Overview
Plant sterols might help reduce cholesterol levels by limiting the amount of cholesterol that is able to enter the body. Some plant sterols might also reduce how much cholesterol is made in the body.
People commonly use plant sterols for lowering cholesterol levels. Plant sterols are also used for heart disease, colon cancer, stomach cancer, obesity, heart attack, and many other conditions, but there is no good scientific evidence to support many of these other uses.
Don't confuse plant sterols with beta-sitosterol or sitostanol. These are specific types of plant sterols.
Uses & Effectiveness ?
Likely Effective for
- Inherited tendency towards high cholesterol (familial hypercholesterolemia). When used along with a cholesterol-lowering diet, taking plant sterols by mouth reduces low-density lipoprotein (LDL or "bad") cholesterol levels in children and adults with high cholesterol levels due to familial hypercholesterolemia.
- High cholesterol. Taking plant sterols by mouth lowers low-density lipoprotein (LDL or "bad") cholesterol levels in people with high cholesterol who are also following a cholesterol-lowering diet. But it doesn't seem to reduce triglyceride levels.
Possibly Effective for
- Heart disease. Eating foods that contain at least 3.4 grams of plant sterols daily as part of a low-fat, low-cholesterol diet might help prevent heart disease.
Side Effects
Special Precautions and Warnings
Children: Plant sterols are likely safe when taken by mouth in doses of 1.6-2.3 grams daily for up to 6 months.
Sitosterolemia, a rare inherited fat storage disease: People with this condition might have a build up of plant sterols and related fats in their blood and tissues. Taking plant sterols might make this condition worse. Don't take plant sterols if you have sitosterolemia.
Short bowel syndrome, a condition related to removal of part of the gut: Plant sterols should be used cautiously in people with this condition. They might affect liver function.
Interactions ?
We currently have no information for PLANT STEROLS overview.
Dosing
Amundsen, A. L., Ntanios, F., Put, N., and Ose, L. Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread. Eur.J Clin.Nutr. 2004;58(12):1612-1620. View abstract.
Clifton, P. M., Noakes, M., Sullivan, D., Erichsen, N., Ross, D., Annison, G., Fassoulakis, A., Cehun, M., and Nestel, P. Cholesterol-lowering effects of plant sterol esters differ in milk, yoghurt, bread and cereal. Eur.J Clin.Nutr. 2004;58(3):503-509. View abstract.
De Stefani, E., Boffetta, P., Ronco, A. L., Brennan, P., Deneo-Pellegrini, H., Carzoglio, J. C., and Mendilaharsu, M. Plant sterols and risk of stomach cancer: a case-control study in Uruguay. Nutr.Cancer 2000;37(2):140-144. View abstract.
Demonty, I., Chan, Y. M., Pelled, D., and Jones, P. J. Fish-oil esters of plant sterols improve the lipid profile of dyslipidemic subjects more than do fish-oil or sunflower oil esters of plant sterols. Am J Clin Nutr 2006;84(6):1534-1542. View abstract.
Fernandez, C., Suarez, Y., Ferruelo, A. J., Gomez-Coronado, D., and Lasuncion, M. A. Inhibition of cholesterol biosynthesis by Delta22-unsaturated phytosterols via competitive inhibition of sterol Delta24-reductase in mammalian cells. Biochem.J 8-15-2002;366(Pt 1):109-119. View abstract.
Grundy, S. M., Ahrens, E. H., Jr., and Salen, G. Dietary beta-sitosterol as an internal standard to correct for cholesterol losses in sterol balance studies. J Lipid Res 1968;9(3):374-387. View abstract.
Guardamagna, O., Abello, F., Baracco, V., Federici, G., Bertucci, P., Mozzi, A., Mannucci, L., Gnasso, A., and Cortese, C. Primary hyperlipidemias in children: effect of plant sterol supplementation on plasma lipids and markers of cholesterol synthesis and absorption. Acta Diabetol. 2011;48(2):127-133. View abstract.
Hallikainen, M., Huikko, L., Kontra, K., Nissinen, M., Piironen, V., Miettinen, T., and Gylling, H. Effect of parenteral serum plant sterols on liver enzymes and cholesterol metabolism in a patient with short bowel syndrome. Nutr Clin Pract. 2008;23(4):429-435. View abstract.
Hendriks, H. F., Brink, E. J., Meijer, G. W., Princen, H. M., and Ntanios, F. Y. Safety of long-term consumption of plant sterol esters-enriched spread. Eur.J Clin.Nutr. 2003;57(5):681-692. View abstract.
