Phytosterols in the Diet
Phytosterols are natural components of the human diet; they are found in excellent quantities in vegetable oils, nuts and cereals.
In Western countries the intake of phytosterols in the diet is similar to that of cholesterol (150-400 mg / day) and increases by about 50% in vegetarians. These substances - structurally and functionally similar to animal cholesterol - are not normally absorbed , if not in a very small part, in the intestine.
Effects on Cholesterol
Through a regular intake of about two grams of phytosterols per day - whether of a purely dietary nature or integrated with specific supplements - it is possible to reduce LDL cholesterolemia to a variable extent between 8 and 15%.
This well-known characteristic contributes to making the products enriched with phytosterols, supported by pounding advertising campaigns and freely purchasable in the common supermarkets, very topical. All with the belief that phytosterols represent a panacea for heart and arterial health. It is no coincidence that high cholesterol is considered - albeit to a lesser extent than in the past - an important risk factor for cardiovascular disease (the leading cause of death in the industrialized world).
Side effects
By examining the literature on phytosterols, one can easily come across some studies that accuse them - in certain circumstances - not only of being ineffective in reducing cardiovascular risk, but even of favoring atherosclerotic processes by increasing the susceptibility to myocardial infarction, stroke and other cardiovascular diseases. This side effect is inherent in the small amount of phytosterols absorbed in the intestine and in the consequent increase in their plasma levels.
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Familial sitosterolemia
If we look at a rare genetic disease, known as familial sitosterolemia, we notice the possible side effects of these substances. Those affected have an enhanced intestinal absorption of phytosterols, aggravated by a reduced biliary excretion of the same. The sad result is an increase in blood and tissue concentrations of phytosterols, responsible for particularly serious cardiovascular diseases that arise prematurely despite cholesterolemia being normal or only slightly increased.
This observation has raised the hypothesis - confirmed by some studies and denied by others - that a modest increase in blood concentrations of phytosterols can produce atherogenic effects. Consequently, a chronic excessive dietary intake - especially in the population with an "innate predisposition to their absorption (subjects heterozygous for the gene that causes sitosterolemia) - could favor the appearance of the same diseases that it is proposed to prevent with their use. All this, of course, is not mentioned during the television promotion of phytosterol-based products, nor on their labels.
Although the subject is still debated, and the risk considered very low in the healthy population, it would still be advisable for the loyal users of these products to be made aware of the possible risks, however remote, of this practice.
Bibliography: side effects of phytosterols
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