By Amy Paturel
"What brand of milk are you talking about? "
When your cholesterol levels run high, many favorite foods are forbidden. Butter, whole milk, full-fat cheese, milk chocolate: all out. But now, some of these same foods—and others, like granola bars and yogurt—are being fortified with cholesterol-lowering plant chemicals called sterols and stanols. (The term “phytosterols” includes both.)
Pros: Phytosterols have no taste, odor or negative mouthfeel, so manufacturers have no qualms about fortifying foods with them. “Plant stanols and sterols have the same structure as cholesterol, so they compete for absorption in the intestine with cholesterol produced by the body and that which we get from food,” says Jenna Bell-Wilson, Ph.D., R.D., a nutrition consultant in Arlington, Massachusetts—and they win. Studies confirm these powerful plant substances reduce cholesterol levels by up to 15 percent, a level that could translate into a 20 percent lower risk of heart attack or stroke.
A 2006 report in the Journal of the American College of Nutrition found that consuming spreads fortified with 1.8 to 2.8 grams of sterols/stanols per day for one to three months lowered cholesterol by seven to 11 percent. Other studies have found similar reductions after just two weeks of daily consumption of 2 grams of stanols.
Cons: You need to eat foods fortified with sterols or stanols daily—for the rest of your life—to see lasting results. And while sterols/stanols themselves aren’t high in calories, they’re often incorporated into spreads and other high-calorie foods. Even if the phytosterols might mitigate the unhealthy fats in these foods, you can’t ignore high calorie contents, says cardiologist Philip Ades, M.D., author of EatingWell for a Healthy Heart Cookbook (April 2008). His advice: “If you choose to add sterols and stanols to your diet, get them in the lowest-calorie package possible—particularly since up to 20 percent of people with high cholesterol fail to show improvement with phytosterols.”
Bottom line: To get the most cholesterol-lowering impact from phytosterol-spiked foods, eat two to four servings daily. “A plant-sterol-fortified soft margarine is good to try,” says Bell-Wilson. “Cooking with it instead of butter can dramatically reduce your saturated fat intake.” Substituting milk or yogurt products with phytosterol-fortified versions is also a good idea. A 2004 study in the European Journal of Clinical Nutrition found that drinking plant sterol-fortified low-fat milk dropped cholesterol almost three times more than eating sterol-enriched bread or cereal.
Note: Trace amounts of sterols and stanols are found naturally in corn, rice, apples, bananas, tomatoes and nuts. But you would have to eat about 13 cups of almonds (7,000 calories) to reach the 2 grams a day required to see a cholesterol change.