Normen, A. L., Brants, H. A., Voorrips, L. E., Andersson, H. A., van den Brandt, P. A., and Goldbohm, R. A. Plant sterol intakes and colorectal cancer risk in the Netherlands Cohort Study on Diet and Cancer. Am J Clin.Nutr. 2001;74(1):141-148. View abstract.
Relas, H., Gylling, H., and Miettinen, T. A. Fate of intravenously administered squalene and plant sterols in human subjects. J.Lipid Res. 2001;42(6):988-994. View abstract.
Tuomilehto, J., Tikkanen, M. J., Hogstrom, P., Keinanen-Kiukaanniemi, S., Piironen, V., Toivo, J., Salonen, J. T., Nyyssonen, K., Stenman, U. H., Alfthan, H., and Karppanen, H. Safety assessment of common foods enriched with natural nonesterified plant sterols. Eur J Clin Nutr 2009;63(5):684-691. View abstract.
Acuff RV, Cai DJ, Dong ZP, Bell D. The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects. Lipids Health Dis. 2007 Apr 9;6:11. View abstract.
Amir Shaghaghi M, Abumweis SS, Jones PJ. Cholesterol-lowering efficacy of plant sterols/stanols provided in capsule and tablet formats: results of a systematic review and meta-analysis. J Acad Nutr Diet. 2013 Nov;113(11):1494-503. View abstract.
Anon. FDA authorizes new coronary heart disease health claim for plant sterol and plant stanol esters. FDA. 2000. Available at: <a href="https://www3.scienceblog.com/community/older/archives/M/1/fda0642.htm" target="_blank">https://www3.scienceblog.com/community/older/archives/M/1/fda0642.htm</a>. (Accessed 26 May 2016).
Baumgartner S, Ras RT, Trautwein EA, Mensink RP, Plat J. Plasma fat-soluble vitamin and carotenoid concentrations after plant sterol and plant stanol consumption: a meta-analysis of randomized controlled trials. Eur J Nutr. 2017;56(3):909-923. View abstract.
Casas-Agustench P, Serra M, Pérez-Heras A, Cofán M, Pintó X, Trautwein EA, Ros E. Effects of plant sterol esters in skimmed milk and vegetable-fat-enriched milk on serum lipids and non-cholesterol sterols in hypercholesterolaemic subjects: a randomised, placebo-controlled, crossover study. Br J Nutr. 2012 Jun;107(12):1766-75. View abstract.
Chen JT, Wesley R, Shamburek RD, et al. Meta-Analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol. Pharmacotherapy 2005;25:171-83. View abstract.
Demonty I, Ras RT, van der Knaap HC, Meijer L, Zock PL, Geleijnse JM, Trautwein EA. The effect of plant sterols on serum triglyceride concentrations is dependent on baseline concentrations: a pooled analysis of 12 randomised controlled trials. Eur J Nutr. 2013 Feb;52(1):153-60. View abstract.
Doornbos AM, Meynen EM, Duchateau GS, van der Knaap HC, Trautwein EA. Intake occasion affects the serum cholesterol lowering of a plant sterol-enriched single-dose yoghurt drink in mildly hypercholesterolaemic subjects. Eur J Clin Nutr. 2006 Mar;60(3):325-33. View abstract.
Eady S, Wallace A, Willis J, Scott R, Frampton C. Consumption of a plant sterol-based spread derived from rice bran oil is effective at reducing plasma lipid levels in mildly hypercholesterolaemic individuals. Br J Nutr. 2011 Jun 28;105(12):1808-18. View abstract.
EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA), Turck D, Castenmiller J, et al. Safety of the extension of use of plant sterol esters as a novel food pursuant to Regulation (EU) 2015/2283. EFSA J. 2020;18(6):e06135. View abstract.
Electronic Code of Federal Regulations. Title 21. Part 101.83 - Health claims: plant sterol/stanol esters and risk of coronary heart disease (CHD). Available at: https://www.ecfr.gov/cgi-bin/text-idx?SID=c7e427855f12554dbc292b4c8a7545a0&mc=true&node=pt21.2.101&rgn=div5#se21.2.101_180
Gomes GB, Zazula AD, Shigueoka LS, et al. A randomized open-label trial to assess the effect of plant sterols associated with ezetimibe in low-density lipoprotein levels in patients with coronary artery disease on statin therapy. J Med Food. 2017;20(1):30-36. View abstract.
Hallikainen MA, Sarkkinen ES, Gylling H, et al. Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on a low-fat diet. Eur J Clin Nutr 2000;54:715-25. View abstract.
Haque Hussain SS, Weir J, Roberts N. Severe dermatitis secondary to plant sterol supplements. Clin Exp Dermatol. 2009 Oct;34(7):e276-7. View abstract.
