Want to Benefit from Plant Sterols? Eat Whole Food or Take Supplements With Meals. Plus: Do You "Benefit" at All?

This is not a joke by a blogger this is how Unilever advocates to use their Flora pro.active product to consumers, who "want to lower your cholesterol and follow a healthy diet and lifestyle."

Pharma companies and supplement producers are notorious for picking foods apart and providing you with concentrated extracts of the "active ingredients".

Aside from the fact that more often then not, the activity of those "active ingredients" is critically dependent on co-factors that are lost during the isolation and extraction processes, scientists from the Division of Gastroenterology-Hepatology at the Department of Internal Medicine of the Maastricht University Medical Center have now been able to show that the mere presence of the bulk in which plant sterols would come in the natural form is critically important to their effects.

Can you achieve a "healthily"(?) low cholesterol level by guzzling tuckloads of low-fat yogurt drinks!?

Based on the negative outcomes of previous studies into the benficial effect of "functional" foods or dietary supplements enriched in plant sterols, D. Keszthelyi had hypothesized  that

"100 mL drink, when consumed before a meal, would empty fast from the stomach and would not sufficiently trigger gallbladder emptying, whereas ingestion with or after the solid meal would enable the necessary physiological changes to aid inhibition of cholesterol absorption" (Keszthelyi. 2013)

To test this hypothesis the researchers recruited a total of 12 healthy male subjects (age, 25 ± 3 years; BMI, 23 ± 2 kg/m²) who reported the scientists' lab on three separate test days with one-week washout between test days.

Does the Paleo diet ruin your cholesterol levels as the conclusion to a recently published thesis would indicate (learn more)?

On each of the days, the participants consumed a Phytosterol (PS) containing yoghurt drink (100 mL, Becel Pro-Activ with PS added as their fatty acid esters (3.2 g, equivalent to 2.0 g PS), either

• 45 min before (test condition A), 

• during (test condition B), or

• 45 min after (test condition C) 

the consumption of a 500 g macaroni meal (Macaroni Bolognese, Henri, Drunen, The Netherlands) at lunch time (I know not the ideal, but for the average Westerner a realistic test meal). T

he sequence of the test days had been determined by a random pre-selection prior to the start of the study. During each test day, gastric emptying of the test drink as well as the effect of the test drink on gallbladder volumes were determined (figure 1, left):

Figure 1: Gastric emptying (left) and gallbladder volume (right) depending on the time of ingestion of a phytosterol containing yogurt drink (Keszthelyi. 2013)

As the results go to show you the ingestion of the functional food before the meal resulted in the fastest gastric emptying. The ingestion with or after a solid meal, on the other hand, caused a significant contraction of the gallbladder.

"Accepting the postulate that concurrent presence of PS with dietary and/or biliary cholesterol in the small intestine is an important mechanism for the LDL cholesterol-lowering action (Ostlung. 2004), a significant stimulus leading to gall- bladder contraction with simultaneous delivery of the PS-containing food format from the stomach into the duodenum is required. It is therefore important to ascertain which stimuli are able to elicit this postprandial response to a sufficient and desirable degree." (Keszthelyi. 2013)

This is actually interesting, because in the end it means that cholesterol clearance, even when it's induced / supported by questionable supplemental phytoestrogens critically depend on fat intake! This in turn would explain why the rodents in the "optimal diabesity diet study" from one of the recent installments of the Short News found elevated cholesterol levels only in the high sugar and high fat + high sugar groups, yet not in the rodents on a high fat diet.One thing to keep in mind, though: The main reason I picked and posted this study is not to pimp the use of phytosterol-spiked imho dys-functional junk food. It's rather to raise your awareness of the importance of the whole nutrient matrix in terms of the effects of the individual agent.

If you want to do something for your blood lipids, you better eat more eggs than overpriced Frankenfood. The eggs will not only improve your cholesterol particle profile, the regular consumption of whole eggs will also increase HDL's ability to carry lipids out of the macrophages. If these accumulate, they will turn the macrophage into pro-atherogenic foam cells (learn more).

In how far the isolation is also behind the previously observed side effects of plant sterols and stanols, which are likewise used in functional foods remains questionable, but it is not unlikely that sides such as

• abortion of pregnancy in animal models (Burckh. 1982)
• reduced sperm concentrations & testis weights
• neg. effects on the vascular system (Boberg. 1991)
• increased intestinal tumor formation (Marttinen. 2013)

are eventually also a consquence of the absence of important co-factors, when the sterols and stanols are removed from their original food matrix and "transplanted" into yogurts, margarines and all sorts of overly expensive and at best useless Frankenfoods.

