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Andrea Lugasi National Institute for Food and Nutrition Science, Budapest, Hungary
Gyáli str. 3/a, H-1097, Budapest, Hungary

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Abstract

Phytosterols are isoprene compounds that may be found in a great variety of different food products. Most important phytosterol compounds are β-sitosterol, campesterol and stigmasterol. Plant sources of phytosterols are oily seeds, nuts, plant oils, grains, and pulses. Many controlled clinical studies have demonstrated their ability to reduce blood cholesterol levels in hyper- and normocholesterolaemic subjects. Investigators report that phytosterol intakes of 2 to 3 g/day reduce low-density lipoprotein (LDL) cholesterol levels by about 7 to 11% in human subjects, while LDL and TG levels show no change. Phytosterol intake higher than 3 g daily results in no greater decrease of LDL level, but even the consumption of 8.6 g/day has no detrimental effect on human health. Documented side effect of elevated phytosterol intake is the reduced level of certain carotenoids in sera but this effect can be balanced by increased consumption of fruits and vegetables rich in carotenoids. Subjects having hereditary sitosterolaemia are highly advised to refrain from consuming foods supplemented with phytosterols. As dietary intake of phytosterols is too low to achieve a significant reduction of cholesterol level, based on the Community legislation of 258/97/EC regulation related to novel foods and novel food ingredients the European Union authorized to use phytosterols in certain food products at a concentration which resulted in a daily phytosterol intake less than 3 g. European survey of European Food Safety Authority (EFSA) shows that only 10 to 15% of the population consume foods supplemented with phytosterols, and phytosterol intake is less than the effective dose. Based on this survey it is supposed that the risk of phytosterol overdose is low. EFSA also stated that — based on the relevant scientific information — regular intake of foods supplemented with phytosterols/phytostanols is in significant correlation with reduced serum cholesterol level. Based on this statement authorized foods enriched with phytosterols will be the first food group legally having health claim for reduced risk of disease since the new Community legislation on nutritional and health claim on foods 1924/2006/EC exists. Consumers will have a scientifically substantiated health claim on the label of these foods: “Plant sterols/stanols have been shown to lower/reduce blood cholesterol. Blood cholesterol lowering may reduce the risk of coronary heart disease”.

  • [1]. M. A. Hartmann 1998 Plant sterols and the membrane environment Trends Plants Sci. 3 170175.

  • [2]. R. E. Ostlund 2002 Phytosterols in human nutrition Ann. Rev. Nutr. 22 533549.

  • [3]. G. Brufau M. A. Canela M. Rafecas 2008 Phytosterols: physiologic and metabolic aspects related to cholesterol-lowering properties Nutr. Res. 28 217225.

    • Search Google Scholar
    • Export Citation
  • [4]. R. T. Lorentz K. Haeckler G. Fenner 1989 Analysis of steryl esters W. D. Nes E. J. Parish Analysis of Sterols and Other Biologically Significant Steroids Academic Press Inc San Diego 3348.

    • Search Google Scholar
    • Export Citation
  • [5]. L. Normén 2001 Phytosterols — effects of intake on cholesterol absorption and colorectal cancer risk Department of Clinical Nutrition, Göteborg University Göteborg, Sweden.

    • Search Google Scholar
    • Export Citation
  • [6]. T. T. Nguyen 1999 The cholesterol-lowering action of plant stanol esters J. Nutr. 129 21092112.

  • [7]. H. Gylling T. A. Miettinen 2002 LDL cholesterol lowering by bile acid malabsorption during inhibited synthesis and absorption of cholesterol in hypercholesterolemic coronary subjects Nutr. Metab. Cardiovasc. Dis. 12 1923.

    • Search Google Scholar
    • Export Citation
  • [8]. H. Gylling T. A. Miettinen 2000 Plant sterols in nutrition — promise or threat for the future Scand. J. Nutr. 44 104S.

  • [9]. R. A. Moreau B. D. Whitaker K. B. Hicks 2002 Phytosterols, phytostanols and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses Prog. Lipid Res. 41 457500.

