Q1 for October
Q1. Would you as a dietitian recommend the use of phytosterols (in functional foods like Benecol®) to your patients that have high cholesterol? Support your opinion.
posted by Nisa M. @ 1:31 PM
13 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
13 Comments:
I would recommend the use of phytosterols (in functional foods such as Benecol) to patients with high cholesterol. Research shows that phytosertols can reduce TC and LDL-C up to 10%. Furthermore, phytosertols have not been shown to be harmful in any way.
I would also recommend phytosterols in margarines such as Benecol to patients with high cholesterol. The reserch shows that it is useful in lowering cholesterol. I would also be interested in more research to find the phyosterols in other foods, since nutrition data bases are limited in this area. I think it would be important to learn about a clients tatstes before recommending these margarines because they are not for everyone (and as mentioned in question 3 they cost more). Education on subsitition of these spreads for other fats needs to be noted. It does no good to put Benecol on their toast if they put extra butter on their mashed potatoes, bagel, steak and vegetables (especially if they never did this before).
I agree with both of you. The evidence suggests that these products are beneficial. But Mary Ellen brings up a good point about how they must be used exclusively and their benefits will be limited if one continues to use other fats.
Yes, I would recommend the use of phytosterols for patients that have high cholesterol in order to promote long-term and short-term prevention of CAD. Adding phytosterols as part of the intensive lifestyle intervention, namely the TLC (Therapeutic Lifestyle Changes) guidelines in LDL-lowering therapy, have been recommended due to the accumulation of scientific research. Phytosterols are another approach to lowering LDL-cholesterol in individuals who are not seeing results from just following the Step II diet and medication. Other than possibly increased cost, there are relatively few barriers to adding products such as Benecol® to one’s diet.
I would limit my recommendation to pts with slightly elevated cholesterol or who had a recent onset of high cholesterol because of the mediocre absorption rates compared with drugs from foods. It would be too risky of a treatment to rely heavily on phytosterol absorbtion with pts who have genetic disordes like familial hypercholestemia.
Everyone has brought up valid points. While adding sterol margarines to the diet may be an easy way to aid in cholesterol lowering treatment, one must weigh the costs and benefits as they apply to each pt.
Individuals with familial hypercholesterolemia who wish to add phytosterols to their diet through the available margarines should first and forement meet with an RD to avoid unintentionally raising their lipid profile or even body weight. The client's current diet habits should be examined in order to carefully examine if the addition is a good choice.
Yes I would recommend the use of phytosterols to my patients who still had high cholesterol even after using a high dose of statins. In studies it has been found that stanols and sterols are helpful for lower cholesterol so if medication does not work they really have nothing to lose by trying products like benecol. It is important to remind patients that it is still important to follow a healthy diet. It will be interesting to see if sterols and stanols will be added to other products in the future.
I think you all have done a great job of noting the benefits of using phytosterols in a person’s diet who has elevated cholesterol levels. It is also important to look at any potential side effects of plant sterols and stanols. The International Food Information Council shares there were concerns of reduced absorption of fat-soluble vitamins, but thus far, no research as reported this. However, some studies have reported that absorption of betacarotene was affected in some people, but can be compensated for by including carotenoid rich fruits and veggies in the diet. Again, like many of you stated, with the addition of phytosterols, it remains important to follow a healthy diet.
Brittany,
I think that is a valid point of yours to remember that patients should try multiple methods to lower their cholesterol. So many people think that if they take statins they don't need to worry about anything else. It is so important that they change their diet as well, and as you suggested they can try plant sterols in conjunction with the statins.
Julie,
I agree with your point that is still important to continue performing studies involving the use to sterols to make sure there are not any side effects of adding sterols to a diet.
Yes, all the research we have is rather current. There haven't been very many studies on the long term effects of using sterols or even statins for that matter. Our work in this field is far from over.
Julie,
I think it is a good point that the possible side effects of phytosterols should be taken into consideration. It will be interesting to see what the research shows. It is interesting to look back and see how much nutrtion recommendations have changed as more and more research has been done.
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