Nutrition Bytes

Research has demonstrated that plant sterol and stanol ester-enriched margarine spreads lower LDL cholesterol by 9-14% (1). Maximal LDL reduction is achieved at plant sterol or stanol ester doses of 1.6-2.0 g/day (2,3). The mechanism for LDL reduction is the inhibition of cholesterol absorption in the gastrointestinal tract. For patients following a low-fat diet, plant sterols provide LDL-lowering beyond that obtained through diet alone. Plant sterols also provide additional LDL-lowering when used in conjunction with statins (2,4). Recent studies of esterified and non-esterified sterols and stanols in low-fat foods have demonstrated the same extent of LDL reduction observed with sterol ester-enriched fatty foods. Plant sterols and stanols appear safe, but are associated with decreased lycopene and carotene levels. However, these reductions can be prevented by consuming one additional serving/day of a high-carotenoid food (5). Despite demonstrated effectiveness and safety, sales of phytosterol-enriched products have been slow. Future research is needed to develop better marketing strategies and to expand the number of phytosterol-enriched products. The role of low levels of phytosterols present naturally in the diet should also be evaluated.