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A Sweet Way to Lower Cholesterol

Healthnotes Newswire (December 28, 2006)—People with high cholesterol don’t necessarily need to skip dessert to avoid raising their cardiac risk: a new study found that a chocolate snack bar fortified with plant sterols from soy can lower cholesterol levels.

More than 100 million Americans have cholesterol levels above the healthy level of 200 mg/dl, and of them, more than one third have levels over 240 mg/dl. High cholesterol increases the risk of atherosclerosis and heart attack, the number one killer in the developed world.

Cholesterol levels are strongly affected by lifestyle and diet. Healthy levels can usually be reached through regular exercise and eating plenty of vegetables, fruits, whole grains, beans, lentils, soy foods, nuts and seeds, and fish. Cholesterol is raised by eating foods high in cholesterol or saturated fats and spending too much time sitting.

Despite the evidence in favor of healthy eating, many people find it difficult to resist the draw of high-fat and processed foods, and have a hard time regularly eating foods that have fiber, antioxidants, and healthy fats. The food industry has tried to accommodate these appetites by fortifying commonly eaten foods with nutrients and extracts believed to promote health.

Extracts from soybeans are among the more popular additives to prepared foods. In particular, the phytosterols found in soy oil have been added to foods such as orange juice, milk, yogurt, and margarine to help people reduce their cholesterol levels, and research has found that these fortified foods can be effective.

In the new study, published in the Journal of the American Dietetic Association, soy phytosterols were added to chocolate snack bars. Half of the 67 participants, all who had high cholesterol, ate two sterol-fortified candy bars (1.5 grams of phytosterols each) per day, while the other half ate two unfortified chocolate bars.

At the end of the six-week trial, total cholesterol levels in the people who had been eating the phytosterol-enriched bars were 4.7% lower and LDL (“bad”) cholesterol levels were 6% lower than at the beginning of the study. In the other group, however, cholesterol levels did not change.

One of the ways that sterols lower cholesterol levels is by interfering with the absorption of cholesterol from food. Some nutrition experts are concerned that they might block fat-soluble vitamins and other nutrients from getting into circulation as well. In this study, blood levels of vitamins A and E and of several fat-soluble flavonoids known as carotenoids did not change in either group. Only beta-carotene levels dropped in the phytosterol-eating group.

“Candy bars that lower cholesterol are better than regular candy bars,” commented Julianne Forbes, a naturopathic doctor in Maine who prescribes nutritional interventions for preventing heart disease. Forbes added, “No amount of enriching will make up for what is lost in processing. The importance of eating real foods that naturally contain the nutrients necessary to maintain heart health—and health in general—is not diminished by adding fortified foods that are otherwise not nutritionally sound. Nevertheless, it is good to have choices like this when you feel like you need a treat.”

Although the place for phytosterol-fortified chocolate bars is limited, they could be a reasonable part of a larger plan for people with high cholesterol who struggle with eating well. There is even evidence that dark chocolate, which was also part of these phytosterol-enriched bars, could have beneficial effects for people with cardiac risk factors. The clinical importance of the drop in beta-carotene levels, and whether eating more fruits and vegetables can make up for this drop, remain topics for future research.

(J Am Diet Assoc 2006;106:1804–13)

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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