    • Search Google Scholar
    • Export Citation
  • [10]. V. Piironen D. G. Lindsay T. A. Miettinen et al.2000 Plant sterols: biosynthesis, biological function and their importance to human nutrition J. Sci. Food Agric. 80 939966.

    • Search Google Scholar
    • Export Citation
  • [11]. S. Klingberg H. Andersson A. Mulligan et al.2008 Food sources of plant sterols in the EPIC Norfolk population Eur. J. Clin. Nutr. 62 6 695703.

    • Search Google Scholar
    • Export Citation
  • [12]. M. J. Lagarda G. García-Llatas R. Farré 2006 Analysis of phytosterols in foods Review. J. Pharmaceut. Biomed. Anal. 41 14861496.

    • Search Google Scholar
    • Export Citation
  • [13]. L. Normen S. Bryngelsson M. Johnsson et al.2002 The phytosterol content of some cereal foods commonly consumed in Sweden and in the Netherlands J. Food Compos. Anal. 15 6 693704.

    • Search Google Scholar
    • Export Citation
  • [14]. L. Normen M. Johnsson H. Andersson et al.1999 Plant sterols in vegetables and fruits commonly consumed in Sweden Eur. J. Nutr. 38 2 8489.

    • Search Google Scholar
    • Export Citation
  • [15]. K. M. Phillips D. M. Ruggio J. I. Toivo et al.2002 Free and esterified sterol composition of edible oils and fats J. Food Compos. Anal. 15 2 123142.

    • Search Google Scholar
    • Export Citation
  • [16]. M. H. Moghadasian 2000 Pharmacological properties of plant sterols in vivo and in vitro observations Life Sci. 67 605615.

  • [17]. G. Salen E. H. Ahrens S. M. Grundy 1970 Metabolism of beta-sitosterol in man J. Clin. Invest. 49 952967.

  • [18]. B. J. Kudchodkar H. S. Sodhi L. Horlick 1973 Absorption of dietary cholesterol in man Metabolism 22 155163.

  • [19]. K. Von Bergmann T. Sudhop D. Lütjohann 2005 Cholesterol and plant sterol absorption: recent insights Am. J. Cardiol. 6 10D14D.

    • Search Google Scholar
    • Export Citation
  • [20]. T. Heinemann G. Axtmann K. von Bergmann 1993 Comparison of intestinal absorption of cholesterol with different plant sterols in man Eur. J. Clin. Invest. 23 827831.

    • Search Google Scholar
    • Export Citation
  • [21]. Scientific Committee on Food: General view on the long-term effects of the intake of elevated levels of phytosterols from multiple dietary sources with particular attention to the effects on β-carotene. Opinion adopted by the Scientific Committee on Food on 26 September, 2002. Available online at: http://ec.europa.eu/food/fs/sc/scf/out143_en.pdf.

    • Search Google Scholar
    • Export Citation
  • [22]. G. M. Morton S. M. Lee D. H. Buss et al.1995 Intakes and major dietary sources of cholesterol and phytosterols in the British diet J. Hum. Nutr. Diet 8 429440.

    • Search Google Scholar
    • Export Citation
  • [23]. M. Poulsen 2007 Noforisk — Quantitative risk assessment strategies for novel foods 3rd Periodic Activity Report National Food Institute, Technical University Denmark 150156.

    • Search Google Scholar
    • Export Citation
  • [24]. L. M. Valsta A. Lemström M. L. Ovaskainen et al.2004 Estimation of plant sterol and cholesterol intake in Finland: quality of new values and their effect on intake Br. J. Nutr. 92 671678.

    • Search Google Scholar
    • Export Citation
  • [25]. A. A. Jekel H. A. M. G. Vaessen R. C. Schothorst 1998 Capillary gas-chromatographic method for determining non-derivatized sterols — some results for duplicate 24 h diet samples collected in 1994 Fresen J. Anal. Chem. 360 595600.

    • Search Google Scholar
    • Export Citation
  • [26]. A. L. Normén H. A. Brants L. E. Voorrips et al.2001 Plant sterol intakes and colorectal cancer risk in the Netherlands Cohort Study on Diet and Cancer Am. J. Clin. Nutr. 74 141148.

