Food With Plant Sterols


The FDA has approved health claims for foods containing plant sterols and stanols. People suffering from high cholesterol problems, or those who want to avoid developing this problem, need to reduce the amount of cholesterol in their diets. Health claims state that eating 0.6 grams a day of foods with plant sterols or stanols may reduce the risk of heart disease by lowering LDL (“bad”) cholesterol levels by 5-10% and total cholesterol levels by 4-8%.

Food With Plant Sterols

7 foods that lower your cholesterol

There’s good evidence that following a heart-healthy diet can improve your blood cholesterol and heart health. Find out which foods are best at helping to lower your cholesterol.

Heart healthy foods on table

What is cholesterol?

Cholesterol is a type of fat in your blood which is produced naturally by your body. It’s also found in some foods like eggs, offal (such as kidney and liver) and shellfish. Your body needs some cholesterol for it to work properly.

When you have high cholesterol levels in the blood (also called hyperlipidaemia) it speeds up the process of atherosclerosis. This is when plaque builds up in your artery walls, making them narrower. This makes it hard for blood to flow through them, and over time it can cause a heart attack or stroke.

Types of cholesterol

High cholesterol doesn’t show any symptoms. You need a blood test to find out if you have it. The blood test will tell you the levels of ‘good’ and ‘bad’ cholesterol in your blood (explained below).

Cholesterol is carried around the body by different ‘carriers’ (also called lipoproteins). The two most common are:

  • Low density lipoprotein (LDL) cholesterol: the ‘bad’ cholesterol. LDL cholesterol is ‘bad’ because if you have too much it gets stuck to the walls of your arteries
  • High density lipoprotein (HDL) cholesterol: the ‘good’ cholesterol. HDL cholesterol is ‘good’ because it gets rid of ‘bad’ cholesterol from your blood vessels.

Triglycerides are the most common form of fat in your body and store and transport fat in the blood. Any extra energy from food that your body doesn’t need is turned into triglycerides.

High total blood cholesterol is a measure of all the cholesterol and triglycerides in your blood and is a risk factor for developing heart disease1.

Can my diet help my cholesterol?

Eating certain foods can help improve your cholesterol and overall heart health.

The best place to start is to eat a wide variety of plant foods. These include:

  • vegetables
  • fruit
  • legumes
  • whole grains
  • nut
  • seeds.

Eating plant foods will help you get a range of nutrients, heart-healthy fats and fibre. These all promote optimal heart health.

7 foods that lower your cholesterol

Some foods can actively help to lower your cholesterol and they all work in different ways. Try to include these foods in your meals whenever you can:

1. Oats and barley

Eating whole grain foods reduces your risk of heart disease. Oats and barley are extra special because they are high in a type of soluble fibre called ‘beta glucan’. Beta glucan helps to lower ‘bad’ LDL cholesterol in your blood2,3.

Tip: Flavoured oat products like ‘Quick Oats’ often contain added salt and/or sugar. Choose products that contain 100% oats (like rolled oats) as they’re closest to how they’re found in nature.

oats in bowl with milk and fresh berries

2. Vegetables and fruit

Eating a variety of colourful vegetables and fruit everyday can help protect you against heart disease, stroke and some cancers4,5. Many vegetables and fruit are high in soluble fibre which helps to reduce the absorption of cholesterol and lower ‘bad’ LDL cholesterol in your blood.

Tip: Leave the skins on vegetables like pumpkin, kūmara and carrot to maximise your intake of fibre. Use orange and lemon peel in dressings and sauces.

vegetables and fruit o ntable and in basket

3. Foods rich in heart-healthy fats

Eating plenty of foods that contain heart-healthy mono and poly-unsaturated fats increases the levels of ‘good’ HDL cholesterol in your blood. 

These foods contain heart-healthy fats.

  • Avocado
  • Oily fish like mackerel, sardines and salmon 
  • Nuts and seeds
  • Olives
  • Vegetable oils and spreads

Eating these foods instead of foods high in saturated fat (butter, cream, meat fats) improves your cholesterol. It’ll reduce your risk of heart disease too6.

Tip: Coconut, palm oil and many convenience foods are high in saturated fat and increase your ‘bad’ LDL cholesterol. Switch to heart-healthy fats and whole foods where possible.

Foods rich in heart healthy fats

4. Legumes and beans

Legumes like chickpeas and lentils are a great source of soluble fibre and plant-based protein. Eating legumes and beans instead of meat (animal protein) can help to lower your ‘bad’ LDL cholesterol7.

Tip: Choose canned legumes for a quick and easy option. Rinse and drain the salty brine before using them. Use them in salads, sauces, casseroles and when making legume-based dips like hummus.

