Which is more effective for lowering Low-Density Lipoprotein (LDL) cholesterol, brown rice or plant sterols?

Plant Sterols Are Superior to Brown Rice for Lowering Cholesterol

Plant sterols are significantly more effective than brown rice for lowering LDL cholesterol, with studies showing plant sterols can reduce LDL cholesterol by 9-20% at doses of 2-3g per day. 1

Mechanism of Action and Efficacy

• Plant sterols (phytosterols) are structurally similar to cholesterol and work by competing with cholesterol for absorption in the intestine, decreasing cholesterol absorption by approximately 30% 2
• Plant sterols block intestinal absorption of both dietary and biliary cholesterol by displacing cholesterol from intestinal micelles 3
• The maximum effective dose of plant sterols is approximately 2-3g per day, which can reduce LDL cholesterol by 9-20% 1, 2
• Plant sterols have little to no effect on HDL cholesterol or triglyceride levels 1
• Intakes of plant sterols exceeding 3g/day do not provide additional cholesterol-lowering benefits 1

Forms and Administration

• Plant sterols occur naturally and are typically isolated from soybean and tall oils 1
• For commercial use, plant sterols are often esterified to increase solubility and sometimes saturated to form stanol esters 1
• Both forms (sterol esters and stanol esters) have comparable efficacy in lowering cholesterol 1
• Plant sterols can be incorporated into various food products, particularly margarines and other fat-containing foods 4
• Newer delivery methods include emulsification with lecithin for incorporation into non-fat or low-fat foods and beverages 3

Brown Rice vs. Plant Sterols

• There is no significant evidence in the provided literature supporting brown rice as an effective cholesterol-lowering agent 1
• While brown rice may have other health benefits as a whole grain, it does not demonstrate the specific cholesterol-lowering properties that plant sterols do 1
• Plant sterols have been extensively studied and consistently show significant cholesterol-lowering effects 2, 3, 5, 4

Safety and Recommendations

• Plant sterols are considered safe at recommended doses (2-3g/day) 2
• Plant sterols are poorly absorbed systemically, which contributes to their safety profile 2, 3
• Some concerns exist regarding plant sterols potentially decreasing plasma levels of fat-soluble vitamins and antioxidants (α- and β-carotene, α-tocopherol, and lycopene) 1
• Due to these concerns, the American Heart Association recommends that plant sterol-containing foods be reserved for adults requiring lowering of total and LDL cholesterol due to hypercholesterolemia or for secondary prevention after an atherosclerotic event 1
• Additional monitoring may be prudent when using plant sterols long-term 1

Clinical Application

• Plant sterols can be used as an adjunct to other cholesterol-lowering strategies, including statins, as their effects are additive 2
• Individuals most likely to respond to plant sterols are those with high cholesterol absorption and low cholesterol biosynthesis 3
• The Academy of Nutrition and Dietetics recommends that individuals with dyslipidemia incorporate 2-3g of plant sterol and stanol esters per day as part of a cardioprotective diet 1
• Studies in people with diabetes have shown similar efficacy of plant sterols in lowering cholesterol compared to people without diabetes 1

While plant sterols effectively lower cholesterol, it's important to note that there is currently no direct evidence that they reduce the risk of coronary heart disease mortality, despite their cholesterol-lowering effects 1.