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How could plant sterol enriched foods help your patients manage their heart health?
Approximately 6.5 million Australian adults are living with elevated cholesterol, which impacts heart health.2, 3
Healthy lifestyle changes including diet, physical activity, ceasing smoking, limiting alcohol intake, and managing body weight are recommended in the first instance to individuals who have elevated cholesterol. In addition, cholesterol-lowering medication particularly statins, are often indicated as second line of defence or for those who need to manage their heart health.4
What are plant sterols?
Plant sterols (also known as phytosterols) are natural compounds found in all plant foods. They have a similar chemical structure to cholesterol and perform similar biological functions. This enables their ability to inhibit cholesterol absorption in the gut, thus leading to an overall reduction in blood cholesterol levels.
Daily dietary intake of plant sterols varies between populations and dietary patterns but is generally between 160-400mg. People following vegetarian dietary patterns may consume up to 750mg/day, which would provide some mild cholesterol-lowering effects.5-8
It is well established that 2-3 g/day of plant sterols from enriched foods lowers LDL-cholesterol on average by 5 to 10%,1 and in combination with other dietary changes such as a reduction in saturated fats and an increase in fibre, LDL-cholesterol can be lowered further by up to 20%.9
Together with a healthy balanced diet, the Heart Foundation recommends the daily intake of 2-3g of plant sterols to lower cholesterol. Read more about the role of plant sterol enriched foods for lowering cholesterol and managing heart health in the Heart Foundation’s Dietary Position Statement on Phytosterol/stanol Enriched foods & Heart Healthy Foods. For further information on healthy eating and cholesterol, visit heartfoundation.org.au.
Plant sterols are found naturally in all plant foods such as fruits, vegetables, wholegrains, legumes, nuts, seeds, oils of nuts and seeds. Although widely abundant in the diet, they are only present in these foods in very small amounts,10 making it quite difficult to consume 2g of plant sterols through natural dietary sources alone.
In Australia, plant sterol enriched foods are available in low-fat milk, spreads, and cereals.
What role could Weet-Bix™ play?
One cereal option is Weet-Bix™ Cholesterol Lowering, which takes Australia’s No. 1 breakfast cereal and adds the functional benefit of cholesterol-lowering plant sterols. One serve (that’s 2 wheat biscuits) contains the effective dose of plant sterols, making it an easy choice for those wanting to reduce their cholesterol.
Weet-Bix™ Cholesterol Lowering has been tested in a 4-week randomized cross-over clinical trial in Australian adults with elevated cholesterol. The study included 50 volunteers who after a 2-week run-in period were randomised to receive either 2 standard wholegrain wheat biscuits (Weet-Bix) for 4 weeks or a serve of wholegrain wheat biscuit enriched with 2g plant sterols (Weet-Bix Cholesterol Lowering) for 4 weeks, and then crossed over to the alternate intervention. Forty-five successfully completed the study, and overall LDL cholesterol was reported to be lowered by up to 9% in this sample. Read the published journal article here: Clifton & Keogh, Foods (2018), 7(3), 39.
Plant sterols and cholesterol-lowering medication
The Heart Foundation recommends that people taking statins can benefit from eating plant sterol-enriched foods in addition to their statin therapy.1, 11
How do I tell my clients about Weet-BixTM Cholesterol Lowering?
Accredited Practising Dietitians from Sanitarium have developed some resources to make it easy for you to tell your clients about the benefits of Weet-BixTM Cholesterol Lowering. The Weet-BixTM Cholesterol Lowering website contains downloadable fact sheets for clients and Health Care Professionals, recipes as well as links to further education material about plant sterols and heart health. Visit here to learn more.
How will plant sterol enriched foods affect a patient’s statin treatment?
The Heart Foundation recommends that if patients are already on cholesterol-lowering medication, they should continue taking it. Research shows that plant sterol enriched foods work together with statins, to lower LDL-cholesterol.11 The Heart Foundation recommends that Health Professionals advise Australian adults on statin therapy about the benefits of consuming plant sterol-enriched foods.1
My patients like to switch up their breakfast – do they need to eat Weet-Bix Cholesterol Lowering every day?
Yes, it needs to be consumed daily to achieve and maintain optimal cholesterol-lowering benefits. Weet-Bix™ Cholesterol Lowering is versatile and can be enjoyed in several different ways. From a warm porridge to a fruit smoothie, fritters, or pancakes! We’ve tried to take the guesswork out, so visit here to access our Dietitian-approved recipes and meal ideas using Weet-Bix™ Cholesterol Lowering!
What if your clients want to eat more than 2 Weet-BixTM Cholesterol Lowering for breakfast?
Having more than 2 Weet-BixTM Cholesterol Lowering will not cause harm, however, it will not provide further cholesterol-lowering benefits. For individuals who like to enjoy more than 2 Bix, we recommend ensuring the first 2 are Weet-BixTM Cholesterol Lowering, then topping up with another type of Weet-BixTM.
Are plant sterols safe?
Plant sterol enriched foods can be included in a healthy eating plan. Plant sterols have been approved as safe to add to certain foods in several countries around the world, including Australia and New Zealand, with plant sterol-enriched foods being on the market in Australia for over 20 years. Together with a healthy balanced diet, the Heart Foundation recommends the daily intake of 2g of plant sterols to lower cholesterol.1, 11 Sterol-enriched foods are not recommended for pregnant women or children under 5 years of age because these groups have particular nutrition requirements.
For more diet and lifestyle information on how to help
manage your heart health visit the Heart Foundation website
1. National Heart Foundation of Australia. Dietary Position Statement: Phytosterol/stanol enriched foods & Heart Healthy foods. Available at: https://resources.heartfoundation.org.au/images/uploads/publications/190729_Nutrition_Position_Statement_-_Phyto_Sterol.pdf. 2017.
2. Australian Bureau of Statistics. Australian Health Survey: Biomedical Results for Chronic Diseases [Internet]. Canberra: ABS; 2011 [Available from: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-biomedical-results-chronic-diseases/2011-12.
3. Australian Bureau of Statistics. National, state and territory population [Internet]. Canberra: ABS; 2022 [cited 2022 27 March]. Available from: https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/mar-2022.
4. The Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice. 9th edn, updated. East Melbourne, Vic.: RACGP; 2018.
5. Ahrens EH, Jr., Boucher CA. The composition of a simulated American diet. Comparison of chemical analyses and estimates from food composition tables. J Am Diet Assoc. 1978;73(6):613-20.
6. Moreau RA, Whitaker BD, Hicks KB. Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Prog Lipid Res. 2002;41(6):457-500.
7. Morton GM, Lee SM, Buss DH, et al. Intakes and major dietary sources of cholesterol and phytosterols in the British diet. J Hum Nutr Diet. 1995;8(6):429-40.
8. Piironen V, Lindsay DG, Miettinen TA, et al. Plant sterols: biosynthesis, biological function and their importance to human nutrition. J Sci Food Agric. 2000;80(7):939-66.
9. Skeaff CM, Thoma C, Mann J, et al. Isocaloric substitution of plant sterol-enriched fat spread for carbohydrate-rich foods in a low-fat, fibre-rich diet decreases plasma low-density lipoprotein cholesterol and increases high-density lipoprotein concentrations. Nutr Metab Cardiovasc Dis. 2005;15(5):337-44.
10. Klingberg, S., Andersson, H., Mulligan, A. et al. Food sources of plant sterols in the EPIC Norfolk population. Eur J Clin Nutr 62, 695–703 (2008).
11. National Heart Foundation of Australia. Position Statement Phytosterol/stanol enriched foods: Questions and Answers – Professional 2017.