    • Search Google Scholar
    • Export Citation
  • [27]. M. S. Bosner L. G. Lange W. F. Stenson et al.1999 Percent cholesterol absorption in normal women and men quantified with dual stable isotopic tracers and negative ion mass spectrometry J. Lipid Res. 40 302308.

    • Search Google Scholar
    • Export Citation
  • [28]. R. E. Ostlund J. B. McGill C.M. Zeng et al.2002 Gastrointestinal absorption and plasma kinetics of soy delta(5)-phytosterols and phytostanols in humans Am. J. Physiol. Endocrinol. Metab. 282 E911E916.

    • Search Google Scholar
    • Export Citation
  • [29]. I. Rodler L. Bíró E. Greiner et al.2005 Táplálkozási vizsgálat Magyarországon Orv. Hetil. 146 34 17811789 (Nutrition survey in Hungary.).

    • Search Google Scholar
    • Export Citation
  • [30]. D. W. Peterson 1958 Plant sterols and tissue cholesterol levels Am. J. Clin. Nutr. 6 644649.

  • [31]. A. M. Lees H. Y. Mok R. S. Lees et al.1977 Plant sterols as cholesterol-lowering agents: clinical trials in patients with hypercholesterolemia and studies of sterol balance Atherosclerosis 28 325338.

    • Search Google Scholar
    • Export Citation
  • [32]. R. P. Mensink S. Ebbing M. Lindhout et al.2002 Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations Atherosclerosis 160 205213.

    • Search Google Scholar
    • Export Citation
  • [33]. T. A. Miettinen P. Puska H. Gylling et al.1995 Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population N. Engl. J. Med. 333 13081312.

    • Search Google Scholar
    • Export Citation
  • [34]. T. A. Miettinen M. Vuoristo M. Nissinen et al.2000 Serum, biliary, and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine Am. J. Clin. Nutr. 71 10951102.

    • Search Google Scholar
    • Export Citation
  • [35]. J. Plat E. N. van Onselen M. M. van Heugten et al.2000 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. 54 671677.

    • Search Google Scholar
    • Export Citation
  • [36]. K. C. Hayes A. Pronczuc D. Perlman 2004 Nonesterified phytosterols dissolved and recrystallized in oil reduce plasma cholesterol in gerbils and humans J. Nutr. 134 13951399.

    • Search Google Scholar
    • Export Citation
  • [37]. C. A. Vanstone M. Raeini-Sarjaz W. E. Parsons et al.2002 Unesterified plant sterols and stanols lower LDL-cholesterol concentrations equivalently in hypercholesterolemic persons Am. J. Clin. Nutr. 76 12721278.

    • Search Google Scholar
    • Export Citation
  • [38]. M. B. Katan S. M. Grundy P. Jones et al.2003 Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels Mayo Clin. Proc. 78 965978.

    • Search Google Scholar
    • Export Citation
  • [39]. S. M. Grundy 1983 Absorption, metabolism of dietary cholesterol Ann. Rev. Nutr. 3 7196.

  • [40]. L. Normen P. Dutta A. Lia et al.2000 Soy sterol esters and beta-sitostanol ester as inhibitors of cholesterol absorption in human small bowel Am. J. Clin. Nutr. 71 908913.

    • Search Google Scholar
    • Export Citation
  • [41]. S. N. Blair D. M. Capuzzi S. O. Gottlieb et al.2000 Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester containing spread to statin therapy Am. J. Cardiol. 86 4652.

    • Search Google Scholar
    • Export Citation
  • [42]. L. I. Christiansen P. L. Lahteenmaki M. R. Mannelin et al.2001 Cholesterol-lowering effect of spreads enriched with microcrystalline plant sterols in hypercholesterolemic subjects Eur. J. Nutr. 40 6673.

    • Search Google Scholar
    • Export Citation
  • [43]. M. H. Davidson K. C. Maki D. M. Umporowicz et al.2001 Safety and tolerability of esterified phytosterols administered in reduced-fat spread and salad dressing to healthy adult men and women J. Am. Coll. Nutr. 20 307319.

