What is the average daily intake of plant sterols (phytosterols) in a regular diet?

Average Daily Intake of Plant Sterols in a Regular Diet

The dietary intake of plant sterols in a regular diet ranges between an average of 250 mg/day in Northern Europe to 500 mg/day in Mediterranean countries. 1

What Are Plant Sterols?

Plant sterols (phytosterols) are naturally occurring compounds found in various plant-based foods. The principal phytosterols are:

• Sitosterol
• Campesterol
• Stigmasterol

These compounds occur naturally in:

• Vegetable oils (highest concentration)
• Vegetables
• Fresh fruits
• Chestnuts
• Grains
• Legumes

Geographical Variations in Plant Sterol Intake

There are notable regional differences in daily plant sterol consumption:

• Northern European diets: approximately 250 mg/day
• Mediterranean diets: approximately 500 mg/day 1

This variation is likely due to differences in dietary patterns, with Mediterranean diets typically including more plant-based foods and vegetable oils that are rich sources of plant sterols.

Physiological Role and Mechanism

Plant sterols compete with cholesterol for intestinal absorption, which explains their cholesterol-lowering effects. They are:

• Structurally similar to cholesterol
• Poorly absorbed in the intestine
• Able to displace cholesterol from intestinal micelles 2
• Capable of reducing the pool of absorbable cholesterol

Therapeutic Applications

While the average intake in regular diets is 250-500 mg/day, therapeutic doses for cholesterol-lowering effects are significantly higher:

• 2-3 g/day of plant sterols can effectively lower total cholesterol and LDL-C by 7-10% 1
• Maximum effective dose is approximately 2 g/day 2, 3
• Intakes above 3 g/day confer no additional benefit for cholesterol lowering 1

Safety Considerations

When consumed at normal dietary levels (250-500 mg/day), plant sterols pose no known health risks. However, at higher supplemental doses, some considerations include:

• Plant sterol supplementation may decrease plasma levels of fat-soluble vitamins and carotenoids 1, 3
• There is ongoing scientific debate about the safety of high-dose plant sterol supplementation 4
• Even at very high intake levels (8.8 g/day), serum plant stanol levels remain relatively low and normalize within 4 weeks after discontinuation 5

Clinical Implications

For healthcare providers, it's important to recognize that:

1. The average person consumes 250-500 mg/day of plant sterols through regular diet
2. This amount is insufficient for therapeutic cholesterol-lowering effects
3. Supplementation to reach 2-3 g/day may be considered for patients requiring cholesterol reduction
4. Plant sterol-enriched foods can be part of a comprehensive approach to managing dyslipidemia

Plant sterols represent one of several dietary approaches to cholesterol management, alongside limiting saturated fat intake, maintaining healthy body weight, and regular physical activity.