Summary points

Plant sterols and stanols reduce the absorption of cholesterol from the gut and so lower serum concentrations of cholesterol

Plant sterols or stanols that have been esterified to increase their lipid solubilitycan be incorporated into foods

The 2 g of plant sterol or stanol added to an average daily portion of margarine reduces serum concentrations of low density lipoprotein cholesterol by an average of 0.54 mmol/l in people aged 50-59, 0.43 mmol/l in those aged 40-49, and 0.33 mmol/l in those aged 30-39

A reduction in the risk of heart disease of about 25% would be expected for this reduction in low density lipoprotein cholesterol; this is larger than the effect that could be expected to be achieved by people reducing their intake of saturated fat

The added costs of £70 per person per year will limit consumption; however, if stanols and sterols become cheaper, their introduction into the food chain will make them an important innovation in the primary prevention of heart disease