Phytosterols to lower cholesterol or prevent heart disease

Question: What do you think about stanols or sterols to prevent heart disease?

Answer: The FDA permits sterol-containing products to claim that they help reduce the risk of coronary heart disease, although no study has shown a direct reduction in heart disease, heart attacks, strokes, or premature death. Nevertheless, dietary experts advise, “Along with a healthy diet, eating foods that provide you with around 2 grams of plant stanols and sterols every day has been shown to reduce blood cholesterol levels. A healthy diet typically contains only 200-400 mg of sterols and stanols a day. However, this intake is too low to bring about a significant cholesterol-lowering effect.”

Foods fortified with plant stanols and sterols come in many forms such as the healthy-fat-based spreads; juices such as Minute Maid^® Premium Heart Wise Orange Juice; and fortified dairy-type foods (milk, yogurt, and yogurt drinks) such Dairy Farmers HeartActive^® or Yoplait Healthy Heart^® products which typically contain 0.5 to 2 gram of phytosterols per serving size and can help you reach the amount needed to help lower your cholesterol (tinyurl.com/5yjmjkuh). For example, you could have one cup of Minute Maid^® Premium Heart Wise Orange Juice at breakfast and one tablespoon of Promise^® Activ Spread on vegetables at dinner, or one tablespoon of Smart Balance Heart Right^® spread on oatmeal at breakfast and two Benecol^® Soft Chews or CholestOff^® Plus soft gels with dinner).

I always prefer whole foods over supplements, but for those choosing a supplement, they are easy to take (and to take with you) if you need a backup when you cannot reach the 2-3 grams from food sources, for example, when on vacation or when dining out. The experts at ConsumerLab.com^® (subscription) have tested phytosterol supplements and “Approved” as their “Top Pick” Nature Made^® CholestOff^® Plus, which they found “provides the right ingredients at the best price and even has a clinical study to support its efficacy … [and] was by far the least expensive source of sterols/stanols, at just sixteen cents per day. The cost to obtain the same amount of sterols/stanols from other products ranged from forty-seven to seventy-four cents per day.”

For most people, it is not essential to take phytosterols to help manage your cholesterol. Being more active, stopping smoking, and eating an overall heart-healthy diet are far more important. And for many people, a cholesterol-lowering medication is needed. Supplements should not substitute for a healthy diet or prescribed medication but can be used in addition to these steps. Nevertheless, phytosterol supplements are safe to use with a good diet and with a statin drug. If you decide to try one, check with your family physician or pharmacist first. If they okay it, try the phytosterols every day for 6-12 weeks. If your cholesterol levels improve, then it would be wise to continue them.