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What are phytosterols?

Phytosterols, which include plant sterols and stanols, are plant-derived lipids similar to cholesterol.

Name origin: from the Greek phyt = a plant.

Foods Rich in Phytosterols

Foods naturally rich in phytosterols include unrefined sesame and corn oil, rice bran oil, whole grains, sunflower seeds, Brussel’s sprouts, rye bread, nuts and legumes [2].

Examples of foods enriched with plant sterols and stanols: certain spreads, margarines, low-fat yogurt, low-fat milk, low-fat cheese, dark chocolate, salad dressings and orange juice [1].

Phytosterols Function

Phytosterols decrease the absorption of cholesterol in the intestine [1].

Phytosterols Supplements

Non-prescription oral phytosterol supplements containing beta-sitosterol without prescription are available.

Phytosterols Benefits

The minimal intake of phytosterols that can have beneficial health effects is about 1 g/day and the maximal effect can be achieved by about 2-3 g/day [1,8]. Consuming foods naturally high in phytosterols rarely provides more than 0.5 g phytosterols per day [1]. 1 tablespoon of phytosterols-enriched margarine can provide 1.3 g of phytosterols [2].

Phytosterols in doses about 2 g/day are EFFECTIVE in:

  • Decreasing total and LDL cholesterol and triglycerides in individuals with increased cholesterol levels [1,4,5,10]. Daily intake of 2 grams of phytosterols was associated with 10% decrease of LDL levels, in average [1,5,8,9]; intake greater than 2-3 g/day has not been associated with further LDL decrease [1]. Cholesterol-lowering effect was sustained for up to 85 weeks [9]. In individuals on statin therapy (to lower LDL cholesterol), phytosterols in doses 2-3 g/day can further decrease LDL levels by up to 10% [1].

There is INSUFFICIENT EVIDENCE about the effectiveness of supplements containing beta-sitosterol in prevention or treatment of benign prostate hyperplasia [1] or cancer [1].

There seems to be NO EVIDENCE about phytosterols intake and decreased risk of cardiovascular disease (coronary heart disease, stroke) [6,7].

Phytosterols Safety: Toxicity, Side Effects

Phytosterols added to foods and ingested at doses up to 3 g/day are Generally Recognized As Safe by the U.S. Food and Drug Administration (FDA) [3]. Still, these supplements are not recommended for pregnant and breastfeeding women, since their safety in these periods has not been tested.

Side effects may include nausea, indigestion, diarrhea and constipation [1].

Who should avoid phytosterols?

Individuals with a rare genetic disease sitosterolemia should avoid foods with added phytosterols in order to prevent premature atherosclerosis (hardening of the arteries) [1].

  1. Phytosterols  Linus Pauling Institute
  2. List of Foods high in phytosterols  US Department of Agriculture
  3. 2005, GRAS notification for plant phytosterols for use in egg products including egg whites, and egg substitutes  US Food and Drug Administration
  4. Wu T et al, 2009, The effects of phytosterols/stanols on blood lipid profiles: a systematic review with meta-analysis  PubMed
  5. Moruisi KG et al, 2006, Phytosterols/stanols lower cholesterol concentrations in familial hypercholesterolemic subjects: a systematic review with meta-analysis  PubMed
  6. Genser B et al, 2012, Plant sterols and cardiovascular disease: a systematic review and meta-analysis  PubMed
  7. Gupta AK et al, 2011, Role of phytosterols in lipid-lowering: current perspectives  QJM
  8. 2010, Plant Sterols and Blood Cholesterol Lowering  Health Canada
  9. 2009, Blood cholesterol reduction health claims on phytosterols can now be judged against EFSA new scientific advice  European Food Safety Authority
  10. Plana N et al, 2008, Plant sterol-enriched fermented milk enhances the attainment of LDL-cholesterol goal in hypercholesterolemic subjects  PubMed

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