICT CHOLESTEROL- LOWERING DIET Cholesterol- lowering diet n=17 * Plant stanol ester specific effect; a= significantly different from wk 0 p<0.01; b=significantly different from wk 0 p<0.001; significantly different vs. control p<0.01 Cholesterol- lowering diet + plant stanol ester (2.3 g/d plant stanol) n=38 Change % in LDL cholesterol Total cholesterol LDL cholesterol a a b b

7. Hallikainen & Uusitupa, 19997 Conclusions Low-fat diet reduces serum total and LDL cholesterol levels significantly Adding plant stanol ester containing spread to a low-fat diet reduced TC and LDL-C levels significantly more than diet alone Plant stanol ester has additional benefit on cholesterol lowering also when used as part of a low-fat diet recommended for hypercholesterolemic subjects (resembling that of the National Cholesterol Education Program’s Step II diet)

8. 8 Thank You!