As a Registered Dietitian with over a decade of experience working with individuals living with heart disease, I have seen firsthand the impact that dietary choices can have on cardiovascular health.
Managing cholesterol levels is a critical component of reducing the risk of cardiovascular disease, a leading cause of mortality worldwide.
While medications such as statins are often necessary to lower cholesterol, many of my clients are interested in natural ways to support heart health. Including plant sterols and stanols in the diet is a promising, effective approach to lowering LDL cholesterol levels. Let me tell you why…
This post is sponsored by the International Plant Sterols and Stanols Association (IPSSA). All opinions and thoughts expressed in this article are my own. As always, I only promote products and services I believe will benefit my readers.
Understanding How Plant Sterols Lower Cholesterol
Plant sterols and stanols, also known as phytosterols, are naturally occurring compounds found in various plant foods (fruits, vegetables, nuts, seeds, and legumes). These compounds have a structure similar to cholesterol, allowing them to compete with cholesterol for absorption in the intestine.
When you consume foods containing plant sterols and stanols, these compounds effectively block cholesterol absorption by competing with cholesterol for receptors in the intestine. This competition reduces the amount of cholesterol that enters the bloodstream.
The cholesterol that is not absorbed remains in the intestine and is eventually eliminated from the body through digestion. This reduction in cholesterol absorption results in lower levels of LDL cholesterol in the blood.
What Do The Guidelines and Scientific Evidence Say?
Knowing this mechanism, guidelines are in place to help individuals consume more plant stanols and sterols.
In fact, the FDA has established a heart health claim for plant sterol and stanol intake (1).
The American Heart Association also agrees that these natural plant sterol compounds can help lower cholesterol (2).
Additionally, an eating pattern designed for cholesterol lowering eating called The Portfolio Diet, recommends consuming plant sterols and stanols daily. This plan suggests consuming 2 grams of plant sterols every day, which can result in lowering LDL cholesterol by up to 30% when followed consistently (3).
The above guidelines are in place because of the numerous studies that have demonstrated the efficacy of plant stanols and sterols in reducing LDL cholesterol.
When looking at these numerous studies, it is suggested that consuming 1.5-3 grams per day can lead to a 7-12.5% reduction in LDL cholesterol within 2-3 weeks (4,5). That’s quite impressive, isn’t it?
Challenges and Solutions of Plant Sterols and Stanols
Despite their benefits, getting enough plant sterols and stanols from food alone can be a bit of a challenge.
These compounds are present in foods like (6):
- broccoli (39 mg per 100g serving size)
- avocado (75 mg per 100g serving size)
- apples (12 mg per 100g serving size)
In fact, to get the recommended 2 grams of plant sterols, you’d have to eat about 100 medium apples a day. That’s a lot of apples and definitely not something I’d suggest trying!
Given the naturally low levels in foods, turning to fortified products or supplements is often the easiest way to ensure you’re getting enough. Fortified foods make it convenient to reach those target intake levels, ensuring you reap the heart health benefits.
Looking to Europe, they do just that. These compounds are more widely recognized and used. They are often incorporated into functional foods and dietary supplements as a natural way to manage cholesterol.
Safety of Plant Sterols For Cholesterol
Plant stanols and sterols have an established safety profile for healthy populations. They are well-tolerated and do not have adverse effects when consumed at recommended levels, nor do they interfere with the effectiveness of pharmaceutical treatments.
Final Thoughts
As a dietitian working with clients living with heart disease, I am consistently impressed by the potential of plant sterols and stanols to support heart health naturally and safely.
I encourage my clients to explore fortified foods and consider supplementation as part of their dietary strategy to manage cholesterol, alongside a balanced diet rich in plant foods and low in saturated and trans fats. However, before making any changes to your diet, please check with your Registered Dietitian or Health Care provider for personalized recommendations.
References
- Food, Administration D. Food labeling: health claims; plant sterol/stanol esters and coronary heart disease; interim final rule. Federal Register. 2000;65:21.
- Jacobson TA, Maki KC, Orringer CE, et al. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. J Clin Lipidol. Nov-Dec 2015;9(6 Suppl):S1-122.e1. doi:10.1016/j.jacl.2015.09.002
- Jenkins DJ, Kendall CW, Marchie A, et al. Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. Am J Clin Nutr. Feb 2005;81(2):380-7. doi:10.1093/ajcn.81.2.380
- Ras RT, Hiemstra H, Lin Y, Vermeer MA, Duchateau GS, Trautwein EA. Consumption of plant sterol-enriched foods and effects on plasma plant sterol concentrations–a meta-analysis of randomized controlled studies. Atherosclerosis. Oct 2013;230(2):336-46. doi:10.1016/j.atherosclerosis.2013.08.012
- Cicero AFG, Colletti A, Bajraktari G, et al. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutrition reviews. Sep 1 2017;75(9):731-767. doi:10.1093/nutrit/nux047
- National Library of Medicine. Plant Sterol and Stanol Contents in Different Foods. Table 12. [Plant Sterol and Stanol Contents in Different Foods]. – Endotext – NCBI Bookshelf (nih.gov)