Cholesterol-Lowering Spreads May Benefit Children with High Cholesterol

BACKGROUND: Familial hypercholesterolemia is a genetic disorder that increases blood levels of low-density lipoprotein (LDL) cholesterol, which in turn raise the risk of heart disease at an early age. Margarines enriched with esterified plant sterols are well established for lowering cholesterol levels in adults. The following study is the first using esterified sterol-ester-enriched spreads in children with familial hypercholesterolemia. Many such children are prescribed cholesterol- lowering drugs.

RESEARCH: Prior to the study, researchers coached 38 children with familial hypercholesterolemia, along with their parents, on reducing dietary saturated fat and cholesterol and increasing fruit and vegetable consumption. Then, for eight weeks, the children added a margarine spread providing 1.6 grams of sterol esters daily or a similar spread without sterol esters. The children consumed both spreads during separate intervention periods.

RESULTS: When the children were consuming the sterol ester-enriched spread, their LDL blood cholesterol levels decreased by an average 10.2 percent, compared to when they consumed a nonenriched spread. In addition, their total cholesterol and apolipoprotein B (another risk factor) concentrations declined by 7.4 percent. No changes in levels of high-density lipoprotein (HDL) cholesterol or triglycerides were observed.

IMPLICATIONS: This study suggests that a sterol-enriched spread can significantly reduce LDL and total cholesterol levels in children with familial hypercholesterolemia. The 10.2% reduction in LDL cholesterol levels is comparable to the reduction in adults consuming larger quantities of sterol esters. No serious side effects were noted in the children.

Amundsen AL, Ose L, Nenseter MS, et al., "Plant sterol ester-enriched spread lowers plasma total and LDL cholesterol in children with familial hypercholesterolemia," American Journal of Clinical Nutrition, 2002;76:338- 344.

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