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Plant Sterols and Stanols: What You Need to Know

Do They Really Help Lower Cholesterol?

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Heart health is on a lot of people's minds these days, especially as more and more people are developing high blood pressure, high cholesterol and type II diabetes. You may think that you're on your way to figuring it all out, too. Eating a heart-healthy diet? Check. Engaging in regular exercise to improve your cardiovascular fitness? You bet. Working to achieve or maintain a healthy weight? Of course.

So when new products comes to market, whether a prescription medication you see on a TV commercial or the latest "functional foods" from the grocery, you probably feel confused all over again. Plant sterols and plant stanols are becoming increasingly popular as supplements and food additives. If you've seen (or used) orange juice, yogurt, and chocolates that boast cholesterol-lowering benefits, then you've probably encountered plant sterols and stanols without even knowing it. The foods that contain them boast heart healthy benefits on their packages, which may have caught your interest. So what are these sterols and stanols? Do you need them? But maybe more importantly, will they really help to lower your cholesterol?

What Are Sterols and Stanols?
Plant sterols and plant stanols are phytoesterols (small but essential components of certain plant membranes). They are found naturally (in very small amounts) in some vegetable oils, nuts, grains, legumes, fruits, and vegetables. Research has shown that plant sterols and plant stanols have the ability to help lower cholesterol. Hoping to cash in and make common food products even "healthier," food manufacturers have taken these phytoesterols from their naturally occurring sources, concentrated them, and added them to common foods that wouldn't normally contain them, such as vegetable oil spreads (margarine), mayonnaise, yogurt smoothies, orange juice, cereals, and snack bars to name a few.

How Do They Work?
When you eat food that contains dietary cholesterol (which is found in animal products like meat, eggs and dairy), your intestinal tract absorbs that cholesterol and puts it into the bloodstream. Plant sterols and plant stanols are chemically similar to dietary cholesterol found in animal products. So when the sterols and stanols travel through your digestive tract, they get in the way of dietary cholesterol, preventing it from being absorbed into the bloodstream. Therefore, less total cholesterol is absorbed by your body when plant sterols and stanols are present. The cholesterol that is not absorbed leaves the body as waste. With regular use, plant sterols and plant stanols can result in a reduction in blood cholesterol levels.

Are They Safe and Effective?
Plant sterols and plant stanols have been studied for over 50 years. More than 140 published clinical studies have shown that plant sterols and plant stanols lower total cholesterol and LDL (bad) cholesterol. For example:
  • Consuming 1.8 to 2.8 grams of plant sterols and plant stanols per day over a period of 4 weeks to 3 months significantly lowered total cholesterol in participants by 7%-11%.
  • Consuming 2.0 to 2.5 grams of plant sterols and plant stanols per day resulted in 10%-14% reduction in LDL (bad) cholesterol without side effects.
  • The National Cholesterol Education Program’s Adult Treatment Panel III also states that intakes of 2-3 grams of plant sterols and plant stanols daily will reduce LDL cholesterol by 6%-15%.
To put these numbers into perspective, let's assume that your total cholesterol is 225 mg/dL (that's considered high) and you added a therapeutic dose of plant sterols or plant stanols daily (according to package directions). You could lower your cholesterol down to 202 mg/dL—a significant reduction.

Because of the proven efficacy of sterols and stanols, the Food and Drug Administration (FDA) has approved this health claim:

“Diets low in saturated fat and cholesterol that include at least 1.3 grams of plant sterols or 3.4 grams of plant stanols, consumed in two meals with other foods, may reduce the risk of heart disease.” A food product may carry the health claim if the product itself is also low saturated fat (1g or less per serving), low in cholesterol (20mg or less per serving), and contains no more than 13 grams of total fat per serving and per 50 grams.

How much do you need?
The American Heart Association's (AHA), Diet and Lifestyle Recommendations (2006) state that individuals should consume plant sterols and plant stanols from a variety of foods and beverages every day—just as they would use cholesterol-lowering medication to maintain LDL (bad) cholesterol reductions from these products. The AHA also notes that maximum effects are achieved at plant sterol and plant stanol intake of approximately 2 grams per day.

As stated above, plant sterols and stanols can occur naturally in foods or be fortified into other food products. Check out the chart below for examples of foods that contain them. Note: All amounts have been converted to grams of sterols in order to provide equivalent measures per product (0.8g sterols = 1.3 g sterol esters = 3.4 g stanol/stanol esters). 

