Healthy Living

Phytosterols – Nature’s Cholesterol Fighters

Phytosterols, natural compounds found in plants, have gained significant attention in recent years due to their potential cardiovascular benefits. These plant-derived substances have shown promise in managing lipid levels and reducing the risk of heart disease. In this article, we will delve into the world of phytosterols, exploring their sources, consumption methods, evidence for lipid modulation, and the potential benefits of incorporating them into your diet. We will also discuss precautions and potential side effects to ensure a comprehensive understanding of these compounds.


Understanding Phytosterols

Phytosterols, also known as plant sterols or stanols, are structurally similar to cholesterol but differ in their side chain configuration. These compounds are naturally found in various plant-based foods, including fruits, vegetables, nuts, seeds, and whole grains. Common phytosterols include beta-sitosterol, campesterol, and stigmasterol.


Phytosterols - Nature's Cholesterol Fighters Heart Matters


Derived Sources and Consumption Methods

Phytosterols can be obtained through dietary sources or as fortified products. Dietary sources include plant-based oils (for example such as olive oil), legumes, whole grains, fruits, and vegetables. Additionally, fortified foods such as margarines, yogurts, milks and spreads are available, specifically enriched with phytosterols for easy incorporation into one’s diet.


Table: Phytosterol Content in Various Food (source)

Food Serving Phytosterol content (mg)
Peas, green, mature seeds, raw ½ cup 133
Kidney beans, mature seeds, raw ½ cup 117
Pistachio nuts 1 ounce (49 kernels) 61
Lentils, pink or red, mature seeds, raw ½ cup 54
Cashew nuts 1 ounce 45
Orange, raw 1 fruit 34
Olive oil  1 tablespoon (14 g) 30
Banana, raw 1 large 24
Brussels sprouts, raw  1 cup 21



Evidential Support for Lipid Modulation

Numerous studies have investigated the impact of phytosterols on lipid levels, particularly low-density lipoprotein cholesterol (LDL-C), also known as “bad” cholesterol. [1-4]. The results consistently demonstrate that phytosterols can lower LDL-C levels by reducing cholesterol absorption in the intestine. The cholesterol-lowering effects of phytosterols have been validated by organizations such as the American Heart Association and the National Cholesterol Education Program and may products now are freely available on supermarket shelves.

Benefits of Incorporating Phytosterols into Your Diet

By incorporating phytosterols into your diet, you may experience a range of benefits for your cardiovascular health. The primary advantage is the potential reduction in LDL-C levels, which plays a crucial role in preventing the development and progression of heart disease. Studies suggest that a daily intake of 2 to 3 grams of phytosterols can lead to significant reductions in LDL-C levels by up to 10% [1].

Moreover, phytosterols do not appear to impact levels of high-density lipoprotein cholesterol (HDL-C), the “good” cholesterol. This selective action makes phytosterols an attractive option for managing lipid profiles while preserving the beneficial effects of HDL-C. There is also evidence indicating that phytosterols may offer a positive benefit in reducing triglyceride levels. [2].

Precautions and Potential Side Effects

While phytosterols offer promising benefits, it is important to consider a few precautions. Individuals already taking cholesterol-lowering medications should consult their healthcare provider before adding phytosterols to their regimen, as the combined effects may require adjustments to their medication dosage. Additionally, pregnant or breastfeeding women and children should seek medical advice before incorporating phytosterol-enriched products into their diet.

Possible side effects of excessive phytosterol consumption may include mild gastrointestinal disturbances. However, these effects are generally rare and occur at significantly high levels of phytosterol intake.

Other potential benefits

While the primary focus of phytosterols is their potential cardiovascular benefits, these compounds have also been associated with other health advantages. Here are a few additional benefits of phytosterols:

  1. Anti-inflammatory properties: Phytosterols possess anti-inflammatory properties, which can help modulate the body’s immune response and reduce chronic inflammation. Chronic inflammation has been linked to various health conditions, including heart disease, cancer, and metabolic disorders.
  2. Antioxidant effects: Some phytosterols, such as beta-sitosterol, exhibit antioxidant activity. Antioxidants help protect the body against oxidative stress caused by free radicals, which can contribute to the development of chronic diseases and aging.
  3. Prostate health: Research suggests that phytosterols, particularly beta-sitosterol, may benefit individuals with prostate-related issues. These compounds have shown potential in improving urinary symptoms associated with benign prostatic hyperplasia (BPH) and supporting prostate health.


Phytosterols present an exciting opportunity to enhance cardiovascular health through natural means. By incorporating these plant-derived compounds into your diet, you can potentially lower LDL-C levels and contribute to a reduced risk of cardiovascular disease. Phytosterols are readily available through dietary sources and fortified products, offering a convenient approach to harness their benefits. As with any dietary modification, it is important to consult your healthcare provider and make informed choices to optimize your cardiovascular well-being.



