Assessment of the Efficacy of Plant Stanol Esters in Reducing Cholesterol, Medellin 2011 (Ben2011)

Introduction:

Cardiovascular diseases have become the leading cause of death from chronic diseases in the world. One of the major risk factors for this disease is hypercholesterolemia, caused in most cases by a rich-fat diet, so came to our country Benecol ® yogurt, whose active ingredient is plant stanol ester that competes with total cholesterol and low density lipoprotein or LDL cholesterol by preventing them to be absorbed by the body and reducing blood levels.

Objective: To evaluate the efficacy of plant stanol ester in Benecol ® yogurt lowering blood lipids in moderately hypercholesterolemic patients treated at the CES Clinic during 2011.

Methods: A randomized crossover clinical trial, double-blind, placebo-controlled study in patients between 20 and 50 years with moderate hypercholesterolemia and are cared for CES control clinic in Medellin.

Expected results: Test the effectiveness of plant stanol esters in reducing total cholesterol and LDL cholesterol in patients with moderate hypercholesterolemia.

Study Overview

• Status: Unknown
• Conditions: Risk Reduction Behavior
• Intervention / Treatment: Dietary supplement: assessment of efficacy of Benecol yogurt; Dietary supplement: Placebo Yogurt; Dietary supplement: yogurt

Detailed Description

The main cause of death worldwide are cardiovascular diseases, generated mainly by disturbances in the lipid profile. Several studies have shown that dyslipidemia is an important risk factor for this condition, thus maintaining the level of lipids in an appropriate range is ideal for preventing cardiovascular diseases (1)

Cardiovascular diseases are a serious epidemiological problem in the contemporary world, with approximately 17 million people die each year from causes such as myocardial infarction and stroke. The increase in cardiovascular disease and mortality attributable to them is a topic widely reported by several authors in the world. In Colombia after death from violent causes, cardiovascular diseases are on the second of the five leading causes of mortality in the general population.

Having high total cholesterol is a risk factor for the occurrence of various diseases of the circulatory system, therefore it is important to keep total cholesterol below 200 mg / dl and LDL cholesterol levels under 150 mg/dl, to avoid the accumulation of fat within the walls of the arteries that can lead to the formation of atherosclerotic plaques that cause decreased blood flow

The atlas published by WHO in 2005 provides comprehensive data on morbidity and mortality attributable to noncommunicable diseases, which are increasing. It is estimated that in 2001 approximately 60% of the 56.5 million deaths worldwide and 46% of diseases are due to noncommunicable diseases. The epidemiological burden of these diseases will increase to 57% by the year 2020. Almost 50% of deaths due to noncommunicable diseases are due to cardiovascular disease. By 2020, these diseases are responsible for 75% of all deaths worldwide.

Given the high prevalence of cardiovascular disease and dyslipidemia are considered a high risk factor for these occur, it is necessary to test the effectiveness of including the consumption of plant stanol esters in the diet to lower cholesterol values Total and LDL Cholesterol.

• Study Type: Interventional
• Enrollment (Anticipated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Johanna Romero Palacio, Microbiologa; Phone Number: 300788362; Email: jrp922@gmail.com
• Study Contact Backup: Name: Elsa María Vásquez Trespalacios, Epidemióloga; Phone Number: 4440555; Email: evasquez@ces.edu.co

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 48 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Sign voluntarily the informed consent
• Male or female 20 to 50 years
• The concentration of total serum cholesterol of 5.2 - 7.5 mmol / l (205-290 mg / dl) at the screening visit (Visit 1 to 2 week)

Exclusion Criteria:

• Lipid-lowering medication or other drugs that significantly affect lipid values
• Diabetes Type I or II
• Severe obesity (BMI greater than 35 kg/m2)
• Fasting serum triglycerides> 4.0 mmol / l
• Liver or kidney disorder according to medical history
• History of coronary revascularization percutaneous transluminal coronary angioplasty within six months prior to screening
• History of temporary ischemic attack or stroke within six months prior to screening
• History of cancer or other malignant disease in the last five years
• Consumption of more than 15 parts of alcohol/week
• Pregnant or lactating
• Benecol consumption in your diet, or other plant sterol enriched products 30 days before visit 2 (Week 1), these will be identified by the survey
• Severe lactose intolerance, milk allergy or any other form of intolerance to the ingredients of the test products
• Celiac Disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Benecol; In 2009, the dairy Cooperative Colanta Launches Benecol ® yogurt, a product with optimal daily dose of plant stanol, each portion of 100 g containing 3.4 g of Benecol ®, corresponding to 2 g of plant stanol esters . Skim yogurt with Benecol ® is a product made from pasteurized skim milk, sweetened with sucralose homogenized and fermented by the action of specific lactic culture to obtain the optimal characteristics of texture and acidity. With the addition of fruit pulp and supplemented with plant stanol esters (Benecol ®) to help reduce the risk of cardiovascular disease (31). According to Weiss et al, drinkable yogurt with Benecol ® reduces total cholesterol by 5.8% and 9.8% in LDL cholesterol (32).	Dietary supplement: assessment of efficacy of Benecol yogurt; Benecol Yogurt and Yogurt placebo for 4 weeks each, at a dose of 100 ml (200 ml in total) of yogurt twice a day with main meals; Other Names: Benecol Yogurt; Placebo Yogurt; Dietary supplement: Placebo Yogurt; Yogurt without the active principle; Other Names: Colanta Yogurt
Placebo Comparator: yogurt; Yogurt without plant stanols	Dietary supplement: yogurt; yogurt without plant stanols; Other Names: Yogurt Colanta

