Volume 88, Issue 5, November (2002), pp. 479-488 © The Author 2002
doi:10.1079/BJN2002690

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Consumption of tall oil-derived phytosterols in a chocolate matrix significantly decreases plasma total and low-density lipoprotein-cholesterol levels

Jacqueline de Graaf¹, Pernette R. W. de Sauvage Nolting², Marjel van Dam², Elizabeth M. Belsey³, John J. P. Kastelein², P. Haydn Pritchard⁴, Anton F. H. Stalenhoef^1
1Department of General Internal Medicine, University Medical Centre Nijmegen, Nijmegen, The Netherlands
²Department of Vascular Medicine, Academic Medical Centre, Amsterdam, The Netherlands
³Department of Statistics, Division of Infectious Diseases, Northwestern University, Chicago, IL, USA
⁴Department of Pathology and Laboratory Medicine, University of British Columbia,Vancouver, Canada

 (Received 1 October 2001–Revised 29 May 2002–Accepted 18 June 2002)

Abstract

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.

Keywords:
Phytosterols: Lipids: Chocolate