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Original paper

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Supporting Cardiovascular Health

Plant sterols lower LDL-cholesterol and triglycerides in dyslipidemic individuals with or at risk of developing type 2 diabetes; a randomized, double-blind, placebo-controlled study

Authors: Elke A. Trautwein, Wieneke P. Koppenol, Arienne de Jong, Harry Hiemstra, Mario A. Vermeer, Manny Noakes, Natalie D. Luscombe-Marsh

DOI: 10.1038/s41387-018-0039-8

Publication date: May 21, 2018

Keywords: Endocrinology Diabetes and Metabolism Internal Medicine

  • Having type 2 diabetes mellitus (T2DM) doubles the risk of an individual developing cardiovascular disease (CVD) when compared to those without the disease. 
  • Reducing CVD risk factors such as elevated blood cholesterol and trilglyceride (TG) levels is vital as CVD is the major cause of death in people with T2DM.
  • This randomized, double-blind, placebo- controlled study showed a dual blood lipid lowering benefit from the daily consumption of a low-fat spread enriched with 2 g of plant sterols in people with or at risk of developing T2DM and raised blood cholesterol and TG levels .

Reducing the risk of CVD in individuals who have or who are at risk of T2DM is crucial. This double-blind, randomized, placebo-controlled, parallel study, set in Australia, studied dyslipidaemic individuals  with T2DM or at risk of developingT2DM and assessed the impact of six weeks intake of a low-fat spread enriched with plant sterols (PS) on elevated low-density lipoprotein cholesterol (LDL-C) and TG.

After a two week run-in period the 161 study participants consumed low-fat spread with 2 g of added PS or placebo low-fat spread daily for a six week period. Fasted total cholesterol (TC), LDL-C, TG and high-density lipoprotein cholesterol (HDL-C), glucose and insulin were measured at baseline and after the 6-week intervention period. In the 138 individuals included in the per protocol analysis a significant reduction of 4.6 % in LDL-C and 8.3 % in TG was observed in the group consuming 2 g of plant sterol enriched low-fat spread compared with the control. All other measures were the same between the placebo and plant sterol groups.

Only 13 participants were excluded for low compliance rates with the test product and the low-fat spread was generally well tolerated.

The study demonstrates that a low-fat spread with added PS has a dual blood lipid benefit with a reduction in both elevated TG and LDL-C. PS, as part of a healthy balanced diet, may offer an effective option for those with or at risk of developing T2DM in helping to manage dyslipidaemia and reduce overall CVD risk.