Sucrose polyester: substitution for dietary fats in hypocaloric diets in the treatment of familial hypercholesterolemia

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Abstract
In five obese women heterozygous for familial hypercholesterolemia, we assessed the combination of weight loss and sucrose polyester (SPE) in lowering low-density lipoprotein cholesterol (LDLC). After a 10-day basal hypocaloric (1426 cal/day), 270 mg cholesterol, P/S 1.2:1 diet, an average of 36 g of dietary fat/day was replaced by 36 g of an 80/20 SPE-hydrogenated palm oil mixture, providing 30 g SPE for 30 days; during the SPE substitution period mean dietary cholesterol and P/S were unchanged, mean caloric intake was 1104 cal/day. During the hypocaloric basal diet, mean weight fell 1.2 kg, p < 0.02, total plasma cholesterol fell 8% from 358 ± 46 to 330 ± 47 mg/dl, p < 0.01, LDLC fell 4% from 264 ± 37 to 254 ± 44 mg/dl, p > 0.1, and mean high-density lipoprotein cholesterol fell 11%, from 52 ± 4 to 46 ± 4, p < 0.05. Over the 30-day SPE substitution, mean cholesterol fell 20% from 330 ± 47 at the end of the basal diet to 265 ± 42 mg/dl, p < 0.001; mean LDLC fell 23%, from 254 ± 44 to 195 ± 41 mg/dl (p < 0.01); weight fell 4%, p < 0.01, from 91 ± 7 to 87 ± 7 kg, and mean high-density lipoprotein cholesterol fell 11% from 46 ± 4 to 41 ± 2, p < 0.05. Hypocaloric removal of dietary fat by SPE, an artificial fat with culinary properties of conventional dietary fats, effectively reduces LDLC (by 23%) in familial hypercholesterolemia subjects, with additive effects of SPE and weight loss.