Margarine: sterol spreads lower LDL, old trials leave questions

The one firm number about margarine comes from an additive. Across 125 controlled studies of foods fortified with plant sterols or stanols, LDL cholesterol fell by 21 mg/dL (0.55 mmol/L) on average, and spreads such as margarine lowered it more than bread, biscuits or cereals carrying the same compounds. The effect depends on the sterol dose, and that paper reports its confidence interval in a form we could not use, so only the average is given here. In a 3 week crossover trial on 63 adults with LDL above 130 mg/dL, 20 g a day of sterol margarine, holding 1.82 g of sterols, cut LDL by 5.4% against a plain margarine. These sterol spreads carry a label limit in the EU: more than 3 g of added sterols or stanols a day should be avoided, and the spread may not suit pregnant or breastfeeding women or children under 5. Plain polyunsaturated margarine has a less clear record. A meta-analysis of five randomized trials with 10,808 people swapped saturated fat for corn oil and corn oil margarine, and it found no evidence of benefit on coronary death (1.13, 95% CI 0.83 to 1.54) or death from any cause. Those trials ran in the 1960s and 70s, and the margarines in the control diets contained trans fats, so they are old trials of old products.

The numbers, per 3.5 oz (100 g)

As people eat it, per 3.5 oz (100 g)

How much is actually in it

• No sampled composition range exists for margarine: USDA Foundation Foods holds no margarine record, and the UK table lists only a hard baking block, not a spread. — USDA Foundation Foods (395 foods) and UK CoFID 2021, searched for margarine (n = 0 records) Evidence E source
  No sampling range and no second independent value for margarine spreads

What a real portion looks like

• US dietary survey coding counts a tablespoon of margarine as 14 g and a pat, or the amount on one slice of bread, as 7 g. — US food coding portion measures for margarine (n = 8 measures) Evidence E source
  1 tablespoon 14 g; 1 pat 7 g; per slice of bread 7 g; large sandwich 28 g

What your body absorbs

• A meta-analysis of 41 RCTs with 3306 people eating about 2.5 g a day of plant sterols or stanols found blood beta-carotene 16.3% lower and lycopene 12.3% lower, while retinol and vitamin D did not change and levels stayed within normal ranges. — 41 randomized controlled trials involving 3306 subjects, average plant sterol or stanol intake 2.5 g/d (n = 3306) Evidence A source
  Beta-carotene -16.3% (95% CI -18.3 to -14.3), cholesterol-standardized -10.1%; alpha-carotene -14.4%; lycopene -12.3%; retinol and vitamin D not affected; levels stayed within normal ranges
• In a supervised feeding RCT on 19 adults, 1.8 g a day of plant sterols in margarine cut cholesterol absorption by 36 to 39%, but LDL fell by 6% only when the dose was split over three meals. — 19 adults, supervised feeding, three 6-day crossover phases (n = 19) Evidence B source
  Cholesterol absorption efficiency -36% (three doses) and -39% (one breakfast dose); LDL -8.1 mg/dL (-0.21 mmol/L) (6%) only with three doses a day
• In a crossover RCT on 10 men, margarine with free sitostanol cut cholesterol absorption from 41.6% to 10.2%, a stronger effect than the ester forms at 17.0% and 20.5%. — 10 normolipemic healthy male volunteers, one-week treatment periods (n = 10) Evidence B source
  Cholesterol absorption 41.6% placebo vs 10.2% sitostanol, 17.0% sitostanol acetate, 20.5% sitostanol oleate

What cooking and storage change

• A scoping review of 233 studies found that interesterification is the most cited way to harden oils without trans fats, and margarines and spreads are the main foods using such substitutes. — 233 studies on industrial trans fat substitutes in packaged foods (n = 233 studies) Evidence C source
  Interesterification cited in 46% of studies; palm stearin the most frequent raw material

