The role of red yeast rice (RYR) supplementation in plasma cholesterol control: a review and expert opinion

International audienc

Dietary effects on cholesterol absorption and excretion. Studies in ileostomy subjects

Cholesterol is a steroid molecule essential to man, but a high level of cholesterol in serum is a risk factor for cardiovascular disease (CVD). Most cholesterol in the body is derived from endogenous synthesis, but in affluent societies a substantial part is derived from the diet. The absorption of dietary cholesterol ranges from 30 to 80%. CVD is common in Sweden, and mean levels of serum cholesterol are high. Saturated fat and dietary cholesterol intake increase serum cholesterol levels, while unsaturated fat and plant sterols have the opposite effect. Dietary recommendations aim to prevent diet-related diseases. We have investigated the effects of such recommendations on the absorption of cholesterol, and the excretion of cholesterol and bile acids, in 20 ileostomy subjects. Controlled diets according to recommendations were compared to standard controlled diets. We have also investigated the effects of adding dietary cholesterol, or inulin and oligofructose (two indigestible, new varieties of soluble dietary fibre). Cholesterol and bile acids in ileostomy effluents were analysed by gas liquid chromatography, and cholesterol absorption was determined by isotope labelling and liquid scintillation counting.Cholesterol increased absolute cholesterol absorption within 6 hours, although fractional absorption decreased. Inulin and oligofructose had no detectable effects on cholesterol absorption or sterol excretion. Moderate total fat reduction (saturated fat intake cut by half) reduced cholesterol absorption by 5%, but did not significantly affect sterol excretion, compared to a standard diet. A dietary fibre intake of 30 g/day reduced cholesterol absorption by 9%, and increased small bowel cholesterol excretion, compared to standard diet. The combined dietary modifications of reduced saturated fat, and increased dietary fibre, reduced cholesterol absorption by 8-16%, and increased net sterol excretion by 11-33%. Cholesterol absorption was negatively correlated to plant sterol excretion, suggesting that plant sterols in cereals and vegetable oils might partly explain the cholesterol-lowering properties of a recommended diet

Energy – a scoping review for the Nordic Nutrition Recommendations 2023 project

We need energy intake to provide energy and nutrients to our cells. The amount of daily energy intake should aim for energy balance, which results in good health. Under- or overconsumption of total daily energy over a longer period leads to increased risk of diseases. In this scoping review, the components of daily energy requirement are defined. Several methods to estimate energy requirements and the amount of total daily energy intake (kJ) related to health are also discussed. Reference values for energy intake in children, adults and pregnant and postpartum women, and older adults are evaluated.Results show that it is challenging to set reference values for energy intake since existing methods are not accurate and precise, and there are several factors that influence the estimated amount of energy. Energy requirement is increased during growth as in childhood, pregnancy and lactation. We conclude that more research in this area is needed, and that new high-quality studies in both Nordic and Baltic countries are needed to obtain new recommendation numbers for energy intake