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Sitostanol

What other names is Sitostanol known by?

24-alpha-ethylcholestanol, Beta-sitostanol, Bêta-sitostanol, Dihydro-beta-sitosterol, Ester de Stanol Végétal, Fucostanol, Phytostanol, Plant Stanol, Plant Stanol Esters, Stanol Végétal, Stigmastanol.

What is Sitostanol?

Sitostanol is a plant product. It is made from vegetable oils or the oil from pine tree wood pulp, and is then combined with canola oil. Sitostanol is used for prevention of heart disease and treatment of high cholesterol.

Sitostanol is an ingredient in Benecol margarine and some salad dressings. The U.S. Food and Drug Administration (FDA) allows manufacturers of products that contain sitostanol or related plant chemicals (stanol esters) to claim that the product lowers the risk of getting coronary heart disease (CHD). The FDA reasons that sitostanol and other plant stanol esters along with a diet low in saturated fat and cholesterol might reduce the risk of CHD by lowering blood cholesterol levels. Although there is plenty of evidence that sitostanol does lower cholesterol levels, so far there is no proof that long-term use actually lowers the risk of developing CHD.

Do not confuse sitostanol with beta-sitosterol, an unsaturated plant sterol in the cholesterol-lowering margarine Take Control. Both sitostanol and beta-sitosterol are used to lower cholesterol levels in people with high cholesterol and appear to be equally effective.

Likely Effective for...

  • Reducing cholesterol levels. Sitostanol is effective for reducing cholesterol levels in adults with high cholesterol. It doesn't have to be taken with meals to work. Cholesterol levels decrease within 2 to 3 weeks of starting sitostanol, and return to pretreament levels within 2 to 3 weeks of discontinuation. Sitostanol may not have the same effect in all people. About 12% of patients do not respond to sitostanol.

    People usually take sitostanol as part of a sitostanol-enriched food such as margarine. Sitostanol alone can reduce total and "bad" low-density lipoprotein (LDL) cholesterol levels by 6% to 20%. Most research shows that a dose of about 2-3 grams per day lowers cholesterol the most. Higher doses do not seem to work any better. When added to a cholesterol-lowering prescription medication, sitostanol reduces total cholesterol by an additional 3% to 11% and LDL cholesterol by another 7% to 16%.

    Sitostanol also seems to be effective for reducing cholesterol levels in healthy children. However, treating children is not recommended unless "bad" low-density lipoprotein (LDL) cholesterol levels are greater than 190 mg/dL or greater than 160 mg/dL if the child also has other risk factors for heart disease.

Possibly Effective for...

  • Reducing cholesterol levels in people with an inherited tendency toward high cholesterol (familial hypercholesterolemia). Sitostanol is possibly effective for reducing cholesterol levels in children and adults with high cholesterol levels due to familial hypercholesterolemia. Taking sitostanol seems to reduce total cholesterol by 11% to 14% and "bad" low-density lipoprotein (LDL) cholesterol levels by 15% to 33% in children and adults already being treated with cholesterol-lowering drugs called statins. Sitostanol doesn't increase levels of "good" high-density lipoprotein (HDL) cholesterol or reduce levels of blood fats called triglycerides.

SLIDESHOW

Lower Your Cholesterol, Save Your Heart See Slideshow

Insufficient Evidence to Rate Effectiveness for...

  • Heart disease.

How does Sitostanol work?

Sitostanol blocks both the cholesterol from food and the cholesterol made by the liver from entering the body.

Are there safety concerns?

Sitostanol is LIKELY SAFE for most people when taken by mouth. Adults can safely use sitostanol for up to 1 year, and children can safely use it for up to 3 months. Sitostanol might cause stomach upset or too much fat in the stool (steatorrhea).

There is some concern that sitostanol might decrease absorption of some nutrients since it decreases fat absorption. Sitostanol does seem to reduce the absorption of dietary beta-carotene, but this reduction may not be important to health.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about the use of sitostanol during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Dosing considerations for Sitostanol.

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

  • For high cholesterol: 200 mg to 9 grams of sitostanol-rich plant stanols have been used daily. Doses above 2-3 grams per day may be only slightly more effective. Single daily doses seem to be as effective as divided doses administered twice or three times daily.
  • For reducing cholesterol levels in adults with an inherited tendency toward high cholesterol (familial hypercholesterolemia): About 2 grams of sitostanol has been taken daily for up to 3 months.
CHILDREN

BY MOUTH:

  • For high cholesterol: 1.5 grams of sitostanol has been used daily in children up to age 6 years of age.
  • For reducing cholesterol levels in children with an inherited tendency toward high cholesterol (familial hypercholesterolemia): 1.5-6.0 grams of sitostanol per day have been used in children aged 2-15 years.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Reviewed on 9/17/2019
References

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Miettinen TA, Puska P, Gylling H, et al. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med 1995;333(20):1308-12. View abstract.

Musa-Veloso K, Poon TH, Elliot JA, Chung C. A comparison of the LDL-cholesterol lowering efficacy of plant stanols and plant sterols over a continuous dose range: results of a meta-analysis of randomized, placebo-controlled trials. Prostaglandins Leukot Essent Fatty Acids. 2011 Jul;85(1):9-28. View abstract.

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Vásquez-Trespalacios EM, Romero-Palacio J. Efficacy of yogurt drink with added plant stanol esters (Benecol®, Colanta) in reducing total and LDL cholesterol in subjects with moderate hypercholesterolemia: a randomized placebo-controlled crossover trial NCT01461798. Lipids Health Dis. 2014 Aug 6;13:125. View abstract.

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