What it does to your health

• In a crossover RCT on 63 adults with raised LDL, 20 g a day of phytosterol margarine (1.82 g sterols) lowered LDL cholesterol by 5.4% within 3 weeks compared with ordinary margarine. — 63 healthy adults (38 women, 25 men) with LDL cholesterol above 130 mg/dL, 3 weeks per arm (n = 63) Evidence B source
  LDL cholesterol -5.4% (144 vs 154 mg/dL), total cholesterol -3.4%
• Pooled prospective cohorts of 211,676 people linked neither butter nor margarine intake with age-related macular degeneration. — 211,676 subjects in prospective cohorts, 7154 AMD cases (n = 211676) Evidence C source
  No significant association for oils, butter and margarine, highest vs lowest intake
• In US data on 16,760 adults, margarine was among eight foods linked with lower serum urate, yet whole diet explained at most 0.3% of urate variation. — 16,760 US adults of European ancestry from five cohorts, without gout or kidney disease (n = 16760) Evidence C source
  Margarine associated with lower serum urate; diet scores explained 0.3% or less of variance vs 23.9% for genetics
• In a crossover RCT on 47 adults, palmitic and stearic acid interesterified fats in margarine spreads and muffins at 10% of energy for 6 weeks gave the same total to HDL cholesterol ratio. — 51 healthy adults aged 35-65 randomized, 47 completed, 6 weeks per arm (n = 47) Evidence B source
  Total:HDL ratio difference 0.05 (95% CI -0.08 to 0.18)
• In an 8-week RCT on 90 adults eating 1.8 oz (50 g) a day of fat as margarine, interesterified palm fats and native palm olein left IL-6, TNF-alpha and hsCRP unchanged. — 90 healthy adults, 50 g test fat daily as margarine, 8 weeks (n = 90) Evidence B source
  No significant difference in IL-6, TNF-alpha, visfatin or hsCRP between diets
• In a 4-week RCT on 42 adults, margarine trans fat (elaidic acid) and butter trans fat (vaccenic acid) each showed up as a distinct pattern in blood fatty acids. — 42 healthy volunteers aged 45-69, subgroup of a three-arm parallel trial, 4 weeks (n = 42) Evidence B source
  Serum C18:1 t9 tracked margarine iTFA (4.1 g per 3.5 oz (100 g)) and C18:1 t11 tracked butter rTFA

Safety, limits and interactions

• EFSA concluded in 2012 that 3 g a day of plant sterols or stanols lowers LDL cholesterol by 11.3%, that intakes of 1.5 to 3.0 g a day have similar efficacy, and that the maximum effect is reached within two to three weeks. — adults, plant sterols or stanol esters in EU-approved foods Evidence E source
  3 g/day (2.6 to 3.4 g) lowers LDL cholesterol by 11.3% (95% CI 10.0 to 12.5); 1.5 to 3.0 g/day similar efficacy; maximum effect within 2 to 3 weeks

What people believe that the data does not support

• Across 125 studies, foods fortified with plant sterols or stanols lowered LDL cholesterol by 21 mg/dL (0.55 mmol/L) on average, and spreads such as margarine cut it more than bread, biscuit or cereal formats. — adults in controlled trials of phytosterol fortified foods, 125 studies pooled (n = 125 studies) Evidence A source
  LDL-C -21 mg/dL (-0.55 mmol/L) on average; bread, biscuits and cereals gave a 5.4 mg/dL (0.14 mmol/L) smaller drop than butter, margarine and spreads
• A meta-analysis of five RCTs (10,808 people) that swapped saturated fat for linoleic acid from corn oil and polyunsaturated margarine found no benefit on coronary or all-cause death despite lower cholesterol. — five randomized trials replacing saturated fat with linoleic acid rich vegetable oil, 10,808 participants (n = 10808) Evidence A source
  Coronary heart disease death 1.13 (95% CI 0.83 to 1.54), all-cause death 1.07 (0.90 to 1.27)
• US rules allow a heart claim on foods with at least 0.65 g plant sterol esters per serving, eaten twice a day for at least 1.3 g daily, within a diet low in saturated fat. — US food labels, authorized health claim Evidence E source
  Threshold 0.65 g per serving, 1.3 g per day of plant sterol esters
• FDA revoked the old authorization for partially hydrogenated oils in margarine, effective 22 December 2023, because these uses may be injurious to health. — US food supply Evidence E source
  Partially hydrogenated oils no longer permitted in margarine from 22 December 2023

