What brands of orange juice have plant sterols

Cholesterol-lowering drugs from the supermarket: Not suitable for everyone

What do foods with added plant sterol do?

Plant sterols (phytosterols) are natural components of plant cells. The term includes both plant sterols and plant stanols. Small amounts of plant sterols occur in all high-fat plant foods (for example in oils, nuts, seeds, grain germs) and in foods made from them.

They are not essential for humans and are almost not used in the human metabolism. Plant sterol supplements used as an ingredient in "cholesterol-lowering foods" are usually concentrates made from vegetable oils or made from tall oil, a by-product of wood processing.

Plant sterols have a structure similar to that of cholesterol. When absorbed in the intestines, they compete with cholesterol and hinder its absorption. This leads to a slight lowering of the cholesterol level. Regular consumption of foods with plant sterol added (with 1.5-3 grams of plant sterols per day) can reduce the LDL cholesterol level by 7-12.5% ​​in around 70% of the population after two to three weeks.

However, that does not mean that there are any health benefits from it. So far there are no studies that show a positive influence of plant sterols on the disease and mortality rate in coronary heart disease. Higher amounts cannot increase the effect, on the contrary: They can even be harmful.

Daily consumption of 2 grams increases the blood level of plant sterols two to three times and the absorption of carotenoids and fat-soluble vitamins from food is impaired, which means a health risk for pregnant women, breastfeeding women and children.

Manufacturers may refer to the cholesterol-lowering effect of foods with added plant sterol both on the packaging and in advertisements, television or radio spots. This statement has been approved by the EU as a so-called "health claim". An amount of 2 grams per day is required for the desired effect.

The fortified foods are not suitable to prevent high cholesterol levels - this is best achieved with a plant-based, high-fiber diet.

What should I watch out for?

The European Food Safety Authority has set a maximum daily intake of 3 grams of plant sterols. The products on offer contain the effective amount of plant sterols in a typical consumption amount for one day: 25 grams of margarine or 1 bottle of yoghurt drink (100 milliliters) or 500 milliliters of milk. This limit can be exceeded quickly through the combined consumption of several of these products, but in Germany practically only margarine is offered. The products are not suitable for healthy people - without a high cholesterol level.

Foods fortified with plant sterols can be compared to medicinal products in terms of their effects and not without side effects.

Caution is advised with capsules (food supplements) with phytosterols (phytosterol, beta-sitosterol), whether as a product for the prostate or the bladder or for lowering cholesterol.

The recommended daily amounts vary widely (0.2-2.9 g). So be sure to look at the label on the package and make sure not to exceed 3 grams per day from any source.

To be on the safe side, you should refrain from using products without precise quantities.

 

Therefore, you should strictly observe the following information:

  • Only use foods with added plant sterol if you have high blood cholesterol and want to lower it. There is no need for anyone else to spend money on these expensive products - there may even be health risks associated with them.
  • Discuss the use of these products with a doctor, especially if you are also taking cholesterol-lowering medicines.
  • These special foods are by no means suitable for the whole family, especially not for pregnant women, breastfeeding women and children. Therefore: Store these products separately from similar products.
  • Make sure that you do not consume more than 3 grams of plant sterols per day. Consume enough vegetables and fruits at the same time (5 servings per day).
  • Follow the instructions on the packaging.
     

Prescribed labeling insufficient

A nationwide representative survey of consumer advice centers and the Federal Institute for Risk Assessment in 2007 showed that 45% of the consumers of foods with an added plant sterols consume these products even though they do not have any high cholesterol levels. Only a third of those questioned who take cholesterol-lowering medication discussed the consumption of the special food with their doctor.
Less than 1% of the respondents knew all of the warning and usage instructions below that must be observed when using foods with added plant sterols.

These results were confirmed in 2011 by a Belgian study. According to this, 21% of preschool children ate such foods on a regular basis. More than half of the adult users did not have high cholesterol levels.

The following are stipulated:

  • Note "with added plant sterols / plant stanols" in the immediate vicinity of the name of the food
  • Notice that the product is not intended for people who do not need to control their blood cholesterol level
  • In the same field of vision, the advice that the intake of more than 3 grams per day of added plant sterols should be avoided
  • Note that patients taking cholesterol-lowering drugs should only consume the product under medical supervision
  • Amount of added plant sterols per 100 grams or 100 milliliters (in the list of ingredients)
  • Clearly visible indication that the product is not suitable for pregnant or breastfeeding women or for children under five years of age
  • Advice that regular consumption of fruits and vegetables is important for maintaining blood carotenoid levels
  • Recommendation to use the product as part of a balanced and varied diet, which also includes regular consumption of fruit and vegetables in order to maintain the carotenoid level in the blood
  • Definition of the portion size (g or ml) stating the amount of plant sterols contained in the portion

Demand of the consumer advice center

Because of the apparently widespread safe handling of these foods and the possible health risks for healthy people through long-term consumption, the consumer advice centers as well as the Federal Institute for Risk Assessment demand that the European Food Safety Authority reassess plant sterols as an ingredient in food.

Possible risks

Long-term effects of consuming these special foods on human health have not yet been investigated. Plant sterols presumably not only have a cholesterol-lowering effect in the body. For example, it is unclear what effect they have on the immune system and whether and to what extent they reduce the intake of fat-soluble vitamins such as vitamin E and beta-carotene.

Studies suggest that plant sterols themselves can cause arteriosclerosis. Among other things, there are indications that fortifying foods with plant sterols could lead to a stiffening of the blood vessels, an increase in stroke rates and the storage of plant sterols in the heart valves. In a Dutch study, plant sterols had a negative effect on the microvessels in the human retina. These changes are an early detection signal for cardiovascular risks.

The Federal Institute for Risk Assessment (BfR) and the French Food Safety Authority (Agence française de sécurité sanitaire des aliments) have therefore been demanding for years that the use of plant sterols as a food ingredient be put to the test at European level.

Foods with added plant sterol require approval

Products with the addition of plant sterol (except food supplements) belong to the so-called "novel foods", as plant sterols are added to them in isolated form as well as in unusually high amounts for foods and they were not yet available as food in the EU before the Novel Food Regulation came into force were used. They are therefore subject to the Novel Food Regulation. This stipulates that such foods must go through a testing and approval process before they can be placed on the market.

In the European Union, a wide range of foods with added plant sterols is already approved for marketing - for example salad and spice sauces, milk, yoghurt and cheese-like products, soy drinks, milk-based fruit drinks and rye bread. Further applications have been made.
The approvals can be viewed at EFSA, as can the current applications.

This information was created as part of a nutrition project funded by the Federal Ministry of Food and Agriculture.