Historical and scientific basis for the development of plant stanol ester foods as cholesterol-lowering agents

Introduction of plant stanol ester foods in the 1990s is the culmination of nearly 50 years of scientific investigation. Early research investigated the efficacy of large amounts of plant sterols. Focus shifted to evaluating smaller quantities when they were shown to have an effectiveness similar to larger amounts. Studies then found that consumption of plant stanols resulted in even greater cholesterol-lowering than consumption of plant sterols because of their greater ability to reduce intestinal cholesterol absorption. Further-more, it was shown that whereas plant stanols were virtually unabsorbed, plant sterols were absorbed to a greater degree. Therefore, the focus of research shifted from plant sterols to plant stanols because of the greater efficacy and safety of the latter. Because dietary fat appeared to be the most effective vehicle for delivery of plant stanols to the small intestine, a process was developed such that plant stanols could be esterified and solubilized in fat-based foods. Numerous studies have found that foods containing plant stanol esters, providing 2-3g . day(-1) of plant stanols, lower serum low-density lipoprotein (LDL) cholesterol levels significantly by about 14% compared with foods without plant stanols. When incorporated into diets low in saturated fat and cholesterol, mean reductions in LDL cholesterol of up to 24% have been achieved, a level comparable with that produced with low doses of cholesterol-lowering drugs. Thus, plant stanol ester foods are clinically proven, highly effective new dietary tools for managing blood cholesterol levels.