Who this works differently for

• EU law requires spreads with added plant sterols or stanols to warn that more than 3 g a day should be avoided and that the food may not be nutritionally appropriate for pregnant or breastfeeding women and children under 5. — foods with added plant sterols or stanols sold in the EU; pregnant or breastfeeding women and children under 5 Evidence E source
  Label must say to avoid more than 3 g/day of added plant sterols/stanols and that the food may not suit pregnant or breastfeeding women and children under 5
• The same EU rules make the label say the spread is not meant for people who do not need to control their cholesterol, that patients on cholesterol-lowering medicine should use it only under medical supervision, and that fruit and vegetables help keep carotenoid levels up. — people who do not need to control blood cholesterol; patients on cholesterol-lowering medication Evidence E source
  Label must say the product is not intended for people without a need to control cholesterol, and that patients on cholesterol-lowering drugs should use it only under medical supervision; advice on fruit and vegetables for carotenoids
• In 60 patients with sitosterolemia, a rare inherited disorder of plant sterol handling, blood phytosterols were raised in all of them, and the authors call a low-phytosterol diet the cornerstone of treatment. — 55 children and 5 adults with sitosterolemia at Xinhua Hospital, 2016 to 2021 (n = 60) Evidence C source
  Phytosterols raised in 100% of patients; xanthomas in 93% of children; dietary therapy lowered TC and LDL-C by 54% and 52% in 13 children; low-phytosterol diet is the cornerstone of treatment
• In a crossover RCT on 17 adults, carriers of one sitosterolemia gene copy given margarine with 2 g of plant sterols a day for 6 weeks saw serum phytosterols rise 23.0%, close to the 20.5% in controls, while stanol margarine lowered them in both groups. — 7 heterozygous relatives of sitosterolemia patients and 10 controls, Muenster, Germany (n = 17) Evidence B source
  2 g/day plant sterol margarine for 6 weeks: serum phytosterols +23.0% in heterozygotes vs +20.5% in controls (no significant difference); stanol margarine lowered them by about half in both
• In a crossover RCT on 88 young adults, sterol margarine (3.2 g a day for 3 weeks) lowered LDL by 12.2% in ApoE3/3 carriers and 9.8% in ApoE4 carriers, a gap that was not significant. — 88 healthy subjects (31 E3/4 or E4/4, 57 E3/3), mean age 25, 3 weeks per arm (n = 88) Evidence B source
  LDL -13 mg/dL (-0.34 mmol/L) (12.2%) in E3/3 vs -12 mg/dL (-0.32 mmol/L) (9.8%) in epsilon 4, P = 0.68
• In the Sydney Diet Heart RCT on 458 men after a coronary event, switching to safflower oil and safflower margarine raised all-cause deaths to 17.6% vs 11.8% in controls. — 458 men aged 30-59 with a recent coronary event, trial run 1966-73 (n = 458) Evidence B source
  All-cause death 17.6% vs 11.8%, HR 1.62 (95% CI 1.00 to 2.64)
• In a Swedish birth cohort of 430 children, those with food allergy at 6 had been given margarine earlier (9 vs 12 months), which the authors think reflects reverse causation. — 430 children from the Swedish NICE birth cohort, followed to age 6 (n = 430) Evidence C source
  Median age at margarine introduction 9.0 vs 12.0 months, p = 0.021

What is still unknown

• A 2024 meta-analysis of vitamin D fortified foods (49 trial papers) found no suitable RCT using margarine or dairy spreads as the vehicle, so fortified margarine is untested for raising blood vitamin D. — randomized trials of vitamin D fortified foods, 49 papers (n = 49 papers) Evidence A source
  0 eligible trials for margarine or dairy spreads; other vehicles raised 25(OH)D by about 9 to 35 nmol/L