[1] Gylling, H., & Simonen, P. (2015). Phytosterols, phytostanols, and lipoprotein metabolism. Nutrients, 7(9), 7965–7977. doi: 10.3390/nu7095377

[2] Plat J, Mensink RP. Plant stanol esters lower serum triacylglycerol concentrations via a reduced hepatic VLDL-1 production. Lipids. 2009 Dec;44(12):1149-53. doi: 10.1007/s11745-009-3361-z. Epub 2009 Oct 25. PMID: 19856194; PMCID: PMC2779439.

[3] Demonty, I., Ras, R. T., van der Knaap, H. C., Meijer, L., Zock, P. L., & Geleijnse, J. M. (2009). Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. Journal of Nutrition, 139(2), 271–284. doi: 10.3945/jn.108.095125

[4] Katan, M. B., Grundy, S. M., Jones, P., Law, M., Miettinen, T., Paoletti, R., & Stresa Workshop Participants. (2003). Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clinic Proceedings, 78(8), 965–978. doi: 10.4065/78.8.965

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other anti-anginals

When first-line therapies for angina, such as beta blockers, calcium channel blockers, and nitrates, prove inadequate or are not well-tolerated, second-line therapies may be considered.
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lipid lowering therapies

Lipid-lowering therapies play a critical role in managing coronary artery disease (CAD), a condition characterized by the narrowing of blood vessels that supply the heart. Among the most commonly discussed and debated classes of medications are statins, which effectively reduce cholesterol levels and are widely prescribed to lower the risk of cardiovascular events. Alongside statins, other medications like ezetimibe, fibrates, and niacin are also utilized to target specific aspects of lipid metabolism, such as cholesterol absorption, triglyceride levels, and raising high-density lipoprotein (HDL) cholesterol. Additionally, the introduction of medications that inhibit PCSK9, an enzyme involved in cholesterol metabolism, has provided a promising new approach to further lower LDL cholesterol levels. These PCSK9 inhibitors, such as Repatha (evolocumab), have shown significant efficacy in reducing LDL cholesterol levels in patients with CAD, especially for those who may not respond well to traditional therapies.


Nitrates are widely used to treat angina and provide quick relief for chest pain. Commonly available in the form of sublingual sprays or tablets, patches, and long-acting tablets, nitrates work by dilating blood vessels, allowing for increased blood flow and reduced resistance. This dilation eases the heart's workload, leading to a decreased demand for oxygen and prompt alleviation of angina symptoms. Sublingual nitrates act rapidly and are often used to provide immediate relief during angina attacks, while patches and long-acting tablets are employed for preventive purposes. However, nitrates may cause side effects such as headaches, dizziness, and flushing, which usually subside over time.

calcium channel blockers

Calcium channel blockers, including amlodipine, felodipine, cardizem (diltiazem), and verapamil, are commonly prescribed for the treatment of angina. These medications work by inhibiting the influx of calcium into the muscle cells of the heart and blood vessels, leading to their relaxation. As a result, blood vessels widen, promoting improved blood flow and reduced blood pressure. In the context of angina, this relaxation decreases the heart's workload, lowering the demand for oxygen and alleviating chest pain. Calcium channel blockers offer a valuable treatment option for individuals with angina, but it is essential to be aware of potential side effects, which may include headaches, dizziness, flushing, and ankle swelling.

Beta blockers

Beta blockers, such as metoprolol, propranolol, atenolol, carvedilol, and bisoprolol, play a crucial role in treating angina. By blocking certain receptors in the heart, they effectively reduce heart rate and the force of contraction, thereby easing the heart's workload. This mechanism of action leads to a decreased demand for oxygen, making beta blockers highly effective in relieving chest pain associated with angina. As with any medication, it's important to consider potential side effects, including tiredness, worsened asthma, erectile dysfunction in some males, and more vivid dreams during sleep. Consult your healthcare provider to determine the suitability of beta blockers for managing your angina and overall heart health.

Anti-platelet Medications

Anti-platelet medications play a crucial role in preventing blood clot formation, reducing the risk of serious cardiovascular events such as heart attacks and strokes. Among the widely used anti-platelet drugs are aspirin, clopidogrel, and ticagrelor.

Aspirin: This well-known medication inhibits platelet activation, making it less likely for platelets to stick together and form clots. Aspirin is commonly used for primary and secondary prevention of heart attacks and strokes.

Clopidogrel: As a potent anti-platelet agent, clopidogrel works by blocking specific receptors on platelets, preventing them from aggregating. It is often prescribed to patients with acute coronary syndrome, those undergoing stent procedures, and for some cases of peripheral arterial disease.

Ticagrelor: Ticagrelor is another effective anti-platelet drug that works by inhibiting platelet activation. It is used in acute coronary syndrome, often given alongside aspirin to reduce the risk of heart-related events.