 Food Sources of Plant Sterols  Amount (grams)
 Avocado, 1 small  0.13 g
 Corn oil, 1 Tbsp  0.13 g
 Sunflower seeds, 1/4 cup  0.19 g
 Oat bar with plant sterols, 1 bar  0.40 g
 Milk with plant sterols, 8 oz  0.40 g
 Lifetime Low-Fat Cheese Singles, 1 slice (2/3 oz)  0.40 g
 Carazonas Tortilla Chips, 10 chips  0.40 g
 Nature Valley Healthy Heart Honey Nut Bar, 1 bar  0.40 g
 Thomas’ Hearty Grains Oatmeal & Honey English Muffin, 1  0.40 g
 CocoaVia Chocolate Covered Almonds, 13 almonds  0.70 g
 CocoaVia Snack Bar, 1 bar  0.90 g
 Orange juice with plant sterols, 1 cup  1.00 g
 Vegetable oil spread with plant sterols, 1 Tbsp  1.00 g
 Right Direction Chocolate Chip Cookies, 1 cookie  1.30 g
Fruit and yogurt flavored drink with plant sterols, 3.4 oz bottle  2.00 g

Keep these points in mind if you choose to ad plant sterols and plant stanols to your diet:
  • Plant sterols and plant stanols are NOT a replacement for prescribed medications. Always consult your doctor and/or a Registered Dietitian concerning any dietary changes you may make, especially if you are taking other medications.
  • Consume 2 to 3 grams per day of plant sterols or plant stanols. For best results, consume sterols and stanols with a meal. Eating up to 2 grams of plant sterols or plant stanols at one sitting is fine.
  • Eating more than 2 to 3 grams of plant sterols or plant stanols per day does NOT provide additional cholesterol-lowering benefits.
There's more to lowering your cholesterol than taking plant sterols and stanols. Be sure to meet with your doctor regularly to discuss your cholesterol profile and how to keep it in check. For more specific cholesterol-lowering eating, exercise and lifestyle tips, visit SparkPeople's High Cholesterol Condition Center.

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Member Comments

  • This article reads like a 'promotional health ad' for processed packaged food...I'm sure including crappy junk food along with these additional benefits will negate the benefits. Eat REAL food!
  • LILYOFVALEE
    I agree with many of the commenters: where are more whole foods with sterols/stanols? I've worked very hard to get rid of "fake" food from my life. I know there may be small amounts but, with a variety of choices, I could come closer to reaching the amount needed without having to resort to processed food.
  • METAMORPH2010
    And note that the recommendation is for 2 to 3 grams of the stuff *every day*. Otherwise it does not have the same effect. Hence the need for supplementation, whether with maca powder (yuck), in capsule form, or in processed foods that aren't all that healthy in and of themselves.
    MM
  • METAMORPH2010
    Yup, so if I eat this brand of chocolate covered almonds, I'm improving my health. NOT! Unfortunately, it isn't easy to get enough sterols and stanols from real food on a daily basis, at least not in sufficient quantities to lower one's cholesterol, and for a change, the studies are unequivocal -- sterols and stanols do help.

    I've heard there are supplements available, and that's what I'm looking for, not these pseudo-health foods.

    Mind you, 2 Tbsp of maca powder gives you what you need, if you can stomach the stuff. Not recommended for smoothies (been there, done that), but some strong coffee helps cover the flavour if you make some sort of a coffee drink.

    Note that another thing not mentioned in the article is that sterols and stanols have no effect whatsoever on a person with normal cholesterol levels.

    Wish there were real food out there, aside from the vile maca root (which is only available in Canada in a rather highly processed form), that had medicinal quantities of these nutrients.
  • Apparently the previous posters missed part of the article...! Yes, they are in SOME veggies, fruits, nuts but in such low quantities that if you want to see a benefit, you must consume copious quantities of those items..... Its not Spark's fault that Mother Nature didn't increase the amounts naturally! LOL As for me, grateful for the info...and the chart listing:
    Avocado, 1 small 0.13 g
    Corn oil, 1 Tbsp 0.13 g
    Sunflower seeds, 1/4 cup 0.19 g

