China Plant Sterol Trial - CPST

Background

Numerous studies conducted in mainly Western populations have shown that intake of plant sterol (PS) enriched foods in various food formats decreases blood cholesterol levels. The cholesterol lowering effects of PS-enriched food consumption in Chinese individuals have so far not been investigated.

Aim

This study aimed to test the cholesterol-lowering efficacy of a PS-enriched instant milk tea powder, a food format suitable for the Chinese population.

Methods

This was a double blind, randomised and controlled trial. 309 healthy adult Chinese with above average cholesterol levels and dietary fat intake were recruited from three community-based clinical research centres in Beijing.

After a 10 day placebo run-in period eligible participants were randomly assigned to three equal groups that received 5 weeks intervention with 2.3g/day or 1.5g/day of PS or placebo. PS and placebo were delivered as a soluble milk tea powder consumed twice daily with the two fattiest meals of the day. Mean reductions (95% confidence interval, p-values) were calculated for total cholesterol and low-density lipoprotein cholesterol (LDL-C).

Results

The mean age of study participants was 44 (SD: 11.9 ) years, 62% was female and 62% had a history of hypercholesterolemia. Baseline mean total cholesterol was 5.45mmol/l and LDL-C was 3.19 mmol/l. 6% were using cholesterol lowering medications. Compared to placebo, 2.3g/day PS reduced total cholesterol by 0.25 (0.07 to 0.43; p =0.01) mmol/l and 1.5g/day by 0.23 (0.06 to 0.41; p =0.01) mmol/l. For LDL-C the corresponding reductions were 0.17 (0.00 to 0.35, p =0.06) mmol/l and 0.15 (-0.02 to 0.32; p =0.08) mmol/l . For neither outcome was there evidence of differences between the effects of the two doses (both p values >0.4).

Conclusion

Dietary PS resulted in significant reductions in total cholesterol. The magnitude of the cholesterol reduction was moderate compared to previous studies investigating PS effects at this daily dose. The reason for this lesser magnitude of cholesterol reduction remains unclear. Nevertheless, the observed cholesterol reduction would be anticipated to reduce cardiovascular risk in the Chinese population.

Institute Investigators

Project Managers

  • Nicole Li
  • Dorothy Han

Collaborators

Funding Agencies