Nutrition & Health Info Sheets for Health Professionals - Phytosterols

Cheese, almonds, and brussel sprouts

Nutrition & Health Info Sheets contain up-to-date information about nutrition, health, and food. They are provided in two different formats for consumer and professional users. These resources are produced by Dr. Rachel Scherr and her research staff. Produced by Anna Jones, BS, Sheri Zidenberg-Cherr, PhD, UC Cooperative Extension, Center for Health and Nutrition Research, Department of Nutrition, University of California, Davis, 2011.

What are phytosterols?

Phytosterols are the plant version of cholesterol. Animals primarily make cholesterol, and plants make a variety of phytosterols and stanols. While humans can make cholesterol or obtain it from the diet, we are unable to make any kind of phytosterol, and thus only get those from dietary sources. There are two main classes: sterols and stanols. Sterols have a double bond in their sterol ring, while stanols do not.

What is the evidence that phytosterols protect against disease?

Studies have found that consuming 1-2 grams each day of phytosterols can lower low-density lipoprotein (LDL) cholesterol by 6 to 10 percent, which may reduce risk for coronary heart disease (1-3). They are also effective when combined with cholesterol-lowering medication; adding phytosterols to statin medications can lower LDL more than doubling the statin dose (4, 5).

How do phytosterols work?

Phytosterols work by reducing the amount of cholesterol that is absorbed in the small intestine. This includes cholesterol from dietary sources, as well as cholesterol from bile that would normally be reabsorbed and reused (2, 3). The decrease in absorbed cholesterol upregulates LDL receptors, which in turn removes more LDL from circulation. It also causes an increase in endogenous production of cholesterol, although not enough to compensate for the increased blood clearance. The end result is lower LDL cholesterol (2, 3).

What is the recommended intake?

The National Cholesterol Education Program recommends 2 grams of sterol or stanol esters a day as a therapeutic option to enhance cholesterol lowering (6). It is recommended that pregnant and breast-feeding women avoid foods with added phytosterols, as the safety of these compounds has not been studied in these groups (6).

Can too much be harmful?

High intake of phytosterols may reduce the absorption of beta-carotene (7). Those with the rare disorder known as sitosterolemia or hytosterolemia, which increases absorption and decreases excretion of phytosterols, should avoid foods with added phytosterols (6).

What are some foods that have phytosterols?

Phytosterols are found in small amounts naturally in many vegetable oils and nuts. Over the last decade, products enriched with phytosterols, such as margarine, and orange juice have become widely available (Table 1).

Table 1. Foods containing plant sterols
Food or Supplement Serving Size Phytosterols per serving (g) Calories per serving
Brussel sprouts 1/2 cup, cooked 0.035 28
Almonds 1 ounce 0.039 163
Wheat bun 1/2 cup 0.058 63
Peanuts 1 ounce 0.062 166
Canola oil 1 tablespoon 0.092 120
Corn oil 1 tablespoon 0.102 120
Sesame oil 1 tablespoon 0.118 120
Wheat germ 1/2 cup 0.197 207
Centrum Cardio 1 tablet 0.4 N/A
Giant Eagle Fat Free Milk with Corowise Plant Sterols 8 fl oz (1 cup) 0.4 90
Kroger Active Lifestyle Milk 8 fl oz (1 cup) 0.4 90
Smart Balance Heart Right Fat Free Milk 8 fl oz (1 cup) 0.4 110
VitaFusion HeartOne Gummy Vitamins 2 gummy vitamins 0.4 15
Lifetime Low Fat Cheese (Cheddar, Extra Sharp Cheddar, Jalapeno Jack, Mozzarella and Swiss) 1 oz 0.65 47
Rice Dream Heart Wise - Original Flavor 8 fl oz (1 cup) 0.65 130
Rice Dream Heart Wise - Vanilla Flavor 8 fl oz (1 cup) 0.65 140
Silk Heart Health 8 fl oz (1 cup) 0.65 80
Benecol Smart Chews 1 chew 0.7 20
Cardio Chews (Cherry and Chocolate flavors) 2 chews 0.8 30
Kroger Active Lifestyle Bread 5 Seed Whole Grain 2 slices 0.8 160
Kroger Active Lifestyle Bread Honey Oat 2 slices 0.8 150
Benecol Light Spread 1 tablespoon 0.85 50
Benecol Spread 1 tablespoon 0.85 70
Minute Maid Premium Heartwise Orange Juice 8 fl oz (1 cup) 1 110
Promise activ Light Spread 1 tablespoon 1 45
Smart Balance Heart Right Light Spread 1 tablespoon 1.7 45
Smart Balance Heart Right Spread 1 tablespoon 1.7 80

Information for this table was obtained from: USDA Nutrient Database for Standard Reference; manufacturer’s published data; Oregon State University Linus Pauling Institute Micronutrient Research Center (http://lpi.oregonstate.edu/infocenter/phytochemicals/sterols/).


References:

  1. Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 2003;78:965-78.
  2. Ostlund RE, Jr. Phytosterols in human nutrition. Annu Rev Nutr 2002;22:533-49.
  3. Plat J, Mensink RP. Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects. Am J Cardiol 2005;96:15D-22D.
  4. Talati R, Sobieraj DM, Makanji SS, Phung OJ, Coleman CI. The comparative efficacy of plant sterols and stanols on serum lipids: a systematic review and meta-analysis. J Am Diet Assoc 2010;110:719-26.
  5. Thompson GR. Additive effects of plant sterol and stanol esters to statin therapy. Am J Cardiol 2005;96:37D-39D.
  6. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-421.
  7. Gylling H, Hallikainen M, Nissinen MJ, Miettinen TA. The effect of a very high daily plant stanol ester intake on serum lipids, carotenoids, and fat-soluble vitamins. Clin Nutr 2010;29:112-8.


Production of this material was supported by a grant from the Vitamin Cases Consumer Settlement Fund, created as a result of an antitrust class action. One of the purposes of the fund is to improve the health and nutrition of California consumers.


The University of California prohibits discrimination or harassment of any person on the basis of race, color, national origin, religion, sex, gender identity, pregnancy (including childbirth, and medical conditions related to pregnancy or childbirth), physical or mental disability, medical condition (cancer-related or genetic characteristics), ancestry, marital status, age, sexual orientation, citizenship, or service in the uniformed services (as defined by the Uniformed Services Employment and Reemployment Rights Act of 1994: service  in the uniformed services includes membership, application for membership, performance of service, application for service, or obligation for service in the uniformed services) in any of its programs or activities.

University policy also prohibits reprisal or retaliation against any person in any of its programs or activities for making a complaint of discrimination or sexual harassment or for using or participating in the investigation or resolution process of any such complaint. University policy is intended to be consistent with the provisions of applicable State and Federal laws.

Copyright © The Regents of the University of California, Davis campus, 2018. All rights reserved. Inquiries regarding this publication may be directed to cns@ucdavis.edu. The information provided in this publication is intended for general consumer understanding, and is not intended to be used for medical diagnosis or treatment, or to substitute for professional medical advice.