Variations in dietary intake and plasma concentrations of plant sterols across plant-based diets among North American adults

SCOPE: Phytosterols are bioactive compounds in plants with similar cholesterol-lowering properties as vegetarian diets. However, information on phytosterol intake and plasma plant sterols among vegetarians is sparse.

METHODS AND RESULTS: We examined dietary intake and plasma concentration of plant sterols and cholesterol across five dietary patterns in the Adventist Health Study-2 Calibration Sub-study (n = 861, 66% females, average age 61 years). To measure intake and plasma concentrations of these compounds, we used 24-h dietary recalls and gas-liquid chromatography-flame ionization detection, respectively. Mean (SD) total phytosterol and cholesterol intake were 363 (176) mg/day and 131 (111) mg/day; plasma β-sitosterol, campesterol, and cholesterol were 3.3 (1.7) μg/mL, 4.2 (2.3) μg/mL, and 1.9 (0.4) mg/mL, respectively. Total phytosterol intake was lowest among non-vegetarians (263 mg/day) and highest among vegans (428 mg/day) (p < 0.0001). Cholesterol intake was lowest among vegans (15.2 mg/day) and highest among non-vegetarians (124.6 mg/day) (p < 0.0001). Plasma plant sterols and cholesterol did not differ by diet. Cholesterol-adjusted plasma β-sitosterol and campesterol were significantly higher in Blacks than Whites, though no ethnic differences were observed in dietary intake of these plant sterols.

CONCLUSION: Dietary intake but not plasma concentration of plant sterols and cholesterol varies across distinct plant-based diets.