How A “European Secret” Reduces Heart Disease Risk
This post is sponsored by the International Plant Sterols and Stanols Association (IPSSA). All opinions and thoughts expressed in this article are our own. We only promote products and services we believe will benefit our readers.
I had the opportunity to study abroad in Innsbruck, Austria when I was in college. At the time, I was barely into the coursework for my nutrition degree, healthy, and not too concerned about health habits to reduce chronic disease risk down the road. Yet, there was one thing that really stuck out to me in Austria and the other neighboring countries I visited and that was how much healthier the European approach to living is compared to that in the United States.
Meals and food choices are centered around whole and less-processed foods and usually ones that were locally sourced and in-season.
Activity and movement seem to be naturally built into daily activities and routines, and people walk everywhere.
Lastly, Europeans seem much better about taking time to slow down, enjoy life, and connect with others. And the culture seems to support this, which floored me even more.
I came back to the United States in awe of how conducive the European way of life is for good physical and mental health, and this realization has been re-confirmed every time I have the opportunity to return. So when I heard that Europeans were taking a more targeted approach at lowering heart disease through their food supply, it didn’t surprise me. What some have dubbed a “European secret,” the approach involves fortifying foods with plant sterols and stanols, compounds which research suggest have the potential to significantly lower LDL cholesterol in as few as two to three weeks. It’s a fairly easy addition for manufacturers, doesn’t alter the taste of those foods, and the results are pretty impressive.
What exactly are plant sterols and stanols? How effective are they at lowering cholesterol and heart disease risk? How much do you need? What foods are the best sources? And why aren’t plant sterols added to more foods in the United States? Here’s exactly what you need to know!
What Are Plant Sterols and Stanols?
Plant sterols and stanols are bioactive compounds naturally occurring in most plant foods, but particularly nuts, seeds, vegetable oils, grains, and marine algae. Sometimes collectively referred to as phytosterols, these compounds have a chemical structure similar to cholesterol, but it’s slight structural differences that allow them to have different health effects. Most people get small amounts of plant sterols and stanols in their daily diet through foods like sunflower seeds, pistachios, olive oil, and almond butter. However, overall intake is pretty low and is significantly below amounts associated with cholesterol-lowering effects.
Common Approaches for Lowering Heart Disease Risk
Heart disease is the leading cause of death in the United States, as well as globally. Research tells us that elevated cholesterol levels increase risk of heart disease, particularly elevated levels of LDL cholesterol (aka, the “bad” cholesterol). Research also tells us the reverse is true: lowering LDL levels decreases heart disease risk. Dietary recommendations for lowering cholesterol and heart disease risk focus on increasing dietary fiber intake through produce, whole grains, beans, and other plant foods; increasing intake of healthier unsaturated fats and oils; and decreasing saturated fat intake that’s found in animal products.
The effects of dietary changes on cholesterol levels vary by individual. Sometimes, a healthcare provider may prescribe a statin drug to lower LDL levels when these dietary changes can’t be adhered to or don’t get the desired results. While statins are usually effective at lowering LDL cholesterol levels, not everyone is a fan due to side effects like fatigue and muscle pain.
Plant Sterols Effect on LDL Cholesterol
Here’s what’s exciting: Research suggests that boosting intake of plant sterols and stanols may add to the effects that following a heart-healthy diet provides.
Here’s some of the most compelling research findings on plant sterols and LDL cholesterol.
A 2021 meta-analysis found that foods low in saturated fat, high in unsaturated fat, high in dietary fibers, and those with added plant sterols had a moderate to large impact in terms of reducing LDL cholesterol.
A combination of diet interventions such as lowering saturated fat intake, choosing more plant-based proteins, and incorporating plant sterols may reduce LDL by 30%. This comes from the updated clinical guidelines for managing high cholesterol that were updated in a 2023 paper.
Lastly, a 2005 study suggests that a heart-healthy diet with plant sterols can have comparable cholesterol-lower effects to that of a statin. At the end of the study, the healthy diet with sterols group decreased LDL levels by 29.1% while the statin group decreased levels by 34.5%
Recommendations for Plant Sterols and Food Sources
As I mentioned earlier, we get a very small amount of phytosterols in our diet (approximately 17-24 mg per day). This amount is significantly below what research suggests is effective to lower cholesterol. In fact, the American Heart Association recommends an intake of 2,000 mg/day (2 g/day) to lower LDL cholesterol and heard disease risk. So, how do you get closer to this recommendation?
Healthy fats and oils and plant foods like nuts, seeds, and whole grains contribute small amounts, but the best way to get close to the recommended amount is to incorporate foods that are fortified with plant sterols and stanols. This fortification is frequently done to foods in Europe making it easier to accomplish. In the United States, only a handful of food products are fortified currently. This makes it a little more challenging, but it can be done. One of the best sources is a vegetable oil spread like Benecol that’s fortified with plant sterols. Look for them also added to some orange juices, milks and milk beverages, and snack bars. Dietary supplements can also be a source.
For more information, visit the International Plant Sterols and Stanols Association.