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Stanols are substances that occur naturally in various plants. Their cholesterol-lowering effects were first observed in animals in the 1950s. Since then, a substantial amount of research suggests that plant stanols (usually modified into stanol esters) can help to lower cholesterol in individuals with normal or mildly to moderately elevated levels. Stanols are available in margarine spreads, salad dressings, and dietary supplement tablets.
Related substances called sterols or phytosterols (such as beta-sitosterol) and sterol esters appear to lower cholesterol in much the same manner as stanols. 1 ( Note: Use of beta-sitosterol for conditions other than high cholesterol is discussed in the beta-sitosterol article.)
Sterols are presumed safe because they are found in many foods. Stanols are also considered safe, but for a different reason: they are not absorbed. 3 No adverse effects have been reported in any of the studies on lowering cholesterol, with the exception of one study that reported mild gastrointestinal complaints in a few preschool children. 4 In addition, no toxic signs were observed in rats given stanol esters for 13 weeks at levels comparable to or exceeding those recommended for lowering cholesterol. 5 Although concerns have been expressed that stanol esters might impair absorption of the fat-soluble vitamins A , D , and E , this does not seem to occur at the dosages required to lower cholesterol. 6 Stanol esters might interfere...