You may not have heard of phytosterols, but you have likely eaten foods that contain them. Phytosterols, comprising plant sterols, stanols and their fatty acid esters, are part of the structure and function of biological membranes of plants. Along with their structural role, phytosterols are precursors to a group of plant hormones that regulate plant growth and development, as well as produce and maintain enzymes important to a plant’s response to stresses. Phytosterols naturally occur in small quantities in all plant foods including fruits, vegetables, nuts, seeds, legumes and whole grains with the highest concentrations found in unrefined vegetable, nut and olive oils. Phytosterols can also be obtained though fortified foods and nutritional supplements.
Similar in structure and function to cholesterol, phytosterols provide the same basic function in plants as cholesterol does in humans, performing as precursors to hormone production and regulating membrane fluidity. Individuals with high blood cholesterol who are at risk of heart disease have been shown to benefit from added sources of phytosterols in their diets. Nutritional phytosterols have been found to inhibit intestinal absorption of dietary cholesterol, thereby reducing serum low density lipoprotein (LDL) cholesterol more than cholesterol-lowering medications alone. While small amounts of phytosterols can be obtained naturally through the diet, larger amounts are needed to effectively reduce high LDL cholesterol levels.
Since the 1950’s abundant research into the LDL cholesterol-lowing effects of phytosterols has shown that a higher consumption of phytosterols through a plant-based diet, as well as inclusion of phytosterol-enriched foods and supplements, is considered a viable adjunct for the management of high LDL cholesterol. Along with a balanced heart-healthy diet and a healthy lifestyle, consumption of approximately one to two grams of plant sterols or stanols daily is needed to obtain cholesterol-lowering benefits. Studies have also shown that consumption of more than two grams daily has little or no additional benefit.
The average American gets only about 80 mg of plant sterols daily, nowhere near enough to make a meaningful impact on cholesterol through natural foods alone. The Asian diet, considered the most sterol-rich diet globally, provides approximately 400 mg daily, while a vegetarian diet may provide about 345 mg per day. In fact, one would have to eat quite a bit of food to obtain significant amounts of phytosterols on a daily basis to achieve a reduction in cholesterol. However, increased consumption of sterols in general can help one avoid high cholesterol before it occurs and can help lower moderately high LDL levels.
Those in the high-risk LDL cholesterol zone who are taking LDL-lowering statin medications can also benefit from increased phytosterol consumption, as each uses a different mechanism to reduce cholesterol. Statin medication lowers LDL by slowing natural cholesterol production and increasing cholesterol removal from the liver, where most of the body’s cholesterol is produced. Phytosterols work by preventing the absorption of cholesterol through the digestive tract. Combining the use of phytosterols with statin medications has been shown to be safe and effective for achieving a greater total reduction of LDL. Plant sterols have no known side effects beyond slightly lowering the absorption of fat-soluble compounds, carotene and vitamin E. However the effect is not significant when following a healthy, balanced colorful diet.
Perhaps, the most surprising aspect of plant sterols effect on cholesterol is that they seem to work for everyone, regardless of an individual’s cholesterol profile or any other factor. Those who do not currently have high LDL cholesterol can decrease the likelihood of ever having high cholesterol by following a healthy diet, exercising regularly and increasing their daily intake of foods naturally rich in plant sterols. As well, foods fortified with plant sterols allow for consumption of the recommended dose of one to two grams daily. Plant sterol supplements are an easy and convenient way to ensure consistent consumption of measured amounts of phytosterols, especially for individuals with high LDL cholesterol levels.
Efficacy and safety data from trials with suitable endpoints have shown that taking a non-statin agent along with a statin medication is a potential strategy to further reduce cardiovascular events. Meta-analysis of 15 randomized controlled trials showed that combination treatment with statins and phytosterols significantly decreased the levels of total cholesterol compared with statins alone. Therapeutic oral intake of phytosterols does not interfere with general health or the metabolism and absorption of foodstuff other than cholesterol. Because phytosterols have very low systemic absorption rates and are already present in healthy diets, increasing intake of phytosterols may be a practical way to reduce coronary heart disease development with minimum risk.
Those taking statins or any other medications should always consult their healthcare practitioner before embarking upon any supplement regimen. Plant sterols should not be used in lieu of medications for those who need them.
Professional Supplement Center offers these and other nutritional supplements in support of cardiovascular and overall health:
Phytosterol Complex™ by Progressive Laboratories®: This purified plant sterol complex provides a blend of three forms of plant sterol esters along with niacin. Phytosterol Complex™ is formulated to relax blood vessels and support healthy circulation, as well as support normal range cholesterol levels.
Foresterol™ Coniferous Plant Sterols/Stanols by Designs for Health®: Foresterol™ is formulated to support healthy LDL cholesterol levels with Reducol®, a blend of 4 free-form phytosterols. This product may be used in conjunction with other cholesterol lowering agents for enhanced activity. Gluten free.
Proto-Sitosterol Plant Sterol Esters by Protocol For Life Balance®: This supplement provides CardioAid®-S, a medley of plant sterol esters to help limit the absorption of cholesterol in the digestive tract. The formula also provides 120 mg of natural fish oil concentrate in support of cardiovascular and overall health. Free of yeast, wheat, gluten, milk, eggs, shellfish and tree nuts.
CholestePure by Pure Encapsulations®: This phytosterol complex provides 1,000 mg of a balanced broad spectrum blend of phytosterols in support of healthy lipid metabolism. Gluten free, Non-GMO formulation.
Plant Stanols. Bioactive Nutrients and Cardiovascular Disease. https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/plant-stanols
Plant Sterols: Diversity, Biosynthesis, and Physiological Functions. https://link.springer.com/article/10.1134%2FS0006297916080046
LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomized controlled studies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071994/
Effects on plant stanol or sterol-enriched diets on lipid profiles in patients treated with statins: systematic review and meta-analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990897/
Phytosterols and cholesterol metabolism. https://www.ncbi.nlm.nih.gov/pubmed/15166807