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Plant Sterols for Cholesterol and LDL

I think the most important topic for almost should be arterial plaque control and regression.  Heart disease is the #1 killer of men and, when plaque gets too high, it can also be game over for your sex life. My path to reverse any plaque I had was a low glycemic, medium high protein Low Fat Diet. And what I am doing seems to be working overall - and I say that humbly because it a tricky business at best - due to the fact that I had a Calcium Score of 0 last year. You can read about it on my page called My Heart Scan Results.

However, I have to admit that I am not quite where I would like to be when it comes my LDL. My LDL was in the upper 80's last time that I examined my lipids.  Keep in mind that, even though LDL is a much more important number than cholesterol, LDL is just a starting point:  there are many other lipid numbers that are as or more important. However, the Plaque Reversers, Drs. Esselstyn, Gould and Davis still laser in on LDL and want it below 80, 70 and 60, respectively.  And that makes me a little above their threshold.  (I cover the Plaque Regressors at the top of the page on Articles on Improving Erectile Strength.)

So how would a guy like me pull his numbers down by 10-15%?  Well, two of the three physicians would use low dose statins to pull LDL lower.  Actually, the third write that he occasionally useds them as well. Now they probably would not give statins to me since I have 0 plaque, but the point is that they are not afraid of using a pharmaceutical solution to get that LDL number down.  However, I try to avoid pharmaceuticals as much as possible and statins are certainly no exception.  They have many issues associated with them and I doubt their long term safety for reasons I outline in my page on The Potential Dangers of Statins.

This is why my I would like to find a more natural solution and just tweak my LDL down a little. I don't see any danger in going down the low 70's, since this was the LDL level of the Tarahumara, who were probably the healthiest and most long-lived culture on the planet. [1] Plant stanols have been offered by some experts as a way to provide a more natural and safe alternative plan. 

How do plant sterols work? They actually block some cholesterol absorption in the gut (intestines).  As odd as that may sound, they are actually a natural part of anyone's diet who eats a fair amount of plant-based foods. Researchers have studied what happens when the phytosterols (plant sterols) are removed from foods, and, as expected, it leads to a much bigger spike in cholesterol. Thus, the plant sterols in one's diet appear to be naturally protective of your arteries and anti-atherogenic. It is estimated that humans consume between 0.15 and 0.70 grams/day. [2] Vegetarians will tend to be at the higher end of that range. 

What happens if we take supplemental amounts of these plant sterols?  Can you have too much of a good thing?

To answer these questions, researchers gave participants either 0.83, 1.61 or 3.24 g of plant sterols daily. They found three key findings: [3]

I) LDL cholesterol levels were lowered by .20, .26 and .30 nmol/l, respectively, for the three different dosages.  This translates to 7.73, 10.05 and 11.60 mg/dl reductions for those in the U.S.  It should be noted that these were not hypercholesterolemic (high cholesterol) patients and, considering its mode of action, even someone with lower LDL like myself should receive roughly the same cholesterol-lowering results.

II) HDL levels were NOT significantly lowered.  This is very important, because ideally one does not want HDL, the "good" cholesterol, to be lowered.  Notice that this improved the LDL/HDL ratio for all dosages of sterols given.

III) Some nutrients were lowered.  This is because these phytosterols do not just partially block cholesterol but can also partially block certain nutrients, although it appears to be a rather short list:

"Plasma vitamin K1 and 25-OH-vitamin D and lipid standardized plasma lycopene and alpha-tocopherol were not affected by consumption of plant sterol enriched spreads, but lipid standardized plasma (alpha + beta)-carotene concentrations were decreased by about 11 and 19% by daily consumption of 0.83 and 3.24 g plant sterols in spread, respectively." [3]

The decrease of alpha carotene caught my attention, because it has been found in one study to be so protective against prostate cancer.  However, in my case, I eat many carrots every day, so even with a small decrease in alpha carotene, I should still be way above my requirements.  If you hate carrots and sweet potatoes, I guess that might be another story. 

CONCLUSION:  In my case, I am considering a small dosage daily of plant sterols - maybe a a gram - in order to hopefully get my LDL just below 80.  I see little downside as this is simply a rough doubling of the amount I might get in my diet as a dang-near vegeterian.  The counterargument is that plant sterols are a relatively new supplement and may have some unanticipated side effect.  My rebuttal would be that a) I feel that the sterols will likely be healthier long term than statins and that it would appear that b) one can more than compensate for the absorption issues by eating a nutrient dense, whole foods diet.

However, as I always say, do your own homework and talk to your doc  And, when it comes to plaque regression, it usually going to be better to find yourself a doctor or a cardiologist that you can work with and help you pull and interpret all the necessary lipid numbers.  Unfortunately, it is somewhat hard to find doctors like that right now. There's not much money in regressing someone's plaque and, to be frank, most cardiologists make their serious money from doing procedures resulting from atherosclerosis in one way or another, so you may have to do some searching.

PRODUCT:  For those interested, I have seen a page on Pritikin's web site that recommends a product called Cholest-Off.

 

REFERENCES::

1)  N Engl J Med, 1991 Dec 12, 325(24):1704-8, "Changes in lipid and lipoprotein levels and body weight in Tarahumara Indians after consumption of an affluent diet"

2) http://lpi.oregonstate.edu/infocenter/phytochemicals/sterols/

3) European Journal of Clinical Nutrition, 1999, 53(4):319-327, "Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects"

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