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Safety Issues
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. 1 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. 2 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. 3 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. 4 Stanol esters might interfere with absorption of alpha- and beta-carotene , 5 although some studies have found no such effect. 6 Evidence is also conflicting whether sterols or sterol esters impair nutrient absorption. 7 Until more is learned, it may be reasonable for people using stanol or sterol products to take a multivitamin/multimineral tablet .
References
- Blair SN, Capuzzi DM, Gottlieb SO, Nguyen T, Morgan JM, Cater NB. Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester-containing spread to statin therapy. Am J Cardiol. 86(1):46-52.
- Williams CL, Bollella MC, Strobino BA, Boccia L, Campanaro L. Plant stanol ester and bran fiber in childhood: effects on lipids, stool weight and stool frequency in preschool children. J Am Coll Nutr. 18(6):572-81.
- Turnbull D, Whittaker MH, Frankos VH, Jonker D. 13-week oral toxicity study with stanol esters in rats. Regul Toxicol Pharmacol. 29(2 Pt 1):216-26.
- Nguyen TT, Dale LV, von Bergmann K, et al. Cholesterol-lowering effect of stanol ester in a US population of mildly hypercholesterolemic men and women: a randomized controlled trial. Mayo Clin Proc. 1999;74:1198-2206.
- Gylling H, Miettinen TA. Cholesterol reduction by different plant stanol mixtures and with variable fat intake. Metabolism. 48(5):575-80.
- Hallikainen MA, Sarkkinen ES, Uusitupa MI. Effects of low-fat stanol ester enriched margarines on concentrations of serum carotenoids in subjects with elevated serum cholesterol concentrations. Eur J Clin Nutr. 53(12):966-9.
- Richelle M, Enslen M, Hager C, Groux M, Tavazzi I, Godin JP, Berger A, Métairon S, Quaile S, Piguet-Welsch C, Sagalowicz L, Green H, Fay LB. Both free and esterified plant sterols reduce cholesterol absorption and the bioavailability of beta-carotene and alpha-tocopherol in normocholesterolemic humans. Am J Clin Nutr. 80(1):171-7.
I have used Shaklee Cholesterol reduction complex and experienced severe diahrea. I do not recomend the product.