What in the world are these plant sterol things?

I wrote an article about plant sterols and stanols that I thought you all might find interesting since they are so ubiquitous on food labels. Enjoy!

Plant Sterols and Stanols Basics

By Jennifer Martin, MS, RD

As a dietitian, it is impossible to walk past certain foods in the supermarket without noticing the abundance of extraordinary claims for heart health on the product labels. There are labels that help us “Take Control” and give us a “Smart Balance” to help lower our cholesterol. Functional foods containing plant sterols and stanols that claim to lower low-density lipoprotein (LDL) cholesterol are a booming food industry trend. With coronary heart disease (CHD) as one of the leading causes of morbidity and mortality worldwide, it is likely a trend that will continue.

The use of these plant sterols and stanols to lower cholesterol is not a new concept. The intake of plant-derived sterols was first found to decrease serum cholesterol levels in research studies conducted in the 1950s.¹ Plant sterols were briefly used therapeutically to reduce blood cholesterol levels until more efficacious pharmacological agents, such as statins, were introduced.

Just as cholesterol is an essential sterol in mammalian cell membranes, plant sterols are essential components of plant membranes. There are slight structural differences between cholesterol and plant sterols that render the plant sterols minimally absorbable by humans.² The typical human consumes plant sterols everyday in plant foods, however, the amounts are much lower than those efficacious for lowering LDL-cholesterol levels in research. An intake of approximately 2gm/day of plant sterol ester has been reported to decrease LDL-cholesterol levels anywhere from 9-20%. There appears to be little additional effect at doses higher than 2.5gm/day.³

Studies have demonstrated that consuming products containing plant-derived sterol esters is beneficial and effective in normolipidemic and dyslipidemic individuals as well as those on lipid-lowering medications.² It is postulated that sterols and stanols displace cholesterol from mixed micelles, reducing intestinal absorption of cholesterol. It should also be noted that while sterols/stanols lower LDL cholesterol, they have little or no effect on serum triglycerides or high-density lipoprotein (HDL) cholesterol.³

The food industry esterifies the sterols/stanols to improve solubility, making them easier to incorporate into products such as margarine. Esterification also helps to enhance dispersion in the intestine, in turn promoting the efficacy of the products.²

The Third Report of the National Cholesterol Education Program (NCEP), more commonly known as the Adult Treatment Panel III (ATP III), included the intake of 2gm/day plant sterols/stanols as one of the therapeutic options to enhance LDL lowering.⁴

The American Heart Association (AHA) Diet and Lifestyle Recommendations 2006 Revision also includes use of plant sterols/stanols at levels up to 2gm/day as a therapeutic option to lower LDL cholesterol levels (in addition to diet and lifestyle modification).⁵ The AHA recommendations also state that individuals need to consume the products daily, the same as using a lipid-lowering medication.

In 2000, the FDA approved the first health claim for plant sterol/stanol esters and heart disease. Products eligible to carry the claim must contain at least 0.65gm of sterol esters of at least 1.7gm stanol esters per serving. The daily dietary intake of sterol/stanol esters must be consumed in 2 servings eaten at different times of the day with other foods as part of a diet low in saturated fat and cholesterol.⁶

The amount of plant sterols/stanols in functional food products varies so be sure to read the label to determine how much of the product to take for the benefits.

Jennifer Martin, MS, RD, is a northern N.J.-based freelance nutrition writer. She has worked in the fields of clinical nutrition, cardiovascular wellness and diabetes research.

REFERENCES

1. Pollak OJ. Reduction of blood cholesterol in man. Circulation. 1953;2:702-706.

2. Lichtenstein AH, Deckelbaum RJ. Stanol/sterol ester-containing foods and blood cholesterol levels. A statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association. Circulation. 2001;103:1177-1179.

3. Katan MB, Grundy SM, Jones P, et al. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc. 2003;78:965-978.

4. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-2497.

5. Lichtenstein AH, Appel LJ, Brands M, et al. Summary of American Heart Association diet and lifestyle recommendations revision 2006. Arterioscler Thromb Vasc Biol. 2006;26:2186-2191.

6. Food and Drug Administration. Food labeling: Health claims; plant sterol/stanols esters and coronary heart disease. Federal Register. 2000;65:54686-54739

The Complicated Story on Beef

So I received a request from my friend Adriane to have an "Ask the dietitian column"- I'll need to ask my tech-savvy brother if I can set up a way to have people write in questions... but in the mean time, here is Adriane's question:

"Ok question # 1. Dear Sexiest Dietitian in Northern New Jersey. Beef is the ugly step child of the meat family. You always hear how bad it is for you and your heart. Is there a "right" way to eat beef? Or should it really just be avoided? Any suggestions?"

That's a fantastic question- I know in my experience when a patient tells me he or she has started to make changes in his or her diet, the first thing mentioned is that he or she has stopped eating red meat. Beef has gotten a bad rap in the public and is not a great food to eat every day but as us dietitians like to say "Everything fits in moderation."