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Benecol Efficacy	Week 1: it will be taken a blood sample for lipid profile and other tests of liver and kidney function, patients will begin the Benecol ® yogurt consumption or placebo for four weeks, at week 5 it will be taken a new blood sample to perform mentioned test lipid levels and meet and determine the changes presented, patients will have a wash out week in Week 6 and groups will change for four weeks, at the end of week 9 will be held the last shot of sample for all tests again	9 weeks

Collaborators and Investigators

• Sponsor: Jose María Maya Mejía
• Investigators: Principal Investigator: Johanna Romero, BML, CES University

Publications and helpful links

General Publications

• Miettinen TA, Puska P, Gylling H, Vanhanen H, Vartiainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med. 1995 Nov 16;333(20):1308-12. doi: 10.1056/NEJM199511163332002.
• Plat J, van Onselen EN, van Heugten MM, Mensink RP. Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur J Clin Nutr. 2000 Sep;54(9):671-7. doi: 10.1038/sj.ejcn.1601071.
• Furgione A y col. Dislipidemias primarias como factor de riesgo para enfermedad coronaria.Revista latinoamericana de hipertensión. 2009;4(1)
• Schmidt B, Ribnicky DM, Poulev A, Logendra S, Cefalu WT, Raskin I. A natural history of botanical therapeutics. Metabolism. 2008 Jul;57(7 Suppl 1):S3-9. doi: 10.1016/j.metabol.2008.03.001.
• Katan MB, Boekschoten MV, Connor WE, Mensink RP, Seidell J, Vessby B, Willett W. Which are the greatest recent discoveries and the greatest future challenges in nutrition? Eur J Clin Nutr. 2009 Jan;63(1):2-10. doi: 10.1038/sj.ejcn.1602923. Epub 2007 Oct 10.
• Musa-Veloso K et al. Una comparación entre la eficacia para disminuir el colesterol - LDL de los estanoles vegetales y los esteroles vegetales dentro de un rango de dosis continúo: Resultados de un meta-análisis de estudios controlados randomizados con placebo. 2011
• Calvo Romero JM, Lima Rodriguez EM. ["Natural" treatments of hypercholesterolemia]. Rev Clin Esp. 2006 Nov;206(10):504-6. doi: 10.1157/13094900. Spanish.
• Gylling H, Hallikainen M, Nissinen MJ, Miettinen TA. The effect of a very high daily plant stanol ester intake on serum lipids, carotenoids, and fat-soluble vitamins. Clin Nutr. 2010 Feb;29(1):112-8. doi: 10.1016/j.clnu.2009.08.005. Epub 2009 Aug 26.
• Vasquez-Trespalacios EM, Romero-Palacio J. Efficacy of yogurt drink with added plant stanol esters (Benecol(R), Colanta) in reducing total and LDL cholesterol in subjects with moderate hypercholesterolemia: a randomized placebo-controlled crossover trial NCT01461798. Lipids Health Dis. 2014 Aug 6;13:125. doi: 10.1186/1476-511X-13-125.

Study record dates

Study Major Dates

• Study Start: October 1, 2011
• Primary Completion (Anticipated): December 1, 2011
• Study Completion (Anticipated): March 1, 2012

Study Registration Dates

• First Submitted: October 20, 2011
• First Submitted That Met QC Criteria: October 26, 2011
• First Posted (Estimate): October 28, 2011

Study Record Updates

• Last Update Posted (Estimate): October 28, 2011
• Last Update Submitted That Met QC Criteria: October 26, 2011
• Last Verified: October 1, 2011

More Information

Terms related to this study

• Keywords: cardiovascular disease; lipids; plant stanols
• Other Study ID Numbers: Ben2011