If you have high cholesterol and take a statin medication like Lipitor or Zocor, to help manage it, you’re not alone. About one-quarter of the adult population is taking a prescription cholesterol-lowering drub, making them the most widely prescribed drugs in the world.
While they work to lower your cholesterol, they don’t come without risk. New warnings of their side effects include everything from muscle weakness and increased risk for type 2 diabetes to liver problems, eye problems, GI issues and even sexual dysfunction.
Because of my family history of high cholesterol and heart disease, I get my cholesterol checked annually and it’s always well within normal. I attribute that entirely to my diet and exercise habits, as research consistently shows that is ultimately the best way to manage heart disease risk factors, including high cholesterol. And, following a good diet and exercise program while you’re taking a statin makes it that much more effective so you may be able to take a lower dose or eventually not take it at all.
There are specific foods that we can eat that provide a significant cholesterol-cutting benefit. These foods contain plant sterols, or compounds found in plants that mimic our own cholesterol. Sterols are found in minute quantities in plant-based foods, but are most concentrated in nuts, oils and seeds with smaller amounts in fruits vegetables and grains. For example, a tablespoon of sunflower oil will provide about 100 mg sterols while an orange has 20 mg sterols.
Other than those who follow a vegetarian diet, most Americans get very little plant sterols naturally from the foods they eat. The ideal amount for cholesterol-lowering is about 2 grams per day or at least 10 times more than most people currently are getting.
Sterols work not only on the dietary cholesterol that you eat, but they are unique in that they also compete with the cholesterol that your body naturally manufactures—which represents about 80% of your body’s total cholesterol.
What’s more, sterols help keep your cholesterol ratio of total cholesterol:LDL cholesterol in line because while they lower LDLs, they leave HDLs (the good kind of cholesterol) alone. The improved cholesterol ratio is why sterols are so much better than other dietary changes that may lower HDL cholesterol levels.
How Effective Are Sterols?
If you add sterols into your diet, it’s likely that they’ll lead to a 10% decrease in LDL cholesterol levels. And that 10 percent decrease can mean a significant reduction in risk for having a heart attack, stroke or other major cardiovascular event in years to come. Research shows that for every 1 percent decrease in LDL, may lead to a 2-3 % reduction in risk for heart disease. That means that for a 10% drop in LDL, one could theoretically get a 20-30% reduction in risk.
Cholesterol goals: Total Cholesterol, <200 mg/dL; LDL-Choleserol, <100 mg/dl; HDL-Cholesterol >40 mg/dL
Which Foods Have Sterols?
You can get your plant sterols naturally by eating a plant-based diet but you can also supplement your diet with several sterol-enhanced foods from spreads, chips, orange juice and some milk and dairy foods. Most of these products will provide about .4 mg plant sterols per serving and you should have it twice a day to obtain about half of the sterols you need daily. The two brand names of the major sterols are CardioAid or CoroWise, which you will see identified on a wide array of products.
From a safety standpoint, there are minimal side effects associated with eating sterol-fortified foods in the proper amounts, says Kendall. There is some research indicating that getting excess amounts of sterols can interfere with the absorption of carotenoids such as beta-carotene, when taken at very high levels. As a precaution, if you add sterols to your diet, you should make sure that you have some vegetables rich in beta-carotene (carrots, squash, sweetpotatoes).
Natural Sources of Plant Sterols
|Corn oil, 1 Tbsp||133|
|Sunflower oil, 1Tbsp||101|
|Beans ½ cup||67|
|Corn ½ cup||57|
|**Peanut Butter, 2 Tbsp||50|
|Soybean oil, 1 Tbsp||31|
|Olive Oil, 1 Tbsp||25|
|Almonds 1 oz||20|
|Banana, 1 sm||16|
|Apple, 1 sm||12|
|Avocado, 1 oz||8|
|**Dry Roasted Valencia Peanuts, 1 oz||3|
1,000 mg = 1 gram
2 grams sterols per day is effective dose
Julie Upton, MS, RD, CSSD