The bottom line

How the sterols are eaten seems to matter. In a supervised feeding trial on 19 adults with 6 day phases, 1.8 g a day of plant sterols in margarine cut cholesterol absorption by 36 to 39% either way, yet LDL fell by 6% only when the dose was split over three meals. In 88 healthy adults with a mean age of 25 on a low cholesterol diet, 3.2 g a day for 3 weeks lowered LDL by 12.2% in ApoE3/3 carriers and 9.8% in ApoE4 carriers, and that gap was not significant. Older people were not tested. US labeling rules allow a heart claim on foods with at least 0.65 g of plant sterol esters per serving, eaten twice a day for at least 1.3 g daily within a diet low in saturated fat. That is permission to use the wording, and the size of the effect comes from the trials above. A US tablespoon of margarine is counted as 14 g and a pat as 7 g, so the 20 g in the trial is a little more than one tablespoon a day. More is not better, and these spreads are not for everyone. EFSA concluded in 2012 that 3 g a day of plant sterols or stanols lowers LDL by 11.3%, that 1.5 to 3.0 g a day work about as well, and that the full effect arrives within two to three weeks. EU rules make the label say the spread is not meant for people who do not need to control their cholesterol, and that people on cholesterol-lowering medicine should use it only under medical supervision. A meta-analysis of 41 trials with 3306 people eating about 2.5 g a day found blood beta-carotene 16.3% lower and lycopene 12.3% lower, while vitamin D and retinol did not change and levels stayed within normal ranges. The EU label also points to fruit and vegetables to keep carotenoid levels up. People with sitosterolemia, a rare inherited disorder of plant sterol handling, are the clearest exception. In 60 patients their blood phytosterols were raised in every case, and the authors call a low-phytosterol diet the cornerstone of treatment. In 17 adults, carriers of one gene copy given 2 g a day of plant sterols for 6 weeks saw phytosterols rise 23.0%, close to 20.5% in controls, while stanol margarine lowered them in both groups. A scoping review of 233 studies found interesterification the most cited way to harden oils without trans fats (46% of studies), with margarines and spreads the main foods using these substitutes. It maps the technology and does not judge health. In a 6 week crossover trial on 47 healthy adults aged 35 to 65, palmitic and stearic acid interesterified fats in spreads and muffins, at 10% of energy, gave the same total to HDL cholesterol ratio (difference 0.05, 95% CI -0.08 to 0.18). We have no longer trial. Pooled cohorts of 211,676 people linked neither butter nor margarine with macular degeneration. In 16,760 US adults margarine went with lower serum urate, while the whole diet explained 0.3% or less of urate variation. Vitamin D fortified margarine is untested: a 2024 meta-analysis of 49 trial papers on fortified foods found no suitable trial using margarine or dairy spreads. That gap is an absence of trials, and it says nothing either way about the vitamin in a spread. If you already have heart disease, the oldest trial here is the one to know. In the Sydney Diet Heart trial, 458 men aged 30 to 59 who had just had a coronary event switched to safflower oil and safflower margarine, and deaths from any cause reached 17.6% against 11.8% in controls (HR 1.62, 95% CI 1.00 to 2.64). The lower bound sits right at no difference, the trial ran from 1966 to 1973, and the intervention group may have been getting trans fats too. In the US, partially hydrogenated oils have not been permitted in margarine since 22 December 2023, when FDA revoked their old authorization because these uses may be injurious to health. Other countries set their own rules, so trans fats in margarine remain possible elsewhere. On allergy, a Swedish cohort of 430 children found that those with food allergy at age 6 had started margarine earlier (median 9 against 12 months), and the authors think this most likely reflects reverse causation.

