Plant sterols and stanols in dyslipidemia
In this section, you will get an insight of:
- What are plant sterols and stanols and how do they lower LDL-cholesterol;
- What are the cardiovascular benefits of including plant sterols and stanols as part of diet and lifestyle interventions in the management of dyslipidemia;
- What are the benefits of plant sterols and stanols in LDL-cholesterol management for patients already on drug therapy;
Based on the current ESC/EAS guidelines, a daily consumption of 2 g of plant sterols and stanols is recommended to achieve a significant inhibition of intestinal cholesterol absorption, subsequently leading to lowering LDL-cholesterol levels in the blood by 7-10%.1
What are plant sterols and stanols
and what foods contain them?
Plant sterols and stanols are components of our everyday diet as they are found in all plant-based foods (see sources of plant sterols and stanols in Table 9). They are bioactive components in plants with similar functions to those of cholesterol in mammals.
In the general population, the daily intake of plant sterols is about 300 mg. Those following a vegetarian or vegan diet may eat up to 600 mg/day2.
Plant stanols are present in smaller amounts than plant sterols in everyday foods2,3. The amounts of plant stanols ingested from the diet is 17-24 mg/day3.
SOURCES OF PLANT STEROLS AND STANOLS:
Vegetable oils (e.g. corn, rapeseed, soybean, sunflower), margarines, cereals (e.g. corn, rye, wheat, barley, millet, oat), legumes (e.g. peas, beans and lentils), seeds (e.g. sunflower) and nuts (e.g. peanuts and almonds), vegetables (e.g. broccoli, cauliflower, carrots) and fruits (e.g. avocado, raspberry, orange).
Plant sterols and stanols are also added to foods such as vegetable fat-based spreads and margarine as well as to milk, yoghurt, yoghurt drinks and other foods and food supplements.
TABLE 9: Plant sterol and stanol content in naturally occurring food sources (in mg/100 g edible food)
| Food group |
Plant sterols and stanols (mg/100 g of edible portion) |
Food group |
Plant sterols and stanols (mg/100 g of edible portion) |
|---|---|---|---|
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Nuts and seeds:
Vegetable oil-based margarines:
Vegetables:
Grains and cereals:
Fruits:Sources: Normen L. et al. 19994; Normen L. et al. 20025; Normen L. et al. 20076; Piironen et al. 20007
Plant sterols and stanols are widely distributed in plant-based foods, but daily intake of plant sterols and stanols from those natural sources in a normal diet, is not sufficient for an effective LDL- cholesterol lowering effect.