Phytosterols (beta-sitosterol complex)

Tier 2 — promising · Cholesterol · Heart

Plant sterols and stanols structurally mimic cholesterol and compete for intestinal absorption sites, reliably lowering LDL-C by 8–10% at 1.5–2 g/day and up to 12–18% at higher doses. The 2013 Ras meta-analysis (41 studies, N=2,084, PMID 24075766) confirmed average LDL-C reduction of 8.5% at a mean dose of 1.6 g/day. Both EFSA and FDA authorise health claims at 1.5–3 g/day. Effect is dose-dependent with potential for further reduction at 4–9 g/day, but routine use above 3 g/day is not generally recommended. Phytosterols mildly reduce absorption of fat-soluble vitamins (A, D, E, K,…

Dose: 1.5–3 g/day phytosterols or stanols, split across 2–3 main meals that contain fat; no additional benefit demonstrated above 3 g/day at standard dosing