Phytosterols Displace cholesterol

Cells’ ferry preferentially accepts them as passengers, dumping LDL

Phytosterols Displaces Cholesterol

Phytosterols Displaces Cholesterol

Also known as stanols, phytosterols were first discovered in 1922 in pumpkin seeds; it wasn't until the 1950s that scientists observed that these plant based compounds, found in nuts and vegetable oils, are so structurally similar to human steroids that the body preferentially absorbs them instead of more dangerous cholesterol and triglycerides.

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FDA: Phytosterols Lower Cholesterol

A half century would pass before the Food and Drug Administration recognized in 2000 that approximately 1.7 grams per day of phytosterols lower cholesterol and can therefore reduce the risk of heart disease. Since then phytosterols have become increasingly popular as a food additive and dietary alternative to medical drugs for mild to moderately elevated cholesterol. They can be found in margarine, orange juice, salad dressings, nutrition bars and dietary supplements to be used in conjunction with statin drugs or for patients who are unable to use them.

How to Displace Cholesterol

Phytosterols compete with triglycerides and cholesterol for the same spot in bile salt micelles. Found in the intestine, micelles ferry triglycerides and cholesterol to the enterocytes, elongated columnar cells that absorb these compounds through the intestinal wall into systemic circulation. When dietary intake is high in phytosterols, micelles preferentially accept them as passengers, leaving dangerous low-density lipoprotein (LDL) cholesterol and triglycerides behind to be eliminated.

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Clinical Evidence

In September 2000 researchers reporting in Tidsskr Nor Laegeforen said an intake of 2 to 3 grams of plant sterols per day “is associated with a 10% reduction of total cholesterol and a 13-15% reduction of LDL cholesterol, whereas [highdensity lipoprotein] cholesterol remains largely unchanged.”

A study in the British Medical Journal reported that average reduction in total cholesterol of 7.4% was achieved after 6 months and 10.2% after 12 months. “Such a 10% reduction translates into a 13% reduction in the risk of coronary disease over 10 years…”

In Nutrition Reviews, Drs S. Devaraj and I. Jialal at the Laboratory for Atherosclerosis and Metabolic Research, Department of Medical Pathology, UC Davis Medical Center, California, concluded: “Present evidence is accumulating to promote their use for lowering LDL cholesterol levels as a first line of therapy (as well as adjunctive therapy) in patients on statin therapy.”

Researchers at the Institute of Health Sciences/Geriatrics, University of Oulu, Finland studied 232 men (with an average age of 60) at high risk of heart disease. The scientists measured levels of phytosterols in their blood and concluded: “Higher serum plant sterol levels in middle-aged men predicted lower long-term mortality risk, possibly reflecting an association between higher synthesis/lower absorption of cholesterol and mortality.”

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Phytosterols And Statin Drug

Phytosterols can be used with statin drugs. Both work by a different mechanism of action. Whereas phytosterols compete with cholesterol for bile salt micelles, statin drugs interfere with cholesterol synthesis by inhibiting the HMG-CoA reductase enzyme. The use of phytosterols is recommended as an adjunct to pharmacologic therapy in high and very high risk patients who fail to achieve cholesterol-lowering targets on statins or are statin-intolerant, says the European Atherosclerosis Society Consensus Panel on Phytosterols in a February 2014 article in the Journal of Atherosclerosis. In the British Journal of Nutrition researchers report that consumption of plant sterols results in an additional LDL-cholesterol reduction of approximately 10%, greater than the average decrease of 3-7% achieved by doubling the statin dose.

Doctors increasingly are taking note of phytosterols as an adjunct to medical drugs, particularly the statins, noting they are safe. Phytosterols can also be used by healthy people with high-normal cholesterol to further lower levels.

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