Those among us with elevated cholesterol levels are typically advised by health professionals to lose weight, exercise and consume a diet high in fiber and low in saturated fats and cholesterol. Although these measures can reduce one’s blood cholesterol, sometimes they do not do enough, and other cholesterol-lowering interventions are needed. Before succumbing to a cholesterol-lowering medication, adding plant sterol and stanol esters to the diet may further decrease blood cholesterol levels. Read on to learn what plant sterol and stanol esters are, where they are found, and how they can affect cholesterol levels.
NUTRITIONAL FACTS AND FIGURES
What are they?
Both plant stanols and sterols are essential components of plant cell membranes and structurally resemble cholesterol. When these plant extracts are ingested, they inhibit the absorption of cholesterol in the small intestine. Thus, dietary cholesterol never gets into the system.
Where are they found?
Sterols are present naturally in small quantities in many fruits, vegetables, nuts, seeds, cereals, legumes, vegetable oils (particularly soybean oil), and other plant sources. Plant stanols occur in even smaller quantities in many of the same sources. Although people consume plant stanols and sterols every day in food, the amounts are often not great enough to have significant blood cholesterol-lowering effects.
Stanols and sterols are also found in processed foods. By modifying plant stanols and sterols to form stanol and sterol esters, they are easily incorporated into fat-containing foods without losing their effectiveness in lowering cholesterol. Plant sterol esters are ingredients in a number of fat-based salad dressings, yogurts and margarines. Plant stanol esters are found in various spreads, salad dressings, juices and dietary supplements in a softgel form. Below are a few examples of foods that have stanols and sterols. These processed sources of plant sterols and stanols tend to be loaded with extraneous ingredients like artificial colors, flavors, and stabilizers. Review the label to help you choose the food item with the most commonplace natural ingredients.
- Smart Balance Buttery Spread with Heartright
- Smart Balance 1% Low Fat Milk with Heartright
- Promise activ Light Spread
- Benecol Spreads
- Benecol “Smart Chews” (caramel chewy candies)Minute Maid HeartWise 100% Orange Juice
- VitaTops and VitaBrownies – Dark Chocolate Pomegranate
- Lifetime Low Fat Cheese
- Corazonas Potato Chips, Tortilla Chips, and Oatmeal Squares
What Does the Research Show?
Numerous research studies show that consuming plant stanol and sterol esters in appropriate quantities can inhibit the absorption of total cholesterol in the small intestine by up to 50%, which can lower LDL blood cholesterol by up to 14% (with no effect on “good” HDL cholesterol). The maximum cholesterol-lowering benefit is achieved at a dose of 2-3 grams per day (a greater intake has no additional effects). The FDA authorized the use of a health claim for plant sterol and stanol esters stating: “Diets low in saturated fat and cholesterol that include at least 1.3 grams of plant sterol esters or 3.4 grams of plant stanol esters, consumed in 2 meals with other foods, may reduce the risk of heart disease and cholesterol levels.” This health claim is currently being expanded by the FDA to eliminate the distinction between types and sources of plant stanols and sterols, using the term “phytosterols” instead, and to state that 2 grams or more per day of phytosterols is the level associated with reduced risk of CHD. Plant sterols and stanols and their esters are Generally Recognized As Safe (GRAS) food-grade substances and have no history of demonstrating any harmful health effects.
Adults with elevated cholesterol levels who want to reduce their cholesterol levels through diet may see better results by eating foods with added sterol and stanol esters. Just remember to read the label and find the food item that has easily identifiable ingredients. Remember, if you can’t pronounce it and do not know what it is, it’s better to avoid it. A typical American diet provides only about 0.25 g of plant sterol/stanol per day. To achieve the cholesterol-lowering benefits of these plant extracts, 1-3 grams must be consumed daily. If you have elevated cholesterol, including some of the plant stanol/sterol rich foods listed above into your daily diet (in combination with a diet low in saturated fat and cholesterol) may further reduce your LDL cholesterol level by up to ~10%. Eat as much real food as possible. If your diet does not usually consist of processed foods, do no start eating processed food to increase your plant sterol and stanol consumption. If you are eating other forms of processed foods, find a version that is rich in plant stanol or sterols. Even though research shows benefits with increased plant sterol and stanol intake, there is limited research regarding the effects of the ingredients in processed food.
Bottom line: Natural sources, even though lower in plant sterol and stanol content, are the optimal choice.