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Plant sterols / stanols (phytosterols)

EFSA-authorised LDL-lowering at 1.5–3 g/day, additive to statins and to dietary changes.

Why

Plant sterols (β-sitosterol, campesterol, stigmasterol) and stanols (saturated equivalents) are structurally similar to cholesterol but poorly absorbed. EFSA has authorised health claims that plant sterols and stanols at 1.5–3 g/day lower blood cholesterol and that this effect is additive to statin therapy. Commercial vehicles include enriched margarines (Benecol, Becel pro.activ), yoghurt drinks, and concentrated supplements.

How it works

Compete with cholesterol for incorporation into mixed micelles in the small intestine, reducing both dietary and biliary cholesterol absorption. Effect saturates above ~3 g/day. Independent of statin mechanism, additive when combined.

Expected onset · LDL reduction at 2–3 weeks; full effect by 8 weeks

How to take

Dosage

1.5–3 g/day plant sterols or stanols, with meals. Higher doses (>3 g/day) do not produce greater LDL reduction.

Timing

Split across 2–3 main meals containing fat for absorption competition

On the label

Stated plant sterol or stanol content (1.5–3 g effective range). Esterified forms in fortified spreads are well-studied; supplement capsules need higher doses to achieve same intake.

Ideal for

Adults with elevated LDL cholesterol; on statin therapy looking for additional LDL reduction; family hypercholesterolaemia.

Safety

Reduces absorption of fat-soluble vitamins, particularly β-carotene. Eat plenty of carotenoid-rich foods (orange, yellow, dark green vegetables). Contraindicated in sitosterolaemia (rare genetic condition causing pathological plant-sterol accumulation). Pregnancy and breastfeeding: avoid concentrated phytosterol products (limited safety data in vulnerable groups).

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Evidence

At a glance

EFSA-authorised health claims at 1.5–3 g/day lower blood cholesterol, the highest regulatory tier in EU food law, with a separate authorisation acknowledging the additive effect to statins. Demonty 2009 dose-response meta-analysis: each 1 g/day reduced LDL by ~0.094 mmol/L, plateauing at ~3 g/day. Ras 2014 confirmed effect across dose ranges and product forms.

Where to get it

Shop Plant sterols / stanols (phytosterols) on Amazon

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