Recommended by international guidelines

Plant stanol ester is recommended by international guidelines

Local and international guidelines consistently recommend the use of plant stanol ester as part of a cholesterol-lowering diet. The 2019 joint European Atherosclerosis Society (EAS)/European Society of Cardiology (ESC) guidelines define the target groups for plant stanol ester use as:1

  • Individuals who have elevated serum cholesterol levels and are at low or intermediate global cardiovascular risk but who do not need cholesterol-lowering medication
  • High- and very high-risk patients, such as patients with diabetes, who fail to achieve low-density lipoprotein cholesterol (LDL-C) targets on statins alone, or are statin intolerant
  • Adults and children (from the age of 6 years) with familial hypercholesterolaemia

Plant stanol ester: Mechanism of action


  1. Mach et al. Eur Heart J 2019; 41(1): 111–188.
  2. Piepoli et al. Atherosclerosis 2016; 252: 207–274.
  3. Expert Dyslipidemia Panel of the IAS Panel members. J Clin Lipidol 2014; 8(1): 29–60.
  4. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series 2003; No. 797 – TRS 797.
  5. Lloyd-Jones et al. J Am Coll Cardiol 2017; 70(14): 1785–1822.
  6. Jacobson et al. J Clin Lipidol 2015; 9(2): 129–169.
  7. JBS3 Board. Heart 2014; 100(Suppl 2): ii1–ii67.
  8. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Pediatrics 2011; 128(Suppl 5): S213–S256.
  9. Daniels et al. Pediatrics 2008; 122(1): 198–208.
  10. American Diabetes Association. Diabetes Care 2019; 42(Suppl 1): S103–S123.
  11. Evert et al. Diabetes Care 2013; 36(11): 3821–3842.
  12. Brunzell et al. J Am Coll Cardiol 2008; 51(15): 1512–1524.
  13. Wiegman et al. Eur Heart J 2015; 36(36): 2425–2437.
  14. Nordestgaard et al. Eur Heart J 2013; 34(45): 3478–3490.
  15. The EU Register of nutrition and health claims made on foods. EU 2016 [online] available at:
    public/?event=search (accessed December 2020).
  16. Miettinen et al. N Engl J Med 1995; 333(20): 1308–1312.
  17. Ministry of Health (MOH) Singapore. Lipids MOH Clinical Practice Guidelines 2016. Available from:

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