by Dr Deborah Lee, Dr Fox Online Pharmacy
Image by Gerd Altmann https://pixabay.com/images/id-3405559/
You are what you eat – and this certainly true when it comes to cholesterol. But did you know you can help your heart and lower your cholesterol simply by eating certain foods?
– Read on and find out more.
What are plant sterols and stanols?
Plant sterols and stanols are naturally occurring substances found in plants which are very similar in structure to cholesterol.
How do they help lower cholesterol?
When these are ingested as part of the diet, they compete with real dietary cholesterol for absorption in the intestines, and as a result, less cholesterol is absorbed into the bloodstream. After absorption, most of the plant sterols and stanols are excreted back into the intestines. Some are excreted through liver metabolism in the bile.
How effective are they at lowering cholesterol?
A 2003 meta-analysis of 41 clinical trials showed that ingesting 2 g/day of stanols or sterols will reduce total cholesterol by 10%. If you also eat a low cholesterol diet, as well as a daily intake of stanols and sterols, you can reduce LDL cholesterol (bad cholesterol) by 20%. If you are already taking statins, adding in a daily dose of stanols and sterols, can have the same effect doubling your dose of statins.
Lowering cholesterol reduces the risk of cardiovascular disease – angina, heart attacks, heart failure and strokes.
How much do you need to lower cholesterol?
The recommended maximum dose is 3g sterols or stanols per day. Increasing the dose any further than this is unlikely to reduce cholesterol any further and may result in failure to absorb essential vitamins from the intestines.
Unfortunately, you can’t rely on plant sterols and stanols on their own. You also need to eat a low cholesterol diet. This means choosing low-fat options, and eating less in the way of red meat, fatty meat, and processed foods. Make sure you eat healthy, unsaturated fats found in vegetable oils, seeds, and nuts. Avoid food high in trans fats – these fats are solid at room temperature, such as butter, lard, or ghee. Foods that contain large amounts of trans fats include cakes, pastries, biscuits, and desserts.
Other important changes you can make to lower your cholesterol include doing more physical exercise and stopping smoking. How do these help lower cholesterol?
Being physically active has a favourable effect to lower LDL cholesterol (bad cholesterol) and raise HDL cholesterol (good cholesterol). Exercise also helps you lose visceral fat (abdominal fat), helps lower your blood pressure, and reduces your risk of type-2 diabetes
Cigarette smoke contains a toxic substance called acrolein which interferes with the way your body metabolises LDL cholesterol. When you stop smoking, and the acrolein is removed, your LDL cholesterol levels are likely to fall. Smoking also lowers HDL cholesterol, so when you stop smoking your HDL cholesterol will tend to rise.
Which foods contain plant sterols and stanols?
Some food manufacturers have produced food items fortified with extra plant sterols and stanols. These are milks, yoghurt drinks, yoghurts, fat spreads, soft cheeses, and cereal bars.
To get the cholesterol-lowering 3g, you need a daily consumption of either –
- 2 x teaspoons of fat spread, or 1 x 250ml glass of milk, or
- 1 x 120 g yoghurt, or 1 x 65-100g bottle of yoghurt mini-drink, or 1 x cereal bar
The two most well-known brands are Benecol and Flora Proactiv, although some supermarkets have their own ranges.
Who might be suitable for plant sterols and stanols?
Anyone –
- who has raised cholesterol and wants to lower it. Although fortified products are healthy and good for you, you don’t need the additional cholesterol-lowering benefit if your cholesterol is in the normal range.
- with familial hypercholesterolaemia
- already taking statins
Who is not suitable for plant sterols and stanols?
You shouldn’t regularly eat products fortified with sterols and stanols –
- if you are pregnant or breastfeeding
- in childhood, unless you have an inherited condition such as familial hypercholesterolaemia
- are taking Ezetrol (Ezetimibe), as this has the same mode of action
Who recommends the use of plant stanols and sterols?
- Heart UK
- The British Heart Foundation
Final thoughts
The best way to lower your cholesterol naturally is to eat a balanced diet. This is a diet that includes 5 portions a day of fresh fruit and vegetables, and healthy unsaturated fats, but minimizes your intake of unhealthy saturated fats. Increase your intake of oats, barley, lentils, nuts, and seeds. Eat more soya containing products.
However, on top of this, if your cholesterol level is elevated, you lower it further by adding additional plant sterols and stanols to your diet. A 3g serving per day has been shown to lower cholesterol by 10%. If you combine this with a low cholesterol diet, this goes up to 20%. What’s not to like!
I think adding some of these fortified food products to the weekly shopping list is a great option. These are foods we eat regularly, and it makes sense to substitute them for the fortified options. I would urge anyone with heart disease to consider this as an easy tweak to their weekly menu plan.
If you haven’t had a cholesterol check, why not make an appointment to see your GP. Adults of any age, should have their cholesterol checked once every 5 years, or more often if it is abnormal.
There are no symptoms or signs of raised cholesterol, that is until you have a stroke or a heart attack. But this can be prevented by thinking ahead and following advice. Don’t be an ostrich. Get your cholesterol checked today.
For more information
- British Association of Dieticians – Stanols and sterols; Food Factsheet