Plant sterols are an important but underused dietary component in
the treatment of elevated blood cholesterol.
This review discusses the background to plant sterol use and reviews
evidence about its use in clinical practice.
When consumed in the recommended amounts, sterols alone
decrease low density lipoprotein cholesterol; in combination with
other dietary changes, low density lipoprotein can be further lowered.
Most patients, whether they are on cholesterol lowering drugs or not,
would benefit from using plant sterols, which are now available in
milk and yoghurt as well as spreads. In animal models, plant sterols
have been shown to reduce atherosclerosis despite an elevation
in the blood level, however there is no hard end point data for this
Plant sterols are plant compounds that perform similar biological functions to cholesterol, and contain a similar chemical structure. They differ from cholesterol only because of the presence of either an extra methyl or ethyl group, or another double bond in the side chain. Absorption efficiency for plant sterols in humans (2–5%) is considerably less than that of cholesterol (60%), except for those with the very rare condition of sitosterolemia.1 Consequently, plant sterol levels in plasma are less than one thousandth of cholesterol levels.2
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