Cholesterol Control: Statins vs. Plant Sterols


Almost a third of American adults — 73.5 million people — have high cholesterol. But less than half of them are getting the treatment they need to lower their levels, according to the U.S. Centers for Disease Control and Prevention (CDC).

There are two different types of cholesterol. High-density lipoprotein (HDL) is considered “good” cholesterol because it helps the body rid itself of low-density lipoprotein (LDL), which is known as the “bad” cholesterol. High levels of LDL cholesterol can double a person’s risk of a heart attack.

What are Desirable Cholesterol Levels?
According to the CDC, ideal cholesterol levels are:
  • LDL cholesterol: less than 100 mg/dL
  • HDL cholesterol: more than 60 mg/dL
  • Total cholesterol: less than 200 mg/dL

Adopting healthy lifestyle habits and including foods that increase HDL cholesterol and lower LDL cholesterol is good for your overall health. But people with chronically high LDL cholesterol might need more than exercise and a healthier diet to reduce their risk of heart disease.

Two possible solutions are statins, which are medications that are prescribed by a doctor, or consuming foods that contain high amounts of plant sterols.

What Are Statins and How Do They Work?

Statins are medications that lower LDL cholesterol levels in the body. They do this by reducing the liver’s production of LDL cholesterol. They also help reabsorb any cholesterol that’s built up in your arteries.

According to Harvard Medical School, one in four Americans over the age of 40 are taking a statin. That equates to 32 million people, or nearly 45 percent of Americans with high cholesterol.

The different types of statins include atorvastatin (Lipitor), rosuvastatin (Crestor), simvastatin (Zocor), pitavastatin (Livalo), fluvastatin (Lescol), lovastatin (Altoprev), and pravastatin (Pravachol).

The American Heart Association and the American College of Cardiology recommend statins specifically for people with an LDL level higher than 189 mg/dL, people who already have cardiovascular disease, people who have diabetes, and people who have an elevated risk of heart attack.

What Are Plant Sterols and How Do They Work?

Plant sterols are substances found in plants. They can help block your body from absorbing cholesterol, and they work similarly to the way fiber works. One Canadian study concluded that plant sterols are the most effective natural treatments for high cholesterol. While they affect LDL cholesterol, they don’t appear to affect your levels of HDL cholesterol or triglycerides.

Did You Know?
Plant sterols and plant sterol esters are both phytosterols, compounds similar to cholesterol that are found naturally in fruits, vegetables, and vegetable oils, wheat bran and germ, cereals, legumes, and nuts.

Plant sterols are sometimes added to foods that are marketed as being able to lower cholesterol. These include margarines like Take Control and Benecol. One study found that people with high cholesterol who substituted regular margarine with one that contains plant sterols were able to lower their LDL cholesterol levels by 36 percent in a year.

Sterols are also added to drinks, such as orange juice and yogurt drinks. To reap their cholesterol-lowering benefits, you need to consume at least 2 grams of plant sterols a day. This equates to about two 8-ounce glasses of sterol-fortified orange juice per day.

How Do They Compare?

Both statins and sterols are effective at lowering LDL cholesterol levels. While statins are the gold standard for pharmaceutical interventions, sterols are considered one of the best natural sources to combat high cholesterol.

Statins are one of the most commonly prescribed drugs, as they’re well-tolerated by most patients. But besides helping cholesterol levels, they can help reduce the risk of heart attack or stroke. Some people, however, do experience side effects, such as memory loss, muscle pain or damage, weakness, and nausea.

There is a less clear association between sterols and these risk factors, but it is proven that sterols are able to help reduce LDL cholesterol. Sterols are also safer for pregnant women, as statins may cause birth defects. Some side effects, including interaction with other drugs, may occur with certain statins.

Statins: The Pros and Cons

Can Statins and Sterols Be Used Together?

A 2006 review found that taking statins and plant sterols together can reduce the risk of cardiovascular issues such as heart attack and stroke by as much as 20 percent.

There’s no evidence to suggest that the combination is dangerous, but check with your doctor first. Allergic reactions, while rare, are not impossible.

Together with a low-fat, high-fiber diet, as well as regular exercise, plant sterols and statins are two ways people can help reduce their cholesterol. Consult with your doctor before beginning any cholesterol-lowering regimen.

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