Phytosterols For Heart Health

A bar of butter with a parsley leaf on top, on a white background.
Butter and margarine hare now foods for phytosterol supplementation. Photo by khumthong, courtesy of FreeDigitalPhotos.com

Ingestion of phytosterols are regularly associated with maintaining good heart health and in many ways they have earned the same reputation as statins. You might ask what these agents, phytosterols happen to be ! They are essentially plant based components which are part of a wider group of compounds called stanols and sterols (Ostland, 2002, 2004). You find them mainly in nuts and various vegetable oils. A typical intake based on a ‘normal’ diet means we ingest nearly 1/2 gram of these health compounds daily. In some cases, food is now fortified with them. Who hasn’t heard of margarine or spreadable butter with added phytosterols. They are added because they help us lower or reduce elevated levels of blood cholesterol which is regarded as a significant health issue where the heart is concerned.

The main reason phytosterols help us is they are similar in chemical structure to cholesterol so they upset or interfere with its absorption in the intestine (Plosch et al., 2006). We need cholesterol however  for our cells to keep living  but we don’t need too much of it. The clinical evidence for the benefits of phytosterols generally has been developing over a number of years but the strongest association is with their cholesterol lowering effects (Gylling et al., 2014). So much so, EFSA (2012) and the US FDA (FDA, 2016) now advise that a heart healthy diet combined with consumption of phytosterols certainly helps in managing blood cholesterol and in doing so probably (I say probably guardedly) reduces the risk of cardiovascular disease.

References

EFSA (2012) Scientific Opinion on the substantiation of a health claim related to 3g/day plant sterols/stanols and lowering blood LDL-cholesterol and reduced risk of (coronary) heart disease pursuant to Article 19 of Regulation (EC) No. 1924/2006. EFSA Journal 2012;10
FDA (2016) Food And Drug Administration. Title 21, Chapt. 1, subchapter B, PART 101, Subpart E — Specific requirements for health claims, Sec. 101.83 health Claims: plant sterol/stanol esters and risk of coronoary heart disease (CHD).
Gylling, H., Plat, J., Turley, S., Ginsberg, H. N., Ellegård, L., Jessup, W., … & Silbernagel, G. (2014). Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease. Atherosclerosis. 232(2), pp. 346-360.
Ostlund, Jr, R. E. (2002). Phytosterols in human nutrition. Annual Review of Nutrition, 22(1), pp. 533-549
Ostlund Jr, R. E. (2004). Phytosterols and cholesterol metabolism. Current Opinion in Lipidology. 15(1), pp. 37-41
Plösch, T., Kruit, J. K., Bloks, V. W., Huijkman, N. C., Havinga, R., Duchateau, G. S., … & Kuipers, F. (2006). Reduction of cholesterol absorption by dietary plant sterols and stanols in mice is independent of the Abcg5/8 transporter. The Journal of Nutrition. 136(8), pp. 2135-2140
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