Plant Sterol

Aka: Plant Sterol, Plant Stanol, Sitosterol, Sitostanol, Benecol

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II. Mechanism

  1. Plant Sterols resemble Cholesterol
    1. Modified side-chain
  2. Reduces intestinal absorption of LDL Cholesterol
  3. Hepatic de novo Cholesterol synthesis may increase

III. Efficacy

  1. Modestly reduces serum LDL Cholesterol (10-14%)
  2. LDL Cholesterol lowered 160 to 134-138
  3. References
    1. Gylling (1996) J Lipid Res 37:1776 [PubMed]
    2. Gyling (1997) Circulation 96:4226 [PubMed]
    3. Hendriks (1999) Eur J Clin Nutr 53:319 [PubMed]
    4. Mietinen (1995) N Engl J Med 333:1308 [PubMed]
    5. Weststrate (1998) Eur J Clin Nutr 52:334 [PubMed]

IV. Preparations: Plant Stanol ester enriched margarine

  1. Benecol (hydrogenated sterols)
    1. Sitostanol from pine tree wood pulp
    2. Less absorption than with Sitosterol (Take Control)
  2. Take Control (unsaturated sterols)
    1. Sitosterol from soybean oil
  3. Minute Maid Heart Wise orange juice
    1. Two glasses per day recommended

V. Dosing

  1. Studies used 2-3 g/day Sterol (30 g/day of spread)

VI. Adverse Effects

  1. Well tolerated without affecting margarine taste
  2. Potentially atherogenic (Coronary Artery Disease risk)
    1. High Plant Sterol concentrations assoc. with CAD
    2. Stanols (Benecol) less absorbed than Sterols
    3. Concentrations lower with Benecol than Take Control

VII. Precautions

  1. Do not use in patients with inherited Sitosterolemia
    1. Risk of premature Ischemic Heart Disease
    2. Risk of xanthoma formation

VIII. References

  1. (1998) J Postgrad Med, Managing High Cholesterol
  2. (1999) Med Lett Drugs Ther 41(1055):56-8 [PubMed]

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