Plant stanols: Clinically proven in 80+ studies

Clinically proven efficacy and tolerability in more than 80 studies

Over 80 studies have been published exploring the efficacy of plant stanol ester in lowering low-density lipoprotein cholesterol (LDL-C) in a range of people and populations.

Studies consistently show that a daily intake of 1.5–3.0 g of plant stanols reduces LDL cholesterol by 7–12.5% in 2–3 weeks1. This effect is sustained as long as the daily intake of plant stanol is within the recommended range2, with no effect on high-density lipoprotein (HDL) cholesterol3.

Benecol® products with plant stanol ester can also be safely
consumed by patients on statin medication, as the cholesterol-
lowering effects of statins and plant stanol ester are additive4,5.

Plant stanols can help lower cholesterol, independent of baseline cholesterol levels

To date, over 80 clinical studies have been published exploring the efficacy of plant stanol ester in different usage situations.

The main finding is that, independent of baseline cholesterol levels or background diet, a daily intake of 1.5–3.0 g of plant stanols (as plant stanol ester) reduces LDL cholesterol by 7–12.5% in 2–3 weeks1. This effect is sustained as long as the daily intake of plant stanol is within the recommended range2, with no effect on high-density lipoprotein (HDL) cholesterol3.

Proven cholesterol-lowering effects in a range of people

Plant stanol ester has been shown to be equally effective in different populations and patient groups, regardless of age, sex, genetics or dietary preferences. The relative cholesterol-lowering effect of plant stanol ester is independent of baseline cholesterol values, and is proven to be universal in all populations studied, from Finland, Sweden, the United Kingdom, the Netherlands, Germany, Spain, Greece, Turkey, the United States and Canada, to Colombia, Japan, Korea, Thailand, Australia and Indonesia. This cholesterol-lowering effect has been proven in both primary and secondary prevention, in a number of patient groups, including:

  • Healthy normocholesterolaemic and hypercholesterolaemic individuals

  • Men, women and children of different ages

  • Patients with type 1 or type 2 diabetes, metabolic syndrome

  • Patients with coronary heart disease

  • Patients with familial hypercholesterolaemia

  • In connection with a habitual diet and a strict cholesterol-lowering diet

  • In combination with cholesterol-lowering statin therapy

  • When plant stanol ester has been added to different types of foods

Studies show that a daily intake of 1.5–3.0 g of plant stanols (as plant stanol ester) reduces LDL cholesterol by 7–12.5% in 2–3 weeks1. This effect is sustained as long as the daily intake of plant stanol is within the recommended range2, with no effect on high-density lipoprotein (HDL) cholesterol3.

Rapid and sustained cholesterol reduction

Reducing cholesterol with plant stanol ester is fast. There is a measurable reduction in serum LDL-C within the first week of continuous plant stanol ester use6,7, and full reduction is typically achieved within 2–3 weeks8–10. Cholesterol reduction can be sustained with daily intake of plant stanol ester2.

The cholesterol-lowering effect of plant stanol ester is fast, and the effect is sustained with sufficient daily consumption. Magnitude of reduction depends on the daily plant stanol dose.
Adapted from EFSA Panel on Dietetic Products, Nutrition and Allergies 201211.

Plant stanol ester provides an additive effect to statins

Plant stanol ester-containing Benecol products can also be recommended to patients on cholesterol-lowering statin medication.

While plant stanol ester partially blocks the absorption of cholesterol in the digestive tract, statins inhibit the synthesis of cholesterol. Because of these differing mechanisms of action, the cholesterol-lowering effects of statins and plant stanol ester are additive.

Adding Benecol products containing plant stanols to the diet of patients already on statin medication provides on average an additional 10% reduction in plasma LDL cholesterol4,5.12.

This reduction is greater than that typically obtained by doubling the statin dose (6–7%)13.14. Additionally, evidence suggests that 25% of statin-treated patients show inadequate LDL-C lowering as a result of low cholesterol synthesis, and may benefit especially from a combination of statins and regimens to lower cholesterol absorption, such as plant stanol ester15.

Ways of characterising patients based on their cholesterol metabolism (high/low cholesterol synthesisers) are not readily available. For this reason, recommending the use of Benecol products with plant stanol ester can be an effective cholesterol-lowering alternative to raising statin dosage and a convenient way to ensure an effective LDL lowering effect independent of cholesterol metabolism.

Plant stanol ester (1.5–3.0 g plant stanols a day) lowers cholesterol as part of any kind of lifestyle by 7–12.5% in just 2–3 weeks1. Best total results are achieved when other dietary alterations are implemented as well. Combining plant stanol ester with statin medication may help to postpone the need to increase the statin dose or help reach further reduction when maximal statin dose is already in use.
Adapted from Gylling et al 201413. De Jong et al. 20084 and Blair et al. 20005.

References

  1. The EU Register of nutrition and health claims made on foods. EU 2016 [online] available at: https://ec.europa.eu/food/safety/labelling_nutrition/claims/register/
    public/?event=search (accessed December 2020).
  2. Miettinen et al. N Engl J Med 1995; 333(20): 1308–1312.
  3. Hallikainen et al. Am J Clin Nutr 1999; 69(3): 403–410.
  4. De Jong et al. Br J of Nutr 2008; 100(5): 937–941.
  5. Blair et al. Am J Cardiol 2000; 86(1): 46–52.
  6. Miettinen et al. Am J Clin Nutr 2000; 71(5): 1095–1102.
  7. Hallikainen et al. BMC Cardiovasc Disord 2002; 2: 14.
  8. Mensink et al. Atherosclerosis 2002; 160(1): 205–213.
  9. Noakes et al. Am J Clin Nutr 2002; 75(1): 79–86.
  10. Jones et al. J Lipid Res 2000; 41(5): 697–705.
  11. EFSA Panel on Dietetic Products, Nutrition and Allergies. EFSA Journal 2012; 10(5): 2693.
  12. Hallikainen et al. Atherosclerosis 2011; 217(2): 473–478.
  13. Gylling et al. Atherosclerosis 2014; 232(2): 346–360.
  14. National Institute for Health and Care Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE 2016 [online] available at: https://www.nice.org.uk/guidance/cg181/chapter/Appendix-A-Grouping-of-statins. (accessed December 2020).
  15. Lütjohann et al. Pharmacol Ther 2019; 199: 111–116.

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