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Stanols, sterols block body's absorption of cholesterol

KathyKolasa

Kathy Kolasa

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Kathy Kolasa

Wednesday, July 4, 2018

Happy birthday, USA. It’s a red, white and blue day.

I have childhood memories of crossing the border into Canada to get some wonderful red cherries for the holiday. Windsor is south of Detroit, so the cherries were ready sooner than in Michigan. We didn’t know how nutritious they were, we just knew that they tasted great. We would get tart ones to make pie and cold cherry soup and sweet ones to eat by the handful. We don’t grow many cherries in eastern North Carolina, so it might be easier to treat your family to watermelon, blueberries and something white … maybe ice cream or yogurt. I’m hoping to have a Bogue Sound watermelon with some blueberries and feta cheese. Be thankful that we live in a land where we grow an abundance of health-promoting foods. All we have to do is choose them.

Q: I am using a butter substitute on toast or bread that claims to reduce bad cholesterol. It’s called a plant stanol ester. However, the list of chemicals added to the spread has me questioning whether it is more harmful to my health than butter. Also, this brand includes either coconut oil or palm oil, and I assume that’s not good. — C.M., Greenville

A: The claim that plant stanol and plant sterol esters can reduce your cholesterol in two weeks is a proven fact. The evidence was so compelling that in addition to keeping saturated fat less than 7 percent of calories, cholesterol less than 200 mg per day and increasing viscous (soluble) fiber (10-25 g per day), the National Heart, Lung  and Blood Institute added to its TLC diet the recommendation to consume 2 grams of plant stanols/sterols every day.

If you use it regularly, stanols and sterols block your body’s absorption of cholesterol. They are found naturally in plants but not in high enough concentration. So in the late 1990s, food makers added plant stanols and sterols to foods — making a functional food — to get the lowering of LDL-cholesterol by a sizeable amount — 10 percent for most and 20 percent for some.

So the margarine you use has one half gram of the plant material. You need four tablespoons a day for the full cholesterol-lowering effect. I have recommended it to patients who have high LDL-cholesterol and are using diet and exercise to lower it — especially if they are trying to avoid going on medications. The sterols and stanols are best absorbed if taken with fat, so it makes sense that they are added to margarine.

There used to be a whole line of products with stanols and sterols in them. I remember buying milk, chews, juice and even bread with them. These products are still sold in Europe, but they weren’t very popular in the U.S. So margarine and dietary supplements are pretty much the only products I can find with the plant stanols and sterols in them.

My reading of the evidence is that the benefit of eating them outweighs your concerns if you are using only small amounts of the margarine. 

If you are taking a cholesterol-lowering medicine, too, I am not sure the benefit outweighs your concerns about saturated fat or the price of the margarine or supplements. You mentioned coconut and palm oils are on the ingredient list. Yes, they are saturated fats, and you should limit your intake of them.

The food industry as of June 18 had to stop producing foods with artificial trans fat. Trans fats clearly were heart-disease-promoting. So foods like margarine — including the one you are using — used to have an ingredient described as “partially hydrogenated oil” in them. The purpose was to make the margarine solid at room temperature.

Food scientists have discovered several different ways to take out the trans fats or partially hydrogenated oils from foods but still provide a food with desirable shelf life and texture — keeping the margarine solid at room temperature. One way is to use naturally saturated oils like coconut and palm. That’s why you see those ingredients in the margarine.

The American Heart Association still recommends margarine over butter. Unless your doctor tells you otherwise, my personal advice is: when you can’t use an oil, use the spread that has the best flavor, texture, smell and price, but use only small amounts.

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