References:

• Boberg KM, Pettersen KS, Prydz H. Toxicity of sitosterol to human umbilical vein endothelial cells in vitro. Scand J Clin Lab Invest. 1991 Oct;51(6):509-16.
• Burck PJ, Thakkar AL, Zimmerman RE. Antifertility action of a sterol sulphate in the rabbit. J Reprod Fertil. 1982 Sep;66(1):109-12. 
• Keszthelyi D, Knol D, Troost FJ, van Avesaat M, Foltz M, Masclee AA. Time of ingestion relative to meal intake determines gastrointestinal responses to a plant sterol-containing yoghurt drink. Eur J Nutr. 2013 Jun;52(4):1417-20.
• Ostlund RE Jr. Phytosterols and cholesterol metabolism. Curr Opin Lipidol. 2004 Feb;15(1):37-41.

New Year, New Weight Loss Pills? Microencapsulated Conjugated Linoleic Acid (CLA) Works in Humans! So Well, In fact, That Subjects Lost Weight Too Fast, But...

Is microencapsulation like calling the artist him hammer away all the blubber? Hmm... maybe that's why it took Michelangelo > 3 years to complete his David. All jokes aside, is this encapsulation business really worth it or do you still have to sculpt your physique the good old way: Diet & Exercise?

If you look at the research, but even more the patents that were filed last year, you will realize the 2010s (looks awkward, right?) could become the decade of microencapsulation. Curcumin, green tea, vitamin C, scientists have and still are playing around with everything ME or NE... "ME or NE?" Yeah, right. Meanwhile it's actually so common that you often see only the acronym ME for microencapsulated and NE for nanoencapsulated in front of a supplement , extract or drug and know: They did it again.

In the case of conjugated linoleic acid (CLA), this is at least to my knowledge the first time that scientists used microencapsulation in order to make what appeared to become the big next thing in diet and weightloss pills - hold on, "next big thing" would imply that there had actually been "a big thing" and that's certainly not the case - at least nothing FDA compliant, let alone the Ally's and other junk from the pharmocracy.

New Year + New Technology + New Diet Pills = New, Leaner You?

Be that as it may, the study a group of Brazilian scientists has just published in Vascular Health and Risk Management does offer some hope, at least for those of the chronically overweight who are willing to use a weight loss supplement, exactly as the name implies, as a supplement that's taken on top of a calorically reduced and not just a "If I don't eat X,Y and Z - Quack A told me I can eat as much as I want and will still lose weight" diet. If you read the scientists research hypothesis, you will probably be surprised that they did actually expect that

"[...] microencapsulated CLA supplementation would improve glucose metabolism, the
serum lipid profile, and body composition, and decrease other cardiovascular risk factors associated with the metabolic syndrome." (Carvalho. 2012)

I mean, we all know that one of the problems with CLA - even in those mouse and few rodent trials, where it appeared to work - was actually that it lead to increases in liver fat, beginning fatty liver and consequent insulin resistance, right?

The addition of DHA to CLA  (as grass-fed butter has it) ameliorates the negative effects (read more). If you stick to the original  racemic mix of 9-cis trans-11 and trans-10, cis-12 isomers it may yet not even be necessary to protect your liver and insulin tolerance.

You will certainly remember the last study on the matter, where I speculated that the combination of DHA (not complete fish oil) and CLA a group of researchers led by Dawn M. Fedor had used to get only the beneficial, yet not the negative side effects in rodents, could actually hold the key to save and effective CLA supplementation in humans, as well (read more here). Now, with this study using a racemic, i.e. a 50:50 mixture of the naturally occuring CLA isomers 9-cis trans-11 and trans-10, cis-12 in humans and, as you are going to see in figure with nothing but beneficial effects on insulin sensitivity and glucose management, the question arises, whether you don't do best just eating more butter from grassfed cows.... ah, I am of course joking, I mean butter will clog your atheries, right? *rofl*

No, what I actually wanted to say was: If you look at the data in figure 2 & 3, there are 3 things I want you to keep in mind:

1. The sedentary, nonsmoking, nondiabetic, not post-menopausal, not having a previous hypocaloric diet, and not taking dietary supplements or any medication to reduce body weight (read up on "Long term dieting makes you fat and insulin resistant") were on a diet with a caloric deficit designed to have them lose 2kg per of body weight per month. That's pretty reasonable, but still a major difference to just popping a pill and waiting for the body fat to fall off (look at how successful the diet alone was!)

2. 