Legumes and beans on spoons

5. Nuts

Nuts contain heart-healthy fats and fibre which can help to keep your cholesterol in check. Regularly eating nuts is linked to lower levels of ‘bad’ LDL cholesterol and triglycerides8.

Tip: Eating a variety of nuts is best because they contain different levels of healthy fats. Choose nuts that are close to how they’re found in nature because they contain more nutrients. Look for nuts that have skins on, are unsalted and unroasted.

nuts in bowls on table

6. Soy products

Soy products include tofu, soy milk, soy beans and edamame beans. Some evidence shows that regularly eating soy products can help to slightly reduce ‘bad’ LDL cholesterol and triglycerides7,9,10.

Tip: Choose soy products that are close to how they are found in nature, like soy beans, plain unsweetened soy milk and unflavoured tofu.

Types of soy products including tofu, soy milk, edamame beans

7. Plant sterols

Low levels of plant sterols are found in in fruits, vegetables, nuts and cereals. However, some foods (like margarine) have plant sterols added. Eating foods that contain plant sterols as part of a balanced diet can reduce ‘bad’ LDL cholesterol. This is because they reduce your absorption of cholesterol11.

Tip: Foods with plant sterols added are only effective if you eat them regularly. Remember that these foods are usually much more expensive than everyday foods and your overall diet matters most.

No single food

There is no single food that will help to lower your cholesterol and it’s important to focus on the quality of your overall diet.

A diet rich in plant foods like vegetables, fruit, legumes, whole grains, nuts and seeds will help to manage your cholesterol and reduce your risk of heart disease.

The lowdown on plant sterols

The lowdown on plant sterols - image

Plant sterols are the latest food additives to gain recognition, and health officials have cited studies showing they help reduce bad cholesterol.

Before slathering mayonnaise on your bread, read the answers to some important questions:

What are plant sterols?

Plant sterols occur naturally in plant based foods. Vegetable oils are a major source of plant sterols in Canadians’ diets but they can also be found in other plant foods, such as nuts, cereals and legumes. Eating foods with added plant sterols can help lower LDL-cholesterol levels, a benefit for those persons who have high LDL-cholesterol levels, a well known risk factor for heart disease.

How do plant sterols lower cholesterol?

Eating up to 3 grams of plant sterols as part of the daily diet increases the removal of cholesterol from the body. The result is a lower LDL-cholesterol, with no effect on HDL (good) cholesterol or triglycerides.

Are plant sterols considered natural health products (NHPs) or food?

When plant sterols are placed in a food product that is intended for normal use as part of the diet, they are considered to be a food. When plant sterols are taken as a supplement, they are considered to be a natural health product.

What kind of foods are plant sterols allowed to be added to?

Plant sterols can be added to spreads, mayonnaise, margarine, calorie-reduced margarine, salad dressing, yogurt and yogurt drinks, and vegetable and fruit juices.

How much plant sterols is allowed to be added to foods? Why?

A limited number of foods will be allowed to contain up to 1 g of plant sterols per serving. Health Canada research determined the levels and ranges of foods to which plant sterols could be added without exceeding the upper intake limit of 3 g of plant sterols per day in adults and 1 g plant sterols per day in children.

Is there a risk of having too much plant sterols?

Health Canada has recently completed a safety assessment regarding the addition of plant sterols to foods. Health Canada has no safety concerns with intakes of plant sterols up to 3 g (as free phytosterols) per day in adults and 1 gram per day in children.

Can I use plant sterol enriched foods with cholesterol lowering medications?

Plant sterol enriched foods used together with cholesterol lowering medications should be done in consultation with your physician. Individuals on statin treatment should advise their doctor that they are consuming plant sterol-enriched foods as the dosage of medication may need to be adjusted.

Can plant sterol enriched foods be used by pregnant or breastfeeding women and young children under 5 years of age?

Plant sterols are considered safe, cholesterol-lowering ingredients within the guidelines set by Health Canada. However, plant sterol enriched foods are not recommended for children, breast-feeding or pregnant women. These groups have specific nutritional and dietary needs and lowering blood cholesterol is not normally a priority for them.

Food to lower your cholesterol

Which cholesterol-lowering foods work best?

Worried about your cholesterol?

Too much cholesterol in the blood causes fatty deposits to gradually build up in blood vessels. This makes it harder for blood to flow through, which increases the risk of heart attack or stroke.

Regular exercise and a healthy diet may help reduce cholesterol levels, but if your cholesterol is particularly high there are extra measures you can take, like taking cholesterol-lowering medications or eating cholesterol-lowering foods.

Getting on the sterols

More and more products that claim to help lower your cholesterol are showing up on supermarket shelves. Where previously this added benefit was offered by spreads alone, you can now get yoghurts and milks that do the same job, with cholesterol-lowering breakfast cereals on the horizon. And there’s good evidence that they do what they say.