Compared with other foods

Sources

1. mgn-r2-19 · dataset search
   CoFID 2021 code 12-500, group BTM: Baking fat and margarine (75-90% fat), hard block [only CoFID match for margarine]; variability_search margarine: no Foundation Foods record
   USDA FoodData Central and UK CoFID, searched 2026-09-28 · checked 2026-09-28
2. mgn-r2-18 · portion dataset
   Margarine, NFS, FNDDS code 81102000, fdc_id 2710158: 1 tablespoon, measure 21000, 14 g; 1 pat, measure 61631, 7 g; Guideline amount per slice of bread/roll, 7 g; Guideline amount on large sandwich, 28 g
   USDA FNDDS, food code 81102000, FDC 2710158 · checked 2026-09-28
3. hf2-mgn-4 · meta-analysis
   Forty-one randomized controlled trials involving 3306 subjects were included. ... Average plant sterol or stanol intake was 2.5 g/d. Relative non-standardized and TC-standardized concentrations of β-carotene decreased by, respectively, -16.3 % (95 % CI -18.3; -14.3) and -10.1 % (-12.3; -8.0), α-carotene by -14.4 % (-17.5; 11.3) and -7.8 % (-11.3; -4.3), and lycopene by -12.3 % (-14.6; -10.1) and -6.3 % (-8.6; -4.0). ... Non-standardized retinol and vitamin D concentrations were not affected. ... Observed concentrations remained within normal ranges.
   Eur J Nutr, 2017 · checked 2026-10-08
4. mgn-r2-03 · RCT
   Relative to the control, end point LDL level was 0.21+/-0.27 mmol/l (6%) lower (P<0.05) at the end of the three times per day phase. ... Cholesterol-absorption efficiency decreased (P<0.05) by 36 and 39% after the three times per day and single-BF phase, respectively, relative to control.
   Eur J Clin Nutr, 2009 · checked 2026-09-28
5. mgn-r2-04 · RCT
   Cholesterol absorption during placebo, sitostanol, sitostanol acetate and sitostanol oleate feeding averaged 41.6 +/- (SD) 8.0, 10.2 +/- 6.6, 17.0 +/- 6.7, and 20.5 +/- 5.3%, respectively (p < 0.001 for all against placebo).
   Arzneimittelforschung, 2003 · checked 2026-09-28
6. mgn-r2-14 · scoping review
   A total of 87 different raw materials were cited as trans fats substitutes in the selected studies, with palm stearin being the most frequent. The processing methods were categorized in 8 groups, with interesterification being the most cited (46% of studies). Food items belonging to 15 food groups were found to contain trans fats substitutes, mainly margarine, shortenings, and spreads.
   Nutr Rev, 2025 · checked 2026-09-28
7. mgn-r2-02 · RCT
   A total of 20 g/d of a phytosterol ester-enriched margarine (1.82 g/d of phytosterols) was compared with a control margarine (0.06 g/d of phytosterols). ... Phytosterol ester-enriched margarine significantly changed total cholesterol (-3.4%, P <.005), LDL cholesterol (-5.4%, P <.001, 144 +/- 28 v 154 +/- 26 mg/dL)
   Metabolism, 2002 · checked 2026-09-28
8. mgn-r2-09 · meta-analysis of cohorts
   At the end of the selection process, 26 articles were included in the meta-analysis, for a total of 211,676 subjects and 7154 cases of AMD. By comparing the highest vs. the lowest consumption, pooled analyses showed no significant association with AMD for vegetables, fruit, nuts, grains, dairy products, as well as dietary fats such as oils, butter and margarine.
   Eur J Nutr, 2019 · checked 2026-09-28
9. mgn-r2-10 · cross-sectional
   eight foods were associated with reduced serum urate levels (eggs, peanuts, cold cereal, skim milk, cheese, brown bread, margarine, and non-citrus fruits) in the male, female, or full cohorts. ... but each explained ≤0.3% of variance in serum urate
   BMJ, 2018 · checked 2026-09-28
10. mgn-r2-12 · RCT
    In a randomized, crossover trial at 2 centers, 51 healthy participants (aged 35-65 y) consumed diets with either palmitic acid-rich or stearic acid-rich IE fats (10% energy intake) for 6 wk per arm, with a 4-wk washout. IE fats were incorporated into muffins and margarine spreads. ... No significant differences were observed in total:HDL cholesterol ratio between interventions (stearic compared with palmitic mean difference: 0.05; 95% confidence interval [CI]: -0.08, 0.18).
