Plant stanol ester in the
treatment and prevention
guidelines
0
Expert bodies recommend the use
of plant stanols
International Atherosclerosis Society, 2013
American Diabetes Association, 2013
European Atherosclerosis Society, 2013
European Society of Cardiology, 2012
National Heart, Lung, and Blood Institute & National Institutes of Health & American Academy of
Pediatrics, 2011
European Society of Cardiology & European Atherosclerosis Society, 2011
The Australian Heart Foundation, 2009
American Academy of Pediatrics, 2008
American Diabetes Association & American College of Cardiology, 2008
American Heart Association & American College of Cardiology, 2006
Joint British Societies, 2005
International Atherosclerosis Society, 2005
Joint WHO/FAO Expert Consultation, 2003
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ESC/EAS Guidelines for the management
of dyslipidemias, 2011
• The magnitude of the effect of functional foods enriched with
phytosterols is graded highest possible and the level of evidence is of
class ’A’
• ’Based on the available evidence, foods enriched with phytosterols (1-2
g/day) may be considered for individuals with elevated TC and LDL-C
values in whom the total CV risk assessment does not justify the use of
cholesterol-lowering drugs.’
• ’Functional food containing phytosterols additionally reduce LDL-C levels
by up to 5-10% in patients taking stable dose of a statin, and this
combination is also well tolerated and safe.’
The Task Force for the management of dyslipidemias of the European Society of cardiology (ESC) and the European
Atherosclerosis Society (EAS). ESC/EAS Guidelines for the management of dyslipidemias. Atherosclerosis 2011; 217S1: S1-S44.
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European Guidelines on cardiovascular
disease prevention in clinical practice
(version 2012)
• Functional foods containing phytosterols (plant sterols and stanols) are
effective in lowering LDL cholesterol levels by on average 10%, when
consumed in amounts of 2 g/day.
• The cholesterol-lowering effect is additional to that obtained with a lowfat diet or use of statins.
• Some recent research indicates that, especially for stanols, further
cholesterol reduction can be obtained with higher doses.
The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease
Prevention in Clinical Practice. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012).
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IAS Position Paper: Global
Recommendations for the
Management of Dyslipidemia, 2013
• ‘Consider using plant sterols/stanols (2 g/day) as a dietary adjunct [--] to
further lower LDL-C levels.’
• ‘if plant sterols/stanols are available, they are a useful adjunct to
lowering of LDL-C by dietary means.‘
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US NHLBI Expert Panel Guidelines for
Cardiovascular Health and Risk Reduction in
Children and Adolescents, 2011
• Plant stanol ester can safely enhance LDL-C lowering effects in children
with FH
• Especially children with primary elevations of LDL-C who do not achieve
LDL-C goals with dietary treatment alone may benefit from plant stanol
ester. Such an approach may lower LDL-C sufficiently to avoid the
necessity of drug treatment.
• Plant stanols (up to 2 g/d) can be used after age 2 years in children with
familial hypercholesterolemia.
• Short-term studies show no harmful effects in healthy children.
National Heart, Lung, and Blood Institute & National Institutes of Health & American Academy of Pediatrics, 2011.
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Nutrition Recommendations and
Interventions for Diabetes
• Plant stanols and sterol are considered as an additional
therapeutic option for LDL cholesterol lowering
complementing the standard recommendations of limiting
saturated and trans fats and dietary cholesterol and
increasing soluble fiber consumption.
• ’in individuals with type 2 diabetes, intake of 2 g/day plant
sterols and stanols has been shown to lower plasma total
and LDL cholesterol’
American Diabetes Association, 2008
American Diabetes Association & American College of Cardiology, 2008
American Diabetes Association, 2013
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