Those eating plant-based diets get the most phytosterols, but there’s still room for improvement to maximize cholesterol reduction.
Optimal Phytosterol Dose
If our enterocyte trash recovery bins are half-filled with phytosterols, might vitamins get crowded out, too? We didn’t know, until last year. But the answer is no, even with a whopping nine-gram dose. Vitamin absorption was unaffected. Plant stanols dose-dependently decrease bad cholesterol concentrations, but not antioxidant concentrations in our blood.
Now, nine grams is like ten times what we would expect from even a healthy diet. There’s a plateau effect. At that nine grams a day, you’re way out here at the end; but, as you can see, the cholesterol-lowering curve starts to flatten out at about two.
So, we can pretty much maximize cholesterol-blocking at around two grams—2000 milligrams. The Standard American Diet has been measured as low as 78 milligrams a day.
Here’s like a model American Heart Association diet, and this is how high folks get eating a plant-based diet—higher than any other diet pattern reported. That could get you a good five percent cholesterol reduction. But there’s definitely room to bump that up further, if necessary.
Those who have improved their diet so much they’re no longer eating any cholesterol should be acing their cholesterol tests. But, in rare cases, your body might not be able to get rid of enough endogenous production. And so, doubling phytosterol intake could easily double LDL reduction down to ten percent, which could double heart disease risk reduction.
In terms of whole foods sources to maximize cholesterol reduction, seeds provide the most (especially sesame), then nuts (especially pistachio), then legumes (like peanuts).
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Kerry Skinner.
Please consider volunteering to help out on the site.
- Racette SB, Spearie CA, Phillips KM, Lin X, Ma L, Ostlund RE Jr. Phytosterol-deficient and high-phytosterol diets developed for controlled feeding studies. J Am Diet Assoc. 2009 Dec;109(12):2043-51.
- Agren JJ, Tvrzicka E, Nenonen MT, Helve T, Hänninen O. Divergent changes in serum sterols during a strict uncooked vegan diet in patients with rheumatoid arthritis. Br J Nutr. 2001 Feb;85(2):137-9.
- Mensink RP, de Jong A, Lütjohann D, Haenen GR, Plat J. Plant stanols dose-dependently decrease LDL-cholesterol concentrations, but not cholesterol-standardized fat-soluble antioxidant concentrations, at intakes up to 9 g/d. Am J Clin Nutr. 2010 Jul;92(1):24-33.
- Phillips KM, Ruggio DM, Ashraf-Khorassani M. Phytosterol composition of nuts and seeds commonly consumed in the United States. J Agric Food Chem. 2005 Nov 30;53(24):9436-45.
- Demonty I, Ras RT, van der Knaap HC, Duchateau GS, Meijer L, Zock PL, Geleijnse JM, Trautwein EA. Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr. 2009 Feb;139(2):271-84.
Images thanks to: Dbenbenn, Zscout370, Jacobolus, Indolences, and Technion via Wikimedia
If our enterocyte trash recovery bins are half-filled with phytosterols, might vitamins get crowded out, too? We didn’t know, until last year. But the answer is no, even with a whopping nine-gram dose. Vitamin absorption was unaffected. Plant stanols dose-dependently decrease bad cholesterol concentrations, but not antioxidant concentrations in our blood.
Now, nine grams is like ten times what we would expect from even a healthy diet. There’s a plateau effect. At that nine grams a day, you’re way out here at the end; but, as you can see, the cholesterol-lowering curve starts to flatten out at about two.
So, we can pretty much maximize cholesterol-blocking at around two grams—2000 milligrams. The Standard American Diet has been measured as low as 78 milligrams a day.
Here’s like a model American Heart Association diet, and this is how high folks get eating a plant-based diet—higher than any other diet pattern reported. That could get you a good five percent cholesterol reduction. But there’s definitely room to bump that up further, if necessary.
Those who have improved their diet so much they’re no longer eating any cholesterol should be acing their cholesterol tests. But, in rare cases, your body might not be able to get rid of enough endogenous production. And so, doubling phytosterol intake could easily double LDL reduction down to ten percent, which could double heart disease risk reduction.
In terms of whole foods sources to maximize cholesterol reduction, seeds provide the most (especially sesame), then nuts (especially pistachio), then legumes (like peanuts).
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Kerry Skinner.
Please consider volunteering to help out on the site.
- Racette SB, Spearie CA, Phillips KM, Lin X, Ma L, Ostlund RE Jr. Phytosterol-deficient and high-phytosterol diets developed for controlled feeding studies. J Am Diet Assoc. 2009 Dec;109(12):2043-51.
- Agren JJ, Tvrzicka E, Nenonen MT, Helve T, Hänninen O. Divergent changes in serum sterols during a strict uncooked vegan diet in patients with rheumatoid arthritis. Br J Nutr. 2001 Feb;85(2):137-9.
- Mensink RP, de Jong A, Lütjohann D, Haenen GR, Plat J. Plant stanols dose-dependently decrease LDL-cholesterol concentrations, but not cholesterol-standardized fat-soluble antioxidant concentrations, at intakes up to 9 g/d. Am J Clin Nutr. 2010 Jul;92(1):24-33.
- Phillips KM, Ruggio DM, Ashraf-Khorassani M. Phytosterol composition of nuts and seeds commonly consumed in the United States. J Agric Food Chem. 2005 Nov 30;53(24):9436-45.
- Demonty I, Ras RT, van der Knaap HC, Duchateau GS, Meijer L, Zock PL, Geleijnse JM, Trautwein EA. Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr. 2009 Feb;139(2):271-84.
Images thanks to: Dbenbenn, Zscout370, Jacobolus, Indolences, and Technion via Wikimedia
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Optimal Phytosterol Dose
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Are there diminishing returns associated with other phytonutrients? See Kiwifruit and DNA Repair. The “enterocyte trash recovery bins” of which I speak are an analogy I introduced in How Fiber Lowers Cholesterol—the second of a loose five-part series on the cholesterol-lowering effects of nuts and seeds (see Nuts and Bolts of Cholesterol Lowering). How Phytosterols Lower Cholesterol offers a bit of phytosterol background, and Optimal Phytosterol Source explains why whole food sources (nuts and seeds) are superior to phytosterol-fortified foods and supplements. Why should one worry about cholesterol in the first place? See Blocking the First Step of Heart Disease; Cholesterol and Lower Back Pain; Cholesterol and Female Sexual Dysfunction; and Heart Attacks and Cholesterol: Purely a Question of Diet. I also have dozens of other videos on cholesterol.
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