Intended for healthcare professionals


Cholesterol lowering margarine is effective

BMJ 1999; 319 doi: (Published 30 October 1999) Cite this as: BMJ 1999;319:1200
  1. Gilbert R Thompson, emeritus professor of clinical lipidology (gthompso{at}
  1. Metabolic Medicine, Division of Investigative Science, Imperial College School of Medicine, Hammersmith Hospital, London W12 0NN
  2. a GRT is a part time medical consultant to McNeil Consumer Nutritionals, distributors of Benecol products in Europe

    EDITOR—Van Heyningen suggests that a margarine containing plant stanol ester (Benecol) may not lower low density lipoprotein cholesterol concentration in people with a fat modified diet.1 He presents no evidence of his own for this assertion but cites a study by Denke in which participants were given plant stanol in gelatin capsules.2

    However, he fails to cite a more recent study in which plant stanol esters were dissolved in margarine and fed to participants eating a diet which provided only 26% of energy as fat and about 150 mg of cholesterol daily.3 Reductions in low density lipoprotein cholesterol concentration in the two test groups were 8.6% and 13.7% respectively compared with controls. In another recent study of subjects on a prudent diet, plant stanol dissolved in margarine lowered low density lipoprotein cholesterol by 15.5% more than did margarine without plant stanol.4

    As pointed out by Jones et al,4 Denke's negative results probably reflect the fact that she administered plant stanol in capsules, which presumably impaired its ability to inhibit cholesterol absorption in the small intestine, rather than the effect of a fat modified diet. Such a diet has been shown to accentuate the extent to which low density lipoprotein cholesterol concentration is lowered by Benecol.5


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