LONDON – A commercially available yogurt drink significantly reduced both total and low-density lipoprotein cholesterol in a 6-month study of 60 children with moderate hyperlipidemia.
After daily intake of the drink (Becel Pro-activ, Unilever), which contains 2-2.5 g of plant sterols, mean total cholesterol levels dropped from 249.1 mg/dL to 221.9 mg/dL (P = .0001). Mean LDL cholesterol also fell, from 181.4 mg/dL at baseline to 155.8 mg/dL at 6 months (P less than .0001). And high-density lipoprotein cholesterol levels did not change.
"This dietary intervention may be an effective and safe practice in treating children and adolescents with severe, modest, or mild hypercholesterolemia," study investigator Dr. Styliani Vorre said at the Excellence in Paediatrics annual meeting.
Dr. Vorre of the Health Center of Karlovasi, Samos, Greece, added: "Plant sterol esters may prove an important strategy for primary prevention of atherosclerosis and be useful in reducing the risk of future cardiovascular disease."
The prospective study involved 28 boys and 32 girls recruited from the outpatient lipid unit of the second department of pediatrics at Athens University. The median age of participants was 9.5 years, ranging from 4 years to 16.5 years.
All children consumed the yogurt drink at lunchtime, every day for 6 months, in addition to following their usual low-fat diet and lifestyle recommendations. Children were advised to eat carotenoid-rich foods, which can be found in carrots, sweet potatoes, spinach, and tomatoes.
Lipids and lipoprotein levels were assessed before the first consumption of yogurt drink, and at 6 months.
"Overall for the whole study group, the plant sterol yogurt drink yielded a significant decrease in total cholesterol, LDL cholesterol, and non-HDL cholesterol," Dr. Vorre reported.
Non-HDL cholesterol (total cholesterol minus HDL cholesterol) decreased from 196.2 mg/dL at baseline to 169.7 mg/dL at 6 months (P less than .0001).
Triglycerides were not reduced, however, with values of 59.6 mg/dL at baseline and 57.3 mg/dL at 6 months. HDL cholesterol was also unaffected (52.4 mg/dL at both assessment points).
The effectiveness of plant sterols in lowering cholesterol levels was similar in girls and boys, and there was no significant difference when the effects were compared by body weight.
"We conclude that daily consumption of 2-2.5 g of a plant sterol–enriched yogurt drink, once daily at lunchtime, lowers significantly LDL cholesterol and non-HDL cholesterol," Dr. Vorre said.
The findings mean that pharmacologic treatment could perhaps be avoided until absolutely necessary in some children.
"One of the big issues in treating children’s hypercholesterolemia is that we do not have good medications that have been robustly tested," Dr. Douglas S. Moodie of the Texas Children’s Hospital in Houston said in an interview at the meeting. While diet and exercise may reduce cholesterol levels by up to 20%, he said, there are few data supporting the use of cholesterol-lowering medications in children.
Dr. Moodie added: "One of the exciting things about these data is that if you could get a reduction of another 20% in total cholesterol [by the use of the yogurt drink] – mainly in LDL cholesterol – without having your ‘good guy’ cholesterol, HDL cholesterol, go down, then that could be a big therapeutic boost for taking care of children at younger ages."
Validation of the findings in a larger study with a stronger control arm is now warranted, Dr. Moodie noted.
He and Dr. Vorre said they had no relevant financial disclosures.