Events around conception such as maternal undernutrition and twinning may have effects on offspring physiology and disease risk in adulthood. Periconceptional undernutrition alters offspring physiology and adult pathology without affecting birth size, while twinning affects birth size and physiology but with inconsistent effects on adult pathology. We investigated the effects of these two periconceptional events and their interaction on maternal cardiovascular adaptation to pregnancy and fetal growth, physiology and endocrinology in late gestation in sheep. Pre and/or postconception undernutrition resulted in increased uterine blood flow in late gestation, but no change in maternal blood volume. Preconception undernutrition alone resulted in a relatively large placenta with a small, slow-growing fetus in late gestation. In contrast, postconception undernutrition alone resulted in a fetus with rapid late-gestation growth that was maintained through a maternal fast. Fetuses of ewes undernourished throughout both periods were similar in growth rate and size to controls. Maternal fasting also demonstrated that plasma levels of C-type natriuretic peptide are acutely and independently regulated by nutrient supply in mother and fetus. Fetuses of ewes undernourished both pre- and postconception had increased glucose disposal following a glucose challenge. Hypothalamic-pituitary-adrenal axis tests in these fetuses showed decreased pituitary adrenocorticotropin hormone response to direct stimulation but increased adrenal response to decreased cortisol negative feedback. Twin fetuses grew more slowly in late gestation than singletons. Twins also had a smaller insulin response to arginine and a greater insulin response to glucose, but periconceptional undernutrition abolished this difference. Twins had suppressed baseline hypothalamic-pituitary-adrenal axis function and decreased adrenal sensitivity compared to singletons, but increased fetal pituitary adrenocorticotropin hormone response to direct stimulation and decreased cortisol negative feedback. These studies suggest that firstly, fetal size is a poor reflection of fetal growth trajectory, physiology and endocrinology. Secondly, pre- and postconception undernutrition affect late-gestation fetal growth in different ways, while undernutrition in both periods alters fetal endocrine status in late gestation. Thirdly, the biology of twin fetal development is fundamentally different from that of singletons, which may explain the inconsistency of the relationship between birth weight and adult disease risk in twins. / Auckland Medical Research Foundation, Health Research Council of New Zealand

Phytosterols have been shown to be effective in reducing serum cholesterol levels in numerous human clinical studies and regular consumption is recommended as part of therapeutic lifestyle changes aimed at reducing low density lipoprotein (LDL-C) in the treatment of hyperlipidaemia, a risk factor for cardiovascular disease. Fat based spreads have been shown to be a very successful vehicle for delivery of plant sterols, readily accepted by consumers and efficacious in reducing cholesterol levels. Alfa One™ Rice Bran Oil (RBO) spread is a new product entering into the market place. It is derived from rice bran oil and contains high levels of unsaponifiable material rich in phytosterols, triterpene alcohols, ferulic acid esters ([gamma]-oryzanol) and vitamin E isomers. As such it may have the potential to lower serum cholesterol levels when consumed on a daily basis. In order to establish the effectiveness of Alfa One™ Rice Bran Oil (RBO) spread compared with Flora pro-activ® margarine, a well established brand of plant sterol margarine already proven to lower cholesterol, a randomised double blind cross-over human clinical trial over 12 weeks was conducted. The study was divided into two treatment arms. The first arm of the study was to determine whether Alfa One™ RBO spread (containing 1.5% plant sterols) could lower total and LDL cholesterol levels to a greater extent than standard Flora margarine (containing no plant sterols) or Flora Pro-activ® margarine (containing 8% plant sterols). The second study arm tested the proposition that daily consumption of Alfa One™ Rice Bran Oil (RBO) spread in conjunction with rice bran oil (containing 0.5% plant sterols) would lower total and LDL cholesterol to a greater extent than Alfa One™ RBO spread in isolation and more than Flora margarine in conjunction with sunflower oil. Eighty mildly hypercholesterolaemic individuals (total cholesterol [greater than or equal to] 5 mmol/L and [less than or equal to] 7.5 mmol/L) were recruited and randomised into two groups of forty. Participants were asked to continue with their normal dietary pattern but to replace any margarine/butter/fat consumption with the trial products. One group of 40 were then assigned to the first treatment arm of the study (margarine-only group) and were randomised to consume 20 g (4 teaspoons) Alfa One™ RBO