Managing Cholesterol Levels with Phytosterols

Feb 09, 2022

Managing Cholesterol Levels with Phytosterols

How Do Plant Sterols and Stanols Work?

Plant sterols and stanols, referred to as phytosterols, are plant-derived compounds that are similar in structure to cholesterol, and competitively help block the absorption of cholesterol in the digestive tract. As a result of this activity, sterols and stanols help contribute to lower total cholesterol, LDL cholesterol and non-HDL cholesterol levels in the blood. There is a consensus in the scientific literature that plant sterols/stanols (consuming at least 2 grams per day from food and supplements), can help significantly reduce LDL cholesterol concentrations between 8-10%.1 Healthy cholesterol levels are important for heart health.

Phytosterols occur naturally in small amounts in many plant-based foods, such as unrefined vegetable oils, whole grains, nuts and legumes. However, one would need to consume an extraordinary amount of these foods to achieve clinically meaningful levels of plant sterols and stanols in one’s diet. A few commercial foods and beverages, such as margarine and orange juice, are fortified with phytosterols, but the caloric price of these alternative fortified food sources can be high. For those who are interested in other forms, dietary supplements, which comes at little to no calories, provides another option for individuals interested in using phytosterols to help manage their cholesterol levels.

Phytosterols from foods and dietary supplements have been studied in a variety of clinical settings. Well-designed studies have demonstrated the cholesterol-lowering effects of phytosterols in both tablet and softgel dietary supplement forms, as well as from foods enriched with phytosterols.2-5

How Much Phytosterols are Naturally Present in Foods?7

The typical American diet provides about 200 mg/day of phytosterols. That leaves a 1.8 g/day nutrient gap.

NAME OF FOOD ITEM

QUANTITY OF FOOD ITEM

QUANTITY OF PHYTOSTEROLS

Corn oil

1 Tablespoon

134 mg

Olive oil

1 Tablespoon

24 mg

Corn

1 ear

63 mg

Apple

1 each

22 mg

Tomato

1 each

9 mg

 

The amount of foods needed to reach 2 g plant sterols and stanols per day

The amount of foods needed to reach 2 g plant sterols and stanols per day

The Qualified Health Claim for plant sterols and stanols states:

Products containing at least 400 mg per serving of plant sterols and stanols, eaten twice a day with meals for a daily intake of at least 800 mg as part of a diet low in saturated fat and cholesterol, may help reduce the risk of heart disease.6

What Does the Science Say?

There is a large body of supportive research surrounding plant sterols and stanols as an effective option for lowering cholesterol. Meta-analyses using an average dose of 2.0 grams/day of plant sterols and stanols, derived from either food sources or in tablet or capsule form, demonstrated significant reductions in LDL cholesterol concentrations up to 12%.9-10

Three clinical studies have shown that 1.8 g/day phytosterols (800 mg twice daily taken with two largest meals of the day), either as a softgel or tablet and along with the Therapeutic Lifestyle Changes (TLC) diet (see back page for more details) resulted in favorable changes in concentrations of total, LDL, and non-HDL cholesterol levels in men and women with high cholesterol in as little as 6 weeks.2-4

What are the Current Guidelines and Recommendations for Cholesterol Management?

There has been a significant increase in the use of statins (cholesterol-lowering drugs) in the last several years.11 While statins are certainly effective, patients are also encouraged to incorporate a healthful diet and lifestyle modifications as part of their cholesterol management efforts.11-13

To help patients manage their cholesterol levels, the National Cholesterol Education Program (NCEP), an umbrella program under the National Institutes of Health

(NIH), issued recommendations, advising a decrease in dietary intake of total saturated fat, cholesterol and trans fat in their diets and an increase in soluble fiber (10-25 g/day), and consumption of plant sterols or stanols (2 g/day).13 While a typical American diet only supplies ~200 mg of plant sterols/stanols per day, adding a plant sterol/stanol supplement can help achieve 2 grams of plant sterols/stanols per day recommendation from the TLC diet.8,13 In addition to dietary changes to include foods low in saturated fat, trans fat, and dietary cholesterol, the NCEP encourages other Therapeutic Lifestyle Changes (TLC). These lifestyle modifications include increasing your physical activity and managing your body weight.

Should I Add a Plant Sterol/Stanol Supplement to My Daily Routine?

It’s important for patients to communicate with their healthcare professionals about any changes to their daily regimen including dietary supplements. Work together to understand personal nutrition needs as well as current dietary patterns to identify nutrient gaps. For those who are still unable to meet their nutrient needs from diet alone, it’s important to discuss the need to fill any potential nutrient gaps with dietary supplements, as a safe and effective way to ensure adequate intake of all essential nutrients.

About Nature Made®

Over the last 50 years, Nature Made has been a trusted leader in the wellness industry. They have helped pioneer quality standards for vitamin, mineral and herbal supplements, and remain dedicated to formulating products backed by science. Committed to Good Manufacturing Practices (GMPs), Nature Made’s quality extends to every aspect of production, from purchasing high-quality raw materials to routine testing for purity and potency. In fact, they were the first national supplement brand to have a product verified by United States Pharmacopeia (USP), and it is the national supplement brand with the most products carrying the USP Verified Mark, verification that products meet stringent quality criteria for purity and potency. Nature Made is also the #1 Pharmacist Recommended Supplement Brand in 9 Categories**

These materials are intended for educational purposes only.

*Find those Nature Made USP verified products on NatureMade.com/USP
**Based on 2019 U.S. News & World Report - Pharmacy Times Survey

†These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

References

  1. Gylling Het al. Atherosclerosis 2014;232(2):346-60.
  2. McKenney JM, et al J Acad Nutr Diet. 2013;244-249.
  3. Maki KC, et al. Int J Food Sci Nutr. 2012;63(4):476-82.
  4. Maki KC, et al. Nutrition. 2013;29(1):96-100
  5. Pirro A, et al. Joint position statement on “Nutraceuticals for the treatment of hypercholesterolemia” of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Artherosclerosis (SISA).
  6. Federal Register Dec. 8, 2010 DHHS 21 CFR Part 101: Food Labeling; Health Claim; Phytosterols and Risk of Coronary Heart Disease
  7. Gupta AK, et al. QJM. 2011;104(4):301-308.
  8. Gylling H, et al. Nutrients 2015;7(9):7965-7977.
  9. Ras RT, et al. Br J Nutr. 2014;112(2):214-9.
  10. Amir Shaghaghi M, et al. J Acad Nutr Diet 2013. 113;(11):1491-503.
  11. National Center for Health Statistics. Health, United States, 2010
  12. Eckel RH, et al. Circulation. 2014;129(25 Suppl 2):S76-S99.
  13. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-3421.