Plant sterols (phytosterols) inhibit intestinal cholesterol absorption, thereby lowering plasma total and low-density lipoprotein (LDL) cholesterol levels. In human studies that used plant sterols to reduce plasma cholesterol levels, subjects saw an average 10% reduction in total cholesterol and 13% reduction in LDL cholesterol levels. Plant sterols have received EFSA approval.
LIST OF CHOLESTEROL LOWERING CLINICAL TRIALS USING PLANT STEROLS
1. Hendriks, HFJ, Westrate, JA, van Vliet, T and Meijer, GW. Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolemic subjects. Eur J Clin Nutr. 1999;53:319-327.
2. Matvienko, OA et al. A single daily dose of soybean phytosterols in ground beef decreases serum total cholesterol and LDL cholesterol in young, mildly hypercholesterolemic men. Am J Clin Nutr 2002;76:57-64.
3. Neil, HAW, Meijer, GW and Roe, LS. Randomised controlled trial of use by
hypercholesterolaemic patients of a vegetable oil sterol-enriched fat spread.
Atherosclerosis. 2001;156:329-337.
4. Nestel, P, Cehun, M, Pomeroy, S, Abbey, M and Weldon, G. Original Communication. Cholesterol-lowering effects of plant sterol esters and non-esterified stanols in margarine, butter and low-fat foods. Eur J Clin Nutr 2001;55:1084-1090.
5. Sierksma, A, Weststrate, JA and Meijer, GW. Spreads enriched with plant sterols, either esterified 4,4-dimethylsterols or free 4-desmethylsterols, and plasma total- and LDL-cholesterol concentrations. British Journal Of Nutrition 1999;82:273-282.
6. Stalenhoef, AFH, Hectors, M and Demacker, PNM. Effect of plant sterol-enriched margarine on plasma lipids and sterols in subjects heterozygous for phytosterolaemia. J Internal Med. 2001;249:163-166.
7. Westrate, JA and Meijer, GW. Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr 1998;52:334-343.
8. Doornbos AM, Meynen EM, Duchateau GS, van der Knaap HC, Trautwein EA. Intake occasion affects the serum cholesterol lowering of a plant sterol-enriched single-dose yoghurt drink in mildly hypercholesterolaemic subjects. Eur J Clin Nutr. 2006;60(3):325-33.
9. Lea LJ, Hepburn PA. Safety evaluation of phytosterol-esters. Part 9: Results of a European post-launch monitoring programme. Food. Chem. Toxicol. 2006; 44 (8): 1213-22
10. Acuff RV, Cai DJ, Dong ZP, Bell D. The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects. Lipids Health Dis. 2007; 9;6:11
Early studies on phytosterols and phytosterol esters
1. Lees AM, Mok HY, Lees RS, McCluskey MA, Grundy SM. Plant sterols as cholesterol-lowering agents: clinical trials in patients with hypercholesterolemia and studies of sterol balance. Atherosclerosis. 1977 Nov;28(3):325-38.
2. Mattson FH, Volpenhein RA, Erickson BA. Effect of plant sterol esters on the absorption of dietary cholesterol. J Nutr. 1977 Jul;107(7):1139-46.
Phytosterol Review Articles
1. Berger A, Jones PJ, Abumweis SS. Plant sterols: factors affecting their efficacy and safety as functional food ingredients. Lipids Health Dis. 2004 Apr 7;3:5.
2. Kritchevsky D, Chen SC. Phytosterols – health benefits and potential concerns: a review. Nutr Res. 2005;25:413-428.
3. Ostlund RE Jr. Phytosterols in human nutrition. Annu Rev Nutr. 2002;22:533-49.
Maintenance of normal blood cholesterol concentrations
The Panel concludes that a cause and effect relationship has been established between the consumption of plant sterols and plant stanols and the reduction of blood cholesterol concentrations.
The Panel considers that in order to bear the claim, a food should provide at least 0.8 g per day of plant sterols/stanols in one or more servings. These amounts can be reasonably achieved in the context of a balanced diet. The target population is adults.
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