spread daily for 4 weeks, or 20 g Flora margarine daily for 4 weeks, or 20 Flora pro-activ® daily for 4 weeks. Phytosterol levels delivered in these amounts were: RBO margarine: 118mg phytosterol and 14 mg [gamma]-oryzanol; Flora proactiv® 1600 mg phytosterol; Flora margarine 0mg phytosterol. The second group of 40 were allocated to the second arm of the trial (margarine and oil group) and consumed 20 g Alfa One™ RBO spread and 30 ml rice bran oil (RBO) daily for 4 weeks, or 20 g Flora margarine and 30 ml sunflower oil daily for 4 weeks, or 20 g Alfa One™ RBO spread daily for 4 weeks, changing treatment at the end of each 4-week period. Phytosterol amounts delivered in these amounts were: RBO margarine: 118 mg phytosterol and 14 mg [gamma] oryzanol; RBO 222mg mg phytosterol, 150 mg [gamma] oryzanol. Each participant consumed all three treatments in a random order over a 12 week period. At baseline and following each 4 week intervention period, measurements were made of weight and blood pressure. Venous blood samples were collected for analysis of total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol: HDL-C, triglycerides and plasma phytosterols. Three-day diet records from each individual were also collected for analysis of normal dietary intake. Results showed that compared to a standard Flora margarine, Alfa One™ RBO spread significantly reduced total cholesterol by 2.2% (P=0.045), total cholesterol:HDL by 4.1% (P=0.005) and LDL-C by 3.5% (P=0.016), but was not as effective overall as Flora Pro-activ® which reduced total cholesterol by 4.4% (P=0.001), total cholesterol:HDL by 3.4% (P=0.014) and LDL-C by 5.6% (P=0.001). Consumption of Flora margarine alone produced no significant decrease from baseline figures in any of the cholesterol parameters measured. Surprisingly, in group two, the addition of rice bran oil to the Alfa One™ RBO spread produced no differences in cholesterol levels. The reason for this unexpected result is being explored further. These results confirm that Alfa One™ RBO spread is effective in lowering serum cholesterol levels when consumed as part of a normal diet. Studies have shown that a 1% reduction in LDL-C can equate to a 2% decrease in coronary heart disease (CHD) risk thus suggesting that the 3.5% reduction demonstrated by Alfa One™ RBO spread in this study could be effective in reducing CHD risk as much as 6% in a mildly hypercholesterolaemic population.

Community participation is a key feature of major global health declarations and a fundamental principle of health strategies in Aotearoa New Zealand. However, the frequency with which it is espoused belies the complexities associated with its practical application. Engaging communities in primary health care programmes designed to improve their health has been identified as a major challenge. This study’s objective was to explore community members’ perspectives of participation within a health development programme. The programme chosen aimed to increase the fruit and vegetable intake of targeted population groups, including M ori, Pacific peoples, and low income earners. A qualitative instrumental case study approach was adopted to examine the programme and investigate what influenced, constrained, and sustained community participation. Data collection included fieldwork over an eighteen-month period. Two programme projects were selected as the study foci: a communityled project involving distributions of thousands of free heritage variety plants; and, instigated by health services, a project establishing community gardens. These projects provided markedly different pictures of participation occurring within the same programme. The plant distributions had widespread appeal, while the community garden faltered. Community participation fitted within a description of ‘focused social action’. Participation was motivated by needs, values, and interests. While some were personal and family based, the programme also became an imagined vehicle for addressing wider health, social justice, and environmental sustainability goals. Ongoing challenges related to defining targeted communities and groups, varying degrees and types of participation, and different perspectives of participation, especially as health sector staff worked from an equity mandate and community members spoke of equality. Programme groups established as mechanisms to foster community participation had contradictory effects, engaging some as advisors, while failing to reach communities targeted for the programme. The complexities of health sector bureaucracy both enabled and constrained the programme and community participation. This thesis provides an in-depth examination of the complexities of community participation in action, the contradictory effects of contexts enveloping programmes, and the resolve of community members. It increases our understandings of how community members perceive health programmes and community participation, which are critical factors in improving population health.