Heinemann T, Kullak-Ublick GA, Pietruck B, von Bergmann K. Mechanisms of action of plant sterols on inhibition of cholesterol absorption. Comparison of sitosterol and sitostanol. Eur J Clin Pharmacol 1991;40 Suppl 1:S59-63. View abstract.
Hongu N, Kitts DD, Zawistowski J, Dossett CM, Kopec A, Pope BT, Buchowski MS. Pigmented rice bran and plant sterol combination reduces serum lipids in overweight and obese adults. J Am Coll Nutr. 2014;33(3):231-8. View abstract.
Jiang L, Zhao X, Xu J, Li C, Yu Y, Wang W, Zhu L. The protective effect of dietary phytosterols on cancer risk: A systematic meta-analysis. J Oncol. 2019;2019:7479518. View abstract.
Jones PJ, Demonty I, Chan YM, Herzog Y, Pelled D. Fish-oil esters of plant sterols differ from vegetable-oil sterol esters in triglycerides lowering, carotenoid bioavailability and impact on plasminogen activator inhibitor-1 (PAI-1) concentrations in hypercholesterolemic subjects. Lipids Health Dis. 2007 Oct 25;6:28. View abstract.
Jones PJ, Ntanios FY, Raeini-Sarjaz M, et al. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men. Am J Clin Nutr 1999;69:1144-50. View abstract.
Jones PJ, Raeini-Sarjaz M, Ntanios FY, et al. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters. J Lipid Res 2000;41:697-705. View abstract.
Klingberg S, Ellegård L, Johansson I, Jansson JH, Hallmans G, Winkvist A. Dietary intake of naturally occurring plant sterols is related to a lower risk of a first myocardial infarction in men but not in women in northern Sweden. J Nutr. 2013 Oct;143(10):1630-5. View abstract.
Korpela R, Tuomilehto J, Högström P, Seppo L, Piironen V, Salo-Väänänen P, Toivo J, Lamberg-Allardt C, Kärkkäinen M, Outila T, Sundvall J, Vilkkilä S, Tikkanen MJ. Safety aspects and cholesterol-lowering efficacy of low fat dairy products containing plant sterols. Eur J Clin Nutr. 2006 May;60(5):633-42. View abstract.
Law M. Plant sterol and stanol margarines and health. BMJ 2000;320:861-4. View abstract.
Lichtenstein AH, Deckelbaum RJ. Stanol/sterol ester-containing foods and blood cholesterol levels: a statement for healthcare professionals from Nutrition Committee, Council on Nutrition, Physical Activity, Metabolism of American Heart Association. Circulation 2001;103:1177-9. View abstract.
Mackay DS, Gebauer SK, Eck PK, Baer DJ, Jones PJ. Lathosterol-to-cholesterol ratio in serum predicts cholesterol-lowering response to plant sterol consumption in a dual-center, randomized, single-blind placebo-controlled trial. Am J Clin Nutr. 2015 Mar;101(3):432-9. View abstract.
Maki KC, Lawless AL, Reeves MS, Dicklin MR, Jenks BH, Shneyvas E, Brooks JR. Lipid-altering effects of a dietary supplement tablet containing free plant sterols and stanols in men and women with primary hypercholesterolaemia: a randomized, placebo-controlled crossover trial. Int J Food Sci Nutr. 2012 Jun;63(4):476-82. View abstract.
Maki KC, Lawless AL, Reeves MS, Kelley KM, Dicklin MR, Jenks BH, Shneyvas E, Brooks JR. Lipid effects of a dietary supplement softgel capsule containing plant sterols/stanols in primary hypercholesterolemia. Nutrition. 2013 Jan;29(1):96-100. View abstract.
Malhotra A, Shafiq N, Arora A, Singh M, Kumar R, Malhotra S. Dietary interventions (plant sterols, stanols, omega-3 fatty acids, soy protein and dietary fibers) for familial hypercholesterolaemia. Cochrane Database Syst Rev. 2014 Jun 10;6:CD001918. View abstract.
McKenney JM, Jenks BH, Shneyvas E, Brooks JR, Shenoy SF, Cook CM, Maki KC. A softgel dietary supplement containing esterified plant sterols and stanols improves the blood lipid profile of adults with primary hypercholesterolemia: a randomized, double-blind, placebo-controlled replication study. J Acad Nutr Diet. 2014 Feb;114(2):244-9. View abstract.
Musa-Veloso K, Poon TH, Elliot JA, Chung C. A comparison of the LDL-cholesterol lowering efficacy of plant stanols and plant sterols over a continuous dose range: results of a meta-analysis of randomized, placebo-controlled trials. Prostaglandins Leukot Essent Fatty Acids. 2011 Jul;85(1):9-28. View abstract.
