Effects of sucrose polyester on cholesterol metabolism in man

Sucrose polyester (SPE) is a nonabsorbable, fat-like material that has been shown to lower plasma cholesterol levels in man and that has a high degree of patient acceptability. This study was carried out to examine further its effects on lipid metabolism. We have investigated the action of feeding SPE on plasma levels of cholesterol, triglycerides, and fatsoluble vitamins, on cholesterol absorption, excretion and synthesis, and on biliary lipid composition. Eleven normolipidemic, overweight subjects were studied on the metabolic ward. The design consisted of a 6-wk control period (weight loss at 1000 cal/day) and a 6-wk period of SPE supplementation (also with 1000 cal/day). SPE was tolerated well by all patients; although each patient experienced some degree of increased frequency of stools during the test period, none averaged more than one stool per day during SPE treatment. SPE feeding caused an overall mean reduction in plasma cholesterol of 6.8% beyond the 20% reduction caused by weight loss and low-cholesterol diet alone. Of the 11 patients, 6 had a mean decrease in plasma cholesterol of 12.5%, while 5 did not show a reduction on SPE. Plasma triglyceride levels were reduced initially by 13% during weight loss, and the addition of SPE caused no further reduction. There was no consistent effect on plasma levels of Vitamin A; Vitamin E levels were reduced by 24%. SPE diminished percent cholesterol absorption in every patient tested (control = 38%; SPE feeding = 17%), and there was an overall net increase in neutral sterol excretion (control = 506 mg/day, SPE feeding = 724 mg/day). Bile acid excretion similarly increased (control = 225 mg/day, SPE feeding = 376 mg/day). Percent saturation of gallbladder bile was not adversely affected by sucrose polyester feeding during weight loss.