Annoyance due to relatively high levels of sound and noise, above 50 dB, has been well documented in noise assessment literature. The potential for annoyance or disturbance from low amplitude sound, below 50 dB to the threshold of an individual’s hearing, is not as well documented. The thesis presents a new approach to the measurement and assessment of intrusive noise and low amplitude sound. Acoustical and sound quality measures are integrated with measures of loudness, pitch, dissonance and tonality to provide physical measures of sound. Individual amenity is assessed with respect to personal noise sensitivity and personal attitudes to sound in the environment, the environment itself and the perceived qualities of the audible sound. A decision-support methodology to integrate perceived noise with noise performance indicators, annoyance criteria, personal noise sensitivity and amenity is presented. A method for rating intrusive noise is derived. Designs for sound measurement and calibration instrumentation are described. Methods to measure and assess low amplitude sound are presented. Keywords annoyance, intrusive-noise, noise-sensitivity, sound-quality, soundscape

Community participation is a key feature of major global health declarations and a fundamental principle of health strategies in Aotearoa New Zealand. However, the frequency with which it is espoused belies the complexities associated with its practical application. Engaging communities in primary health care programmes designed to improve their health has been identified as a major challenge. This study’s objective was to explore community members’ perspectives of participation within a health development programme. The programme chosen aimed to increase the fruit and vegetable intake of targeted population groups, including M ori, Pacific peoples, and low income earners. A qualitative instrumental case study approach was adopted to examine the programme and investigate what influenced, constrained, and sustained community participation. Data collection included fieldwork over an eighteen-month period. Two programme projects were selected as the study foci: a communityled project involving distributions of thousands of free heritage variety plants; and, instigated by health services, a project establishing community gardens. These projects provided markedly different pictures of participation occurring within the same programme. The plant distributions had widespread appeal, while the community garden faltered. Community participation fitted within a description of ‘focused social action’. Participation was motivated by needs, values, and interests. While some were personal and family based, the programme also became an imagined vehicle for addressing wider health, social justice, and environmental sustainability goals. Ongoing challenges related to defining targeted communities and groups, varying degrees and types of participation, and different perspectives of participation, especially as health sector staff worked from an equity mandate and community members spoke of equality. Programme groups established as mechanisms to foster community participation had contradictory effects, engaging some as advisors, while failing to reach communities targeted for the programme. The complexities of health sector bureaucracy both enabled and constrained the programme and community participation. This thesis provides an in-depth examination of the complexities of community participation in action, the contradictory effects of contexts enveloping programmes, and the resolve of community members. It increases our understandings of how community members perceive health programmes and community participation, which are critical factors in improving population health.

