23.08.2011 Copyright® Raisio

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

Kathy Musa-Veloso, Theresa H. Poon, Julie Ann Elliot, Catherine Chung. Prostaglandins, Leukotrienes and Essential Fatty Acids 2011; 85: 9–28.

Kathy Musa-Veloso, Theresa H. Poon. Prostaglandins, Leukotrienes and Essential Fatty Acids doi:10.1016/j.plefa.2011.07.003

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Background: Efficacy of plant stanols vs. plant sterols

• Until now, scientific consensus has largely concluded that the cholesterol-lowering effects of plant stanols and plant sterols are equal

• Higher than recommended daily intakes have been thought to bring no additional benefit (e.g. Katan MB et al. Mayo Clinic Proc 2003; 78: 965-978)

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Background: Efficacy of plant stanols vs. plant sterols• In a meta-analysis published in 2009, the maximal LDL-

cholesterol reduction for the pooled results of plant stanols and plant sterols was 12.3%. (Demonty et al. The Journal of Nutrition 2009;139:271-284.)

• When the efficacy of plant stanols and plant sterols was analysed separately, there was a non-significant 6.7% difference in their maximal relative LDL-CH lowering.

• In 2010, two studies with high daily intakes (up to 9 g) of plant stanols indicated that the cholesterol-lowering effect of plant stanols was enhanced when its intake exceeded the currently recommended 2 g/d. (Mensink et al. Am J Clin Nutr 2010; 92: 24-33. Gylling et al. Clin Nutr 2010; 29:112-118.)

Significantly better maximal efficacy with Plant stanol ester (Musa-Veloso et al. 2011a, 2011b)

• The estimated maximal LDL-cholesterol reduction was 18.3% for plant stanol ester.

• The estimated maximal LDL-cholesterol reduction was 10.3% for plant sterol ester.

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Conclusions (Musa-Veloso et al. 2011a, 2011b)

• The maximal LDL cholesterol reduction achievable with plant stanol ester was significantly better compared to plant sterol ester

• At intakes in excess of the recommended 2 g/day, plant stanols are associated with additional and dose-dependent reductions in LDL cholesterol, possibly resulting in further reductions in the risk of CHD

• No such evidence for a dose-response with plant sterols was found

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