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Plant Sterols Can Lower Your
Cholesterol Naturally.
Your heart will say "thank you" for
plant
sterols!
Plant sterols are currently being lauded as
a natural, cholesterol-busting wonder ingredient, and can be found in
several premium-price margarines, milk products and yogurts. Plant
sterols can be found naturally in small quantities in many fruits, vegetables, nuts, seeds, cereals, beans, and other plant foods containing fats and oils.
The cholesterol-lowering properties of plant
sterols/stanols have been known since the 1950s. In recent years, the
medical community has endorsed consumption of plant sterols/stanols as a
safe and effective means of promoting good cardiovascular health.
In May 2001, the National Cholesterol Education Program Expert Panel,
the U.S. body that provides guidelines to physicians on the management
of high cholesterol, issued new clinical guidelines directing doctors to
advise their patients to consume two grams of plant sterols/stanols
daily to reduce high blood
cholesterol levels. Because their recognized health
benefits and the convenience and ease of use plant sterols have become popular as
an extract included in natural supplements.
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A recent analysis of published controlled, double-blind,
randomized clinical trials of sterol or stanol esters reported an 11% mean reduction in LDL level.
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Beta Sitosterol
There are over 60 types of plant sterol, but the most common form is
beta-sitosterol. Plant sterols are almost identical in chemical structure to cholesterol and are processed by the body in the same way.
They function as cholesterol-lowering agents in blood by blocking the absorption of cholesterol from food during digestion and also by blocking the re-absorption of cholesterol manufactured in the liver.
Do any government or
health associations recommend plant sterols?
The National Cholesterol Education Program (NCEP) of the
National Heart, Lung, and Blood Institute of the National Institutes of
Health suggests
the use of plant sterols in conjunction with other
lifestyle changes to enhance LDL cholesterol
reduction achieved through diet.
The FDA also published an interim final health claim rule in September, 2000, affirming the benefit of plant sterol and stanol esters in reducing blood cholesterol levels and reducing coronary heart disease risk.
Eat your fruit and veggies and take your
vitamins.
Clinical trials have shown that plant sterols
such as beta sitosterol also lower blood concentrations of valuable antioxidants, such as beta-carotene by about 25%,
alpha carotene by 10%, and vitamin E by 8%. People who are taking
plant sterols should consume more fruit and vegetables or
antioxidant
vitamins to compensate for these losses.
Cautions
The American Heart Association warns that products with added plant sterols are intended for people who want or need to lower their blood cholesterol levels. It says that
patients on cholesterol lowering medications should use
plant sterols in consultation with their health care provider.
In particular it advises that the foods may not be appropriate for children or for pregnant and breast-feeding women.
Australian Study of Plant Sterols
The Medical Journal of Australia 2002 found
that margarines enriched with plant sterols are effective at lowering low-density lipoprotein (LDL) cholesterol levels when eaten as recommended.
LDL-cholesterol level reductions of more than 10% are achieved in most people.
Phytosterol-containing foods are valuable additions to other cholesterol-lowering treatments. They should be considered for all patients with increased cardiovascular risk factors in whom LDL reduction is desirable.
The only recognized possible adverse effect
is reduction in some carotenoids in plasma, but this can be overcome by
eating an additional serving of yellow or orange fruit or vegetables.
PLANT STEROLS (PHYTOSTEROLS), are present in high concentration in vegetable oils before they are refined
The two main sterols that are widely present in plant foods other than oils are
beta sitosterol and campesterol, and most of us eat between 150 mg and 400 mg of phytosterols daily. Consumption by vegetarians is even higher and may account partly for their lower LDL levels.
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1 Two studies from Australia with sterol-ester-containing foods, margarine in one, and a mix of margarine, bread and breakfast cereal in the other, resulted in mean
ldl cholesterol reductions of 7.7% and 13.6%, respectively.
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This benefit was additional to that
achieved with a standard low saturated, low cholesterol, high
unsaturated fatty acid diet. Other trials, carried out overseas, have
shown that older people benefit most.
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References
1. Law M. Plant sterol and stanol margarines and health. BMJ 2000; 320: 861-864.
2. Noakes M, Clifton P, Ntanios F, et al. An increase in dietary carotenoids when consuming plant sterol or stanol esters is effective in maintaining plasma carotenoid concentrations. Am J Clin Nutr 2002; 75: 79-86.
3. Nestel PJ, Cehun M, Pomeroy S, et al. Cholesterol-lowering effect of plant sterol ester and non-esterified stanols in margarine, butter and low-fat foods. Eur J Clin Nutr 2001; 55: 1084-1090.
4. Miettinen TA, Gylling H. Regulation of cholesterol metabolism by dietary plant sterols. Curr Opin Lipidol 1999; 10: 9-14.
5. Westrate JA, Meijer GW. Plant sterol-enriched margarines and reductions of plasma total and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr 1998; 52: 334- 343.
(Received 12 Mar 2002, accepted 18 Apr 2002)
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