Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Plant sterols (also called phytosterols) are naturally occurring substances found in plants that are structurally similar to cholesterol. Scientific evidence supports their use in lowering LDL cholesterol levels, which is a major risk factor for arteriosclerosis (also known as atherosclerosis). Multiple randomized controlled trials and meta-analyses have shown that consuming 2 grams per day of plant sterols or stanols can reduce LDL cholesterol by 5-10%. This cholesterol-lowering effect is achieved because plant sterols compete with dietary and biliary cholesterol for absorption in the intestine, thereby reducing the amount of cholesterol that enters the bloodstream.

While lowering LDL cholesterol is an established strategy to reduce the risk of arteriosclerosis, direct evidence that plant sterols prevent or treat existing arteriosclerosis (i.e., reduce plaque burden or clinical cardiovascular events) is limited. Most studies focus on surrogate markers such as blood cholesterol. Nonetheless, expert guidelines—including those from the European Atherosclerosis Society and the National Lipid Association—recommend plant sterol-enriched foods as part of a cholesterol-lowering diet, particularly for individuals with hypercholesterolemia.

It should be noted that "sterol (unspecified)" could refer to both plant and animal sterols, but animal sterols (like cholesterol itself) are not used for arteriosclerosis. The evidence summarized here applies to plant sterols. In summary, there is moderate scientific evidence supporting the use of plant sterols as part of a strategy to lower LDL cholesterol and thereby reduce risk factors associated with arteriosclerosis.

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