Plant sterols 
Plant sterols (or phytosterols) are cholesterol-like substances that occur naturally at low levels in many varieties of fruits, vegetables, nuts and cereals. When eaten in sufficient amounts, plant sterols can reduce low-density lipoprotein (LDL) cholesterol levels in our blood. T he National Heart Foundation of Australia recommends lowering LDL cholesterol as one way of reducing the risk of cardiovascular disease.
We all obtain about 150 – 360 milligrams of plant sterols from natural dietary sources each day, depending on our diet. Vegetarians may get more plant sterols because they tend to eat more fruits and vegetables.
Concentrated mixtures of plant sterols can be extracted either from edible vegetable oils such as soybean or sunflower oil, or are extracted from edible oil from conifer trees which is given off when they are pulped. Manufacturers may now add these mixtures to a small range of foods, like table spreads, low-fat varieties of milk and yoghurt and some breakfast cereals.
FSANZ is currently considering whether to amend the Australia New Zealand Food Standards Codefurther to allow manufacturers to add plant sterols to cheese and processed cheese with a lower fat content, such as reduced fat cheese. Further information on this is development is available here
Are added plant sterols safe?
FSANZ has carried out a rigorous safety assessment and concluded it is safe for most people to consume food products with added plant sterols.
People with an extremely rare inherited metabolic disease called sitosterolaemia should avoid foods with added plant sterols. People with this condition absorb high levels of plant sterols which can lead to premature atherosclerosis and heart disease. There are only 45 reported cases of sitosterolaemia worldwide and all are managed strictly under medical supervision.
What amounts of plant sterols are required for a cholesterol-lowering effect?
Plant sterols are most effective if we eat 2 - 3 grams per day. This is roughly equivalent to 2 - 3 serves of foods containing plant sterols. As a general guide, one cup (250ml) is one serving of low-fat milk, one serving of low-fat yoghurt is a tub or pottle up to 200 grams, and one serving of a muesli-type cereal is about 45 grams of cereal.
Can eating more plant sterols increase these effects?
No. The recommended amount of plant sterols is 2 - 3 grams per day (2 - 3 serves). Eating more than 3 grams per day does not reduce your LDL cholesterol any further.
Are there any other health effects from consuming foods with added plant sterols?
Because plant sterols lower cholesterol absorption, they can also slightly lower the absorption of some fat-soluble vitamins, particularly beta-carotene (used by the body to make Vitamin A). You can help minimise this effect by eating an extra serve of fruit or vegetables rich in beta-carotene such as carrot, spinach, pumpkin, rockmelon, apricots and mango.
Remember, products containing plant sterols should be consumed as part of a healthy diet. For more information see: Food for health: A guide to healthy eating .
What if I am taking medication to lower my cholesterol levels?
You can still safely eat plant sterol enriched foods while you are taking cholesterol lowering drugs. However, plant sterols do not replace cholesterol lowering medication prescribed by your doctor. If you are already on cholesterol lowering medication, consult your doctor for advice about your diet and whether plant sterol enriched foods may provide any additional benefits.
Can children eat plant sterol enriched foods?
It is not unsafe for children to eat plant sterol enriched foods, but neither is it recommended unless advised to do so by a medical practitioner. Plant sterol enriched foods are intended for adults who want to reduce their cholesterol level through changes in their diet. Manufacturers are required to label their products so that consumers will know that plant sterol enriched foods are intended for adults, not children.
What if I am pregnant?
Plant sterol enriched foods have not been tested specifically in pregnant women. However, the latest evidence about plant sterols, and the way in which they work in the body to reduce absorption of dietary cholesterol, does not indicate safety concerns for pregnant or lactating women. Generally speaking, women who are pregnant or breast feeding do not need to be concerned about cholesterol and do not need to consume plant sterol enriched foods.
How will I know how much plant sterols are in a product?
Manufacturers must list plant sterols as an ingredient on the food label. If the manufacturer also makes a claim about their benefits, the nutrition information panel on the label must also include the total amount of plant sterols added per serving and per 100 grams of food. (Remember, the recommended amount is only 2-3g of plant sterols per day).
Are foods with plant sterols available in other countries?
Yes. In Europe, plant sterols are permitted in table spreads, milk, yoghurt and cheese products, some cereal products and spicy sauces, and rye bread (pumpernickel). In the US, plant sterols are also permitted in orange juice.
For more information on plant sterols see:
The National Heart Foundation of Australia’s website at http://www.heartfoundation.org.au/
The Dietitians Association of Australia website at http://www.daa.asn.au/