Eating This Underrated Micronutrient Could Lower Your Diabetes Risk, New Study Suggests

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Reviewed by Dietitian Annie Nguyen, M.A., RD

Photographer: Brittney Cottrell, Food Stylist: Chelsea Zimmer, Prop Stylist: Christina Daley

Key Points

A new study links higher phytosterol intake to reduced risk of heart disease and diabetes.
Diets rich in phytosterols were tied to lower inflammation and better insulin regulation.
Foods like nuts, seeds, legumes and whole grains are great sources of phytosterols.

Heart disease and type 2 diabetes affect millions of people across the United States every year. While many of us are aware of common lifestyle changes to help reduce the risks, like staying active, maintaining a healthy weight and getting enough sleep, what we eat plays a major role too. A diet rich in plant-based foods, like fruits, vegetables, whole grains, and legumes, may do wonders for supporting heart health and managing blood sugar levels. But there’s one lesser-known piece of the puzzle that’s worth exploring further: phytosterols.

Phytosterols, sometimes called plant sterols, are naturally occurring compounds found in plants. What makes phytosterols special is their ability to block cholesterol absorption in the digestive system, which may help lower LDL (the “bad” cholesterol) levels. And new data shared at the American Society for Nutrition meeting in Orlando highlighted the potential impact consuming phytosterols may have on aspects of our overall health.

How Was This Study Conducted?

To conduct this study, researchers gathered and analyzed data from three large cohorts involving over 200,000 adults in the United States. The participants, who were nurses and other health professionals, provided health and dietary information over a follow-up period of up to 36 years. By using food-frequency questionnaires, the researchers estimated the participants’ intake of total phytosterols and three specific types (β-sitosterol, campesterol and stigmasterol). Participants were then categorized into quintiles based on their phytosterol intake, with the highest quintile representing the most plant-forward diets.

Beyond dietary data, the researchers collected biological samples from participants to analyze metabolic biomarkers and other health indicators. Blood samples from over 11,000 participants were examined to identify metabolites and markers related to insulin regulation, inflammation, and metabolic health. Additional blood samples from more than 40,000 participants were analyzed to detect specific biomarkers linked to heart disease and type 2 diabetes. These biomarkers offered insights into potential mechanisms through which phytosterols might influence disease risk.

To explore a potential link between phytosterol intake and gut health, the study also investigated the microbiome composition of a subset of 465 participants. Advanced genetic sequencing techniques were used to identify specific microbial species and enzymes present in these individuals’ gut microbiomes. The goal was to examine whether certain microbes altered the metabolism of phytosterols in ways that contributed to lower disease risk.

What Did The Study Find?

The results of this study showed that those who consumed higher amounts of phytosterols experienced impressive health benefits. Participants in the top quintile of phytosterol intake had a 9% lower likelihood of developing heart disease and an 8% lower risk of type 2 diabetes when compared to those in the bottom quintile. These findings suggest that even within the range of normal dietary intake, phytosterols may make a meaningful difference in reducing the risk of these chronic diseases.

Further analysis revealed that participants who consumed higher levels of total phytosterols and β-sitosterol had favorable changes in their metabolic markers. The researchers found evidence linking higher phytosterol intake to improved insulin regulation, lower levels of inflammation, and the presence of healthier metabolites.

Additionally, when it comes to gut health and phytosterol consumption, researchers identified microbial species and enzymes in the gut microbiome that were associated with higher phytosterol intake. For example, species like Faecalibacterium prausnitzii were linked to the degradation of phytosterols, potentially influencing the production of beneficial metabolites. This suggests that a healthy gut microbiome might amplify the positive effects of phytosterols, per the researchers.

While this study offers valuable insights, it’s important to note a few limitations. Since it’s an observational study, it can only suggest a link between phytosterol intake and a lower risk of heart disease and type 2 diabetes, rather than proving a direct cause-and-effect relationship. Most of the participants were health professionals, which means the results might not fully reflect the broader population. Additionally, the dietary information was self-reported through food-frequency questionnaires, which could include some errors or misremembered details. The study also found connections between phytosterol intake, microbiome changes and metabolic markers, but we still need more research to understand how these connections work. Lastly, the long follow-up period was helpful for tracking outcomes, but changes in diet and lifestyle over time, which weren’t entirely accounted for, could have played a role in the findings.

Also, these results are not published in a peer-reviewed journal, which means they should be interpreted with caution until further scrutiny validates the findings.

How Does This Apply to Real Life?

If you are focused on taking steps toward reducing the risk of heart disease and type 2 diabetes, based on these findings, incorporating phytosterol-rich foods into your meals may have a profound impact.

If you’re curious about where to start, here’s a list of phytosterol-rich foods you can consider adding to your diet:

Nuts (such as almonds, pistachios and walnuts)
Seeds (like sunflower seeds and flaxseeds)
Legumes (including lentils and chickpeas)
Fruits (such as oranges, apples and avocados)
Vegetables (like broccoli, Brussels sprouts and carrots)
Whole grains (such as oats, quinoa and barley)
Vegetable oils (canola, sunflower and olive oil)

By including these foods in your daily meals, you might enjoy the added benefit of lowering LDL cholesterol levels and supporting metabolic health. Something as simple as sprinkling seeds over your salad, choosing whole-grain bread, or swapping out snacks for a handful of nuts can make a big difference over time.

The Bottom Line

This new study presented at an American Society for Nutrition meeting highlights the compelling potential of phytosterols in promoting better heart and metabolic health. Across the three large cohorts studied, higher phytosterol intake was associated with a 9% lower risk of heart disease and an 8% lower risk of type 2 diabetes, which is especially significant given the prevalence of these conditions in the United States. The findings also revealed that individuals with diets rich in phytosterols saw improvements in insulin regulation and reduced inflammation, pointing to their role in fostering overall metabolic balance.

These findings serve as a reminder of the profound impact that diet can have on our health. While more research is needed to fully understand the mechanisms involved, incorporating phytosterol-rich foods into your daily routine is an approachable step toward reducing long-term health risks.

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