When it comes to effective solutions for lowering cholesterol levels in pregnant women, Mother Nature may know best.
Researchers at the University at Buffalo are studying whether plant sterols can be used as a natural alternative to drug therapy in expectant mothers who have high cholesterol.
While it's normal for a woman's cholesterol to spike during pregnancy, excessive lipid levels -- whether from genetic or dietary reasons -- can have negative health effects on the offspring, both early in life and later on as adults, said Todd Rideout, assistant professor of exercise and nutrition sciences in UB's School of Public Health and Health Professions and the study's lead investigator.
In pregnant women who have excessive cholesterol -- measured above 280 milligrams per deciliter (mg/dL) -- the condition is known as supraphysiogical hypercholesterolemia. "There's a lot of data supporting that offspring from hypercholesteremic mothers will have fatty streaks in their arteries along with high cholesterol and high triglycerides early in life, and they may have cardiovascular disease-related complications as they grow older," Rideout said.
Using typical lipid-lowering drugs known as statins is out of the question because of the negative developmental consequences the drugs can have on newborns, Rideout notes. "Right now the treatment options are limited. There's a real need to find an alternative cholesterol therapy for women who wish to become pregnant or are already pregnant," said Rideout, who received an additional one-year, $88,000 grant from the National Center for Complementary and Integrated Health and the Office of Dietary Supplements to continue the plant sterols study that began in 2013.
"Dietary therapy opens the window for natural therapies that are safe for the mother and fetus and also effective in lowering blood cholesterol," he adds.
Plant sterols -- also known as phytosterols -- hold promise because they've been proven to lower cholesterol. "Phytosterols look very similar to the cholesterol that's found in meat and dairy products. You wouldn't be able to tell the difference," Rideout said. "But they're metabolized in our bodies very differently. Plant sterols actually out-compete cholesterol to be absorbed into your blood. That's how they lower cholesterol."
While many of the vegetables people eat contain these sterols, the amounts are so small that even vegetarians consume less than 2 grams daily, the recommended amount for the sterols to be effective. "Vegetarians can get up to almost 1 gram a day, whereas meat eaters are probably getting between 300 and 500 milligrams at best," Rideout said. "Most of the data suggest that even at those lower levels there's a small cholesterol lowering benefit, just from your normal diet. But if you have high cholesterol and are seeking a natural therapy, you'll have to supplement."
Many foods, such as yogurt and margarine, now are being infused with plant sterols, said Rideout, who has researched phytosterols for the past decade. "We were thinking about novel applications for plant sterols and it seemed like an obvious question: Could they be a potential therapy for women who are pregnant and who have excessive levels of cholesterol before they became pregnant?" he says.
Rideout's lab has begun testing with mice and hamsters, feeding one group of animals a high-fat, high-cholesterol diet, while the other is consuming the same diet, but with phytosterols added. "We're comparing the blood lipid levels when the offspring are born to see if the offspring from mothers who were fed phytosterols during pregnancy have a more beneficial lipid profile," Rideout said.
"There's a lot of data showing negative consequences in the offspring of mothers who are fed high-cholesterol, high-fat diets," he adds. "That's pretty well established. But very little work has looked at this question of what if we feed the mothers something beneficial, such as phytosterols?"
Rideout is collaborating with two researchers from UB's Jacobs School of Medicine and Biomedical Sciences -- Mulchand Patel, SUNY Distinguished Professor of Biochemistry and associate dean for research and biomedical education, and Richard Browne, associate professor of biotechnical and clinical laboratory sciences -- as part of the study to examine oxidized cholesterol.
"Hypercholesteremic women have high cholesterol and a high amount of oxidized sterols, which are very problematic," Rideout says, noting they play a role in the development of atherosclerosis, or the buildup of plaque in the arteries.
"Our long-term goal, obviously, is that what we are doing will have a positive effect in humans," Rideout says. "We're not just out to improve hamster health. But there are many questions that need to be addressed, especially because we're dealing with pregnant women. You want to make sure that what you're giving them is safe, and we just don't know that yet."
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