Phytosterols for Cholesterol
Verdict: Counter-Evidence
Across 5 PubMed studies, the evidence for Phytosterols in Cholesterol grades Tier D — counter-evidence. High-quality evidence indicates it is not effective (or is harmful) for this use.
D 🔴 D Counter-Evidence Counter-Evidence
Why this grade7-layer evidence engine
⚖️
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.74
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
D · Counter-Evidence
Confidence
69%
Broadly consistent
Evidence level
E2
Multiple high-quality MAs (≥2 independent, consistent)
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.743
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (3 篇 > 1 negative)
- tier_strict_requirement_check — | A→B 因 L4 有 ≥1 against
- detect_disputes — 偵測到 1 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (5)L2 · primary research & systematic reviews
Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake
Finding: Pooled meta-analysis of 84 RCTs (141 trial arms) found phytosterol intake at a mean 2.15 g/day reduced LDL-cholesterol by 0.34 mmol/L (95% CI -0.36 to -0.31), an 8.8% relative reduction (95% CI -9.4 to -8.3); the effect was dose-dependent and larger in subjects with elevated baseline cholesterol, with no significant difference between sterols and stanols.
View on PubMed Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials
Finding: Meta-analysis of 59 RCTs (1992-2006, >4500 participants) found plant sterol/stanol products lowered LDL-cholesterol by 0.31 mmol/L (95% CI -0.35 to -0.27, P<0.0001) versus placebo; the effect was dose-dependent (-0.25 mmol/L at <1.5 g/day rising to -0.42 mmol/L at >2.5 g/day) and greater in those with high baseline LDL.
View on PubMed LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of RCTs
Finding: Meta-analysis of 124 RCTs (201 strata) found plant sterol/stanol intakes of 0.6-3.3 g/day gradually reduced LDL-cholesterol by 6-12%, with the effect continuing to increase up to ~3 g/day to an average 12%; sterols and stanols showed clear and comparable dose-response curves.
View on PubMed Use of phytosterol-fortified foods to improve LDL cholesterol levels: a systematic review and meta-analysis
Finding: Systematic review and meta-analysis of 125 included studies (from 223 screened) found phytosterol-fortified foods lowered LDL-cholesterol by an average 0.55 mmol/L, with the reduction significantly maintained across all subgroups and a greater effect at higher daily phytosterol dosages.
View on PubMed Plant sterols and cardiovascular disease: a systematic review and meta-analysis
Finding: Meta-analysis of 17 observational studies (11,182 participants) found no significant association between serum concentrations of sitosterol or campesterol and cardiovascular disease risk; the authors caution that observational evidence is limited and the long-term safety of plant-sterol-enriched foods was not addressed.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4a US FDA
Supportive
Foods containing at least 0.65 g per serving of plant sterol esters, eaten twice a day with meals for a daily total intake of at least 1.3 g, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. source↗
L4b EU EFSA
Supportive
L4c UK NHS
Against
Do not advise any of the following to take plant stanols or sterols to prevent CVD: people being treated for primary prevention; people being treated for secondary prevention; people with CKD; people with type 1 diabetes; people with type 2 diabetes. [2014] source↗
L4d TW TFDA / 衛福部
Supportive
市售有兩款添加植醇的植物油（透過衛福部審核通過之健康食品資料庫）。每日攝取2到3克的植物固醇，對於降低血中的總膽固醇與低密度脂蛋白膽固醇（壞的膽固醇）都有顯著的幫助。 source↗
L4e WHO
Neutral
JECFA established a group acceptable daily intake (ADI) of 0-40 mg/kg body weight for phytosterols, phytostanols and their esters, expressed as the sum of phytosterols and phytostanols in their free form, based on an overall NOAEL of 4200 mg/kg bw per day to which a safety factor of 100 was applied. source↗
L5a NIH Office of Dietary Supplements
Cautious
L5b Mayo Clinic
Supportive
Margarines and orange juice with added plant sterols can help lower LDL cholesterol. Adding 2 grams of sterol to your diet every day can lower your LDL cholesterol by 5% to 15%. It's not clear whether food with plant sterols or stanols lowers your risk of heart attack or stroke - although experts assume that foods that lower cholesterol do cut the risk. Plant sterols or stanols don't appear to … source↗
L5c Cleveland Clinic
Supportive
L5d Harvard Health
Neutral
L5e Specialty Society (condition-mapped)
Supportive