These products have been enriched with plant sterols (also known as phytosterols), which have a similar chemical structure to cholesterol. When eaten, they’re thought to compete with and block the absorption of cholesterol from the intestine, ultimately reducing the amount of cholesterol that ends up in your blood.

Eating 2–3 g per day of plant sterols in the form of enriched spread, yoghurt, milk or a combination of these products can help lower your cholesterol.

These products can have an impact on your cholesterol levels in a matter of weeks. But as with cholesterol-lowering medication, you need to have them daily for the benefits to last, so the costs can quickly add up.

Who can they benefit?

People at risk of heart disease and in particular those who have high blood cholesterol levels (total cholesterol of 5.5mmol/L or more) can benefit from eating products enriched with plant sterols. Research shows that if you lower your blood cholesterol levels, you lower your risk of heart disease and stroke. Some research suggests that a reduction in LDL cholesterol levels by about 10% could reduce the risk of heart disease by 20–25% – although a benefit this great is most likely in someone with risk factors (a family history of heart disease, high blood pressure, being overweight or a smoker, for example) as well as high blood cholesterol.

Choosing the right mix to lower your cholesterol

Products enriched with plant sterols can work together with cholesterol-lowering drugs such as statins, as well as cholesterol-lowering diets, to lower blood cholesterol levels even further, but they’re not meant to replace your medication. And if you’re taking cholesterol-lowering medication, check with your doctor first before eating foods enriched with plant sterols.

People with familial hypercholesterolaemia (an inherited genetic condition that results in high blood LDL cholesterol levels from birth) or diabetes may also benefit from eating these products. However, recent research has suggested that people with metabolic syndrome (also known as Syndrome X) may not. People with a very rare, inherited metabolic disease called sitosterolaemia shouldn’t eat these products.

Are they safe?

Foods enriched with plant sterols are generally recognised as being safe to eat, although they haven’t been tested specifically for pregnant women. However, there’s rarely any need for pregnant or breastfeeding women or young children – unless under medical advice – to be concerned about lowering cholesterol.

There’s one small caveat: plant sterols have been shown to lower blood levels of the antioxidants beta-carotene and lycopene. So if you’re regularly eating products enriched with plant sterols, also eat additional fruit and vegetables – orange-coloured ones in particular – to help compensate for any loss.

Costs per serving (spreads vs alternatives)

Overall, spreads are the cheapest and yoghurts the most expensive way to get an equivalent amount of plant sterols (0.8g).

Eating about six teaspoons (three serves) of spread may seem at odds with the usual message to cut down on fat for a healthy heart.

However, the Heart Foundation recommends you replace saturated fats (such as those found in butter and dairy blends) with healthier polyunsaturated and monounsaturated fats, which sterol-enriched products have in abundance – and you have the benefits of plant sterols to help lower your blood cholesterol levels further.

Past CHOICE testing has shown spreads to deliver the appropriate daily serving to help lower your cholesterol at under 17c. Alternatives such as yoghurts and milk with sterol are more expensive with milk costing you around 70 cents a serve while yoghurt can cost up to $2 a serve.

But if cost isn’t such a concern and you don’t normally use spreads, but do pour milk on your cereal and eat a tub of yoghurt every day, you might as well buy the more expensive sterol-enriched milk and yoghurt that you’ll be sure to eat enough of.

How much do you need?

Most of us eat about 200 to 400mg of plant sterols daily – vegetarians often eat more – via plant-based foods that contain them naturally, including vegetable oils, nuts, seeds, legumes, bread and cereals. But the amount recommended to get a significant cholesterol-lowering benefit is much more – 2 to 3g per day – and that’s where products enriched with plant sterols can really make a difference.

Research suggests that eating 2 to 3g of plant sterols daily can lower your LDL (bad) cholesterol levels by 10% on average. Eating more than this amount is unlikely to hurt you, but it’s unlikely to lower your cholesterol any further. Less than this amount will simply have a lesser result.

In order to get the recommended 2 to 3g of plant sterols a day, you need to eat about three standard serves of sterol-enriched products. This could be three cups of milk or two serves of spread and a tub of yoghurt or any other combination of sterol-enriched products – it’s the quantity not the type of product that matters.

Sterols aren’t a get out of jail free card

Even though sterol-enriched products are effective at helping to control cholesterol levels, high blood cholesterol needs to be managed under medical supervision. To reduce your overall risk of heart disease it’s still vital that you eat a healthy diet that’s low in saturated fat and high in fruit, vegetables and whole grains, and that you stop smoking and increase your activity. If your blood cholesterol levels are normal, there’s little advantage to eating these products – they’ll just cost you more money.

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