    Thank You!!
    patti
  • So very disappointed in this article. So we are supposed to eat cookies, vegetable oil, tortilla chips? Wow! I've been trying to go "real food" for health so this article just blew my mind. Not sure I would turn to this site for health counseling. Tracking food, calories and nutrients and then tracking exercise on this site is fine but WOW on this article. This unfortunately is not the only article I have had this kind of reaction to though.
  • I know I am preaching to the choir here, but don't you think this article oversimplifies the role of cholesterol in our body. And isn't it usually true that the food that screams health claims all over the box is usually the very food you should leave right there on the grocery aisle shelf. Real Whole Foods always reign supreme, you don't need a BS in Nutrition to know that.
  • It's obvious the way to get these nutrients naturally is to eat more fruits and vegetables. Haven't we learned anything from the problems cause by removing nutrients and then enriching our foods with the basic 8? While the studies have been going on for 50 years, I doubt the WHOLE picture has been studied, looking how one food has balanced ingredients to make it a complete healthy food. As long as we continue to try to make our cake out of fake ingredients, and then how to eat it and supplement with fake supplements to try to make it okay to do all of that, our health is going to suffer. WHOLE, UNADULTERATED FOOD!!
  • ATTORNEYAMYW
    I'm with all of you. Tell me how to get this from natural foods. I thought the whole point of this website is to help us find the best and most natural ways to health, fitness, and weight loss. Please follow up with an article that tells us where to get this in real food. Thanks.
  • TROOPMOMY
    Come on wake up people, and smell fresh food. The more we eat heal balanced and natural food, less we have to worry about all these stuff. Main problem anywhere is portion. Once that got take care of, other problems will be slowly rest in peace.also don't forget 8 glasses of water everyday.
  • Agree with the others - a followup article with real food, rather than processed/manufac
    tured food, would be terrific.
  • Perhaps these franstein foods are unnecessary for the healthy people, but I would try them as opposed to cholesterol meds any day.
    I had often wondered how they worked. Thanks for the explanation.
    I do have high cholesterol, and am eating most days under 100 mgs of cholesterol, and doing my excercises. I will add other things as I see the need. ANYTHING is better than meds, and I´ll use them only as a last resort.
  • I would never advocate people drinking orange juice for this reason. ALL fruit juice is just concentrated fructose, ( the addictive half of the sugar molecule). Just think how many oranges it takes to make 1 glass of juice. Could you eat that many oranges in one sitting? It may be hard work extracting the juice, but you'd be better off eating 1 orange per day, getting the benefit of the fibre in it. Remember folks, fructose makes you fat!.
    Don't take my word for it, do your own research. Fat doesn't make you fat either, the wrong type of fat may give you heart disease, but it doesn't make you fat. No-one has proved it does, either. Try and follow that research, see where it gets you. To someone's 'opinion' that's where, not a proven fact.

    Silver Angel

    Spread the Love
  • Ditto Bittersweet100... I too would love a list of actual plants/whole foods that are high in sterols/stanols? Thanks, Diane
  • AZURE-SKY
    This article would have been much more informative if it had listed more REAL foods, rather than foods manufactured in a laboratory/factor
    y.

    I'm on a generic statin for high cholesterol (lovastatin), and so is my husband. His doctor wanted him to try Red Yeast Rice because it is "natural." However, I did a lot of research and was very concerned about these products. Numerous studies and lab analyses have shown that:

    1) there are varying levels of cholesterol-lower
    ing ingredients in different brands;
    2) there can be different levels in the same brand, and even in the same batch of product;
    3) some brands contain PRESCRIPTION STATINS;
    4) some of the Red Yeast Rice brands contain MORE of the cholesterol-lower
    ing statins than the Prescription doses - so you don't know what you're getting;
    5) these supplements are not regulated by the FDA - so there are no guidelines or regulations as to what amounts of statins you are getting in these supplements.

    Additionally, the cost of my husband's prescription which has been around for about 40 years - well tested & documented - is $4.00 a month. The equivalent amount of Red Yeast Rice would cost him over $30.00 a month!

    Sometimes a prescription medicine is better than a natural alternative.

    The following is an extract from the Mayo Clinic website:

    Red yeast rice is the product of yeast ( Monascus purpureus ) grown on rice, and is served as a dietary staple in some Asian countries. It contains several compounds collectively known as monacolins, substances known to inhibit cholesterol synthesis. One of these, "monacolin K," is a potent inhibitor of HMG-CoA reductase, and is also known as mevinolin or lovastatin (MevacorŽ, a drug produced by Merck & Co., Inc).

    Red yeast rice extract has been sold as a natural cholesterol-lower
    ing agent in over the counter supplements, such as Cholestin TM (Pharmanex, Inc). However, there has been legal and industrial dispute as to whether red yeast rice is a drug or a dietary supplement, involving the manufacturer, the U.S. Food and Drug A...

About The Author

Becky Hand Becky Hand
Becky is a registered and licensed dietitian with almost 20 years of experience. A certified health coach through the Cooper Institute with a master's degree in health education, she makes nutrition principles practical, easy-to-apply and fun. See all of Becky's articles.

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