ABSTRACT
Recent clinical intervention studies have shown that long-term reduction of serum cholesterol by statins markedly reduces clinical manifestations of atheromatous arterial diseases, such as myocardial infarction and stroke (1,2). However, the studies have shown that before the curves of the event rates start to differ from each other in the placebo and statin treatment groups, the treatment should continue for up to a year or longer. Since dietary measures, including consumption of large amounts of phytosterols since the early 1950s (3), are being increasingly used for serum cholesterol lowering, their effects should also be long lasting, i.e., at least 1 year. However, despite the fact that many different phytosterol preparations lower serum cholesterol in humans in short-term studies (cf. 4, 5), only plant stanol (mixture of campestanol and sitostanol) ester margarine has been shown to be effective for at least 1 year in both men and women as compared with the baseline or control values (6). In contrast, consumption of vegetable sterol (mixture of mainly sitosterol, campesterol, and stigmasterol) ester spread showed some cholesterol reduction for up to 1 year as compared with controls (7), but it was ineffective in women and, despite initial reduction, the 1-year cholesterol values were not significantly different from the baseline values (8). Plant sterol ester spread occasionally had no effect on serum cholesterol (9), but in general the plant sterol and stanol spreads are identical in their lowering of serum cholesterol levels in short-term studies (cf. 4, 5).
