British Journal of Nutrition

Short communication

Divergent changes in serum sterols during a strict uncooked vegan diet in patients with rheumatoid arthritis

J. J. Ågrena1 c1, E. Tvrzickaa2, M. T. Nenonena1, T. Helvea3 and O. Hänninena1

a1 Department of Physiology, University of Kuopio, PO Box 1627, SF-70211 Kuopio, Finland

a2 Faculty of Medicine, Charles University, Prague, Czech Republic

a3 Department of Rheumatology, Helsinki University Hospital, Helsinki, Finland


The effects of a strict uncooked vegan diet on serum lipid and sterol concentrations were studied in patients with rheumatoid arthritis. The subjects were randomized into a vegan diet group (n 16), who consumed a vegan diet for 2–3 months, or into a control group (n 13), who continued their usual omnivorous diets. Serum total and LDL-cholesterol and -phospholipid concentrations were significantly decreased by the vegan diet. The levels of serum cholestanol and lathosterol also decreased, but serum cholestanol:total cholesterol and lathosterol:total cholesterol did not change. The effect of a vegan diet on serum plant sterols was divergent as the concentration of campesterol decreased while that of sitosterol increased. This effect resulted in a significantly greater sitosterol:campesterol value in the vegan diet group than in the control group (1.48 (SD 0.39) V. 0.72 (sd 0.14); P<0.001). A higher concentration of campesterol compared with sitosterol is normal in omnivorous subjects and can be explained by lower absorption and esterification rates of sitosterol. Our results suggest that a strict uncooked vegan diet changes the relative absorption rates of these sterols and/or their biliary clearance.

(Received February 17 2000)

(Revised August 04 2000)

(Accepted August 10 2000)


c1 * Corresponding author: J. J. Ågren, fax +358 17 163112, email: