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

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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Related Studies

Ontology: Phytosterols (C0031866)

Definition (MSH) A class of organic compounds known as STEROLS or STEROIDS derived from plants.
Definition (NCI_NCI-GLOSS) A plant-based compound that can compete with dietary cholesterol to be absorbed by the intestines, resulting in lower blood cholesterol levels. Phytosterols may have some effect in cancer prevention. Also called plant sterol.
Definition (NCI_CRCH) A class of dietary sterols present in plants with chemical structures nearly identical to cholesterol.
Definition (NCI) Any sterol found in the plant kingdom.
Concepts Biologically Active Substance (T123) , Steroid (T110) , Pharmacologic Substance (T121)
MSH D010840
SnomedCT 226360008
LNC LP183760-0
English Phytosterols, Plant Sterols, Sterols, Plant, Phytosterols [Chemical/Ingredient], plant sterols, phytosterols, Plant Sterol, phytosterol, Plant Steroids, Steroids, Plant, plant sterol, Phytosterol, Phytosterol (substance)
Swedish Fytosteroler
Czech fytosteroly, rostlinné steroly
Finnish Kasvisterolit
Japanese 植物ステロール, フィトステロール
Italian Steroli delle piante, Fitosteroli
Polish Fitosterole
Spanish Esteroides Vegetales, fitosterol (sustancia), fitosterol, Esteroles de las Plantas, Fitosteroles
Portuguese Esteroides Vegetais, Esteróis das Plantas, Fitosteróis
French Phytostérols
German Pflanzensterine, Pflanzensterole, Phytosterole

Ontology: Sitosterols (C0037215)

Definition (MSH) A family of sterols commonly found in plants and plant oils. Alpha-, beta-, and gamma-isomers have been characterized.
Definition (CSP) group of closely related natural plant sterols with anticholesterolemic properties.
Concepts Steroid (T110) , Pharmacologic Substance (T121)
MSH D012855
English Sitosterols, sitosterols (medication), sitosterols, Sitosterols [Chemical/Ingredient], sitosterol, SITOSTEROLS
Swedish Sitosteroler
Czech sitosteroly
Finnish Sitosterolit
Japanese シトステロール
Polish Sytosterolu pochodne
Portuguese Sitosteroides
French Sitostérol
German Sitosterole
Italian Sitosteroli
Spanish Sitoesteroles

Ontology: stigmastanol (C0075252)

Definition (NCI) A steroid derivative characterized by the hydroxyl group in position C-3 of the steroid skeleton, and a saturated bond in position 5-6 of the B ring.
Definition (NCI_CRCH) The saturated form of beta-sitosterol.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C021255
LNC LP173721-4, MTHU047879
English (3 beta,5 alpha)-stigmastan- 3-ol, dihydrositosterol, sitostanol, stigmastanol, 5,6-Dihydro-beta-sitosterol, Stigmastanol, Dihydro-beta-sitosterol, 24 alpha-ethyl-5alpha-choestan-3beta-ol, STIGMASTANOL

Ontology: Benecol (C0917633)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C407042
English benecol, Benecol