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Phytosterols for cardiovascular risk reduction

Phytosterols are phytosteroids, similar to cholesterol, that serve as structural components of biological membranes of plants. They encompass plant sterols and stanols.


Katan et al. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc. 2003 Aug;78(8):965-78.doi: 10.4065/78.8.965.

recap: Lifestyle intervention


2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk, European Heart Journal, Volume 41, Issue 1, 1 January 2020, Pages 111–188, https://doi.org/10.1093/eurheartj/ehz455



In western populations typical intake of sitosterol is about 150-350mg/ day and stanols is 15-50mg/ day. Vegetarians consume slighly more: 325mg/d sitosterol, 60mg/d campesterol. Combined intake ranges from 150-400mg/d (1.5-4g/d)



Effective dose of stanols /sterols is 2-3g per day. Little additional effect of higher doses. Half of the effect appears from 0.7-1.1g/ day.


Stanols vs. sterols


Similarly effective, no clear evidence that one is better than the other. Can be used in addition to dietary changes to offer further cholesterol reducing benefit. Benefit observes independent of diet aka even when supplemented in unhealthy diet patterns.





An additive to drug therapy


Products containing plant sterols, stanols or plant sterol esters on the market in the UK.

Benecol, flora proactiv, cholesterol lowering drinks at Aldi, sainsbury's, morrison's, Asda stores.


Products currently on the market (UK) include yoghurt drinks, spreads and soft cheeses.


Products containing sterol, stanol or sterol ester at a ~2g dose per serving for a drink or for 2-3 servings if a spread when used regularly will offer cholesterol lowering benefit.



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