Evidence Trace, complete trial record

In plain terms

In plain terms: Pterostilbene has been tested in human trials aimed at the relevant outcome and did not show benefit at the doses and durations studied. The animal research may be encouraging, but it has not yet translated to humans in these trials.

Pterostilbene

D Not shown: no human trial shows benefit

Route 2 — tested in humans; benefit not shown

Category Supplements

Evidence Randomized controlled trial

Reviewed July 2026

PMIDs 25057276 · 23431291 · 40024751 · 40227411

The endpoint this grade is based on: Surrogate biomarker endpoint, Resveratrol analogue. The single human trial's pre-specified primary outcome was lipids, and LDL cholesterol rose on pterostilbene; blood pressure fell as a secondary outcome.

The evidence as the record states it

Evidence record

PMID 25057276 PMID 23431291 PMID 40024751 PMID 40227411

Riche et al. (Evid Based Complement Alternat Med, 2014; PMID 25057276): randomized, double-blind, placebo-controlled, 80 adults with total cholesterol of 200 mg/dL or more or LDL of 100 mg/dL or more, four arms, 6 to 8 weeks; the stated endpoints were lipids, blood pressure and weight. LDL cholesterol rose by 17.1 mg/dL on pterostilbene alone (P=0.001) and did not rise when grape extract was added; systolic and diastolic blood pressure fell at the higher dose (7.8 and 7.3 mmHg). The authors' conclusion is that pterostilbene increases LDL and reduces blood pressure. Whether lipids were the pre-specified primary endpoint is not stated in the abstract and the registration (NCT01267227) was not read in this pass. Funding: the full text states the trial was supported by a grant through the company that makes the pterostilbene tested, which also supplied the pterostilbene and the placebo, and that the company had no role in the collection or interpretation of the data. Grade D, Route 2: in a population enrolled for raised cholesterol, the lipid result went the wrong way. Companion and later trials: Riche et al. (J Toxicol, 2013; PMID 23431291), the safety report from the same 80-person trial, no hepatic, renal or glucose signals up to 250 mg/day, the same trial and not a replication. Otsuka et al. (J Nutr Sci Vitaminol, 2025; PMID 40024751): 12-week placebo-controlled pilot of 10 or 100 mg/day in 30 healthy men; blood microRNA expression and safety only, no clinical efficacy outcome. Senguttuvan et al. (Antioxidants, 2025; PMID 40227411): randomized phase II of pterostilbene with megestrol against megestrol alone before hysterectomy for endometrial cancer, 44 patients; Ki-67 primary null, lipid metabolism unchanged, a different population and a combination. Trials of nicotinamide riboside combined with pterostilbene are a different product and do not grade pterostilbene alone.

PMID 25057276 PMID 23431291 PMID 40024751 PMID 40227411

Trials showing no benefit

Trial 1

PMID 25057276

Endpoint: Lipids: LDL cholesterol rose 17.1 mg/dL on pterostilbene alone; blood pressure fell as another endpoint
Population: 80 adults with high cholesterol, 6 to 8 weeks, four arms

Observation

Low to moderate. Single small placebo-controlled trial; LDL moved in the harm direction in people enrolled for raised cholesterol; primary-endpoint status not stated in the abstract.

Evidence by specific use

LDL cholesterol in adults enrolled for raised cholesterol

Grade D

Riche et al. (Evid Based Complement Alternat Med, 2014; PMID 25057276): 80 adults with total cholesterol of 200 mg/dL or more or LDL of 100 mg/dL or more, four arms, 6 to 8 weeks; LDL rose 17.1 mg/dL on pterostilbene alone and did not rise when grape extract was added. In a population enrolled for raised cholesterol the lipid result went the wrong way: D on Route 2 with the harm badge. Maker-funded, stated beside the letter.

PMID 25057276

Blood pressure in adults with raised cholesterol

Grade C

In the same trial (Riche et al., 2014; PMID 25057276) systolic and diastolic blood pressure fell 7.8 and 7.3 mmHg at the higher dose. One positive randomized trial on a surrogate, unreplicated, with blood pressure listed among the stated endpoints but not named as primary: C under the written rule. The same trial raised LDL in the same people, graded on the row above; the headline stays on that harm finding so a reader meets it first. Maker-funded, stated beside the letter.

PMID 25057276

Why Grade D Route 2 and not Grade C

Grade D Route 2 applies when a compound has been tested in humans and benefit was not shown. Pterostilbene has been tested in 1 human trial on endpoints relevant to the claim being evaluated, and the primary endpoint was not met.

A randomized, placebo-controlled trial pre-specifying a meaningful clinical or functional endpoint and demonstrating statistically significant benefit would move this to Grade C or higher, depending on effect size, population size, and whether it is independently replicated.

What this grade covers and what it does not

Grade D, Route 2. In the only randomized trial of pterostilbene alone on a metabolic use (Riche et al., Evid Based Complement Alternat Med, 2014; PMID 25057276; 80 adults enrolled for raised cholesterol), LDL cholesterol rose by 17.1 mg/dL on pterostilbene alone while blood pressure fell at the higher dose. The participants were selected for their lipids, the paper lists lipids first among its endpoints and leads its conclusion with the LDL rise, so the lipid result is read as the trial's central answer; whether it was formally pre-specified as primary is not stated in the abstract. A metabolic intervention that raised LDL in people enrolled for high cholesterol is tested and found wanting. Moved from C in October 2026 by editor adjudication. Blood pressure, which fell in the same trial, is graded on its own row at C, a single unreplicated surrogate result; the headline stays on the harm finding so a reader meets it first. WHAT THIS GRADE DOES NOT COVER: blood pressure beyond that one trial, which has not been tested as a primary endpoint elsewhere; pterostilbene combined with other agents; and doses above the 250 mg/day the trial used.

What would move this grade

A randomized, placebo-controlled trial pre-specifying a clinical aging endpoint and demonstrating statistically significant benefit on that primary endpoint would be sufficient to move this to Grade C or higher, depending on effect size and population.

How to track whether this is working Lipid panel (watch LDL), fasting glucose, cognitive assessments