Impact of Consuming Plant Sterols on Endothelial Function and Blood Pressure
Impact of Consuming Plant Sterols on Endothelial Function and Blood Pressure
The purpose of the research is to assess the impact of co-consuming plant sterols-enriched
 food product as part of a healthy eating pattern diet on endothelial function (brachial
 artery FMD, vasodilation-related and vasoconstriction-related biomarkers) and blood pressure
 management (24-hour ambulatory and classic blood pressure) in Singapore individuals with
 MetS.
This is a 13-wk double-blinded, randomized, crossover study design. Following a 1-wk
 pre-intervention baseline period, subjects will be randomly assigned to follow a healthy
 eating pattern diet either contain 2.0 g free plant sterols equivalent of their palmityl
 esters (Plant Sterol Diet) or do not contain plant sterols (Control Diet) for 4 weeks. After
 a 4-week dietary 'washout' period, they will consume the alternative diet for 4 weeks. The
 random assignment will be done with SAS 9.4 software. Body size measurement, dietary
 assessment, brachial artery FMD and blood pressure measurements, and fasting-state blood
 collection will be conducted at week 1, 5, 9, and 13, which correspond to before and during
 the last 1 week of the two 4-week intervention periods.

 During study week 1 and weeks 6-9, all subjects will consume their habitual, unrestricted
 self-chosen diets. During study weeks 2-5 and 10-13, all subject will follow a healthy eating
 pattern diet, referred to as the "My Healthy Plate" designed by HPB. Each subject's energy
 requirement will be estimated using sex-specific equations and Recommended Dietary Allowances
 for healthy Singaporean. One-on-one dietary counselling and written instructions for each
 subject will be provided by a research dietitian and trained research staff to achieve a
 healthy eating pattern diet. Compliance with the plant sterols consumption will be promoted
 by frequent online and in-person contact.
Inclusion Criteria:

 1. Ability to give an informed consent;

 2. Age>35 years old;

 3. Meet any 3 of the 5 following NCEP-ATP III MetS criteria (waist circumference > 90 cm
 (male), > 80 cm (female); fasting glucose concentration ≥ 100 mg/dL or on medication;
 triglyceride ≥ 150 mg/dL or on medication; high density lipoprotein cholesterol (HDL)
 < 40 mg/dL (male), < 50 mg/dL (female); systolic or diastolic blood pressure > 130/80
 mmHg or on medication);

 4. Weight change < 3kg in the past 3 months;

 5. No exercising vigorously over the past 3 months;

 6. No allergy to plant sterols; no acute illness; not smoking;

 7. No drinking more than 2 alcoholic drinks per day;

 8. No pregnant, lactating, or planning pregnancy in the next 6 months.

 Exclusion Criteria:

 1. Unable to give an informed consent;

 2. Age<35 years old;

 3. Meet less than 3 of following NCEP-ATP III MetS criteria (waist circumference > 90 cm
 (male), > 80 cm (female); fasting glucose concentration ≥ 100 mg/dL or on medication;
 triglyceride ≥ 150 mg/dL or on medication; high density lipoprotein cholesterol (HDL)
 < 40 mg/dL (male), < 50 mg/dL (female); systolic or diastolic blood pressure > 130/80
 mmHg or on medication);

 4. Weight change > 3kg in the past 3 months;

 5. Exercise vigorously over the past 3 months;

 6. Allergy to plant sterols; no acute illness; not smoking;

 7. Drinking more than 2 alcoholic drinks per day;

 8. Pregnant, lactate, or plan pregnancy in the next 6 months.