    Am J Clin Nutr, 2025 · checked 2026-09-28
11. mgn-r2-13 · RCT
    We used a double-blind, parallel feeding intervention trial using 50 g of each test fat in the form of margarine, separately incorporated into two servings of snacks for breakfast and afternoon tea daily for eight weeks. ... POo-, CIEPO- and CIEBlend-diets produce no significant difference in the serum levels of interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), visfatin and high-sensitivity C-reactive protein (hsCRP).
    Eur J Nutr, 2026 · checked 2026-09-28
12. mgn-r2-15 · RCT
    Healthy volunteers (n = 42; 45-69 y) were randomly assigned to diets containing margarine without TFA as major source of fat (wTFA control group with 0.4 g TFA per 100 g margarine), margarine with iTFA (iTFA group with 4.1 g TFA per 100 g margarine), or butter with rTFA (rTFA group with 6.3 g TFA per 100 g butter) for 4 weeks. ... The most abundant TFA in the butter, i.e. TFA containing (E)-octadec-11-enoic acid (C18:1 t11; trans vaccenic acid), and margarines, i.e. TFA containing (E)-octadec-9-enoic acid (C18:1 t9; elaidic acid) were reflected in the significantly different serum levels of TFAs measured after the dietary interventions.
    Lipids Health Dis, 2022 · checked 2026-09-28
13. hf2-mgn-3 · EFSA scientific opinion
    On the basis of the data presented, the Panel concludes that plant sterols and stanol esters at daily intakes ranging from 1.5 to 3.0 g plant sterols/stanols in matrices approved by Regulation (EC) No 376/2010 have a similar efficacy on blood LDL-cholesterol lowering, that plant sterols and stanol esters at a daily intake of 3 g (range 2.6 g to 3.4 g) plant sterols/stanols in matrices approved by Regulation (EC) No 376/2010 lower LDL-cholesterol by 11.3 % (95 % CI: 10.0 - 12.5), and that the minimum duration required to achieve the maximum effect of plant sterols and stanols on LDL-cholesterol lowering is two to three weeks.
    EFSA NDA Panel, Scientific Opinion on the substantiation of a health claim related to 3 g/day plant sterols/stanols and lowering blood LDL-cholesterol, EFSA Journal 2012;10(5):2693 · checked 2026-10-08
14. mgn-r2-01 · meta-analysis
    On average, PS lowered LDL-C 0.55 mmol/L [95% confidence interval (CI) = 10.82-12.67], and this decrease was significantly maintained for all analysed subgroups. ... The food format "Bread, biscuits, cereals", conditioned a lower decrease of 0.14 mmol/L (95%CI -8.71 to -2.16) in LDL-C levels, compared to the predominant food format group of "butter, margarine, spreads".
    Nutr Metab Cardiovasc Dis, 2023 · checked 2026-09-28
15. mgn-r2-06 · meta-analysis
    Serum cholesterol lowering diet that replaced saturated fat with linoleic acid (from corn oil and corn oil polyunsaturated margarine). ... Systematic review identified five randomized controlled trials for inclusion (n=10,808). In meta-analyses, these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease (1.13, 0.83 to 1.54) or all cause mortality (1.07, 0.90 to 1.27).
    BMJ, 2016 · checked 2026-09-28
16. mgn-r2-16 · regulation
    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.
    21 CFR 101.83, Health claims: plant sterol/stanol esters and risk of coronary heart disease · checked 2026-09-28
17. mgn-r2-17 · regulation
    This rule is effective December 22, 2023. ... We are revoking prior sanctions (i.e., pre-1958 authorization of certain uses) for the use of PHOs in margarine, shortening, and bread, rolls, and buns based on our conclusion that these uses of PHOs may be injurious to health.
