High cholesterol is a condition estimated to affect around half of all adults in the UK and is a leading risk factor for heart disease. In the UK, non-HDL cholesterol is associated with 25% of all cardiovascular disease deaths and 44% of deaths from coronary heart disease, according to the British Heart Foundation1. The condition is often referred to as the silent killer as it doesn’t usually cause symptoms.
Lipid-lowering drugs such as statins are used as a treatment for people with high cholesterol, and in the UK, around 7-8 million people have been prescribed them. Some people can manage their cholesterol by addressing their diet and taking plant sterols.
What is cholesterol?
Cholesterol is a waxy substance found in your blood and your cells. Your liver makes most of the cholesterol in your body, and the rest comes from the foods you eat. Cholesterol isn’t bad, and your body needs it to make hormones, vitamin D, and digestive fluids and for your organs to function correctly.
Cholesterol is carried around by proteins in the blood, and when they join are called lipoproteins. There are two types of lipoproteins, one good for your health and the other bad.
High-density lipoprotein (HDL) is referred to as ‘good’ cholesterol. HDL helps to rid the body of ‘bad’ cholesterol by taking it back to the liver, where it is broken down and removed.
Non-HDL cholesterol (non-HDL) is referred to as ‘bad’ cholesterol. If too much non-HDL builds up in the body, this can result in fatty deposits inside the walls of blood vessels. These deposits can narrow blood vessels, increasing your risk of heart attack or stroke.
What is high cholesterol?
You have too much ‘bad’ cholesterol in the blood if you have high cholesterol. The healthy levels of cholesterol include:
|Total cholesterol||5 mmol/L or below|
|HDL (good cholesterol)||1 mmol/L or above|
|Non-HDL (bad cholesterol)||4 mmol/L or below|
|Total cholesterol to HDL cholesterol ratio||6 or below|
What causes high cholesterol?
Diet can influence your cholesterol levels, especially overeating saturated fat which reduces the liver’s ability to remove cholesterol from the body. Lifestyle factors such as a lack of physical activity can also influence the balance of cholesterol, as being active lowers ‘bad’ cholesterol and raises ‘good’ cholesterol.
Your biology also plays a role, as males are more likely to have higher cholesterol than women. High cholesterol is also more likely as you get older, and culturally, people with South Asian origins are more predisposed to the condition.
Liver and kidney disease can impact the ability of these organs to handle cholesterol and remove it from the body, increasing the risk of high cholesterol. If you carry excess weight around your middle or have either of the health conditions, type 2 diabetes or an underactive thyroid, you are more at risk of high cholesterol.
What are plant sterols?
Plant sterols help to lower cholesterol by mimicking it in the body and competing for its absorption. This leads to less cholesterol being absorbed into the bloodstream from the gut.
It is well understood that people who consume the most plant sterols have the lowest cholesterol levels. Furthermore, plant sterols have been shown to lower levels of non-HDL cholesterol by as much as 15%2. The benefit of this is a reduced risk of heart attack and stroke.
Statin users can also experience a more significant cholesterol-lowering effect by taking it alongside plant sterols. This amplified effect on cholesterol is more effective than doubling the dose of statins.
What are good sources?
Plant sterols can be found in vegetables, fruits, legumes, oils, nuts, seeds and cereals.
A convenient way to increase your intake of plant sterols is in a supplement form (try Healthspan Plant Sterols – 90 tablets for £16.45). You should ideally take 2g per day to get the best results. Taking higher doses over 3g daily is not likely to have any added benefit and may decrease the absorption of some fat-soluble vitamins and carotenoids.
There are no reported side effects to taking plant sterols and a reduction in cholesterol levels is within two to four weeks.
Are there any alternatives?
Artichoke extract is another supplement shown to have cholesterol-lowering effects. A study of adults with high cholesterol found that taking artichoke extract for 6 weeks daily led to a 22.9% reduction in non-HDL (bad) cholesterol3.
Reducing cholesterol is a step in the right direction to lowering your risk of heart disease. While diet should always come first, investing in plant sterols alongside other healthy lifestyle changes is an effective way to get your health back on track.
- British Heart Foundation, Heart & Circulatory Disease Statistics 2021: Chapter 5 – Risk Factors, accessed July 2021
- Berger, A., Jones, P. J., & Abumweis, S. S. (2004). Plant sterols: factors affecting their efficacy and safety as functional food ingredients. Lipids in health and disease, 3, 5. https://doi.org/10.1186/1476-511X-3-5
- Englisch, W., Beckers, C., Unkauf, M., Ruepp, M., & Zinserling, V. (2000). Efficacy of Artichoke dry extract in patients with hyperlipoproteinemia. Arzneimittel-Forschung, 50(3), 260–265. https://doi.org/10.1055/s-0031-1300196