European Journal of Nutrition

, Volume 49, Issue 2, pp 111–117

Very high plant stanol intake and serum plant stanols and non-cholesterol sterols


    • Department of Clinical NutritionUniversity of Kuopio
    • Department of MedicineKuopio University Hospital
  • Maarit Hallikainen
    • Department of Clinical NutritionUniversity of Kuopio
  • Markku J. Nissinen
    • Division of Gastroenterology, Department of MedicineUniversity of Helsinki
  • Piia Simonen
    • Division of Internal Medicine, Department of MedicineUniversity of Helsinki
  • Tatu A. Miettinen
    • Division of Internal Medicine, Department of MedicineUniversity of Helsinki
Original Contribution

DOI: 10.1007/s00394-009-0055-5

Cite this article as:
Gylling, H., Hallikainen, M., Nissinen, M.J. et al. Eur J Nutr (2010) 49: 111. doi:10.1007/s00394-009-0055-5



Today, consumers meet abundant supply of functional foods with plant stanol increments for serum cholesterol lowering purposes. However, efficacy and safety of plant stanols intake beyond 4 g/day have remained unexplored.

Aim of the study

We evaluated the effects of very high daily intake of plant stanols (8.8 g/day) as esters on cholesterol metabolism, and serum levels of plant sterols and stanols.


In a randomized, double-blind, parallel study of 49 hypercholesterolemic subjects (mean age 62 years, range 41–73) consumed a test diet without (control, n = 24), and with added plant stanol esters (staest, n = 25) over 10 weeks followed by 4 weeks on home diet. Serum lipids, lipoprotein lipids, and non-cholesterol sterols were determined at baseline, during intervention, and 4 weeks afterwards. Cholesterol precursor sterol lathosterol reflected cholesterol synthesis, and serum plant sterols and cholestanol mirrored cholesterol absorption.


When compared with controls, 8.8 g/day of plant stanols reduced serum and LDL cholesterol by 12 and 17% (P < 0.01 for both). Synthesis marker lathosterol was increased by 30%, while absorption markers decreased up to 62% when compared with controls (P < 0.001 for both). Serum plant stanols increased slightly, but significantly compared with controls (serum sitostanol during intervention, controls: 16 ± 1 μg/dL, staest: 37 ± 2 μg/dL, serum campestanol during intervention, controls: 0.5 ± 0 μg/dL, staest: 9 ± 1 μg/dL, P < 0.001 for both). Changes in serum cholesterol, non-cholesterol sterols, and plant stanols were normalized during post-treatment weeks.


Serum plant stanol levels remained at comparable low levels as in studies with daily intake of 2–3 g, and were normalized in 4 weeks suggesting that daily intake of 8.8 g of plant stanols might not increase systemic availability of plant stanols, but reduces effectively serum cholesterol and plant sterol levels.


Plant stanol esterSitostanolCampestanolSitosterolCholesterol

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© Springer-Verlag 2009