Plant sterols/stanols (when taken at 2 g/day) cause significant inhibition of
cholesterol absorption and lower LDL-C levels by between 8 and 10%. The relative proportions of
cholesterol versus sterol/stanol levels are similar in both plasma and tissue, with levels of sterols/stanols
being 500-/10,000-fold lower than those of cholesterol, suggesting they are handled similarly to
cholesterol in most cells. Despite possible atherogenicity of marked elevations in circulating levels of
plant sterols/stanols, protective effects have been observed in some animal models of atherosclerosis.
Higher plasma levels of plant sterols/stanols associated with intakes of 2 g/day in man have not been
linked to adverse effects on health in long-term human studies. Importantly, at this dose, plant sterol/
stanol-mediated LDL-C lowering is additive to that of statins in dyslipidaemic subjects, equivalent to
doubling the dose of statin. The reported 6e9% lowering of plasma triglyceride by 2 g/day in hypertriglyceridaemic
patients warrants further evaluation.
Conclusion: Based on LDL-C lowering and the absence of adverse signals, this EAS Consensus Panel
concludes that functional foods with plant sterols/stanols may be considered 1) in individuals with high
cholesterol levels at intermediate or low global cardiovascular risk who do not qualify for pharmacotherapy,
2) as an adjunct to pharmacologic therapy in high and very high risk patients who fail to achieve