health · nutrition

Getting cholesterol under control: Why eating plant sterols and stanols works!

nuts
The first in a series: food, exercise and smoking- how they really impact our cholesterol.

Going Nuts!

Even though I eat healthy, exercise to a fault, and don’t smoke, my ‘genes’ still don’t seem to fit. Over the past fifteen years my cholesterol has teetered between 230 and 255 (not horrifying numbers but not great either). But, over the past three to four years it has been consistently dropping, now landing at 209. How is that possible?

One thing I’ve increased in my diet besides consumption of red wine (which will be another discussion point) is the addition of nuts, leaving me wondering if those nutrient packed little nuggets are really lowering my LDL levels.

Believe it or not cholesterol is not just a dirty eleven letter word; our bodies actually need it to function properly.  The waxy substance is utilized to protect our nerves, make cell tissue and produce certain hormones. Our livers actually make all the cholesterol we need, but we’re still going to get it from our food.   It’s when LDL (bad cholesterol) levels rise, that it’s time we looked at our diets. One way to combat these rising levels is with the incorporation of plant sterols and stanols.

To get right to it, nuts contain plant sterols and stanols. What are those? – cholesterol’s plant cousin. Healthharvard.edu explains, “Plants contain a host of compounds that are chemically related to cholesterol.  They do for plants what cholesterol does for us – they help make hormones, vitamins, and the ‘skin’ that surrounds cells.”

How do they work? “On a molecular level, sterols and stanols look a lot like cholesterol. So when the travel through your digestive tract, they get in the way. They can prevent real cholesterol from being absorbed into your bloodstream. Instead of clogging up your arteries, the cholesterol just goes out with the waste.” (webmd.com)

Here’s another explanation, “When eaten, plant sterols and stanols gum up the body’s system for absorbing cholesterol from food.  Since the liver needs cholesterol to make bile acids for digestion, it grabs LDL (bad) cholesterol from the bloodstream while leaving HDL (good) cholesterol alone. The result is lower levels of total and LDL cholesterol.” (health.harvard.edu)

Why you should care? Because atherosclerosis (plaque build-up on artery walls) is the real deal.  The best explanation I’ve read about plaque buildup comes from howstuffworks.com. Since LDL doesn’t dissolve in our bloodstream, any LDL that our cells don’t utilize can end up on our artery walls. It’s likened to using a low grade spackle; eventually it tends to break off leaving a nick that the body wants to repair, but when it does it can actually cause a clot which results in blockage and then boom- heart attack and stroke are a real and scary possibility, which is why you don’t want wayward LDL looking for a place to attach to your arteries.

HDL’s do their part to bring wayward LDL’s back to the liver to be reused or turned into bile for digestion, but, if we can increase plant sterols and stanols in our diet, we are lending a helping hand to our HDL friends – literally ‘fist to mouth’.

Plant sterols and stanols (phytosterols) occur naturally in small amounts in whole grains, vegetables, fruits, legumes, nuts and seeds. Manufacturers add them to orange juice, cereal, margarine spreads and granola to name a few fortified products. “Research shows that three servings (of plant stanol esters) a day can reduce cholesterol by 20 points,” according to Ruth Frenchman, R.D. for American Dietetic Association. (webmd.com)

What are the general recommendations? “The National Cholesterol Education Program recommends that people who have high cholesterol get 2 grams of stanols or sterols a day.” And now we ask, how should we take it in – through whole foods or from fortified products, and secondly, what does two grams look like?

“Whole foods provide not just vitamins and minerals, but also energy in the form of protein, fat and carbohydrates.  They also provide phytochemicals which may help to lower our risk for certain diseases.  The nutrients and other components in whole foods are usually more balanced and may be more biologically active and able to survive digestion,” according to a 2009 article by David R. Jacobs, Jr. according to the “American Journal of Clinical Nutrition.” (livestrong.com)

Eating real food, “Getting nutrients from whole foods instead of additives is the best way to go,” says ADA spokeswoman Keecha Harris, DrPH, RD. (webmd.com). “Supplements that are fortified with sterols do not offer as many benefits as getting sterols and stanols as they naturally occur.”

