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Reply to Dr. Brendsel and Dr. Green

      We thank Drs. Brendsel and Green for their thoughtful comments on our review of phytosterols. We share their concern that phytosterol dietary supplementation could increase atherosclerotic risk, but we are reassured by the ability of plant stanols and sterols to reduce circulating cholesterol levels. As detailed in our review, circulating phytosterols should increase blood cholesterol measurements. In contrast, presently available agents reduce blood cholesterol levels suggesting that they are not absorbed and therefore could not contribute to atherosclerotic risk. This issue is not settled, however, and additional research on this question is required to address the question of atherosclerotic risk with these agents.
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