Why Plant Sterols Are Important
Phytosterols, also called plant sterols or plant stanols1 – are substances found naturally in plant-based foods such as nuts, seeds, grains, fruit, vegetables and plant-based oils.2
They have a chemical structure similar to cholesterol. Because of this, when we eat plant sterols, they have an effect on how our bodies process cholesterol. Plant sterols decrease the absorption of cholesterol in our intestine so more cholesterol is excreted from the body. The result is reduced levels of "LDL-cholesterol". At the same time, plants sterols are reported to have no impact on "HDL-cholesterol" levels.1-3
Extensive research has concluded that a daily dose of 2-3g of plant sterols can lead to an "LDL-cholesterol" reduction of around 6-15%. These results were found in normal adults and in those with elevated cholesterol (regardless whether they were treated with statins or not).4-6
According to a meta-analysis of 124 studies, the "LDL-cholesterol-lowering" effect of plant sterols continues to increase up to a maximum of about 3g per day, with an average effect reduction of 12%.5
If you stop consuming plant sterols, then the cholesterol lowering effects also stop.7
Discover why cholesterol levels matter for heart health.
Recommended plant sterol consumption
According to the Canadian Cardiovascular Society 2016 guidelines, it is recommended to consume 2g or more of plant sterols per day to see a LDL-cholesterol lowering effect.8
Health Canada has reviewed the safety of plant sterols and concluded that “acceptable scientific evidence exists in support of the claim about the relationship between the consumption of plant sterol-fortified foods and blood cholesterol lowering.”1
To sustain a continued cholesterol lowering effect, plant sterol-fortified foods should be consumed every day.7 Keep in mind that plant sterol-fortified foods are not recommended for children, breastfeeding or pregnant women.9
Cholesterol lowering can make a difference
A high level of "LDL cholesterol" is a risk factor for cardiovascular disease, which is a public health concern in Canada.1 ,10 About one third (29%) of all deaths in Canada are due to heart disease.11 An estimated 50% of the Canadian adult population has elevated cholesterol.1
Studies consistently show a reduction in the risk for cardiovascular disease as "LDL cholesterol" levels are reduced.8
What types of food should you eat when trying to consume more plant sterols?
Although plant sterols are found naturally in plant-based foods,it’s difficult to get the recommended daily amount from whole foods alone.7
A healthy diet, including many plant-based foods, provides only about 160-400 mg per day of plant sterols, with vegetarian diets providing up to 600 mg per day.7
That’s where plant sterol-fortified foods come in. Consuming 2-3 servings of plant sterol-fortified foods, every day will provide the recommended daily amount (2g) of plant sterols. Two sources of foods fortified with plant sterols available in Canada include Becel® pro.activ® and a leading brand of orange juice.
Becel® pro.activ® is a calorie-reduced margarine with plant sterols. Each 10g serving (two teaspoons) of Becel® pro.activ® provides 40% of the daily amount of plant sterols and 250 ml serving (1 cup) of fortified orange juice provides 50% of the daily amount of plant sterols shown to help lower cholesterol in adults.
Plant sterol safety
The safety of plant sterols has been supported by extensive research, including high-dosage studies in different groups and long-term studies that assessed plant sterols against recognized safety concerns.
Health Canada, the U.S. Food & Drug Administration and the European Food Safety Authority all confirm that plant sterols are safe for most adults who want to lower their "LDL cholesterol".1,12,13 People taking cholesterol lowering medication, such as statins and fibrates, may be able to take plant sterols as well; however, this must be discussed with their physician first. Plant sterols are not a replacement for any cholesterol lowering medicationand are not recommended for children, breastfeeding or pregnant women.
Learn more about plant sterols and healthy eating.
- Health Canada. Plant sterols and blood cholesterol lowering - Summary of Health Canada’s assessment of a health claim about plant sterols in foods and blood cholesterol lowering. 2010. https://www.canada.ca/en/health-canada/services/food-nutrition/food-labelling/health-claims/assessments/plant-sterols-blood-cholesterol-lowering-nutrition-health-claims-food-labelling.html Sourced Dec 5, 2019.
- British Heart Foundation. Plant sterols and stanols. 2014. https://www.bhf.org.uk/informationsupport/publications/heart-conditions/medical-information-sheets/plant-sterols-and-stanols Sourced Dec 5, 2019.
- Mayo Clinic. Cholesterol: top foods to improve your numbers. 2018. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol/art-20045192 Sourced Dec 5, 2019.
- Cofan M, et al. Use of plant sterol and stanol fortified foods in clinical practice. Current Medicinal Chemistry 2018;25:1-12.https://www.ncbi.nlm.nih.gov/pubmed/29984649 Sourced Dec 5, 2019.
- Ras RT, et al. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: A meta-analysis of randomized controlled studies. British Journal of Nutrition 2014;112:214–19.https://www.ncbi.nlm.nih.gov/pubmed/24780090 Sourced Dec 5, 2019.
- Casas R, et al. Nutrition and cardiovascular health. Int J Mol Sci 2018;19(12):3988.https://www.mdpi.com/1422-0067/19/12/3988 Sourced Jan 24, 2019.
- British Dietetic Association (BDA). Stanols and sterols. 2018.https://www.bda.uk.com/foodfacts/PlantStanolsAndSterols.pdf Sourced Dec 5, 2019.
- Anderson TJ et al. 2016 Canadian Cardiovascular Society (CCS) Guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol 2016;32:1263e1282.https://www.onlinecjc.ca/article/S0828-282X(16)30732-2/pdf Sourced Dec 5, 2019.
- Government of Canada. General Qs and As on plant sterols. 2011.https://www.canada.ca/en/health-canada/services/food-nutrition/food-labelling/nutrition-labelling/general-questions-answers-plant-sterols-nutrition-claims.html Sourced Dec 5, 2019.
- Heart and Stroke Foundation. Blood cholesterol. 2019.https://www.heartandstroke.ca/heart/risk-and-prevention/condition-risk-factors/high-cholesterol Sourced Dec 5, 2019.
- Heart Research Institute (Canada) Facts about heart disease. 2019.http://www.hricanada.org/about-heart-disease/facts-about-heart-disease Sourced Jan 24, 2019.
- Cleveland Clinic. Phytosterols: Sterols & stanols. 2019.https://my.clevelandclinic.org/health/articles/17368-phytosterols-sterols--stanols Sourced Dec 5, 2019.
- EFSA. Scientific Opinion on the modification of the authorization of a health claim related to plant sterol esters and lowering blood LDL-cholesterol; high blood LDL-cholesterol is a risk factor in the development of (coronary) heart disease pursuant to Article 14 of Regulation (EC) No 1924/2006, following a request in accordance with Article 19 of Regulation (EC) No 1924/20061.
- EFSA Journal 2014;12(2):3577. Sourced Dec 5, 2019.