I'll start off by stating some of the nutritional properties of beef; this is from the beef.org website- run by the National Cattleman's Association- but they are truthful statements:

"A 3-ounce serving of lean beef is an excellent source (provides 20% or more of daily value) of: iron, niacin, vitamin B6, riboflavin. A 3-ounce serving of lean beef is a good source (provides 10-19% of daily value) of: phosphorus, protein, selenium, vitamin B12."

The iron that we get from beef (and animal foods in general) is more easily absorbed by the body than iron from plant foods. Beef and meat is also an easy way to eat a lot of protein. A 3-ounce serving of sirloin provides 26 grams protein and only 160 calories. So yes, there are some definite good points to beef.

Having said that, the typical American's diet is usually not deficient in niacin, B6 or riboflavin. Very few of us also are deficient in our protein intake- most Americans eat at least double the amount of protein that the body needs to function- even weight lifting guys who need extra protein usually eat way more than they need. Beef is also very high in fat, particularly saturated fat. Saturated fat is a type of fat that increases the 'bad' cholesterol in our blood called LDL-cholesterol. This increased level of bad cholesterol is associated with atherosclerosis, or fatty deposits/plaques in blood vessels. If that same 3-ounce piece of sirloin is broiled or grilled and is a lean cut, it has 2.1 grams of saturated fat (10% of what a person who eats 2000 calories per day should eat). Keep in mind that 3 ounces of beef is not what most people consider a large portion, it is approximately the size of a deck of cards-not what most people eat when they eat steak. Meats in general can also be quite pricey. A can of organic garbanzo beans at Whole Foods runs me less than a dollar and provides lots of good fiber, protein, vitamins and minerals with no saturated fat and little total fat.

I also try to avoid eating beef and meats in general due to the impact of meat production on the environment. Heck, even the beef.org website states that it takes 435 gallons of water to produce 1 lb. of meat. I won't get into a lot of the details but basically producing meat takes up a lot of natural resources including water, petroleum, grains, etc. If any one wants more information on the research concerning the environment, disease, and meat production, I can write another post, but it's too much to write here. There's also a lot of good books with strong scientific research behind them that deal with those issues.

Basically, the story on beef is a mixed one. My personal recommendation is to keep it to no more than once a week, and if you're going to eat beef, keep the portion small, like 3-ounces and choose a leaner cut. I think it's a good idea in general to try to trim back meat consumption and substitute it with other healthy protein sources like whole grains and beans.

The bottom line: beef can be a good source of protein and iron, but is high in saturated fat, has a high cost to the environment and your wallet.

Simple Carrot Soup Recipe

While I was shopping at Whole Foods yesterday I saw a Carrot-Ginger Soup for sale, 18 ounces for over $6. In my opinion that's way too much money to pay for a simple soup. I looked at the ingredient label and it was just about identical so a soup that I've been making for years. So I decided to share the super easy recipe! Pureed vegetable soups are a fantastic way to eat tons of veggies and not even realize it.

Simple Carrot Soup

1 shallot or 1 clove garlic

1 yellow onion

~1 Tbsp olive or canola Oil

1 1/2 pounds carrots

32 ounces (4 cups) chicken or vegetable broth (low-sodium is what I use)

salt and pepper to taste

It's easy if you start off by dicing all of your veggies and add them as you go- think of a cooking show- they always have everything diced up in advance.

Heat a large pot over medium-high heat and add the oil. Add the diced onion to the pot and stir until the onion starts to soften, about 3-5 minutes.

Then add the diced shallot or garlic clove. Stir for another 2-3 minutes then add the diced carrots and the broth.

Bring the soup to a boil and then turn hear down to low, put the lid on the pot and simmer until the carrots are soft (time varies depending on the size of your carrot pieces but ~30 minutes).

Take the soup off of the heat and give it about 10 minutes to cool down a bit so you don't scald yourself if your blender goes crazy.

Use a ladle and put the soup mixture into a blender and blend until it's pureed. It may take 2-3 trips to the blender if you have a small blender. Pour the soup back into the pot, heat if needed and serve!

Some people (example: my boyfriend) aren't used to the taste of lower-sodium foods, so feel free to add salt and pepper to taste.

This recipe can be modified very easily if you are feeling more creative. You can add ginger with the shallot/garlic for the Whole-Foods-like soup. You can get rid of the carrots and make potato/broccoli soup. All you need is to saute some onion, add veggies and broth, cook till soft and puree. Voila- your very own super easy way to tastily eat your veggies.

A bit of the basics

OK- Welcome everyone to the inaugural blog posting for the Nutrition Insiders' Guide.

For my first post I wanted to share something that I consider to be the cardinal rule of nutrition. In one of my very first nutrition classes in college a professor taught this to our class and I will never forget it.

The word "diet" comes from the greek word "diaita" which translates to "way or manner of living". Therefore, the word diet as our society has come to perceive it is not some horrible demonic concept, but instead a word to describe how we live. It is an extremely simple concept that has been hijacked by people looking to make a buck off of people's fears.

So PLEASE! Keep this in mind, a diet is the way that we are all supposed to eat all of the time, not just to lose 10 pounds in 3 days.