Plant sterols (PS) lower total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and inflammatory markers, and decrease risk of atherosclerotic cardiovascular disease (CVD). Exercise increases high density lipoprotein cholesterol (HDL-C) levels and decreases triglycerides (TG) and inflammation, also reducing the risk of CVD. The study objective was to investigate the combined effects of PS and exercise on apolipoproteins (apo) A and B, adiponectin, growth hormone (GH) and ghrelin, in context of previously obtained lipid data. In an 8-wk, placebo-controlled, parallel-arm clinical trial, 84 subjects were randomly assigned to: (1) combination of PS and exercise, (2) exercise, (3) PS, or (4) control group. PS increased (P=0.04) adiponectin values by 15%. ApoA was associated with HDL and apoB with LDL values at baseline. ApoA %change was correlated to HDL %change in the exercise group. ApoB, GH and ghrelin were unchanged. The capability of PS to increase adiponectin values reinforce their role in preventing inflammation, atherosclerosis, and CVD.

The National Cholesterol Education Program Adult Treatment Panel II (NCEP ATP II) unequivocally advocates an initial trial of dietary modification in both primary and secondary prevention prior to the institution of pharmacotherapy. Perhaps the rationale for this delay rests in the inherent, yet unsubstantiated, fear among clinicians that lifestyle change will be compromised in the presence of concurrent pharmacotherapy. However, the question of adherence to diet and exercise interventions following the initiation of lipid-lowering drug therapy has seemingly never been addressed scientifically. / It was therefore hypothesized that pharmacologically-treated patients with untreated hypercholesterolemia started on a program of lifestyle modification would achieve relatively less reduction in dietary fat intake and body weight, and participate less often in physical activity, if a pharmacologic agent was simultaneously prescribed. This was tested by a protocol in which these and related variables were assessed in participants who thought they were taking a lipid-lowering medication at diagnosis, compared to conventional initial treatment of diet and exercise alone. (Abstract shortened by UMI.)

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