• Assessment
    (2005) How might the consumption of carotenoid-rich fruits or vegetables alter plasma carotenoid levels when also consuming sterols?
    • Conclusion

      (2005)

      Preliminary research suggests that consuming one extra carotenoid rich fruit or vegetable per day has been shown to maintain plasma carotenoid levels when also consuming sterol-enriched spreads.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Intervention
    (2005) Can plant stanols further reduce LDL cholesterol and total cholesterol even for people receiving statin therapy?
    • Conclusion

      For patients receiving statin therapy, plant stanols further reduce LDL cholesterol and total cholesterol.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    (2005) Can statin dose be reduced through the use of stanols and sterols?
    • Conclusion

      Data regarding whether the dose of statins can be reduced by the use of stanols and sterols are needed.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    (2005) How are the effects of stanols and sterols on cholesterol levels altered when eaten as part of a cholesterol lowering diet?
    • Conclusion

      The total cholesterol and LDL cholesterol lowering effects of stanols and sterols are evident even when sterols and stanols are consumed as part of a cholesterol lowering diet.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    (2005) How do esterified and nonesterified forms of stanols and sterols compare in terms of their cholesterol lowering ability?
    • Conclusion

      Nonesterified and esterified forms of sterols and stanols are equally effective. Consumption of 2-3 g of nonesterified sterols and stanols reduce TC by 4-11% and LDL-C by 8-15% and esterified sterols and stanols reduce TC by 6-10% and LDL-C by 7-15%.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    (2005) What effect does the intake of plant sterols and stanols have on total cholesterol and LDL cholesterol?
    • Conclusion

      Plant sterols and stanols are potent hypocholesterolemic agents and a daily consumption of 2 - 3 g (through margarine, lowfat yogurt, orange juice, breads, and cereals) lowers TC concentrations in a dose dependent manner by 4 – 11% and LDL cholesterol concentrations by 7 – 15% without changing HDL cholesterol or triacylglycerol concentrations.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    (2006) How do sterols and stanols compare in terms of their efficacy in lowering cholesterol?
    • Conclusion

      The cholesterol loweing effects are similarly caused by sterols and stanols. Sterols lowered TC by 6-11% and LDL-C by 7-15%. Stanols lowered TC by 4-10% and LDL-C by 7-14%. Although the reduction in TC and LDL-C are similar, two high-quality randomized controlled trials in hypercholesterolemic adults report slightly greater though non-significant effects with consumption of stanols compared to sterols.

       

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
  • Monitoring and Evaluation
    (2005) Are there any unintended adverse effects when consuming stanols and sterols?
    • Conclusion

      It is unclear whether there are unintended adverse effects when consuming stanols and sterols. Some studies have observed no significant differences in plasma carotenoid concentrations, including alpha-carotene and lycopene and vitamins A, D and E, but other studies have found that alpha-tocopherol, alpha- and beta-carotene plasma concentrations decrease after consumption of sterols and stanols, even after adjusting for changes in plasma lipid levels.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    (2005) What does the research indicate about the safety of stanol and sterol intake?
    • Conclusion

       

      At an intake of 2 - 3 g of plant sterols and stanols per day generally appears to be safe.

       

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.