   Figure 1: Long diets need adjustments in caloric intake (Carvalho. 2012)

   The whole study lasted 3 months! And it was necessary to readjust the energy intake after 60 days to 1976.8 ± 67.31 kcal, in the CLA group, and 1745.5 ± 118.20 kcal, in the placebo group to keep the weight loss "stable" - check out figure 1 and you know why I put quotationmarks before the word "stable". Also take into consideration that the CLA group ate more mostly because they had already overshot as far as their 2kg per month weight loss goal was concerned.
3. The women would have had tremendously more success if they this study had had an exercise component, as well. With an energy expenditure of 22.27kcal/day and 23.35kcal/day from their usual "physical activity" - they could as well have been lying on the couch. Not that it was important or even smart to burn as many calories as possible, but ~23kcal is what most of you burn in 3-4 minutes of leisurely jogging or even brisk walking.

All that said: This is certainly not an optimal protocol and it cannot be said, whether the negative effects on glucose control would not have been evident if it was not for the game-changing caloric deficit (1). What has to be said in favor of the microencapsulated CLA (ME-CLA), though, is that it did not just come "side effect free", but had the exact opposite effect of what scientists still fear, namely the induction of insulin resistance.

Figure 2: Changes in parameters of blood glucose and lipid management (Carvalho. 2012)

That said, with a dosage for 3g of ME-CLA in *yummy* strawberry jam (sugar reduced *rofl*) per day, the absolute dosage was obviously lower than in most rodent studies and the usage of the racemic mixture could as well an important role in terms of the observed beneficial effects on blood glucose management. After all, previous studies have shown that cis-9,trans-11-octadecadienoate isomer is more potent than fish oil in improving lipid atherogenic risk markers (Valeille. 2004), does not share the pro-triglyceride and pro-insulin resistance effects of its brother and is probably also the anti-cancer isomer in CLA (Churruca. 2009). Unfortunately taken on it's own it does do little for weight or fat loss.

Figure 3: Effects of 3 months supplementation with 3g of microencapsulated CLA on body morphology (Carvalho. 2012)

Apropos, if you take a look at the data in figure 3 you will have to admit that the benefits were there, but compared to the health benefits, the weight loss benefits appear to be rather mediocre. And who telly me that the liver weight of the subjects did not still increase... well, it may not have been measured, but is overall very unlikely, 'cause that usually entails decreases and not improvements in blood glucose and lipid management.

Bottom line: Without a regular CLA control group this study tells us essentially nothing about the potency of microencapsulated conjugated linolic acid. After all, there are other human studies (also in obese individuals, also on a diet) reporting similar benefits with regular CLA (btw. in 99% of the cases also racemic mixtures). If anything the study confirms that in it's natural form, which is not an isolate of the fat burning and in high doses even fat annihilating (read more) trans-10, cis-12 CLA, is save probably healthy, but it is no magic anti-obesity pill (let alone something you take today and wake up ripped to the shreds tomorrow).

Another argument against the necessity of "functional" (?) CLA products, like ME-CLA jam, is the previous study showing that ~1.5g of CLA and vaccenic acid from dairy, beef, veal and lamp could prevent the subtle weight we all tend to ignore until it's already to late (read more)

Moreover, I suspect this will go for nano-encapsulated CLA (I bet a "market oriented" researcher has it already in development), as well, because encapsulation is something you want to do with stuff like curcumin, that won't even get where you want it, if you don't at least mess up your liver with some piperine so that it will let it pass unmetabolized. That's however not an issue with CLA, as the supplementation has proven time and again to increase CLA in serum and even tissue readily - even a higher intake of milk fat, which brings us back full circle to the image of the Kerrygold butter at the top, has been found to correlate significantly with higher levels of CLA in serum and adipose tissue (Jiang. 1999). So, if you see some strawberry jam with microencapsulated CLA in it on the shelves of your local supermarket in the course of 2013, you know that it's overpriced sugar... a pardon me, functional food with a reduced sugar content ;-)

On a different note: Thanks for all the good wishes and the appreciation you expressed in the comments. The did not go unnoticed! Hope all of you are more or less sober again, today, and in case you are not - don't forget the "Bismarck Herring" ;-)

References:

• Carvalho RF, Uehara SK, Rosa G. Microencapsulated conjugated linoleic acid associated with hypocaloric diet reduces body fat in sedentary women with metabolic syndrome. Vasc Health Risk Manag. 2012;8:661-7. doi: 10.2147/VHRM.S37385. Epub 2012 Dec 13.
• Churruca I, Fernández-Quintela A, Portillo MP. Conjugated linoleic acid isomers: differences in metabolism and biological effects. Biofactors. 2009 Jan-Feb;35(1):105-11.
• Valeille K, Gripois D, Blouquit MF, Souidi M, Riottot M, Bouthegourd JC, Sérougne C, Martin JC. Lipid atherogenic risk markers can be more favourably influenced by the cis-9,trans-11-octadecadienoate isomer than a conjugated linoleic acid mixture or fish oil in hamsters. Br J Nutr. 2004 Feb;91(2):191-9.