    • Search Google Scholar
    • Export Citation
  • [44]. S. Devaraj I. Jialal S. Vega-Lopez 2004 Plant sterol-fortified orange juice effectively lowers cholesterol levels in mildly hypercholesterolemic healthy individuals Arterioscler. Thromb. Vasc. Biol. 24 e25e28.

    • Search Google Scholar
    • Export Citation
  • [45]. M. A. Hallikainen E. S. Sarkkinen M. I. Uusitupa 2000 Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner J. Nutr. 130 767776.

    • Search Google Scholar
    • Export Citation
  • [46]. H. F. Hendriks E. J. Brink G. W. Meijer et al.2003 Safety of long-term consumption of plant sterol esters-enriched spread Eur. J. Clin. Nutr. 57 681692.

    • Search Google Scholar
    • Export Citation
  • [47]. T. Jauhiainen P. Salo L. Niittynen et al.2006 Effects of low-fat hard cheese enriched with plant stanol esters on serum lipids and apolipoprotein B in mildly hypercholesterolaemic subjects Eur. J. Clin. Nutr. 60 12531257.

    • Search Google Scholar
    • Export Citation
  • [48]. M. J. Tikkanen P. Hogstrom J. Tuomilehto et al.2001 Effect of a diet based on low-fat foods enriched with nonesterified plant sterols and mineral nutrients on serum cholesterol Am. J. Cardiol. 88 11571162.

    • Search Google Scholar
    • Export Citation
  • [49]. J. Quilez M. Rafecas G. Brufau et al.2003 Bakery products enriched with phytosterol esters, alpha-tocopherol and beta carotene decrease plasma LDLcholesterol and maintain plasma beta-carotene concentrations in normocholesterolemic men and women J. Nutr. 133 31033109.

    • Search Google Scholar
    • Export Citation
  • [50]. J. Plat R. P. Mensink 2002 Increased intestinal ABCA1 expression contributes to the decrease in cholesterol absorption after plant stanol consumption FASEB J. 16 12481253.

    • Search Google Scholar
    • Export Citation
  • [51]. J. Plat J. A. Nichols R. P. Mensink 2005 Plant sterols and stanols: effects on mixed micellar composition and LXR (target gene) activation J. Lipid Res. 46 24682476.

    • Search Google Scholar
    • Export Citation
  • [52]. E. A. Trautwein G. S. Duchateau Y. Lin et al.2003 Proposed mechanisms of cholesterol-lowering action of plant sterols Eur. J. Lipid. Sci. Technol. 105 171185.

    • Search Google Scholar
    • Export Citation
  • [53]. S. W. Altmann H. R. Davis L. J. Zhu et al.2004 Niemann-Pick C1 Like 1 protein is critical for intestinal cholesterol absorption Science 303 12011204.

    • Search Google Scholar
    • Export Citation
  • [54]. L. Calpe-Berdiel J. C. Escola-Gil V. Ribas et al.2005 Changes in intestinal and liver global gene expression in response to a phytosterol-enriched diet Atherosclerosis 181 7585.

    • Search Google Scholar
    • Export Citation
  • [55]. T. Plosch J. K. Kruit N. C. Huijkman et al.2006 Reduction of cholesterol absorption by dietary plant sterols and stanols in mice is independent of the abcg5/8 transporter J. Nutr. 136 21352140.

    • Search Google Scholar
    • Export Citation
  • [56]. V. W. Rodwell J. L. Nordstrom J. J. Mitschelen 1976 Regulation of HMGCoA reductase Adv. Lipid Res. 14 174.

  • [57]. V. W. Y. Lau M. Journoud P. J. H. Jones 2005 Plant sterols are efficacious in lowering plasma LDL and non-HDL cholesterol in hypercholesterolemic type 2 diabetic and nondiabetic persons Am. J. Clin. Nutr. 81 13511358.

