Natural Medicine Update
Shawn M. Carney, ND
Twenty-Two Year Follow-up Shows: Higher the
Plant Sterol, Lower the Cholesterol, and Longer the Life
H
igher levels of plant constituents known as phytosterols, measured twenty-two years ago in then middle-aged men with a
high risk of cardiovascular disease, has been shown to predict lower long-term mortality. Though the merits of phytosterols
have been well established for quite some time, a study with this duration of a follow-up is certainly worth reviewing.
The study mentioned above, which was released from Finland and recently published in the professional journal Athero-
sclerosis, chose to evaluate the predictability of serum levels of non-cholesterol sterols among men with a high cardiovascular
disease risk. There were half a dozen non-cholesterol sterols measured including plant sterols such as campesterol and sitosterol
as well as others related to cholesterol synthesis and absorption. None of the 232 participants in the study were on any form of
cholesterol-lowering drug therapy (statin) when initial data was collected in 1985-1986; however, most had elevated choles-
terol and some furthermore had a history of cardiovascular disease, cancer, or diabetes.
The only noteworthy statistically significant result was that sitosterol was found to have been higher in the survivors than non-
survivors at the time of their initial samples. Specifically, in multi-variable analyses, the highest sitosterol-to-cholesterol tertile
was associated with a significantly lower mortality risk than the lowest tertile in the study. Almost half of the men did not survive
to the twenty-two year follow-up; they were largely noted to have smoked more, exercised less, and had more characteristics
of metabolic syndrome, such as elevated blood pressure, low HDL, and an increased waist-to-hip ratio.
Phytosterols have been widely researched for their ability to decrease cholesterol absorption in humans. The United States
Food and Drug Administration (FDA) has even made permissible a statement to this effect: “foods containing at least 0.4 grams
per serving of plant sterols eaten twice a day with meals for a daily total intake of at least 0.8 grams, as part of a diet low in
saturated fat and cholesterol, may reduce the risk of heart disease”. Their mechanism of action would seem to be inhibition of
cholesterol absorption by displacing cholesterol from the means transport out of the digestive tract, a feat made possible be-
cause the two molecules are structurally very similar.
While statins have been effective in reducing the risk of heart disease, there are individuals who are unwilling or unable to
utilize such cholesterol-lowering medications. Inability to tolerate statins may be due to either of the rather widely publicized
statin-induced complications, such as muscle pains or elevated levels of liver enzymes. Fortunately, the ample evidence link-
ing dietary interventions to successful risk reduction has prompted various regulatory bodies to advocate dietary and lifestyle
changes as the first line of defense for primary prevention of heart disease and cardiovascular well-being. Nutritional supple-
ment manufacturers have accordingly released products using phytosterols and some have even clinically demonstrated their
ability to achieve therapeutic results in conjunction with other lifestyle changes. Thus people seeking to manage elevated cho-
lesterol have several different alternatives to explore.
Lower cholesterol and spontaneously eat less with an herb?
It’s Greek to me!
A
recent study published in the European Journal of Clinical Pharmacology found ingestion of fenugreek seeds, scientifically
known as Trigonella foenum-graecum, reduced spontaneous consumption of fats. Fenugreek has long been used for lower-
ing elevated cholesterol and blood sugar levels, with efficacy determined by preliminary and double-blind trials. This finding
further identifies fenugreek as a strategic component of treatment plans aimed at cardiovascular and glycemic disorders.
The purpose of this study was to assess the effects of repeated supplementation with fenugreek seed extract on the appetite
and food choices, or “energy intake and eating behavior”, of human beings. The researchers noted how animal studies had
demonstrated fenugreek’s ability to moderate feeding behavior in other species, but that there was limited data showing how
this may relate to people. Thus they recruited twelve healthy males and commenced a double-blind, randomized, placebo-
controlled, three-period, cross-over trial comparing two different doses of fenugreek seed extract, 588mg and 1,176mg. Each
of the three treatment periods lasted two weeks and was separated by a two week “washout” period without fenugreek supple-
mentation. Data collected for the study included a three day dietary record, weight measurement, glucose and insulin levels
both before and after breakfast, lipid profile, and visual analogue scale scores of appetite/satiety.
Subjects taking the higher dose of fenugreek seed extract showed a significant reduction in daily fat consumption when com-
pared to the placebo group. This typically reduced the total amount of food consumed that day, or “total energy intake” among
participants. Therefore, the authors of the above study concluded that repeated doses of Trigonella “specifically decreases di-
etary fat consumption in humans”.
Fenugreek’s numerous benefits are a result of its biochemistry. Its steroidal saponins (diosgenin, yamogenin, tigogenin,
and neotigogenin) and mucilaginous fiber are thought to account for many of the positive effects, though the mucilages also
8 NaturalNutmeg www.naturalnutmeg.com
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56