A Scientific Review of
Important Updates on Dietary Supplements
And Key Nutrition Factors For Supporting
This review examines the science that backs up
the health benefits of the four major cholesterol
reducing ingredients available as dietary supplements,
including: phytosterols, omega-3s, beta-glucan, and
Improved heart health relates to reducing the risk of
developing cardiovascular disease (CVD), coronary
heart disease (CHD), and stroke. The major risk factors
for these diseases are numerous, but include smoking
habits, body weight, blood pressure, cholesterol levels,
and physical exercise levels.
Cholesterol is a steroid metabolite, and an essential
structural component of mammalian cell membranes.
However, high blood cholesterol levels (known as
hypercholesterolemia) are strongly associated with
cardiovascular disease (CVD), due to the increased
risk of atherosclerotic plaque formation, which can lead
to an increased risk of myocardial infarction (heart
attack), stroke, and vascular disease.
High blood levels of ‘bad’ LDL cholesterol are known
to contribute to this process of plaque formation, whilst
‘good’ HDL cholesterol has been found to offer protection
against heart disease.
A number of dietary ingredients have been suggested
to reduce the levels of LDL cholesterol: phytosterols,
omega-3s, beta-glucan, and soy protein.
Numerous clinical trials in controlled settings have
reported that daily consumption of 1.5 to 3 grams
of phytosterols/-stanols from foods can reduce total
cholesterol levels by between eight and 17 per cent,
representing a significant reduction in the risk of
A review of 84 clinical trials in the Journal of Nutrition,
authored by researchers from Unilever R&D and
Wageningen University, concluded that phytosterol-
enriched foods are effective for reducing levels of LDL
cholesterol, with no differences between stanols and
sterols, or delivery in fat or non fat foods.
“For the recommended intake of two grams per day,
the expected LDL-C-lowering effect of phytosterols is
about 9 percent,” wrote the researchers. “A reduction
in LDL-C of about 10 percent would reduce the
incidence of CHD by about 10-20 percent.
“Although no direct evidence is available yet for the
ability of phytosterols to lower CHD incidence, the well-
documented cholesterol-lowering effect of phytosterols
is the basis for recommendations to include phytosterols
into strategies to lower LDL-C concentrations,” they
Overall the research suggests that doesn’t seem to
matter whether we consume the ingredients in their sterol
or stanol form, neither does it diminish the benefits if fat or
non-fat-based foods are used. Getting your sterols from
dairy or non-dairy formats also doesn’t affect the results.
Omega-3 has been identified as one of the super-
nutrients, taking the food and supplements industry by
storm, and much of its reputation is based on evidence
that it can help to protect the heart against cardiovascular
The first reports of the heart health benefits of omega-3
fatty acids were reported in the early 1970s by research
scientists in The Lancet and The American Journal of
Clinical Nutrition. The Danish research team sought to
understand how the Greenland Eskimos, or Inuit, could
eat a high fat diet and still have one of the lowest death
rates from cardiovascular disease on the planet.
Since then omega-3s have been studied extensively
for their potential to decrease the risk of cardiovascular
disease, however according to a recent Cochrane review
“dietary omega-3 polyunsaturated fatty acids (PUFAs)
are known to reduce triglyceride levels, but their impact
on cholesterol levels … and vascular outcomes are [still]
not well known.”
However a recent study in the academic journal Clinical
Nutrition suggested that three grams of omega-3 per
day was associated with improvements in a wide range
of cardiovascular risk factors, including cholesterol levels,
and triacylglyceride levels.
Beta-glucan Fiber (Oats and Barley)
Beta-glucan is a type of soluble fiber that is found
predominantly in cereal grains. Oats and barley are said
to contain the highest level of beta-glucan, with barley
containing the highest levels of up to 11 percent.
Previous research has shown consumption of oats to
significantly lower serum total cholesterol concentrations,
and there is emerging data to support the belief that
barley may have similar health benefits. A meta-analysis
of 11 clinical trails published in European Journal of
Clinical Nutrition recently suggested that a daily
consumption of three grams of beta-glucan can
significantly reduce both total and LDL cholesterol
The authors of the meta-analysis also noted that beta-
glucan characteristics, including its solubility and
molecular weight, are important determinants of its
They said that highly water-soluble beta-glucan with
moderate to high molecular weight may reduce serum
LDL cholesterol levels better than beta-glucan with a low
water solubility and low molecular weight.
The Food and Drug Administration (FDA) heart health
claim for soy protein established in 1999 states that “25
grams of soy protein a day, as part of a diet low in
saturated fat and cholesterol, may reduce the risk of
Currently, 11 other countries have approved health
claims for soy protein’s potential to lower blood
cholesterol and lower the risk of coronary heart disease.
A 2008 study suggested that the cholesterol-lowering
effects of soy protein may by located in the liver. The
study, published in the Journal of Agricultural and Food
Chemistry, reported that soybean protein was found
to stimulate the low-density lipoprotein receptor (LDL-R)
transcription in liver cells.
Editor’s Note: This article is not intended to provide medical advice,
diagnosis or treatment.