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Effect of a plant sterol, fish oil and B vitamin combination on cardiovascular risk factors in hypercholesterolemic children and adolescents: a pilot study

Iveta Garaiova1, Jana Muchová2, Zuzana Nagyová3, Csilla Mišľanová4, Stanislav Oravec5, Andrej Dukát5, Duolao Wang6, Sue F Plummer1 and Zdeňka Ďuračková2*

Author Affiliations

1 Research Department, Obsidian Research Ltd, Port Talbot, UK

2 Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, 813 72, Slovakia

3 Juvenalia Paediatric Centre, Dunajská Streda, Slovakia

4 Department of Bioactive Substances and Nutritional Screening, Slovak Medical University, Bratislava, Slovakia

5 2nd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia

6 Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK

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Nutrition Journal 2013, 12:7  doi:10.1186/1475-2891-12-7

Published: 8 January 2013



Assessment of cardiovascular disease (CVD) risk factors can predict clinical manifestations of atherosclerosis in adulthood. In this pilot study with hypercholesterolemic children and adolescents, we investigated the effects of a combination of plant sterols, fish oil and B vitamins on the levels of four independent risk factors for CVD; LDL-cholesterol, triacylglycerols, C-reactive protein and homocysteine.


Twenty five participants (mean age 16 y, BMI 23 kg/m2) received daily for a period of 16 weeks an emulsified preparation comprising plant sterols esters (1300 mg), fish oil (providing 1000 mg eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA)) and vitamins B12 (50 μg), B6 (2.5 mg), folic acid (800 μg) and coenzyme Q10 (3 mg). Atherogenic and inflammatory risk factors, plasma lipophilic vitamins, provitamins and fatty acids were measured at baseline, week 8 and 16.


The serum total cholesterol, LDL- cholesterol, VLDL-cholesterol, subfractions LDL-2, IDL-1, IDL-2 and plasma homocysteine levels were significantly reduced at the end of the intervention period (p<0.05). The triacylglycerols levels decreased by 17.6%, but did not reach significance. No significant changes in high sensitivity C-reactive protein, HDL-cholesterol and apolipoprotein A-1 were observed during the study period. After standardisation for LDL cholesterol, there were no significant changes in the levels of plasma γ-tocopherol, β-carotene and retinol, except for reduction in α-tocopherol levels. The plasma levels of n-3 fatty acids increased significantly with the dietary supplementation (p<0.05).


Daily intake of a combination of plant sterols, fish oil and B vitamins may modulate the lipid profile of hypercholesterolemic children and adolescents.

Trial registration

Current Controlled Trials ISRCTN89549017

Cholesterol; Plant sterols; Fish oil; B vitamins; Children; Adolescents