    US FDA, Revocation of Uses of Partially Hydrogenated Oils in Foods, Federal Register 2023-16725, 2023 · checked 2026-09-28
18. hf2-mgn-1 · EU regulation
    (5) an easily visible statement that the food may not be nutritionally appropriate for pregnant or breastfeeding women and children under the age of 5 years; ... (7) in the same field of vision as the statement required under point (3) above, a statement that the consumption of more than 3 g/day of added plant sterols/plant stanols should be avoided;
    Regulation (EU) No 1169/2011 on the provision of food information to consumers, Annex III point 5.1 (consolidated text 1 January 2018) · checked 2026-10-08
19. hf2-mgn-2 · EU regulation
    (3) a statement that the product is not intended for people who do not need to control their blood cholesterol level; (4) a statement that patients on cholesterol lowering medication should only consume the product under medical supervision; ... (6) advice that the food is to be used as part of a balanced and varied diet, including regular consumption of fruit and vegetables to help maintain carotenoid levels;
    Regulation (EU) No 1169/2011 on the provision of food information to consumers, Annex III point 5.1 (consolidated text 1 January 2018) · checked 2026-10-08
20. hf2-mgn-5 · retrospective cohort
    Sitosterolemia is a rare autosomal recessive disease characterized by phytosterol accumulation in the blood and tissues. ... Clinical, genetic and therapeutic data from 60 patients at Xinhua Hospital from January 2016 to June 2021 were retrospectively collected. ... Elevated total cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C) were observed in 96% patients (pediatric 98%, adult 3/4), and phytosterol levels in 100% patients. ... The low-phytosterol diet is the cornerstone of sitosterolemia treatment.
    J Clin Lipidol, 2022 · checked 2026-10-08
21. hf2-mgn-6 · randomized controlled trial
    Seven heterozygotes and 10 controls received daily portions of margarine containing 2 g of plant sterols, 2 g of stanols or a control margarine for 6 weeks each in a randomized order. ... Compared to the control period, serum phytosterol concentrations increased overall by more than 20% when subjects consumed the plant sterol margarine (F((1,15))=8.719, P=0.01), with no significant difference between heterozygotes (mean +14.5 (s.d. 17.2) micromol/l, +23.0%) and controls (+4.9 (9.9) micromol/l, +20.5%; F((1,15))=2.168, P=0.162), but decreased when subjects consumed the stanol-enriched margarine
    Eur J Clin Nutr, 2007 · checked 2026-10-08
22. mgn-r2-05 · RCT
    The decrease in total cholesterol was 0.36 mmol L-1 (7.4%) in the E3/3 subjects and 0.31 mmol L-1 (5.7%) in the epsilon 4 subjects (P = 0.50) and that in LDL cholesterol was 0.34 mmol L-1 (12.2%) in the E3/3 subjects and 0.32 mmol L-1 (9.8%) in the epsilon 4 subjects (P = 0.68).
    Eur J Clin Invest, 2002 · checked 2026-09-28
23. mgn-r2-07 · RCT
    Replacement of dietary saturated fats (from animal fats, common margarines, and shortenings) with omega 6 linoleic acid (from safflower oil and safflower oil polyunsaturated margarine). ... The intervention group (n=221) had higher rates of death than controls (n=237) (all cause 17.6% v 11.8%, hazard ratio 1.62 (95% confidence interval 1.00 to 2.64), P=0.05
    BMJ, 2013 · checked 2026-09-28
24. mgn-r2-11 · cohort
    Children with food allergies had been introduced to margarine earlier than non-allergic children [9.0 (5.0-12.0) vs. 12.0 (9.0-12.0) months, p = 0.021], although this finding likely reflects reverse causation.
    Nutr J, 2026 · checked 2026-09-28
25. mgn-r2-08 · meta-analysis
    No suitable RCTs were identified for rice, maize flour, butter, margarine or dairy spreads, plant-based milk or yogurt alternatives.
    J Steroid Biochem Mol Biol, 2024 · checked 2026-09-28