1. 23.08.2011 Copyright® Raisio Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population Miettinen TA et al., NEJM, 1995

2. Miettinen et al. 19952 Background The cholesterol lowering effect of plant stanol ester margarine were studied in connection with the internationally renowned North Karelia Project in Finland in 1993-1994 The aim of the study was to verify the sustained cholesterol lowering with continuous daily use of plant stanol ester Landmark study for plant stanol ester

3. Miettinen et al. 19953 Methods Randomized, double-blind, placebo controlled intervention study Sub-group of North Karelia study, n=153, f&m, TC >5.58 mmol/l 6-week run-in with control margarine control group, n=51, control margarine for 12 months plant stanol ester margarine group, n=102, 6 months of plant stanol ester margarine (plant stanol 2.6 g/d) after which: n=51, 6 months of plant stanol ester margarine (plant stanol 2.6 g/d) n=51, 6 months of plant stanol ester margarine (plant stanol 1.8 g/d) 2-month follow-up

4. Miettinen et al. 19954 Results The two different doses of plant stanol ester (1.8 g and 2.6 g plant stanols) caused a similar, beneficial change in the total and LDL-cholesterol values. The total cholesterol decreased about 10 % and the LDL- cholesterol 14 % compared with the control group. No effects on serum HDL-cholesterol or triglycerides

5. Miettinen et al. 199555 CHANGE IN SERUM TOTAL CHOLESTEROL LEVELS DURING THE COURSE OF THE STUDY Significant reduction in total cholesterol during the 12 month study Plant stanol ester margarine (1.8 g/day plant stanols) n=51 Control margarine n=51 Plant stanol ester margarine (2.6 g/day plant stanols) n=51 * * * * CHANGE IN SERUM TOTAL CHOLESTEROL LEVELS DURING THE COURSE OF THE STUDY * * Cholesterol (mg/dl) Months Intervention *p<0.01 compared with the control period

6. Miettinen et al. 19956 Conclusions The use of plant stanol ester margarine for 12 months resulted in significant reduction in total and LDL cholesterol levels Cholesterol reduction was maintained throughout the study with regular use of plant stanol ester Daily consumption of plant stanol ester as a part of a regular diet is an important mean to lower cholesterol both on an individual and on a population bases

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