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An Alternative to Statins in a Margarine Tub?

Among the many foods that might make a difference to people combating high LDL (“bad”) cholesterol, those that include plant sterols and stanols, technically called phytosterols and phytostanols, have proven particularly effective. But to get the amount recommended by the National Heart Lung and Blood Institute, you’d have to eat 10 heads of cauliflower twice a day or 44 apples in the morning and 5 cups of almonds in the evening.

Hence the advent of Benecol and Take Control margarine, along with a growing slew of other functional foods, including granola and chocolate bars, yogurt and fruit juice, all designed to pump the phytosterol and phytostanol dose in any given meal.

The average American diet delivers just 100 to 300 mg of plant sterols or stanols daily, but 1,000 to 2,000 mg can lower LDL cholesterol by 10 to 14 percent, says Robert Nicolosi, Ph.D., a cholesterol researcher and director of the Center for Health and Disease Research at the University of Massachusetts, Lowell. Until recently, shoppers could find plant sterols in only a few foods: margarinelike spreads, salad dressings and snack bars. Things changed in early 2003 when the Food and Drug Administration relaxed their regulations to permit more foods to bear the health claim. Supplements are also now proliferating in the vitamin aisles of drug and health-food stores.

Phytosterols are the plant’s cousin to cholesterol. Both are essential components of the cell membrane in their respective hosts. But while dietary cholesterol is absorbed in the human digestive tract and can ultimately form plaque and block arteries, the plant version is absorbed in only the tiniest of amounts. Sterols and stanols lower cholesterol in the blood by blocking cholesterol’s absorption, forcing it to be eliminated from the body and allowing less cholesterol into the bloodstream.

When sterols and stanols are consumed in combination with other dietary changes, the cholesterol-lowering effects are additive, says Nicolosi. Reduce saturated fat and dietary cholesterol, drop a few pounds, add soy, fiber and plant sterols, and you might lower your cholesterol as much as a statin drug can.

Popping a statin pill may be easier than giving up junk food, cutting calories and grilling up soy burgers, but it also comes with some risks. “Statins get into the bloodstream,” says Nicolosi. They sometimes cause muscle aching and intestinal discomfort. Occasionally, muscle cells break down or liver enzymes increase. By contrast, “Plant sterols are unabsorbable, so they’re unlikely to cause side effects,” says Nicolosi. If you do take a statin, you can lower your cholesterol further by combining it with phytosterols and stanols because they lower cholesterol in different ways. “Statins inhibit the cholesterol your body makes, and sterols inhibit the absorption of cholesterol,” explains Nicolosi.

You can stock your kitchen with any number of these good-tasting fortified foods. But keep in mind that Benecol and Take Control margarines have the most research to back them up. You’ll need two or three servings daily, preferably with other foods and at different times of the day. If you don’t have high LDL cholesterol, extra phytosterols and phytostanols won’t benefit you, but neither will they hurt you.

Not all foods with added phyto-sterols bear the FDA-approved health claim. The FDA grants permission only for those products that meet the criteria for a low-cholesterol, low-saturated-fat food, contain at least 400 mg of plant sterols or stanols per serving, and at least 10 percent of one or more key nutrients.
—Jill Weisenberger, M.S., R.D., C.D.E.



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