Cholesterol-lowering action of plant sterol-enriched products

Abstract

Plant sterols are naturally occurring compounds that interfere with cholesterol absorption and thus reduce blood cholesterol levels. The objective of this review is to present recent advances in knowledge of the cholesterol-lowering action of plant sterols, focusing on the efficacy of plant sterol-enriched products, including full-fat, low-fat and non-fat food products. Although the cholesterol-lowering efficacy of plant sterols is well acknowledged, additional studies are needed to determine whether dietary cholesterol levels affect the cholesterol-lowering action of plant sterols, to establish the best time of day to consume plant sterol-enriched products, and to assess the optimal dose frequency of plant sterol intake. Fat spreads enriched with plant sterols/stanols have been shown to be effective in reducing circulating cholesterol levels in healthy adults with both normal and high cholesterol levels, as well as in children with hypercholesterolaemia. Such spreads can be used in combination with other approaches including a healthy diet, statin therapy and exercise for controlling blood cholesterol levels. Originally, plant sterols/stanols have been incorporated into fat spreads and, more recently, into low- or non-fat food products. However, the efficacy of plant sterols as cholesterol-lowering agents depends on their proper solubilization, while the majority of studies to date have incorporated plant sterols into vegetable oil-based spreads. Therefore, until more information is available, data from older studies using full-fat spreads cannot be used as a platform to promote novel and, as of yet, inadequately tested low-fat and non-fat plant sterol-enriched products.