Sitosterol, a constituent of Benecol and Flora proactive, is associated with an increased occurrence of major coronary events

This study was published in Nutrition, Metabolism and Cardiovascular Diseases 2006 Jan;16(1):13-21

Study title and authors:
Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study.

Assmann G, Cullen P, Erbey J, Ramey DR, Kannenberg F, Schulte H.
Leibniz-Institut für Arterioskleroseforschung an der Universität Münster, Domagkstrasse 3, 48149 Münster, Germany. assmann@uni-muenster.de

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16399487

Phytosterols such as sitosterol are inserted in high quantities (at 841 times than the average vegetable) in plant sterol based margarines such as Benecol and Flora proactive.

This study was conducted to evaluate if sitosterol levels seen in the general population are associated with the occurrence of coronary events. The ten year study included 159 men who suffered a heart attack or sudden coronary death (major coronary event), who were compared with 318 control subjects.

The study found:
(a) Men with the highest sitosterol levels had a 1.8-fold increase in the risk of a major coronary event compared to men with lower levels.
(b) Among men with a high risk of a major coronary event, high sitosterol concentrations were associated with an additional 3-fold increase in the incidence of coronary events.
(c) Men with a high sitosterol/cholesterol ratio had a 3-fold increase in the incidence of coronary events.

Assmann concluded: "Elevations in sitosterol concentrations and the sitosterol/cholesterol ratio appear to be associated with an increased occurrence of major coronary events in men at high global risk of coronary heart disease".