Nguyen LB, Shefer S, Salen G, et al. Competitive inhibition of hepatic sterol 27-hydroxylase by sitosterol: decreased activity in sitosterolemia. Proc Assoc Am Physicians 1998;110:32-9. View abstract.
O'Neill FH, Sanders TA, Thompson GR. Comparison of efficacy of plant stanol ester and sterol ester: short-term and longer-term studies. Am J Cardiol. 2005 Jul 4;96(1A):29D-36D. View abstract.
Oliveira Godoy Ilha A, Sutti Nunes V, Silva Afonso M, et al. Phytosterols supplementation reduces endothelin-1 plasma concentration in moderately hypercholesterolemic individuals independently of their cholesterol-lowering properties. Nutrients. 2020;12(5):1507. View abstract.
Ooi EM, Watts GF, Barrett PH, Chan DC, Clifton PM, Ji J, Nestel PJ. Dietary plant sterols supplementation does not alter lipoprotein kinetics in men with the metabolic syndrome. Asia Pac J Clin Nutr. 2007;16(4):624-31. View abstract.
Patel SB, Honda A, Salen G. Sitosterolemia: exclusion of genes involved in reduced cholesterol biosynthesis. J Lipid Res 1998;39:1055-61. View abstract.
Raeini-Sarjaz M, Ntanios FY, Vanstone CA, Jones PJ. No changes in serum fat-soluble vitamin and carotenoid concentrations with the intake of plant sterol/stanol esters in the context of a controlled diet. Metabolism. 2002 May;51(5):652-6. View abstract.
Ras RT, Geleijnse JM, Trautwein EA. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. Br J Nutr. 2014 Jul 28;112(2):214-9. View abstract.
Ras RT, Koppenol WP, Garczarek U, et al. Increases in plasma plant sterols stabilize within four weeks of plant sterol intake and are independent of cholesterol metabolism. Nutr Metab Cardiovasc Dis. 2016;26(4):302-9. View abstract.
Richelle M, Enslen M, Hager C, et al. Both free and esterified plant sterols reduce cholesterol absorption and the bioavailability of beta-carotene and alpha-tocopherol in normocholesterolemic humans. Am J Clin Nutr 2004;80:171-7. View abstract.
Salen G, Shefer S, Nguyen L, et al. Sisterolemia. J Lipid Res 1992;33:945-55. View abstract.
Salen G, Shore V, Tint GS, et al. Increased sitosterol absorption, decreased removal, and expanded body pools compensate for reduced cholesterol synthesis in sitosterolemia with xanthomatosis. J Lipid Res 1989;30:1319-30. View abstract.
Scholle JM, Baker WL, Talati R, Coleman CI. The effect of adding plant sterols or stanols to statin therapy in hypercholesterolemic patients: systematic review and meta-analysis. J Am Coll Nutr. 2009 Oct;28(5):517-24. View abstract.
Sialvera TE, Pounis GD, Koutelidakis AE, Richter DJ, Yfanti G, Kapsokefalou M, Goumas G, Chiotinis N, Diamantopoulos E, Zampelas A. Phytosterols supplementation decreases plasma small and dense LDL levels in metabolic syndrome patients on a westernized type diet. Nutr Metab Cardiovasc Dis. 2012 Oct;22(10):843-8. View abstract.
Stalenhoef AF, Hectors M, Demacker PN. Effect of plant sterol-enriched margarine on plasma lipids and sterols in subjects heterozygous for phytosterolaemia. J Intern Med 2001;249:163-6.. View abstract.
Stalenhoef AF. Images in clinical medicine. Phytosterolemia and xanthomatosis. N Engl J Med 2003;349:51.. View abstract.
Talati R, Sobieraj DM, Makanji SS, Phung OJ, Coleman CI. The comparative efficacy of plant sterols and stanols on serum lipids: a systematic review and meta-analysis. J Am Diet Assoc. 2010 May;110(5):719-26. View abstract.
Vásquez-Trespalacios EM, Romero-Palacio J. Efficacy of yogurt drink with added plant stanol esters (Benecol®, Colanta) in reducing total and LDL cholesterol in subjects with moderate hypercholesterolemia: a randomized placebo-controlled crossover trial NCT01461798. Lipids Health Dis. 2014 Aug 6;13:125. View abstract.
Weststrate JA, Meijer GW. Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr 1998;52:334-43. View abstract.
Yang W, Gage H, Jackson D, Raats M. The effectiveness and cost-effectiveness of plant sterol or stanol-enriched functional foods as a primary prevention strategy for people with cardiovascular disease risk in England: a modeling study. Eur J Health Econ 2018;19(7):909-22. doi: 10.1007/s10198-017-0934-2. View abstract.
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