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Phytosterols reduce LDL cholesterol, complement other therapies, expert panel finds


  • Plant sterols (2 g/day) reduce LDL-cholesterol by 10%, based on a meta-analysis of 41 clinical trials.
  • Combined with diet therapy, plant sterols reduce LDL-cholesterol by 20%
  • Effective option for lowering LDL-cholesterol when taken alone or combined with other therapies


This review article summarizes the findings of the Stresa Workshop, a group of32 international experts, on the efficacy and safety of plant sterols and stanols for the management of blood cholesterol levels. 

The group reported that, based on a meta-analysis of 41 trials, an intake of 2 g/day of plant sterols (or stanols) reduced low-density lipoprotein (LDL) by 10%, while higher intakes offered little added value. Free (unesterified) sterols and stanols are reported to have the same effect on plasma lipoproteins as stanol and sterol esters.

The ability of plant sterols (or stanols) to reduce LDL-cholesterol is reported to be additive with diet or drug interventions. Combining plant sterols (or stanols) with diet therapy is reported to produce a total decrease in LDL-cholesterol in the range of 20%, essentially doubling the benefit. Combining sterols (or stanols) with statin drugs is also reported to reduce LDL-cholesterol up to 20% and is more effective than doubling the statin dose, which alone is reported to produce an additional lowering of LDL-cholesterol levels of only 5% to 7%.

Plant sterols (and stanols) have been reviewed by the Food and Drug Administration (FDA) and other regulatory agencies and found safe for human use. FDA has also authorized a health claim that qualified foods and supplements containing plant sterols (or stanols) may reduce the risk of coronary heart disease.

These findings indicate that supplementing with plant sterols (2 g/day) is a safe and effective option for lowering LDL-cholesterol in patients with hypercholesterolemia when taken alone or when combined with diet therapy or statin drugs.


Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R; Stresa Workshop Participants. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc. 2003;78(8):965-78. Review.

PMID: 12911045