8 February 11 Plant Sterols & Stanols

Plant sterols and stanols occur naturally in fruits, vegetables, vegetable oils, seeds, nuts, and cereals. Both are plant versions of cholesterol but their effect is to lower rather than raise our LDL blood cholesterol level.

Why care about your LDL level?

Having a high LDL level puts you at high risk for heart disease – the number one cause of death in the United States. A great resource for those of you with high blood cholesterol levels is "Your Guide to Lowering Your Cholesterol with TLC (Therapeutic Lifestyle Changes)." This online booklet describes the key lifestyle factors to change if you have been diagnosed with high blood cholesterol levels (e.g. high total cholesterol, LDL and triglyceride levels and a low HDL level).

Foods Fortified with Sterols & Stanols

Eating plenty of fruits and vegetables is a healthy way to eat, but it will not meet the recommended intake of 2 grams (2000 mg) per day to help lower a high LDL level. Even plant-based diets max out at about 600 mg of sterols and stanols per day.

To fortify foods, sterols and stanols are esterified. That is, a little fat comes along for the ride. You can replace certain food items in your diet with the sterol or stanol fortified versions so that you don't increase your caloric intake. For instance, you would replace butter or regular soft tub margarine with the sterol or stanol fortified spread. Of course, if you track your caloric intake, these dietary adjustments are much easier than just guessing.

There are many food products that are fortified with sterols and stanols: soft margarines, yogurt, orange juice, cereals, cooking oils, salad dressings, bread, and even muffin tops. Foods that are fortified will always list the sterol or stanol content. To insure that you ingest 2 grams per day, be sure to read food labels for serving size and sterol or stanol content. Also, these fortified foods are meant to be taken during meals, so split up your 2 grams between all three meals, or consume them during your two largest meals.

Cost

Foods fortified with sterols and stanols are typically much more expensive than their non-fortified counterparts. For instance, at my local large-chain grocery store, sterol and stanol fortified spreads (e.g. Benecol Spread and Smart Balance Heart Right) cost about twice as much as regular soft tub margarine. Sterol and stanol fortified cow's milk (e.g. Active Lifestyle and Smart Balance Heart Right) cost about 2.5 – 3 times as much as regular skim milk, but the sterol or stanol content was only half that of the fortified spreads.

Before you start doubling and tripling your grocery bill on sterol and stanol fortified foods, remember that the goal of 2 grams per day is specifically for those who have high LDL levels. If you do not have a high LDL level, then simply follow a heart-healthy diet as recommended by the American Heart Association.

Consuming plant sterols and stanols from fortified foods is a dietary option to include if you are struggling to lower your high LDL level. This in addition to limiting saturated and trans fats in your diet, the most important dietary changes to reduce LDL levels. Other dietary changes that can help lower your LDL level include limiting cholesterol, as well as increasing foods high in soluble or viscous fiber.
Katherine Isacks, MPS, RD
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Disclaimer: The information provided here does not constitute medical advice. If you are seeking medical advice, please visit your healthcare provider or medical professional.

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