June 03, 2025
3 min read
Key takeaways:
- Greater phytosterol intake lowered the risk for diabetes by 8% and CVD by 9%.
- Total phytosterol and beta-sitosterol were also tied to favorable metabolite profiles and plasma metabolic profiles.
ORLANDO — Increased consumption of phytosterols reduced the risk for CVD and type 2 diabetes, a study presented at the annual NUTRITION meeting showed.
Greater phytosterol intake also lowered inflammation and was associated with differences in the gut microbiome that may contribute to healthy metabolism, according to a press release.
“My long-standing research interest centers on the beneficial effects of plant-based diet,” Fenglei Wang, PhD, a research associate at Harvard T.H. Chan School of Public Health, told Healio. “Phytosterols are bioactive compounds found in plant-based foods. Therefore, I decided to make full use of our data — including both epidemiological and cutting-edge omics data — to conduct a comprehensive investigation of their association with cardiometabolic disease.”
Wang and colleagues assessed up to 36 years of follow-up data on 206,277 participants enrolled in three large U.S. cohort studies to determine the effects of the phytosterols stigmasterol, beta-sitosterol and campestral on cardiometabolic disease risk. Their analysis included plasma metabolic blood samples, plasma metabolomic data and gut microbiome data from subsets of 40,807, 11,402 and 465 participants, respectively.
The overall cohort was composed of nurses and other health care professionals, 79% of whom were women. Participants with cancer, CVD or diabetes at baseline were excluded, Wang said.
Participants in the highest quintile of phytosterol intake consumed four to five servings of vegetables, two servings of whole grains, half a serving of nuts and two to three servings of fruit daily, the release said.
There were 20,167 cases of type 2 diabetes and 15,806 cases of CVD during the follow-up period.
Greater intake of phytosterols was associated with an 8% lower risk for type 2 diabetes (HR = 0.92; 95% CI, 0.87-0.98) and 9% lower risk for CVD (HR = 0.91; 95% CI, 0.85-0.97) when the highest and lowest quintiles were compared.
The researchers pointed out that similar associations were seen for beta-sitosterol but not stigmasterol or campesterol, while total phytosterol and beta-sitosterol were additionally linked to favorable metabolite profiles and plasma metabolic profiles such as lower C-reactive protein and C-peptide levels.
“Somewhat surprisingly, we did not find a beneficial association between phytosterol intake and LDL cholesterol levels,” Wang told Healio. “The ability of phytosterols to lower LDL cholesterol levels has been demonstrated in randomized clinical trials, but these trials typically used much higher doses of phytosterols (approximately 2,000 mg/day).”
He added that their study “focused on phytosterol intake from a normal diet (typically less than 600 mg/day), which may not be sufficient to lower LDL cholesterol.”
Wang and colleagues wrote that several gut microbiome species and their enzymes, including Faecalibacterium prausnitzii and its enzyme 3-oxosteroid 1-dehydrogenase, were found to play a role in the associations.
Wang acknowledged that the study was observational, “which by nature can only suggest associations and cannot establish causality.”
“However, the supporting evidence from multiple data layers, including clinical biomarkers, metabolomics and gut microbiome data, is reassuring,” he said.
He concluded that the data “support the dietary recommendation of adhering to healthy plant-based dietary patterns that are rich in vegetables, fruits, nuts and whole grains.”
“These findings can help primary care providers give informed dietary advice,” he said. “A potential future direction would be to investigate whether phytosterol intake can improve cardiometabolic profiles in patients with CVD or among those with a high risk for CVD.”
References:
- Eating more phytosterols could lower your risk of heart disease and diabetes. Available at: Available at: https://www.eurekalert.org/news-releases/1084791. Published June 3, 2025. Accessed June 3, 2025.
- Wang F, et al. Abstract OR23-05-25. Presented at: NUTRITION; May 31-June 3, 2025; Orlando.
For more information:
Fenglei Wang, PhD, can be reached at primarycare@healio.com.