Herbs & Supplements

Should I take it?

Although plants do not contain cholesterol, they produce plant sterols, which have a structure very similar to cholesterol. Stanol is a plant sterol that is found in some tree oils (such as pine) and in some vegetable oils (such as canola and soy). Because stanol is not absorbed in the same way that cholesterol is, stanol interferes with the body's use of cholesterol--whether the cholesterol is produced by the body or eaten in foods. When a modified form of stanol is taken by mouth, it blocks some of the spaces that cholesterol usually occupies in cells. Stanol may also affect the breakdown of cholesterol in the intestines. As a result of both effects, more cholesterol leaves the body and less is available to be absorbed.

Dosage and Administration

Originally included only in butter substitutes, stanol is now used in many dairy products (cheese, milk, and yogurt) and in other foods such as salad dressings and snack bars. Although stanol-based foods have been available in Finland and other Scandinavian countries for over 10 years, they were introduced in the U.S. more recently. Foods that may provide exceptional health benefits are often called "functional foods" or "nutraceuticals". Capsules and tablets containing stanol are also available.

In clinical studies, participants with high cholesterol--including children younger than 2 years of age--took stanol doses ranging from 800 mg (0.8 gram) to 4000 mg (4 grams) daily. The results from the higher doses, however, were no better than doses of about 2000 mg (2 grams) per day for adults or about 1500 mg (1.5 grams) per day for children. No significant benefits were seen for children with normal cholesterol levels.

The time of day that doses were taken and the number of doses per day did not seem to have any significant bearing on the effectiveness of stanol. In studies, individuals who took one large dose per day were equally as likely to show beneficial changes in cholesterol levels as those who took smaller amounts of stanol two times or three times a day. About 12% of study participants did not show a response to stanol, but the average reduction in cholesterol from stanol alone was 10% to 15%. By comparison, diet changes typically lower cholesterol levels by about 10% and statin-type drugs generally lower LDL cholesterol by 20% to 45%.

Stanol takes 2 weeks to 3 weeks of daily use to reach its peak effectiveness. Clinical trials lasted one year with adults and 3 months with children, but the use of stanol products has been tracked for as long as 5 years in some individuals.

Summary

Stanol is used to lower "bad" total and LDL cholesterol levels and to prevent heart disease.

Risks

Pregnant women and women who are breastfeeding should avoid using high amounts of stanol because little is known about stanol's effects on developing babies or nursing infants. Children should not use stanol for longer than 3 months unless a doctor supervises such use.

Side Effects

Diarrhea may be caused by stanol.

Interactions

No negative interactions have been attributed to the use of stanol. It may, however, increase the effectiveness of a low-cholesterol diet and cholesterol-lowering medications.

Last Revised August 1, 2008