Background. A high ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol, in addition to increased levels of small low-density lipoprotein (LDL) particles, are important indicators of cardiovascular disease risk. Therefore, interventions that combine the lowering of total cholesterol and raising of HDL cholesterol concentrations that also increase LDL particle size, may be preventive against cardiovascular disease. Plant sterols decrease total cholesterol and LDL cholesterol levels by 10-15%, while exercise increases HDL cholesterol levels by 4-22%. In view of their complementary effects, combining plant sterols with exercise would appear to be an effective lifestyle therapy to decrease the risk of future cardiovascular disease. / Objective. The aim of this study was to examine the independent and combined effects of plant sterols and exercise on blood lipid levels, and LDL particle size in previously sedentary, hypercholesterolemic adults. An additional objective of this trial was to assess the underlying mechanism by which this combination therapy modulates whole body cholesterol metabolism, to in turn improve lipid profiles. / Methods. In an 8-week, parallel-arm trial, 84 subjects were randomized to 1 of 4 interventions: (1) plant sterols and exercise,(2) plant sterols alone, (3) exercise alone, or (4) control. Blood lipid concentrations were measured using enzymatic kits, and LDL particle size was assessed using polyacrylamide gel electrophoresis. Cholesterol absorption and synthesis were determined using the single isotope single tracer technique and the deuterium incorporation approach, respectively. / Results. Plant sterol supplementation decreased (P < 0.01) total cholesterol concentrations by 8.2% when compared to baseline. Exercise increased (P < 0.01) HDL cholesterol levels by 7.5% while decreasing (P < 0.01) triglyceride concentrations by 13.3% when compared to baseline. Exercise reduced (P < 0.05) post-treatment LDL peak particle size from 255 to 253 A, and decreased (P < 0.05) the proportion of large LDL particles by 13.1%. Plant sterols had no effect on particle size distribution. Plant sterol supplementation decreased (P < 0.01) intestinal cholesterol absorption by 18%, while exercise had no effect on cholesterol absorption. Non-significant increases in cholesterol synthesis rates of 63%, 59%, and 57%, were observed in the combination, exercise, and plant sterol groups, respectively, relative to control. / Conclusion. These findings suggest that this combination therapy yields the most favourable alterations in lipid profiles when compared to each intervention alone. This combined intervention exerts its beneficial effects on lipid profiles by suppressing intestinal cholesterol absorption. Therefore, this lifestyle therapy may be an effective means of decreasing the risk of cardiovascular disease in hypercholesterolemic adults.

To evaluate the relative efficacy of plant sterols (PS) esterified with the fatty acids from fish oil (PS-FO), olive oil (PS-OO) and sunflower oil (PS-SO) on blood lipid and PS concentrations, 21 hyperlipidemic subjects were randomly assigned to each of five treatments for 28 days using a cross-over design. The results showed that: (1) in a comparison of olive oil (OO), fish oil (FO), PS-FO and PS-SO subgroup, PS-FO reduced triacylglycerols (TG) relative to PS-SO. Total cholesterol (T-C)/high-density lipoprotein cholesterol (HDL-C) ratio was reduced with PS-FO compared with FO. Plasma PS levels were increased with PS-SO and PS-FO. (2) in a comparison of OO, PS-SO and PS-OO subgroup, PS-OO had a larger decrease in T-C than OO, while PS-SO and OO reduced T-C equally. Both PS-SO and PS-OO elevated plasma PS levels. Overall, PS-FO and PS-OO have a higher potential for decreasing the risk of cardiovascular disease in hyperlipidemic subjects than PS-SO and OO supplementations.

Plant sterols are effective cholesterol-lowering agents; however, recent evidence suggests that this treatment may not be safe and beneficial in all individuals. This study determined whether high and low baseline circulating plasma campesterol and sitosterol are related to subsequent changes in plasma LDL-C, plant sterol or CRP levels, after accounting for plant sterol supplementation in hypercholesterolemic men (n=82). This trial was a 2-phase randomized cross-over design consisting of a controlled diet with and without a dose of 2.0 g/d of plant sterols over 4 weeks. There was no significant difference in plasma LDL-C, in the elevation of plasma plant sterol or in the changes of CRP levels for high and low groups, respectively. In view of these data, a supplement of 2.0 g/d of plant sterols should be viewed as a safe and beneficial cholesterol-lowering therapy for all individuals, with respect to their baseline plasma plant sterol levels.

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.

Orientador: Helena Teixeira Godoy / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos / Made available in DSpace on 2018-08-08T02:47:43Z (GMT). No. of bitstreams: 1 Costa_PauloAfonsoDa_D.pdf: 23936384 bytes, checksum: a6d6688127d488f15b73823f62bef97d (MD5) Previous issue date: 2007 / Doutorado / Doutor em Ciência de Alimentos

