Cholesterol-lowering effects of plant sterol esters differ in milk, yoghurt, bread and cereal

Peter M. Clifton, M. Noakes, D. Sullivan, N. Erichsen, D. Ross, G. Annison, A. Fassoulakis, M. Cehun, P. Nestel

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150 Citations (Scopus)


Objective: To measure the relative effects of each of four phytosterol ester-enriched low-fat foods (bread, breakfast cereal, milk and yoghurt) on serum lipids, plasma phytosterols and carotenoids. Design: Three research centres undertook a randomised, incomplete crossover, single-blind study consisting of four treatment periods of 3 weeks each, one of which was a control period. Each sterol-enriched test food provided 1.6g/day of phytosterols as sterol esters. Setting: General Community. Subjects: In all 58, free-living men and women with mean age (s.d.) 54 (8)y, moderately elevated plasma total cholesterol 6.2 (0.7) mmol/l and body mass index 26.2 (3.0) kg/m2. Main outcome measures: Serum lipids, plasma phytosterols and carotenoids. Results: Serum total and LDL cholesterol levels were significantly lowered by consumption of phytosterol-enriched foods: milk (8.7 and 15.9%) and yoghurt (5.6 and 8.6%). Serum LDL cholesterol levels fell significantly by 6.5% with bread and 5.4% with cereal. They were both significantly less efficacious than sterol-enriched milk (P<0.001). Plasma sitosterol increased by 17-23% and campesterol by 48-52% with phytosterol-enriched milk and bread. Lipid-adjusted β-carotene was lowered by 5-10% by sterols in bread and milk, respectively. Conclusions: This is the first study to demonstrate that cholesterol-lowering effects of plant sterol esters may differ according to the food matrix. Plant sterols in low-fat milk was almost three times more effective than in bread and cereal. Despite phytosterol-enriched cereal products resulting in lower serum cholesterol reductions compared to sterol-enriched milk, the detection of similar changes in plasma phytosterols demonstrated that such products still delivered and released phytosterols to the gut.

Original languageEnglish
Pages (from-to)503-509
Number of pages7
JournalEuropean Journal of Clinical Nutrition
Issue number3
Publication statusPublished - 1 Mar 2004


  • Campesterol
  • Carotenoids
  • LDL cholesterol
  • Sitosterol

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Clifton, P. M., Noakes, M., Sullivan, D., Erichsen, N., Ross, D., Annison, G., ... Nestel, P. (2004). Cholesterol-lowering effects of plant sterol esters differ in milk, yoghurt, bread and cereal. European Journal of Clinical Nutrition, 58(3), 503-509.