Phytosterols have been shown to be effective in reducing serum cholesterol levels in numerous human clinical studies and regular consumption is recommended as part of therapeutic lifestyle changes aimed at reducing low density lipoprotein (LDL-C) in the treatment of hyperlipidaemia, a risk factor for cardiovascular disease. Fat based spreads have been shown to be a very successful vehicle for delivery of plant sterols, readily accepted by consumers and efficacious in reducing cholesterol levels. Alfa One™ Rice Bran Oil (RBO) spread is a new product entering into the market place. It is derived from rice bran oil and contains high levels of unsaponifiable material rich in phytosterols, triterpene alcohols, ferulic acid esters ([gamma]-oryzanol) and vitamin E isomers. As such it may have the potential to lower serum cholesterol levels when consumed on a daily basis. In order to establish the effectiveness of Alfa One™ Rice Bran Oil (RBO) spread compared with Flora pro-activ® margarine, a well established brand of plant sterol margarine already proven to lower cholesterol, a randomised double blind cross-over human clinical trial over 12 weeks was conducted. The study was divided into two treatment arms. The first arm of the study was to determine whether Alfa One™ RBO spread (containing 1.5% plant sterols) could lower total and LDL cholesterol levels to a greater extent than standard Flora margarine (containing no plant sterols) or Flora Pro-activ® margarine (containing 8% plant sterols). The second study arm tested the proposition that daily consumption of Alfa One™ Rice Bran Oil (RBO) spread in conjunction with rice bran oil (containing 0.5% plant sterols) would lower total and LDL cholesterol to a greater extent than Alfa One™ RBO spread in isolation and more than Flora margarine in conjunction with sunflower oil. Eighty mildly hypercholesterolaemic individuals (total cholesterol [greater than or equal to] 5 mmol/L and [less than or equal to] 7.5 mmol/L) were recruited and randomised into two groups of forty. Participants were asked to continue with their normal dietary pattern but to replace any margarine/butter/fat consumption with the trial products. One group of 40 were then assigned to the first treatment arm of the study (margarine-only group) and were randomised to consume 20 g (4 teaspoons) Alfa One™ RBO spread daily for 4 weeks, or 20 g Flora margarine daily for 4 weeks, or 20 Flora pro-activ® daily for 4 weeks. Phytosterol levels delivered in these amounts were: RBO margarine: 118mg phytosterol and 14 mg [gamma]-oryzanol; Flora proactiv® 1600 mg phytosterol; Flora margarine 0mg phytosterol. The second group of 40 were allocated to the second arm of the trial (margarine and oil group) and consumed 20 g Alfa One™ RBO spread and 30 ml rice bran oil (RBO) daily for 4 weeks, or 20 g Flora margarine and 30 ml sunflower oil daily for 4 weeks, or 20 g Alfa One™ RBO spread daily for 4 weeks, changing treatment at the end of each 4-week period. Phytosterol amounts delivered in these amounts were: RBO margarine: 118 mg phytosterol and 14 mg [gamma] oryzanol; RBO 222mg mg phytosterol, 150 mg [gamma] oryzanol. Each participant consumed all three treatments in a random order over a 12 week period. At baseline and following each 4 week intervention period, measurements were made of weight and blood pressure. Venous blood samples were collected for analysis of total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol: HDL-C, triglycerides and plasma phytosterols. Three-day diet records from each individual were also collected for analysis of normal dietary intake. Results showed that compared to a standard Flora margarine, Alfa One™ RBO spread significantly reduced total cholesterol by 2.2% (P=0.045), total cholesterol:HDL by 4.1% (P=0.005) and LDL-C by 3.5% (P=0.016), but was not as effective overall as Flora Pro-activ® which reduced total cholesterol by 4.4% (P=0.001), total cholesterol:HDL by 3.4% (P=0.014) and LDL-C by 5.6% (P=0.001). Consumption of Flora margarine alone produced no significant decrease from baseline figures in any of the cholesterol parameters measured. Surprisingly, in group two, the addition of rice bran oil to the Alfa One™ RBO spread produced no differences in cholesterol levels. The reason for this unexpected result is being explored further. These results confirm that Alfa One™ RBO spread is effective in lowering serum cholesterol levels when consumed as part of a normal diet. Studies have shown that a 1% reduction in LDL-C can equate to a 2% decrease in coronary heart disease (CHD) risk thus suggesting that the 3.5% reduction demonstrated by Alfa One™ RBO spread in this study could be effective in reducing CHD risk as much as 6% in a mildly hypercholesterolaemic population.