    • Search Google Scholar
    • Export Citation
  • [58]. A. L. Amundsen F. Ntanios N. Put et al.2004 Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread Eur. J. Clin. Nutr. 58 16121620.

    • Search Google Scholar
    • Export Citation
  • [59]. M. A. Micallef M. L. Garg 2008 The lipid-lowering effects of phytosterols and (n-3) polyunsaturated fatty acids are synergistic and complementary in hyperlipidemic men and women J. Nutr. 138 10861090.

    • Search Google Scholar
    • Export Citation
  • [60]. F. Nigon C. Serfaty-Lacrosnière I. Beucler et al.2001 Plant sterol-enriched margarine lowers plasma LDL in hyperlipidemic subjects with low cholesterol intake: effect of fibrate treatment Clin. Chem. Lab. Med. 39 634640.

    • Search Google Scholar
    • Export Citation
  • [61]. V. A. Baker P. A. Hepburn S. J. Kennedy et al.1999 Safety evaluation of phytosterol esters: Part 1. Assessment of oestrogenicity using a combination of in vivo and in vitro assays Food Chem. Toxicol. 37 1322.

    • Search Google Scholar
    • Export Citation
  • [62]. P. A. Hepburn S. A. Horner M. Smith 1999 Safety evaluation of phytosterol esters: Part 2. Subchronic 90-day oral toxicity on phytosterol esters — a novel functional food Food Chem. Toxicol. 37 521532.

    • Search Google Scholar
    • Export Citation
  • [63]. D. H. Waalkens-Berendsen A. P. Wolterbeek M. V. Wijnands et al.1999 Safety evaluation of phytosterol esters: Part 3. Two generation reproduction study in rats with phytosterol esters: a novel functional food Food Chem. Toxicol. 37 683696.

    • Search Google Scholar
    • Export Citation
  • [64]. R. Ayesh J. A. Weststrate P. N. Drewitt et al.1999 Safety evaluation of phytosterol esters: Part 5. Faecal short-chain fatty acid and microflora content, faecal bacterial enzyme activity and serum female sex hormones in healthy normolipidaemic volunteers consuming a controlled diet either with or without phytosterol ester-enriched margarine Food Chem. Toxicol. 37 11271138.

    • Search Google Scholar
    • Export Citation
  • [65]. J. A. Weststrate R. Ayesh C. Blauer-Plank et al.1999 Safety evaluation of phytosterol esters: Part 4. Faecal concentrations of bile acids and neutral sterols in healthy normolipaedemic volunteers consuming a controlled diet either with or without a phytosterol ester-enriched margarine Food Chem. Toxicol. 37 10631071.

    • Search Google Scholar
    • Export Citation
  • [66]. N. De Jong L. Pijpers J. K. Bleeker et al.2004 Potential intake of phytosterols/-stanols: results of a simulation study Eur. J. Clin. Nutr. 58 907919.

    • Search Google Scholar
    • Export Citation
  • [67]. D. Turnbull V. H. Frankos J. H. van Delft et al.1999 Genotoxicity evaluation of wood-derived and vegetable oil-derived stanol esters Regul. Toxicol. Pharmacol. 29 205210.

    • Search Google Scholar
    • Export Citation
  • [68]. A. Berger P. J. H. Jones S. S. Abumweis 2004 Plant sterols: factors affecting their efficacy and safety as functional food ingredients Lipids Health Dis. 3 5.

    • Search Google Scholar
    • Export Citation
  • [69]. M. A. Hallikainen E. S. Sarkkinen M. I. J. Uusitupa 1999 Effects of low-fat stanol ester enriched margarine on concentrations of serum carotenoids in subjects with elevated serum cholesterol concentrations Eur. J. Clin. Nutr. 53 966969.

    • Search Google Scholar
    • Export Citation
  • [70]. J. A. Weststrate G. W. Meijer 1998 Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects Eur. J. Clin. Nutr. 52 334343.

    • Search Google Scholar
    • Export Citation
  • [71]. J. T. Judd D. J. Baer S. C. Chen et al.2002 Plant sterol esters lower plasma lipids and most carotenoids in mildly hypercholesterolemic adults Lipids 37 3342.

