Information for Healthcare professionals. Naturally occurring plant stanols are clinically proven to lower blood cholesterol. The presentation explains their mechanism of action and shows how plant stanol ester works.

1. Reducing cholesterol
with plant stanol ester
CONFIDENTIAL – Copyright® Raisio1

2. Cholesterol lowering mechanism of action of Plant
stanol ester: Plant stanols reduce the absorption of
cholesterol
Plant stanols are structural components of plant cells, naturally present in foods in small amounts, and added to
cholesterol-lowering functional foods (Benecol®)
Plant stanol ester lowers blood cholesterol by partly inhibiting the absorption of cholesterol in the small intestine
Plant stanols can then interfere with the solubilisation of cholesterol, i.e. the incorporation of cholesterol into
mixed micelles, a necessary part of cholesterol uptake1
The less cholesterol is solubilised into mixed micelles, the more cholesterol is excreted from the body
Plant stanols may also directly activate certain transport proteins in the enterocytes that affect cholesterol
absorption, but these mechanisms are currently poorly understood2
1. Gylling H, Plat J, Turley S, Ginsberg HN, Ellegård L, Jessup W, Jones PJ, Lütjohann D, Maerz W, Masana L, Silbernagel G, Staels B, Borén J, Catapano AL, De Backer G,
Deanfield J, Descamps OS, Kovanen PT, Riccardi G, Tokgözoglu L, Chapman MJ, for the European Atherosclerosis Society Consensus Panel on Phytosterols. Plant sterols and
plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease. Atherosclerosis 2014; 232: 346-360.
2. De Smet E, Mensink RP, Plat J. Effects of plant sterols and stanols on intestinal cholesterol metabolism: suggested mechanisms from past to present. Mol Nutr Food Res
2012; 56: 1058-1072.
2

3. Plant stanols interfere with the solubilisation of cholesterol, i.e. the incorporation of cholesterol into mixed
micelles in the small intestine
Plant stanol ester replaces cholesterol in mixed micelles, which leads to reduced cholesterol absorption and
lowers blood cholesterol concentration
As less cholesterol is solubilised into mixed micelles more cholesterol is excreted from the body 3

4. Less cholesterol is absorbed
Cholesterol absorption efficiency is reduced by about
50% with 2 g/d plant stanols1,2
• both dietary cholesterol (the cholesterol coming to
the digestive tract via food)
• and biliary cholesterol (the cholesterol coming to
the digestive tract via bile)
Consuming plant stanols with a meal ensures optimal
reduction of cholesterol absorption, because bile is
excreted into the digestive tract following a meal
1. Gylling H, Radhakrishnan R, Miettinen TA. Reduction of serum cholesterol in
postmenopausal women with previous myocardial infarction and cholesterol
malabsorption induced by dietary sitostanol ester margarine: women and dietary
sitostanol. Circulation 1997; 96: 4226-4231.
2. Gylling H, Miettinen TA. Effects of inhibiting cholesterol absorption and synthesis on
cholesterol and lipoprotein metabolism in hypercholesterolemic non-insulin-dependent
diabetic men. J Lipid Res 1996; 37: 1776-1785.
0
100
200
300
400
500
600
Normal diet Normal diet + plant stanol ester
Cholesterol absorbtion with normal diet vs.
normal diet with 2 g of plant stanols as plant
stanol ester
Dietary cholesterol Biliary cholesterol
Adapted from Gylling et al. 1997.