Phytosterols have been shown to be effective in reducing serum cholesterol levels in numerous human clinical studies and regular consumption is recommended as part of therapeutic lifestyle changes aimed at reducing low density lipoprotein (LDL-C) in the treatment of hyperlipidaemia, a risk factor for cardiovascular disease. Fat based spreads have been shown to be a very successful vehicle for delivery of plant sterols, readily accepted by consumers and efficacious in reducing cholesterol levels. Alfa One™ Rice Bran Oil (RBO) spread is a new product entering into the market place. It is derived from rice bran oil and contains high levels of unsaponifiable material rich in phytosterols, triterpene alcohols, ferulic acid esters ([gamma]-oryzanol) and vitamin E isomers. As such it may have the potential to lower serum cholesterol levels when consumed on a daily basis. In order to establish the effectiveness of Alfa One™ Rice Bran Oil (RBO) spread compared with Flora pro-activ® margarine, a well established brand of plant sterol margarine already proven to lower cholesterol, a randomised double blind cross-over human clinical trial over 12 weeks was conducted. The study was divided into two treatment arms. The first arm of the study was to determine whether Alfa One™ RBO spread (containing 1.5% plant sterols) could lower total and LDL cholesterol levels to a greater extent than standard Flora margarine (containing no plant sterols) or Flora Pro-activ® margarine (containing 8% plant sterols). The second study arm tested the proposition that daily consumption of Alfa One™ Rice Bran Oil (RBO) spread in conjunction with rice bran oil (containing 0.5% plant sterols) would lower total and LDL cholesterol to a greater extent than Alfa One™ RBO spread in isolation and more than Flora margarine in conjunction with sunflower oil. Eighty mildly hypercholesterolaemic individuals (total cholesterol [greater than or equal to] 5 mmol/L and [less than or equal to] 7.5 mmol/L) were recruited and randomised into two groups of forty. Participants were asked to continue with their normal dietary pattern but to replace any margarine/butter/fat consumption with the trial products. One group of 40 were then assigned to the first treatment arm of the study (margarine-only group) and were randomised to consume 20 g (4 teaspoons) Alfa One™ RBO spread daily for 4 weeks, or 20 g Flora margarine daily for 4 weeks, or 20 Flora pro-activ® daily for 4 weeks. Phytosterol levels delivered in these amounts were: RBO margarine: 118mg phytosterol and 14 mg [gamma]-oryzanol; Flora proactiv® 1600 mg phytosterol; Flora margarine 0mg phytosterol. The second group of 40 were allocated to the second arm of the trial (margarine and oil group) and consumed 20 g Alfa One™ RBO spread and 30 ml rice bran oil (RBO) daily for 4 weeks, or 20 g Flora margarine and 30 ml sunflower oil daily for 4 weeks, or 20 g Alfa One™ RBO spread daily for 4 weeks, changing treatment at the end of each 4-week period. Phytosterol amounts delivered in these amounts were: RBO margarine: 118 mg phytosterol and 14 mg [gamma] oryzanol; RBO 222mg mg phytosterol, 150 mg [gamma] oryzanol. Each participant consumed all three treatments in a random order over a 12 week period. At baseline and following each 4 week intervention period, measurements were made of weight and blood pressure. Venous blood samples were collected for analysis of total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol: HDL-C, triglycerides and plasma phytosterols. Three-day diet records from each individual were also collected for analysis of normal dietary intake. Results showed that compared to a standard Flora margarine, Alfa One™ RBO spread significantly reduced total cholesterol by 2.2% (P=0.045), total cholesterol:HDL by 4.1% (P=0.005) and LDL-C by 3.5% (P=0.016), but was not as effective overall as Flora Pro-activ® which reduced total cholesterol by 4.4% (P=0.001), total cholesterol:HDL by 3.4% (P=0.014) and LDL-C by 5.6% (P=0.001). Consumption of Flora margarine alone produced no significant decrease from baseline figures in any of the cholesterol parameters measured. Surprisingly, in group two, the addition of rice bran oil to the Alfa One™ RBO spread produced no differences in cholesterol levels. The reason for this unexpected result is being explored further. These results confirm that Alfa One™ RBO spread is effective in lowering serum cholesterol levels when consumed as part of a normal diet. Studies have shown that a 1% reduction in LDL-C can equate to a 2% decrease in coronary heart disease (CHD) risk thus suggesting that the 3.5% reduction demonstrated by Alfa One™ RBO spread in this study could be effective in reducing CHD risk as much as 6% in a mildly hypercholesterolaemic population.

