Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects

Am J Cardiol. 2005 Jul 4;96(1A):15D-22D. doi: 10.1016/j.amjcard.2005.03.015.

Abstract

Incorporation of plant stanol esters into margarine is among the first examples of a functional food with proven low-density lipoprotein (LDL) cholesterol-lowering effectiveness. Recently, there have been many studies on the effects of plant stanols/sterols on cholesterol metabolism. It has been found that the serum LDL cholesterol-lowering effect of plant stanols/sterols originates from reduced intestinal cholesterol absorption, a process in which changes in micellar composition are thought to play a major role. However, recent findings suggest that there is an additional process in which plant stanols/sterols actively influence cellular cholesterol metabolism within intestinal enterocytes. Furthermore, in response to the reduced supply of exogenous cholesterol, receptor-mediated lipoprotein cholesterol uptake is probably enhanced, as shown by increased LDL receptor expression. At recommended intakes of about 2 to 2.5 g/day, products enriched with plant stanol/sterol esters lower plasma LDL cholesterol levels by 10% to 14% without any reported side effects. Thus, plant stanols/sterols can be considered to be effective and safe cholesterol-lowering functional food ingredients.

Publication types

  • Review

MeSH terms

  • Cholesterol, LDL / metabolism*
  • Humans
  • Hypercholesterolemia / drug therapy*
  • Intestinal Absorption
  • Phytosterols / adverse effects*
  • Phytosterols / pharmacology*
  • Phytosterols / therapeutic use
  • Phytotherapy
  • Sitosterols / adverse effects*
  • Sitosterols / pharmacology*
  • Sitosterols / therapeutic use

Substances

  • Cholesterol, LDL
  • Phytosterols
  • Sitosterols
  • plant stanol ester