    • Search Google Scholar
    • Export Citation
  • [72]. M. Law 2000 Plant sterol and stanol margarines and health BMJ 320 861864.

  • [73]. M. Noakes P. Clifton F. Ntanios et al.2002 An increase in dietary carotenoids when consuming plant sterols or stanols is effective in maintaining plasma carotenoid concentrations Am. J. Clin. Nutr. 75 7986.

    • Search Google Scholar
    • Export Citation
  • [74]. Scientific Committee on Food: Opinion applications for approval of a variety of plant sterol-enriched foods. Opinion adopted by the Scientific Committee on Food on 5 March, 2003. Available online at: http://ec.europa.eu/food/fs/sc/scf/out174_en.pdf.

    • Search Google Scholar
    • Export Citation
  • [75]. A. K. Bhattacharyya W. E. Connor 1974 Beta-sitosterolemia and xanthomatosis. A newly described lipid storage disease in two sisters J. Clin. Invest. 53 10331043.

    • Search Google Scholar
    • Export Citation
  • [76]. G. Salen P. O. Kwiterovich S. Shefer et al.1985 Increased plasma cholestanol and 5 alpha-saturated plant sterol derivatives in subjects with sitosterolemia and xanthomatosis J. Lipid Res. 26 203209.

    • Search Google Scholar
    • Export Citation
  • [77]. Watts, G. F., Mitchell, W. D.: Clinical and metabolic findings in a patient with phytosterolaemia. Ann. Clin. Biochem., 1992, 29,(Part 2).

    • Search Google Scholar
    • Export Citation
  • [78]. G. Salen S. Shefer L. Nguyen et al.1992 Sitosterolemia J. Lipid Res. 33 945955.

  • [79]. T. A. Miettinen 1980 Phytosterolaemia, xanthomatosis and premature atherosclerotic arterial disease: a case with high plant sterol absorption, impaired sterol elimination and low cholesterol synthesis Eur. J. Clin. Invest. 10 2735.

    • Search Google Scholar
    • Export Citation
  • [80]. D. Lütjohann I. Bjorkhem U. F. Beil et al.1995 Sterol absorption and sterol balance in phytosterolemia evaluated by deuterium-labeled sterols: effect of sitostanol treatment J. Lipid Res. 36 17631773.

    • Search Google Scholar
    • Export Citation
  • [81]. K. E. Berge K. von Bergmann D. Lutjohann et al.2002 Heritability of plasma noncholesterol sterols and relationship to DNA sequence polymorphism in ABCG5 and ABCG8 J. Lipid Res. 43 486494.

    • Search Google Scholar
    • Export Citation
  • [82]. K. Lu M. H. Lee S. Hazard et al.2001 Two genes that map to the STSL locus cause sitosterolemia: genomic structure and spectrum of mutations involving sterolin-1 and sterolin-2, encoded by ABCG5 and ABCG8, respectively Am. J. Hum. Genet. 69 278290.

    • Search Google Scholar
    • Export Citation
  • [83]. G. Lizard 2008 Phytosterols: to be or not to be toxic; that is the question Br. J. Nutr. 100 11501151.

  • [84]. B. Rubins A. Paszel M. Kaczmarek et al.2008 Beneficial or harmful influence of phytosterols on human cells? Br. J. Nutr. 100 11831191.

    • Search Google Scholar
    • Export Citation
  • [85]. G. Salen I. Horak M. Rothkopf et al.1985 Lethal atherosclerosis associated with abnormal plasma and tissue steroid composition and sitosterolemia with xanthomatosis J. Lipid Res. 26 11261133.

    • Search Google Scholar
    • Export Citation
  • [86]. M. D. Patel P. D. Thompson 2006 Phytosterols and vascular disease Atherosclerosis 186 1219.

  • [87]. EFSA Report from the Data Collection and Exposure Unit in response to a request from the European Commission. Consumption of food and beverages with added plant sterols in the European Union. EFSA J., 2008a, 133, 121.

