Can Plant Sterols Help Lower Your Cholesterol?

Cholesterol is something you might not think about on a daily basis—that is, until a doctor tells you to think about it. Even if you’re relatively young and healthy, your cholesterol level may be higher than recommended, putting your health at risk. Eating a healthy diet can help manage cholesterol levels in some cases, as can taking plant sterol supplements. Here’s what you need to know—but as always, please consult your doctor before adding any supplement to your diet.

What does it mean when we talk about “good” and “bad” cholesterol?

The term “good cholesterol” typically refers to high density lipoproteins (HDL), says Tiffany Thai, a registered dietitian in Toronto. “This type of cholesterol has a protective function as it helps transport extra cholesterol to the liver for elimination,” she explains.

“Bad cholesterol” is a term that typically refers to low density lipoproteins (LDL). This type of cholesterol is undesirable because it can contribute to the formation of plaque on artery walls. “When plaque deposits in the artery, there is less space for blood to flow through,” Thai says.

Research indicates that 28 percent of Canadians between the ages of 18 and 79 have hypercholesterolemia—the technical term for high LDL cholesterol—and are at increased risk of serious health issues. In many cases, family history is a contributing factor.

Related: Inside The Red River Cereal Revival

What are the dangers of high cholesterol?

An excess of plaque deposits in your arteries is known as atherosclerosis, Thai explains, and it can lead to heart disease, strokes and coronary artery disease. Essentially, these plaque deposits increasingly restrict blood flow and heighten your risk of developing a blood clot. If a blood clot moves to your heart, it can cause a heart attack, whereas a blood clot that migrates to the brain can cause a stroke.

Women need to be particularly mindful of cholesterol as they age. “Following the menopause-associated drop in estrogen levels, blood cholesterol levels tend to increase,” says Thai.

My LDL level is higher than my doctor advises. What’s the standard treatment?

Your doctor should give personalized medical guidance, but there are a few standard practices. It all starts with an assessment of your overall risk of cardiovascular disease, Thai says, and may start with dietary changes and other lifestyle modifications, such as moving your body more throughout the week.

Prescription medications, such as statins, may be recommended—however, dietary changes often play a significant role. “A dietitian will often recommend a dietary pattern that emphasizes more plant-based foods, such as The Portfolio Diet,” Thai says. The Portfolio Diet was developed by a University of Toronto nutrition researcher and emphasizes the inclusion of plant proteins, soluble fibre, nuts and plant sterols (which are also known as phytosterols) through diet or by taking supplements.

Can plant sterols improve my cholesterol levels?

Yes, says Thai—and they’re also recommended by a number of reputable health organizations including Hamilton Health Sciences, The Cleveland Clinic and even Health Canada.

“Plant sterols are substances that can naturally be found in plants—structurally, they look like cholesterol,” Thai explains. “This allows these substances to block some of the absorption of dietary cholesterol in the body.” Nuts, legumes, whole grain cereals and vegetable oils are a good source of plant sterols in food, and some products—non-hydrated margarine, yogurts and orange juice, for example—are available with added plant sterols. Read the label; it will say if plant sterols have been added!

Research has shown that plant sterols can lower LDL cholesterol by an average of six to 12 percent, Thai says, and The Portfolio Diet recommends taking two grams of plant sterols via supplement per day. However, Thai recommends speaking to a doctor before adding plant sterols to your diet, especially if you’re already taking a statin medication (for example, Lipitor).

While dietary changes are key, it’s nearly impossible to consume the recommended amount of plant sterols through nutrition alone. This is why they are offered as a supplement. “Look for one with a Drug Information Number (DIN) or Natural Product Number (NPN),” Thai advises. This is a simple way to ensure that what you’re buying is authorized for sale in Canada (meaning, it’s met regulatory standards and been approved by Health Canada).

Focus on "nutrition by addition"

Taking a high-quality plant sterol supplement can be beneficial, but eating well is critical to maintaining healthy cholesterol levels, Thai says. Don’t focus on what you can’t have—instead, think “nutrition by addition” and incorporate specific foods into your routine. Thai recommends including a variety of healthy fat sources such as salmon, trout, mackerel, Arctic char, sardines, herring, anchovies and other oily fish. It’s also good to regularly consume nuts, seeds, avocados and olive oil. If you’re following The Portfolio Diet to combat high LDL levels, it also recommends consuming legumes, soy proteins, oats, barley, eggplant, okra, broccoli, apples, oranges, berries and psyllium husks (found in All-Bran and Metamucil). (And you likely already are eating some or all of this good stuff.)

That said, there are foods to avoid. “LDL cholesterol numbers often go up when a diet contains large quantities of saturated and trans-fat sources,” Thai explains. Examples of these foods include red meats (beef, pork and lamb), butter and lard, coconut oil, palm oil, cheese, deep-fried food and processed baked goods. It’s not that you can’t ever eat these foods—rather, they should be minimized in favour of the list above.

“In 2018, Health Canada banned the addition of trans fats in foods sold in Canada,” Thai notes, which makes it somewhat easier to avoid.

Talk to your doctor

Each and every body is unique and health is inherently personal, so talk to your doctor about any concerns you may have about your cholesterol levels. Eating well and moving your body is a great place to start, but they may have specific recommendations based on your needs. A registered dietitian can also help you make the right nutritional choices to reduce your risk of serious illness and live a happy, healthy life. You may be pleasantly surprised how simple it is—the key is to get started.