Considering these sources, one could conclude that whole foods are the best way to get our plant sterols and stanols. So, I ask myself again, is it possible that the nuts are the reason why my LDL has lowered over the past few years?  From what I understand, they certainly have helped, but the amount of plant sterols and stanols needed to reach recommended levels to lower cholesterol and the amount a serving of nuts provides in a day just doesn’t add up.

If you need two grams of a plant sterol in a day and you eat a serving of whole nuts (1 ounce serving), you are only getting about 0.03 to 0.04 grams of phytosterols, according to USDA Beltsville Human Nutrition Research Center. According to livestrong.com, “the average amount of phytosterols consumed through a regular diet is less than 0.5 grams daily,” notes the Cleveland Clinic.

So as much as I’d like to think it was ‘all’ in the nuts, it’s probably not. Although I would much rather get my phytosterols from whole foods because of the overall health benefits, adding fortified foods to my diet may not be a bad thing, but knowing the possible adverse effects is important.

When it comes to adding fortified products to your diet, The Association of UK Dieticians offers the following information: fortified products are generally more expensive, should be taken with a meal (because it must mix with food in the intestines), should not replace fruits and vegetables since they can reduce the absorption of fat soluble vitamins and beta-carotene, and are not considered a replacement for cholesterol lowering medication.

“For the most part, phytosterols (in fortified foods) are well-tolerated when first started, with only some individuals experiencing side effects such as constipation, bloating, or an upset stomach,” according to cholesterolabout.com.

Obviously we have two routes to go, but a combination of the two may be just what the doctor ordered. Now let’s talk amounts.

In the whole foods category, we’re already aware that reaching the two-gram goal is pretty much impossible. Keep in mind that eating extra calories through nuts and seeds, for example, will just pack on pounds no matter how good they are for you. A handful of nuts or TB of a nut butter is about a 1.5 ounce serving according to mayoclinic.org.  They also advise using nut oils in moderation since they lack the fiber benefits of whole nuts. Remember, we can also find phytosterols in a variety of fruits, vegetables and whole grains as part of a healthy diet.

When it comes to fortified foods remember, “the amount of plant sterols/stanols varies from product to product,” according to familydoctor.org. Two 8 ounce servings of fortified orange juice or 2 to 4 tablespoons of fortified margarine can provide the recommended amount.

Again, whether we’re talking whole foods or fortified foods, know this – “Consuming more than the recommended amount will not lower your cholesterol more and consuming less than the recommended amount may result in little to no effects.” (Dieticians Association of Australia, daa.asn.au)

According to health.harvard.edu, in order to see consistent benefits, you need to get your two grams worth daily; doing it once in a while won’t work. When you stop eating them, the benefits cease.

The bottom line is you have to be smart.  Know how much your consuming whether it’s fortified or not. Read the labels on fortified products for serving sizes and don’t go nuts over the nuts, especially those covered in chocolate, sugar and salt.  If you’re serious about using fortified products, do yourself a favor and talk to your doctor about whether you should incorporate them into your diet and how to do it safely.  Although they haven’t been shown to interact with any foods or medicines, be smart, know your body, and don’t be hesitant to ask for advice.

By the way, I still love nuts and all they have to offer even if they aren’t solely responsible for lowering my LDL, and here’s a few reasons why: Nuts contain good monounsaturated and polyunsaturated fat as well as immeasurable nutrients for the body. Walnuts and almonds help with stress, according to huffingtonpost.com, and have a high satiety factor which aides in weight maintenance.

According to webmd.com, walnuts also have higher levels of omega-3 fatty acids than other nuts which, “lower triglycerides, slow down growth of plaques in the arteries and reduce swelling throughout the body.” A small study published in the journal Diabetes Care stated, “People who ate walnuts on a daily basis found an increase in their HDL cholesterol and a drop of 10 % in the LDL levels.”

Theories and ongoing research link the benefits of nuts in the diet to brain health, sperm quality, and possible protection from certain cancers. And, nuts are rich in arginine, an amino acid that converts nitric oxide in the body to help relax blood vessels, which means they are less prone to blood clots. (huffingtonpost.com)

In the end, getting your two grams of plant sterols and stanols will help your cholesterol levels.  And if you can tolerate nuts, enjoy them! Nuts have a lot going for them and can do a lot of good for our bodies if we treat them right; joyfully eating them in their ‘whole’ dry roasted or raw state, and in the recommended amounts.

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