Exposure and effectiveness of phytosterol/-stanol-enriched margarines

N de Jong, A Zuur, M C J Wolfs, G C W Wendel-Vos, J M A van Raaij, A.J. Schuit

Research output: Contribution to journalArticleScientificpeer-review

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Studies on effectiveness of phytosterol/-stanol-enriched margarines in the community have received low priority. For postlaunch monitoring purposes including risk-benefit analyses, it is needed to investigate both exposure and effectiveness of these margarines.


To study the use and effectiveness of phytosterol/-stanol-enriched margarine.

Design, setting and subjects:

The study population consisted of 2379 subjects that participated in a community intervention study ('Hartslag Limburg') aged 28-76 years. In 1998 and 2003, blood samples for total and high-density lipoprotein (HDL) cholesterol were obtained. A general questionnaire and food frequency questionnaire (FFQ) were administered. From 1999 onwards, phytosterol/-stanol-enriched margarines were introduced on the Dutch market. On the basis of 2003 data, subjects were classified in users of (a) phytosterol/-stanol-enriched margarine, (b) cholesterol-lowering drugs, (c) the combination (both enriched margarine and drugs) and (d) neither enriched margarines nor cholesterol-lowering drugs.


Mean (+/-s.d.) daily intake of phytosterol-enriched margarine (n=99) and phytostanol-enriched margarine (n=16) was 14+/-9 g. From 1998 to 2003, total serum cholesterol concentration changed significantly different among the four groups: in the combination users -2.04+/-1.50 mmol/l (-29%), in cholesterol-lowering drug users -1.09+/-1.17 mmol/l (-17%), in the enriched margarine users -0.24+/-0.75 mmol/l (-4%) and in non-users +0.10+/-0.72 mmol/l (+2%)(P<0.05).


Recommended doses are not consumed, but phytosterol/-stanol-enriched margarines can modestly reduce serum total cholesterol in the community. These margarines cannot equal the effect of cholesterol-lowering drugs, but may act additively. Further investigation of the health effects that may occur during simultaneous cholesterol lowering drugs and phytosterol-or -stanol-enriched margarines usage is important, as well as community education about the cholesterol lowering foods and drugs.

SPONSORSHIP: Netherlands Organization for Health Research and Development (ZonMW) (data collection of Hartslag Limburg and further data- analyses).

Original languageEnglish
Pages (from-to)1407-1415
JournalEuropean Journal of Clinical Nutrition
Issue number12
Publication statusPublished - Dec 2007
Externally publishedYes


  • Adult
  • Aged
  • Anticholesteremic Agents
  • Cholesterol
  • Cholesterol, HDL
  • Diet
  • Female
  • Food, Fortified
  • Humans
  • Hypercholesterolemia
  • Male
  • Margarine
  • Middle Aged
  • Phytosterols
  • Product Surveillance, Postmarketing
  • Risk Assessment
  • Sitosterols
  • Surveys and Questionnaires
  • Time Factors
  • Journal Article
  • Research Support, Non-U.S. Gov't


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