Phytosterols: Sterols & Stanols

Boost Your Cholesterol Lowering Potential with Phytosterols

The first strategy for lowering cholesterol is to modify your eating patterns. Replace unhealthy fats (trans and saturated) with healthy ones (monounsaturated and polyunsaturated), and increase dietary fiber by emphasizing whole grains, fruits, vegetables and legumes. If these strategies haven’t worked to their fullest potential, or if you want to work to lower your bad cholesterol even further, you can try adding phytosterols to your diet.

What are Phytosterols?

Phytosterols (referred to as plant sterol and stanol esters) are a group of naturally occurring compounds found in plant cell membranes. Because phytosterols are structurally similar to the body’s cholesterol, when they are consumed they compete with cholesterol for absorption in the digestive system. As a result, cholesterol absorption is blocked, and blood cholesterol levels reduced.

As part of a heart-healthy eating plan, consuming phytosterols in recommended quantities have been shown to lower total cholesterol up to 10 percent and LDL or “bad” cholesterol up to 14 percent. This reduction is in addition to other cholesterol-lowering strategies you may have initiated, such as eating more heart healthfully or taking a cholesterol-lowering statin. The effectiveness of phytosterols is so strong that The National Cholesterol Education Program recommends people with high cholesterol consume 2 grams of phytosterols each day.

The Food and Drug Administration (FDA) has even approved a health claim on phytosterols, which states: “Foods containing at least 0.65 gram per serving of vegetable oil plant sterol esters, eaten twice a day with meals for a daily total intake of at least 1.3 grams, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.”

How can I include Phytosterols in my diet?

Phytosterols are naturally present in small quantities in vegetable oil, nuts, legumes, whole grains, fruits and vegetables. However, the average intake of these substances is less than 500 milligrams (mg) a day - falling short of the amount needed to lower cholesterol. That’s why many manufacturers fortify foods with phytosterols.

The chart below lists common foods or dietary supplements fortified with sterols or stanol esters. The far right column lists the amount contained in a single serving. To optimize their effectiveness, the following must be consumed two to three times daily before or with meals or snacks (please carefully read instructions indicated on the package).

NOTE: Product information came from manufacturers’ published data, as well as the website corowise.com

Phytosterol Dietary Supplements

We have provided only a sampling of the over-the-counter phytosterol nutritional supplements available. You can find more information about the quality of the supplements available by going online to www.consumerlabs.com, talking with your local pharmacist, or talk with your physician or registered dietitian.

Which is better, taking a Sterol or Stanol?

Head to head trials comparing the LDL-lowering effect of sterols versus stanol esters have shown no significant difference between the two when consumed as part of a low-fat diet. Neither have an effect on blood levels of triglycerides or HDL “good” cholesterol.

Are Phytosterols safe to consume on a regular basis?

No known negative health effects have been shown in research. The body’s tissues do not retain phytosterols, and they do not affect the absorption of fat-soluble vitamins A, D, E and K. Talk to your doctor and/or registered dietitian if you have any questions about including phytosterols in your diet. In addition, do not use these products as a substitute for any prescription medications you are currently taking.

Are Phytosterols safe for children to consume? (PDF) There has not been adequate testing to determine the safety in children. Intermittent use is considered GRAS (Generally Recognized as Safe) by the FDA (Food & Drug Administration). The ADI (acceptable daily intake) is 130 milligrams per kilogram (kg) of body weight. Therefore a child that weighs 50 kilograms (110 lbs) can have up to 6.5 grams.

Get more information on nutrition strategies. To make an appointment with a registered dietitian, call the Cleveland Clinic Preventive Cardiology - 216.444.9353 or 800.223.2273 ext. 9353. Or, get a nutrition consultation online with our private and secure MyConsult Nutrition Consultation.

If you need more information or would like to make an appointment with a specialist, contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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