Phytosterols have been shown to be effective in reducing serum cholesterol levels in numerous human clinical studies and regular consumption is recommended as part of therapeutic lifestyle changes aimed at reducing low density lipoprotein (LDL-C) in the treatment of hyperlipidaemia, a risk factor for cardiovascular disease. Fat based spreads have been shown to be a very successful vehicle for delivery of plant sterols, readily accepted by consumers and efficacious in reducing cholesterol levels. Alfa One™ Rice Bran Oil (RBO) spread is a new product entering into the market place. It is derived from rice bran oil and contains high levels of unsaponifiable material rich in phytosterols, triterpene alcohols, ferulic acid esters ([gamma]-oryzanol) and vitamin E isomers. As such it may have the potential to lower serum cholesterol levels when consumed on a daily basis. In order to establish the effectiveness of Alfa One™ Rice Bran Oil (RBO) spread compared with Flora pro-activ® margarine, a well established brand of plant sterol margarine already proven to lower cholesterol, a randomised double blind cross-over human clinical trial over 12 weeks was conducted. The study was divided into two treatment arms. The first arm of the study was to determine whether Alfa One™ RBO spread (containing 1.5% plant sterols) could lower total and LDL cholesterol levels to a greater extent than standard Flora margarine (containing no plant sterols) or Flora Pro-activ® margarine (containing 8% plant sterols). The second study arm tested the proposition that daily consumption of Alfa One™ Rice Bran Oil (RBO) spread in conjunction with rice bran oil (containing 0.5% plant sterols) would lower total and LDL cholesterol to a greater extent than Alfa One™ RBO spread in isolation and more than Flora margarine in conjunction with sunflower oil. Eighty mildly hypercholesterolaemic individuals (total cholesterol [greater than or equal to] 5 mmol/L and [less than or equal to] 7.5 mmol/L) were recruited and randomised into two groups of forty. Participants were asked to continue with their normal dietary pattern but to replace any margarine/butter/fat consumption with the trial products. One group of 40 were then assigned to the first treatment arm of the study (margarine-only group) and were randomised to consume 20 g (4 teaspoons) Alfa One™ RBO spread daily for 4 weeks, or 20 g Flora margarine daily for 4 weeks, or 20 Flora pro-activ® daily for 4 weeks. Phytosterol levels delivered in these amounts were: RBO margarine: 118mg phytosterol and 14 mg [gamma]-oryzanol; Flora proactiv® 1600 mg phytosterol; Flora margarine 0mg phytosterol. The second group of 40 were allocated to the second arm of the trial (margarine and oil group) and consumed 20 g Alfa One™ RBO spread and 30 ml rice bran oil (RBO) daily for 4 weeks, or 20 g Flora margarine and 30 ml sunflower oil daily for 4 weeks, or 20 g Alfa One™ RBO spread daily for 4 weeks, changing treatment at the end of each 4-week period. Phytosterol amounts delivered in these amounts were: RBO margarine: 118 mg phytosterol and 14 mg [gamma] oryzanol; RBO 222mg mg phytosterol, 150 mg [gamma] oryzanol. Each participant consumed all three treatments in a random order over a 12 week period. At baseline and following each 4 week intervention period, measurements were made of weight and blood pressure. Venous blood samples were collected for analysis of total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol: HDL-C, triglycerides and plasma phytosterols. Three-day diet records from each individual were also collected for analysis of normal dietary intake. Results showed that compared to a standard Flora margarine, Alfa One™ RBO spread significantly reduced total cholesterol by 2.2% (P=0.045), total cholesterol:HDL by 4.1% (P=0.005) and LDL-C by 3.5% (P=0.016), but was not as effective overall as Flora Pro-activ® which reduced total cholesterol by 4.4% (P=0.001), total cholesterol:HDL by 3.4% (P=0.014) and LDL-C by 5.6% (P=0.001). Consumption of Flora margarine alone produced no significant decrease from baseline figures in any of the cholesterol parameters measured. Surprisingly, in group two, the addition of rice bran oil to the Alfa One™ RBO spread produced no differences in cholesterol levels. The reason for this unexpected result is being explored further. These results confirm that Alfa One™ RBO spread is effective in lowering serum cholesterol levels when consumed as part of a normal diet. Studies have shown that a 1% reduction in LDL-C can equate to a 2% decrease in coronary heart disease (CHD) risk thus suggesting that the 3.5% reduction demonstrated by Alfa One™ RBO spread in this study could be effective in reducing CHD risk as much as 6% in a mildly hypercholesterolaemic population.

