1. Introduction
death, Atherosclerosis
ATHEROSCLEROTIC CARDIOVASCULAR DISEASE, FAMILIAL HYPERCHOLESTEROLEMIA, CHOLESTEROLEMIA, POLYGENIC HYPERCHOLESTEROLEMIA, ATHEROSCLEROSIS
Plant sterols are well-known natural lipid-lowering agents. The DESCO (Diet and plant sterols in the control of cholesterolemia) study was a single-center, randomized, double-blind, placebo-controlled, two-way crossover clinical trial designed to investigate the effect of a once-a-day ready-to-drink dietary supplement containing 2.5 g of phytosterols on the lipid profile, also in relation to the quality of the diet, in a cohort of 50 Italian individuals with polygenic hypercholesterolemia and low global cardiovascular risk. Eligible individuals were enrolled in a run-in period of 2 weeks. Then, participants who qualified for continuation in the study were randomly allocated (1:1) to a 3-week treatment with either phytosterols or placebo. After a 2-week washout period, enrolled individuals were crossed over to receive the alternative treatment. Dietary supplementation with phytosterols was associated with significant improvement in plasma levels of total cholesterol (TC; −11.8 ± 4.0 mg/dL, Atherosclerotic cardiovascular diseases (ASCVDs) still represent a leading cause of death and morbidity in most European and North American countries, and elsewhere in the world [The latest International guidelines of the European Society of Cardiology (ESC) and the European Society of Atherosclerosis (EAS) recommend the daily consumption of functional food with 2 g of plant sterols/stanols (i) in individuals at low or intermediate CV risk and high cholesterol levels who do not qualify for pharmacotherapy according to their global CV risk; (ii) in addition to pharmacotherapy in high and very high risk patients who failed to achieve LDL-C-goals on statins or who cannot be treated with statins; and (iii) in individuals with familial hypercholesterolemia (FH) [It has to be acknowledged that most of the available evidence on this issue comes from clinical trials conducted in North America and Northern and Central Europe, where the consumption of meat and dairy products is high and the diet tends to be low in whole grains, fruit, and vegetables [