By Jane Hart, MD

Healthnotes Newswire (December 6, 2007)—Combining plant oils (sterols), sometimes called phytosterols, with a cholesterol-lowering medication (pravastatin, brand name Pravachol) may help lower cholesterol.

Plant sterols—chemicals found in small amounts in fruits, vegetables, nuts, and legumes—have a variety of health benefits including antioxidant and cholesterol-lowering activity and hold promise as a way to help lower cholesterol through dietary measures. Although the exact mechanism is not known, plant sterols may lower cholesterol by preventing cholesterol from being absorbed in the digestive tract.

In this study, which was published in Nutrition, Metabolism & Cardiovascular Diseases, 61 people were randomly assigned to replace their usual cooking oil with one of three test oils for 12 weeks: diacylglycerol oil (which contains oleic acid and linoleic acid), diacylglycerol oil with plant sterols (beta-sitosterol, stigmasterol, campesterol, and brassicasterol), or a control oil that was not expected to have an effect (rapeseed and safflower oils). Participants were also taking 10 mg per day of the cholesterol-lowering medication pravastatin.

Total cholesterol and LDL (“bad”) cholesterol were significantly reduced in the group that used the diacylglycerol oil with plant sterols. These changes were not seen in the groups that used the diacylglycerol oil alone or the control oil. HDL (“good”) cholesterol levels were not affected.

“Despite low doses given [of phytosterols], a phytosterol-enriched diet fortified the potential cholesterol-lowering effect of pravastatin treatment,” said Masao Takeshita, lead author of the study and a researcher at the Kao Corporation in Tokyo, Japan, which produces the cooking oil. “Before increasing the normal dose of a statin, clinicians may consider the additional use of phytosterols as a therapeutic option.”

Some people cannot tolerate high doses of cholesterol-lowering medications due to side effects such as muscle cramps or liver damage. In such people, the use of plant sterols should be considered, Takeshita said. The National Cholesterol Education Program recommends the use of a mixture of phytosterols for people with high cholesterol levels and suggests that LDL cholesterol may be reduced by about 10% with the use of plant sterols, according to the study’s authors.

Although the cooking oil used in this study is currently available only in Japan, research in this area is emerging and may yield more widely available plant-based food options to help lower cholesterol. If you have high cholesterol, talk to your doctor about known dietary interventions that may help, and whether it makes sense to add more plant sterols to your diet.

(Nutr Metab Cardiovasc Dis 2007; doi:10.1016/j.numecd.2007.05.009)

Jane Hart, MD, board-certified in internal medicine, serves in a variety of professional roles including consultant, journalist, and educator. Dr. Hart, a Clinical Instructor at Case Medical School in Cleveland, Ohio, writes extensively about health and wellness and a variety of other topics for nationally recognized organizations, Web sites, and print publications. Sought out for her expertise in the areas of integrative and preventive medicine, she is frequently quoted by national and local media. Dr. Hart is a professional lecturer for healthcare professionals, consumers, and youth and is a regular corporate speaker.

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