Phytosterols

What are phytosterols?

Phytosterols (fi-TAH-ster-ols) are natural products (compounds) found in plants. Eating plant-based foods with phytosterols as part of a healthy diet may help you lower your cholesterol levels. You can find phytosterols in:

• Fruits and vegetables.
• Whole grains.
• Nuts.
• Cheese and milk made (fortified) with phytosterols.

It's also available in dietary supplements. Ask your healthcare provider how adding phytosterols to your diet could improve your heart health.

Other names for phytosterols are:

• Plant stanols.
• Plant sterols.
• Stanol esters.

What do phytosterols treat?

Phytosterols help you manage blood cholesterol levels, reducing your risk of cardiovascular disease, heart attack or stroke. Cholesterol is a waxy substance made by your liver that circulates in your blood.

Your body needs cholesterol to build cells, protect nerves and make vitamins and hormones. But too much of a certain type of cholesterol (LDL or "bad" cholesterol) can cause heart problems if it builds up in your arteries and blocks them.

Phytosterols may also help prevent obesity, diabetes and cancer. Early studies suggest diets rich in phytosterols could reduce cancer risk by up to 20%.

What are the types of cholesterol?

There are two main types of cholesterol:

• Low-density lipoprotein cholesterol (LDL): LDL or “bad” cholesterol can clog your arteries and is a major cause of heart disease.
• High-density lipoprotein cholesterol (HDL): HDL or“good” cholesterol helps protect arteries and may help prevent heart disease.

How do plant sterols work?

The cell structure of phytosterols looks and acts like cholesterol, so it competes with cholesterol for absorption by your digestive system.

When your body digests plant sterols instead of cholesterol, it removes some of the cholesterol as waste. This results in lower cholesterol levels and improved health.

What are the types of phytosterols?

Researchers have identified more than 250 types of phytosterols. Common ones include:

• Beta-sitosterol.
• Beta-sitostanol.
• Campestanol.
• Campesterol.
• Stigmasterol.

Who should use phytosterols?

Most people can benefit from eating more foods that contain phytosterols. You may benefit from a diet especially high in phytosterols or by taking a daily phytosterol supplement if you have:

• Heart disease or family history of heart disease.
• High cholesterol, including familial hypercholesterolemia (FH), that's difficult to manage.
• History of atherosclerosis.

Who should not take phytosterols?

Phytosterols aren't recommended for people with sitosterolemia, a genetic disorder in which cholesterol and plant sterols build up in the body. High plant sterol levels may cause an increased risk of early (premature) atherosclerosis. Talk to your healthcare provider or dietitian to develop an eating plan that’s right for you.

What are the benefits of phytosterols?

Phytosterols are effective in lowering cholesterol if you eat enough of them as part of a heart-healthy diet low in saturated fat and cholesterol. Studies have shown that a daily diet that contains 2 grams of phytosterols correlates with an 8% to 10% lower LDL cholesterol level. Phytosterols can also benefit people taking statins or ezetimibe, a cholesterol-lowering drug.

What are the risks of phytosterols?

Phytosterols are generally safe for most healthy people. They typically don't stay in your body or affect how your body absorbs fat-soluble vitamins A, D, E and K. (Fat-soluble vitamins can dissolve in fat.)

Don't replace any prescription medications with plant sterols. If you use phytosterol supplements, read labels to check for ingredients and side effects. Talk to your healthcare provider if you have any questions or concerns.

Are phytosterol supplements safe for children?

Phytosterol supplements haven't been sufficiently tested in children to determine their safety. Talk to your child’s healthcare provider about phytosterols for your child, especially if they're at high risk of heart disease.

What is the recommended daily intake of phytosterols?

According to the U.S. Food and Drug Administration (FDA), phytosterol-containing foods can help reduce your risk of heart disease. Eat foods with at least 0.65 grams per serving of phytosterols twice a day with meals (total daily intake at least 1.3 grams). Eat these foods as part of a diet low in saturated fat and cholesterol.

Adults with high cholesterol may need to consume a higher amount of phytosterols. The National Cholesterol Education Program (NCEP) recommends 2 grams of phytosterols daily to help protect against cardiovascular disease risk.

In the U.S., most people get between 160 and 500 milligrams of phytosterols per day — a fraction of the recommended totals. That means you need to eat foods with added plant sterols (phytosterol-enriched) or take dietary supplements to meet that goal. Your healthcare provider can help determine if a daily phytosterol supplement is right for you.

What foods are high in phytosterols?

Small amounts of phytosterols occur naturally in certain foods. You can find them in:

• Fruits.
• Legumes.
• Nuts.
• Vegetables.
• Vegetable oil.
• Wheat germ.
• Whole grains.

Other foods have added plant sterols, which can help you reach your dietary goals. They include:

• Bread.
• Breakfast and snack bars.
• Cereal.
• Cheese.
• Chocolate.
• Juice.
• Low-fat cheese spread.
• Margarine.
• Milk.
• Salad dressing.
• Yogurt.

Talk to your healthcare provider or a dietitian to help develop a healthy eating plan. Many of these foods are high in sugar or calories, so it’s important to plan a diet that helps you meet your needs.

You may need to take phytosterols as dietary supplements in tablets or capsules. Discuss supplements with your provider, especially if you're taking any medications.

Where can I find more information about plant sterol supplements?

The quality of nutritional supplements varies. Read labels carefully and talk to your healthcare provider or a registered dietitian for more information.

A note from Cleveland Clinic

The best first step for lowering cholesterol is to eat heart-healthy meals. Replace unhealthy fats (trans and saturated fats) with healthy ones (monounsaturated and polyunsaturated fats). Increase your fiber intake by eating fresh fruits, vegetables, whole grains and legumes. Talk to your healthcare provider about adding foods fortified with phytosterol to your diet or taking a phytosterol supplement to maximize your heart health.