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Original paper

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Supporting Cardiovascular Health

A low-fat spread with added plant sterols and fish omega-3 fatty acids lowers serum triglyceride and LDL-cholesterol concentrations in individuals with modest hypercholesterolaemia and hypertriglyceridaemia

Authors: Wendy A. M. Blom, Wieneke P. Koppenol, Harry Hiemstra, Tatjana Stojakovic, Hubert Scharnagl, Elke A. Trautwein

DOI: 10.1007/s00394-018-1706-1

Publication date: May 3, 2018

Keywords: Medicine (miscellaneous) Nutrition and Dietetics

  • This study showed that consuming daily a low- fat spread with 2 g added plant sterols and 1 g fish omega-3 fatty acids over 4 weeks significantly lowers blood triglyceride (TG) and LDL-cholesterol levels. 
  • Consuming a low-fat spread with added plant sterols and fish omega-3 fatty acids as part of a healthy, balanced diet may help individuals to maintaining low TG and LDL-C concentrations and so help to reduce their overall cardiovascular (CVD) risk.

This randomised, double-blind, placebo-controlled, parallel group study (conducted in Berlin, Germany) followed 260 participants (aged 18-75 years) who, after a 2 week placebo run-in period, were allocated to receive for four weeks either a low-fat spread with 1 g/d of eicosapentaenoic acid (EPA) and docosahexanoic acid (DHD) from fish oils and 2 g/d of plant sterols or a placebo low-fat spread.

The study group had moderately elevated blood TG of (≥1.4 mmol/L and low density lipoprotein cholesterol (LDL-C) of ≥3.4 mmol/L. Fasting lipid levels as well as apolipoproteins (Apo) were measured at the end of the two week run-in and at the end of the four week intervention periods.

Individuals in the intervention group of the study benefited from significant reductions in both TG (10.6% reduction) and LDL-C (5.2% reduction) levels when compared with the placebo group. There was also a significant reduction in total cholesterol, non-high density lipoprotein (non-HDL-C), remnant cholesterol and Apo B, Apo AII and ApoCIII levels when compared with placebo. No significant difference was seen in HDL-cholesterol,  and other apolipopreotin concentrations.

In this study the daily low-fat spread portion was consumed over at least two main meals and this appears to lead to a better effect than in studies where a single daily intake was given.

The decrease in elevated blood TG next to the LDL-C lowering with the combined intake of plant sterols and fish oils is particularly interesting as elevated blood TG are an emerging risk factor in the development of atherosclerosis and cardiovascular disease (CVD). Lifelong management of LDL-C and TG levels is seen as important to reduce life time CVD risk and hence early, easy to use interventions are needed.