Introdução-- Os fitosteróis (FS) são esteróis de origem vegetal, reconhecidos como componentes funcionais devido ao seu papel hipocolesterolêmico. A recomendação de ingestão diária desses compostos é de 1,6 a 2 g/dia, no entanto há poucos estudos que avaliem os teores desses compostos em alimentos, sendo necessária sua quantificação. Objetivo - O objetivo deste projeto foi desenvolver uma metodologia e determinar os teores de FS em alguns alimentos usualmente consumidos e comercializados em São Paulo. Metodologia Foram avaliadas amostras de creme vegetal sem sal (in natura, e aquecidas a 100o C e 140o C), dos farináceos: farinha de trigo, farinha de milho, farinha de mandioca, amido de milho, café em pó (torras: tradicional, forte e extraforte, descafeinado e gourmet), café solúvel instantâneo, cappuccino e da bebida coada. As amostras, em triplicata, foram submetidas ao processo de saponificação a frio e a matéria insaponificável extraída foi derivatizada e posteriormente injetada em cromatógrafo gasoso. Resultados Os principais FS encontrados foram: -Sitosterol, campesterol e estigmasterol. As maiores médias de teores de FS foram encontradas nos cremes vegetais (186,2 ± 21,7 mg /100g) e nos pós de café moído (92,24 ± 3,95 mg /100g). As farinhas apresentaram teores intermediários, 42,27 ± 7,09 mg /100g; 35,10 ± 10,49 mg /100g; 22,02 ± 1,22 mg /100g; 14,33 ± 3,07 mg /100g para farinha de rosca, milho, trigo e mandioca, respectivamente. As amostras cappuccino (5,73 ± 0,78 mg /100g), café solúvel (4,03 ± 0,84 mg /100g) e amido de milho (3,55 ± 0,8 mg /100g) foram as apresentaram menores teores de FS. Nas amostras de creme vegetal, o processamento térmico reduziu os teores totais de FS das amostras in natura em 10 por cento e 53,7 por cento , para os aquecimentos até 100o C e 140o C, respectivamente. . Não houve influencia do grau de torra e do processo de descafeinização nos teores totais de FS encontrados nas amostras de pó de café moído. Conclusão: De acordo com os resultados obtidos os alimentos com maior teor de fitosteróis são a creme vegetal e o pó de café. Pode-se considerar que o creme vegetal, mesmo sem adição de FS é boa fonte desse nutriente. Nas amostras de café o processamento térmico pouco influenciou nos teores de FS, o mesmo não aconteceu com as amostras de creme vegetal. As mais baixas concentrações de FS foram observadas nas amostras de farinhas, amidos, cappuccino e café em pó solúvel. / Introduction: Phytosterols (PS) are plant sterols, known as functional components due to its hypocholesterolemic role. The recommendation for daily intake of these compounds is 1.6-2 g/day, however there are few studies that evaluate the content of these compounds in foods, requiring its quantification. Objective: the objective of this project was to develop a methodology and determine the content of PS in some foods usually consumed and traded in Sao Paulo. Methodology: Were evaluated samples of: unsalted vegetable cream (in natura, and heated to 100oC and 140oC), farinaceous: wheat, corn and cassava flour, breadcrumbs and cornstarch, powdered coffee (roasts: traditional, strong and extra strong, decaffeinated and gourmet), instant coffee, cappuccino and strained drink coffee. Samples in triplicate were subjected to cold saponification process and unsaponificable matter was extracted, derivatized and subsequently injected into the gas chromatograph. Results: The main PS founded in the samples were: -sitosterol, campesterol and stigmasterol. The highest average levels of PS were found in vegetable creams (186.2 ± 21.7 mg / 100g) and powdered coffee (92.24 ± 3.95 mg / 100g). Farinaceous had intermediate levels, 42.27 ± 7.09 mg / 100g; 35.10 ± 10.49 mg / 100g; 22.02 ± 1.22 mg / 100g; 14.33 ± 3.07 mg / 100g for breadcrumbs, corn, and wheat and cassava flour, respectively. Cappuccino samples (5.73 ± 0.78 mg / 100g), soluble coffee (4.03 ± 0.84 mg / 100g) and corn starch (3.55 ± 0.8 mg / 100g) showed lower levels of PS. In samples of vegetable cream, thermal processing reduced in 10 per cent and 53.7 per cent , for heating up to 100°C and 140°C, the total content of PS comparing with in natura samples. There was no influence of the degree of roasting and decaffeination process in the total levels of PS founded in samples of ground coffee powder. Conclusions: According to the results, in the samples evaluated, foods with the highest content of phytosterols are vegetable cream and powder coffee. Margarine can be considered good source of PS even without it industry addition. The heat treatment did not affected the PS content in the coffee samples, however, the same didn\'t happen with samples of vegetable cream. The lowest concentrations of PS were observed in samples of farinaceous, cappuccino and soluble coffee.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objective: To evaluate the safety and tolerability of an oral herbal supplement containing glucosinolates, phytosterols, and citrus flavonoids (Warmi®, Lima Perú;) in otherwise healthy adult women. Methods: This was a phase-I, randomized parallel three arms, double-blinded, and a placebo-controlled clinical trial. A total of 55 participants aged 18-40 were randomly assigned to one of three groups to receive for three months: (1) an oral herbal supplement of 1650 mg/day; (2) an oral herbal supplement of 3300 mg/day; or (3) an oral placebo 3300 mg/day. The primary endpoints were oral safety and tolerability of the supplement. The secondary endpoint was its effect on vital functions, anthropometrics, and laboratory tests. We used an exploratory approach by covariance analysis (ANCOVA) adjusted for the variables’ baseline value for the secondary outcomes. Results: All women completed three months of follow-up, reporting no side effects. Our exploratory analysis revealed that treatment with the herbal supplement of 1650 mg/day was associated with increased glucose and uric acid levels. In comparison, the herbal supplement 3300 mg/day was associated with reduced breathing rate, increased basal temperature, and systolic blood pressure, both compared to the placebo group. However, despite significant differences, none of these was clinically significant. Conclusion: The oral herbal supplement had a favorable safety and tolerability profile in studied women. There is a need to study its potential as an option to treat menopausal symptoms. / Revisión por pares

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