Phytosterols have been shown to be effective in reducing serum cholesterol levels in numerous human clinical studies and regular consumption is recommended as part of therapeutic lifestyle changes aimed at reducing low density lipoprotein (LDL-C) in the treatment of hyperlipidaemia, a risk factor for cardiovascular disease. Fat based spreads have been shown to be a very successful vehicle for delivery of plant sterols, readily accepted by consumers and efficacious in reducing cholesterol levels. Alfa One™ Rice Bran Oil (RBO) spread is a new product entering into the market place. It is derived from rice bran oil and contains high levels of unsaponifiable material rich in phytosterols, triterpene alcohols, ferulic acid esters ([gamma]-oryzanol) and vitamin E isomers. As such it may have the potential to lower serum cholesterol levels when consumed on a daily basis. In order to establish the effectiveness of Alfa One™ Rice Bran Oil (RBO) spread compared with Flora pro-activ® margarine, a well established brand of plant sterol margarine already proven to lower cholesterol, a randomised double blind cross-over human clinical trial over 12 weeks was conducted. The study was divided into two treatment arms. The first arm of the study was to determine whether Alfa One™ RBO spread (containing 1.5% plant sterols) could lower total and LDL cholesterol levels to a greater extent than standard Flora margarine (containing no plant sterols) or Flora Pro-activ® margarine (containing 8% plant sterols). The second study arm tested the proposition that daily consumption of Alfa One™ Rice Bran Oil (RBO) spread in conjunction with rice bran oil (containing 0.5% plant sterols) would lower total and LDL cholesterol to a greater extent than Alfa One™ RBO spread in isolation and more than Flora margarine in conjunction with sunflower oil. Eighty mildly hypercholesterolaemic individuals (total cholesterol [greater than or equal to] 5 mmol/L and [less than or equal to] 7.5 mmol/L) were recruited and randomised into two groups of forty. Participants were asked to continue with their normal dietary pattern but to replace any margarine/butter/fat consumption with the trial products. One group of 40 were then assigned to the first treatment arm of the study (margarine-only group) and were randomised to consume 20 g (4 teaspoons) Alfa One™ RBO spread daily for 4 weeks, or 20 g Flora margarine daily for 4 weeks, or 20 Flora pro-activ® daily for 4 weeks. Phytosterol levels delivered in these amounts were: RBO margarine: 118mg phytosterol and 14 mg [gamma]-oryzanol; Flora proactiv® 1600 mg phytosterol; Flora margarine 0mg phytosterol. The second group of 40 were allocated to the second arm of the trial (margarine and oil group) and consumed 20 g Alfa One™ RBO spread and 30 ml rice bran oil (RBO) daily for 4 weeks, or 20 g Flora margarine and 30 ml sunflower oil daily for 4 weeks, or 20 g Alfa One™ RBO spread daily for 4 weeks, changing treatment at the end of each 4-week period. Phytosterol amounts delivered in these amounts were: RBO margarine: 118 mg phytosterol and 14 mg [gamma] oryzanol; RBO 222mg mg phytosterol, 150 mg [gamma] oryzanol. Each participant consumed all three treatments in a random order over a 12 week period. At baseline and following each 4 week intervention period, measurements were made of weight and blood pressure. Venous blood samples were collected for analysis of total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol: HDL-C, triglycerides and plasma phytosterols. Three-day diet records from each individual were also collected for analysis of normal dietary intake. Results showed that compared to a standard Flora margarine, Alfa One™ RBO spread significantly reduced total cholesterol by 2.2% (P=0.045), total cholesterol:HDL by 4.1% (P=0.005) and LDL-C by 3.5% (P=0.016), but was not as effective overall as Flora Pro-activ® which reduced total cholesterol by 4.4% (P=0.001), total cholesterol:HDL by 3.4% (P=0.014) and LDL-C by 5.6% (P=0.001). Consumption of Flora margarine alone produced no significant decrease from baseline figures in any of the cholesterol parameters measured. Surprisingly, in group two, the addition of rice bran oil to the Alfa One™ RBO spread produced no differences in cholesterol levels. The reason for this unexpected result is being explored further. These results confirm that Alfa One™ RBO spread is effective in lowering serum cholesterol levels when consumed as part of a normal diet. Studies have shown that a 1% reduction in LDL-C can equate to a 2% decrease in coronary heart disease (CHD) risk thus suggesting that the 3.5% reduction demonstrated by Alfa One™ RBO spread in this study could be effective in reducing CHD risk as much as 6% in a mildly hypercholesterolaemic population.