    • Search Google Scholar
    • Export Citation
  • [88]. International Atherosclerosis Society 2003 Harmonized clinical guidelines on the prevention of atherosclerotic vascular disease International Atherosclerosis Society Hamburg, Germany 128.

    • Search Google Scholar
    • Export Citation
  • [89]. NCEP 2001 Expert panel on detection evaluation and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) (Adult Treatment Panel III) JAMA 285 24862497.

    • Search Google Scholar
    • Export Citation
  • [90]. NHF 2001 National Heart Foundation. Lipid management guidelines — 2001 Med. J. Aust. 175 136.

  • [91]. NHFA: National Heart Foundation of Australia, Summary of the evidence on phytosterols/ stanol enriched foods. 2007, Available at: http://www.heartfoundation.org.au/document/NHF/HF_Phytosterols_Stanols_SummofEvidence_2007_Aug_FINAL.pdf.

    • Search Google Scholar
    • Export Citation
  • [92]. NHFA: National Heart Foundation of Australia: Plant sterols and stanols. A position statement from the National Heart Foundation of Australia's Nutrition and Metabolism Advisory Committee., NHFA, 2003, Available at: www.heartfoundation.org.au.

    • Search Google Scholar
    • Export Citation
  • [93]. NHMRC 1999 National Health and Medical Research Council: A guide to the development, implementation and evaluation of clinical practice guidelines NHMRC Canberra.

    • Search Google Scholar
    • Export Citation
  • [94]. Commission Regulation 258/97/EC of the European Parliament and of the Council of the 27 January 1997 concerning novel foods and novel food ingredients. Off. J. Eur. Comm., L 43/1., 1997, 1–7,.

    • Search Google Scholar
    • Export Citation
  • [95]. A. Lugasi 2006 Az új élelmiszerek engedélyezése az Európai Unió 258/97/EK rendeletében foglaltak szerint A Hús 16 1 3335 (Authorisation of novel foods according to the European Regulation No 258/97/EC.).

    • Search Google Scholar
    • Export Citation
  • [96]. A. Lugasi 2005 Az új élelmiszerek engedélyezése és a noni (Morinda citrifolia L.) jelenlegi helyzete Közinfó 8 1 2227 (Authorisation of novel foods and the present status of noni (Morinda citrifolia L.).).

    • Search Google Scholar
    • Export Citation
  • [97]. Commission Decision 2000/500/EC on authorising the placing on the market of “yellow fat spreads with added phytosterol esters” as a novel food or novel food ingredient under Regulation (EC) No 258/97 of the European Parliament and of the Council. Off. J. Eur. Comm., L 200/59., 2000, 5960.

    • Search Google Scholar
    • Export Citation
  • [98]. Commission Regulation 608/2004/EC concerning the labelling of foods and food ingredients with added phytosterols, phytosterol esters, phytostanols and/or phytostanol esters. Off. J. Eur. Comm., L97, 2004, p. 4445.

    • Search Google Scholar
    • Export Citation
  • [99]. Anon. Strategic analysis of the European phytosterols market. Market Report. Frost & Sullivan Research Service, London, United Kingdom, 2006.

    • Search Google Scholar
    • Export Citation
  • [100]. Commission Regulation 1924/2006/EC of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods. Off. J. Eur. Union, L404, 2006, pp. Corrigendum Off. J. Eur. Union L12, 2007, 318.

    • Search Google Scholar
    • Export Citation
  • [101]. EFSA Scientific Opinion of the Panel on Dietetic Products Nutrition and Allergies on a request from Unilever PLC/NV on Plant Sterols and lower/reduced blood cholesterol, reduced the risk of (coronary) heart disease. EFSA J., 2008b, 781, 112.

    • Search Google Scholar
    • Export Citation
  • [102]. EFSA Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies on a request from McNeil Nutritionals Ltd. related to the scientific substantiation of a health claim on plant stanol esters and lower/reduced blood cholesterol and reduced risk of (coronary) heart disease. EFSA J., 2008c, 825, 113.

    • Search Google Scholar
    • Export Citation
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Clinical and Experimental Medical Journal
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