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Stanols and Sterols

Note:  All the margarines that I'm seen that contain stanol esters also contain hydrogenated oils, i.e., trans fatty acids, which defeats the whole purpose of eating it for health reasons.  The only margarine that I know that doesn't contain trans fatty acids is Smart Balance.

Specific Recommendations:

• Phytosterols products at iHerb

News & Research:

• Preventive effect of plant sterols in Alzheimer’s disease - Science Daily, 10/24/13 - "It's no secret that many of the phytochemicals in fruit and vegetables have a positive effect on our health. For instance, plant sterols (also known as phytosterols) help to lower cholesterol levels. According to a new study by researchers at Saarland University, they also appear to prevent the onset of Alzheimer's disease ... one sterol in particular, stigmasterol, actually inhibited protein formation ... Stigmasterol has an effect on a variety of molecular processes: it lowers enzyme activity, it inhibits the formation of proteins implicated in the development of Alzheimer's disease, and it alters the structure of the cell membrane ... Together, these effects synergistically reduce the production of beta-amyloid proteins" - See phytosterols products at iHerb.
• Stanols better than sterols for LDL-cholesterol reduction, suggests meta-analysis. - Nutra USA, 3/1/11
• Plant stanol-ester enriched foods diet can cut CVD risk, study - Nutra USA, 12/22/09
• Study extends understanding of phytosterol benefits - Nutra USA, 8/28/07
• Plant Sterol Pills Significantly Lower LDL Cholesterol - Science Daily, 3/13/06 - "The addition of plant sterols helped further lower total cholesterol and contributed to a nearly 10 percent reduction in low-density lipoprotein (LDL) cholesterol"
• Pistachios Pummel Cholesterol - WebMD, 12/9/05 - "Among commonly eaten nuts and seeds, pistachios and sunflower seeds had the highest phytosterol content"
• Plant Sterols May Help Lower Cholesterol - WebMD, 6/17/05 - "Plant sterols are already on the market in various products, including cholesterol-lowering margarines such as Take Control and Benecol ... LDL cholesterol fell by more than a quarter (27%) for diabetic people who received the sterol spread. For those without diabetes, LDL dropped 15%"
• The phytosterol phenomenon - Functional Foods and Nutraceuticals, 4/05
• Sterols: the key to heart health - Functional Foods and Nutraceuticals, 11/04 - "volunteers who drank one glass of sterol-fortified orange juice twice a day for eight weeks reduced their total cholesterol by 7.2 per cent, their LDL cholesterol by 12.4 per cent and their non-high-density lipoprotein levels 7.8 per cent"
• Plant sterols impact absorption of other nutrients - Nutra USA, 7/13/04 - "both of the milks enriched with plant sterols reduced cholesterol absorption by 60 per cent ... Both also reduced the bioavailability of beta-carotene by around 50 per cent and that of alpha-tocopherol by around 20 per cent but the reduction in beta-carotene bioavailability was significantly less with plant free sterols than with plant sterol esters"
• Breakfast Table Therapy: Plant Sterols in O.J. Reduce Cholesterol - Healthwell Exchange Daily News, 4/15/04 - "72 people with high LDL cholesterol were randomly assigned to either drink orange juice with phytosterols or plain orange juice for eight weeks ... total cholesterol levels dropped more than 7% and LDL cholesterol levels dropped more than 12%. In contrast, no changes were seen in those receiving the plain orange juice"
• Moving Beyond Margarine - Natural Foods Merchandiser, 11/03 - "plant-derived sterols are called phytosterols. The difference between sterols and stanols is that stanols are saturated ... Phytosterols, because of their molecular similarity to cholesterol, interfere with cholesterol absorption in the gut by competing for the intestinal spaces where cholesterol is transferred to the bloodstream ... When cholesterol is blocked in this way, it is excreted rather than absorbed, resulting in reduced serum cholesterol"
• Non-Esterified Stanol Diet Decreases Cholesterol Absorption Without Increasing Synthesis - Doctor's Guide, 6/13/02
• Vegetable Oil Helps Reduce Cholesterol - WebMD, 6/7/02
• Plant Sterol-Enriched Spread Reduces Cholesterol Levels In Belgian Population - Doctor's Guide, 5/16/02
• Super Foods: Able to Leap Broccoli in a Single Bound? - WebMD, 1/7/02
• Trans Fatty Acids Enough of a Risk for the FDA to Consider New Labeling Laws - WebMD, 3/8/01 - "Increasingly, scientific evidence is demonstrating that eating foods containing trans fatty acids contributes to increases in LDL or "bad" cholesterol and decreases in HDL or "good" cholesterol. They also may have other negative effects on heart health. This is a major concern in North America, where intake of trans fatty acids, which are found not only in margarines but also in many baked goods as well as processed and fast foods, is high and where heart disease is the leading cause of death . . . a 2% increase in trans fatty acid intake causes a 25% jump in the risk of heart disease . . . you are not doing yourself any favors by substituting trans fatty acids for saturated fats"
• Benecol Good With Cholesterol-lowering Drugs - Nutrition Science News, 10/00
• Spread the Word: Plant-Based Margarines Lower Cholesterol - WebMD, 9/12/00
• FDA: Plant Margarines Heart Healthy - Intelihealth, 9/6/00
• Study Shows Spread Reduces Cholesterol Levels in Patients Taking Statin Drugs - Medscape, 6/27/00
• Kids Lower Cholesterol With Help From a New Margarine - WebMD, 5/5/00
• Special Margarine Cuts Cholesterol Levels in Children With Genetic Risk of Early Heart Disease - Medscape, 2/10/00
• Anti-Cholesterol Spread Approved - Intelihealth, 5/3/99
• Cholesterol-lowering margarine expected in stores next year - CNN, 10/22/98