Phytosterols have been shown to be effective in reducing serum cholesterol levels in numerous human clinical studies and regular consumption is recommended as part of therapeutic lifestyle changes aimed at reducing low density lipoprotein (LDL-C) in the treatment of hyperlipidaemia, a risk factor for cardiovascular disease. Fat based spreads have been shown to be a very successful vehicle for delivery of plant sterols, readily accepted by consumers and efficacious in reducing cholesterol levels. Alfa One™ Rice Bran Oil (RBO) spread is a new product entering into the market place. It is derived from rice bran oil and contains high levels of unsaponifiable material rich in phytosterols, triterpene alcohols, ferulic acid esters ([gamma]-oryzanol) and vitamin E isomers. As such it may have the potential to lower serum cholesterol levels when consumed on a daily basis. In order to establish the effectiveness of Alfa One™ Rice Bran Oil (RBO) spread compared with Flora pro-activ® margarine, a well established brand of plant sterol margarine already proven to lower cholesterol, a randomised double blind cross-over human clinical trial over 12 weeks was conducted. The study was divided into two treatment arms. The first arm of the study was to determine whether Alfa One™ RBO spread (containing 1.5% plant sterols) could lower total and LDL cholesterol levels to a greater extent than standard Flora margarine (containing no plant sterols) or Flora Pro-activ® margarine (containing 8% plant sterols). The second study arm tested the proposition that daily consumption of Alfa One™ Rice Bran Oil (RBO) spread in conjunction with rice bran oil (containing 0.5% plant sterols) would lower total and LDL cholesterol to a greater extent than Alfa One™ RBO spread in isolation and more than Flora margarine in conjunction with sunflower oil. Eighty mildly hypercholesterolaemic individuals (total cholesterol [greater than or equal to] 5 mmol/L and [less than or equal to] 7.5 mmol/L) were recruited and randomised into two groups of forty. Participants were asked to continue with their normal dietary pattern but to replace any margarine/butter/fat consumption with the trial products. One group of 40 were then assigned to the first treatment arm of the study (margarine-only group) and were randomised to consume 20 g (4 teaspoons) Alfa One™ RBO spread daily for 4 weeks, or 20 g Flora margarine daily for 4 weeks, or 20 Flora pro-activ® daily for 4 weeks. Phytosterol levels delivered in these amounts were: RBO margarine: 118mg phytosterol and 14 mg [gamma]-oryzanol; Flora proactiv® 1600 mg phytosterol; Flora margarine 0mg phytosterol. The second group of 40 were allocated to the second arm of the trial (margarine and oil group) and consumed 20 g Alfa One™ RBO spread and 30 ml rice bran oil (RBO) daily for 4 weeks, or 20 g Flora margarine and 30 ml sunflower oil daily for 4 weeks, or 20 g Alfa One™ RBO spread daily for 4 weeks, changing treatment at the end of each 4-week period. Phytosterol amounts delivered in these amounts were: RBO margarine: 118 mg phytosterol and 14 mg [gamma] oryzanol; RBO 222mg mg phytosterol, 150 mg [gamma] oryzanol. Each participant consumed all three treatments in a random order over a 12 week period. At baseline and following each 4 week intervention period, measurements were made of weight and blood pressure. Venous blood samples were collected for analysis of total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol: HDL-C, triglycerides and plasma phytosterols. Three-day diet records from each individual were also collected for analysis of normal dietary intake. Results showed that compared to a standard Flora margarine, Alfa One™ RBO spread significantly reduced total cholesterol by 2.2% (P=0.045), total cholesterol:HDL by 4.1% (P=0.005) and LDL-C by 3.5% (P=0.016), but was not as effective overall as Flora Pro-activ® which reduced total cholesterol by 4.4% (P=0.001), total cholesterol:HDL by 3.4% (P=0.014) and LDL-C by 5.6% (P=0.001). Consumption of Flora margarine alone produced no significant decrease from baseline figures in any of the cholesterol parameters measured. Surprisingly, in group two, the addition of rice bran oil to the Alfa One™ RBO spread produced no differences in cholesterol levels. The reason for this unexpected result is being explored further. These results confirm that Alfa One™ RBO spread is effective in lowering serum cholesterol levels when consumed as part of a normal diet. Studies have shown that a 1% reduction in LDL-C can equate to a 2% decrease in coronary heart disease (CHD) risk thus suggesting that the 3.5% reduction demonstrated by Alfa One™ RBO spread in this study could be effective in reducing CHD risk as much as 6% in a mildly hypercholesterolaemic population.