Abstracts:

• Phytosterols, red yeast rice, and lifestyle changes instead of statins: A randomized, double-blinded, placebo-controlled trial - Am Heart J. 2013 Jul;166(1):187-196.e2 - "lifestyle change (LC) ... red yeast rice (RYR) ... A total of 187 participants (mean low-density lipoprotein cholesterol [LDL-C], 154 mg/dL) took RYR 1800 mg twice daily and were randomized to phytosterol tablets 900 mg twice daily or placebo. Participants were also randomized to a 12-week LC program or usual care (UC) ... All participants took RYR and had significant decreases in LDL-C, total cholesterol, triglycerides, high-sensitivity C-reactive protein, and an increase in high-density lipoprotein cholesterol for 1 year when compared with baseline ... The addition of phytosterol tablets to RYR did not result in further lowering of LDL-C levels" - See red yeast rice at Amazon.com.
• Consumption of a plant sterol-based spread derived from rice bran oil is effective at reducing plasma lipid levels in mildly hypercholesterolaemic individuals - Br J Nutr. 2011 Feb 15:1-12
• Phytosterols supplementation decreases plasma small and dense LDL levels in metabolic syndrome patients on a westernized type diet - Nutr Metab Cardiovasc Dis. 2011 Feb 11 - "After 2 months supplementation with phytosterols, a significant reduction in total cholesterol, LDL-cholesterol, small and dense LDL (sdLDL) levels, as well as, apoB and triglycerides concentrations were observed in the intervention group (P < 0.05) compared to the control group. In addition, phytosterol supplementation lowered serum total cholesterol by 15.9%, LDL-cholesterol by 20.3% and triglyceride levels by 19.1% (P = 0.02, P < 0.001 and P < 0.001, respectively), although the patients kept their habitual westernized type diet. No differences were observed in HDL cholesterol, apoA1, glucose, C-reactive protein, fibrinogen levels and blood pressure"
• Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals - Atherosclerosis. 2008 Sep 27 - "The combination of n-3 PUFA and plant sterols reduced several inflammatory markers. High sensitivity C-reactive protein (hs-CRP) was reduced by 39% (P=0.009), tumor necrosis factor-alpha (TNF-alpha) by 10% (P=0.02), interleukin-6 (IL-6) by 10.7% (P=0.009), leukotriene B(4) (LTB(4)) by 29.5% (P=0.01) and adiponectin was increased by 29.5% (P=0.05). Overall cardiovascular risk was reduced by 22.6% (P=0.006) in the combination group. CONCLUSION: We have demonstrated, for the first time that dietary intervention with n-3 PUFA and plant sterols reduces systemic inflammation in hyperlipidemic individuals. Furthermore, our results suggest that reducing inflammation provides a potential mechanism by which the combination of n-3 PUFA and plant sterols are cardioprotective" - See Mega Twin EPA at Amazon.com and Jarrow Max DHA at Amazon.com.
• Comparison of the effects of dietary plant sterol and stanol esters on lipid metabolism - Nutr Metab Cardiovasc Dis. 2004 Jun;14(3):133-42 - "These findings suggest that absorption of dietary plant sterols suppressed bile acid synthesis, thereby diminishing their cholesterol-lowering efficacy. In contrast, plant stanols reduced plant sterol absorption and maintained their cholesterol-lowering efficacy"
• Plant sterol ester-enriched milk and yoghurt effectively reduce serum cholesterol in modestly hypercholesterolemic subjects - Eur J Nutr. 2004 Aug 17 - "PSteE-milk and PSteE-spread were equally efficacious in lowering total and LDL-cholesterol as compared to placebo by 6-8% and 8-10%, respectively. No significant additional cholesterol-lowering was observed with the combination of PSteE-milk and PSteE-spread (4 g plant sterols/d)"
• Plant stanol and sterol esters in prevention of cardiovascular diseases - Ann Med. 2004;36(2):126-34 - "A small dose of statin should be added to treatment in individuals resistant to monotherapy with plant stanol ester spread. A life-long consumption of plant stanol ester spread has been predicted to lower coronary events by about 20%" - Note:  Smart Balance Omega-Plus contains plant stanol esters and omega-3 from fish oil.
• Impact of margarine enriched with plant sterols on blood lipids, platelet function, and fibrinogen level in young men - Metabolism. 2003 Nov;52(11):1373-8 - "The subjects consuming margarine with sterols showed a significant (11%) decrease in LDL-C (P <.001) ... After the consumption of margarine with sterols, the adhesion and aggregation time of blood platelets was significantly prolonged after collagen-epinephrine activation. Margarine with sterols, through its antiplatelet activity and the significant reduction of LDL-C, can play a vital role in the nonpharmacologic prevention of circulatory diseases"
• Effects of phytosterol ester-enriched vegetable oil on plasma lipoproteins in healthy men - Asia Pac J Clin Nutr. 2003;12(3):282-91
• Safety of long-term consumption of plant sterol esters-enriched spread - Eur J Clin Nutr 2003 May;57(5):681-692 - "Consumption of a plant sterol esters-enriched spread is an effective way to consistently lower blood cholesterol concentrations and is safe to use over a long period of time"
• Non-nutritive bioactive constituents of plants: phytosterols - Int J Vitam Nutr Res 2003 Mar;73(2):127-34 - "Addition of plant sterols, or especially of their delta-5 saturated derivatives plant stanols into diet as fat-soluble esters inhibit cholesterol absorption and lower serum cholesterol similarly in short-term studies. Long-term consumption of plant stanol esters lowers serum cholesterol to the extent expected to reduce clinical manifestation of coronary heart disease by over 20% without detectable side effects, cholesterol lowering being especially effective in combination with cholesterol synthesis inhibitors statins"