Plant Sterol Concentration in Plasma and Intake in Plant‐Based Diets

Background Limited information is available on intake and plasma concentration of plant sterols among vegetarians. Objective We measured plasma concentration of plant sterols, and estimated phytosterol intake in a representative sample (n=916) of the Adventist Health Study‐2 cohort with a range of plant‐based diets (10% vegans, 28% lacto ovo‐, 11% pesco‐, 5% semi‐vegetarians, and 46% non‐vegetarians). Design Plasma concentration of campesterol, sitosterol, cholestanol, lathosterol and cholesterol were measured by gas‐liquid chromatography. Campesterol, β‐stitosterol, and stigmasterol intake was estimated from six 24‐hour dietary recalls using plant sterol data of foods from USDA SR 27 and available literature. Differences by diet were determined using ANCOVA with Tukey‐Kramer's test and 95% CI to adjust for multiple comparisons. Results The analytic cohort included 66% women, and 46% Blacks. Mean (SD) age was 60 (14) y, and cholesterol 191 (39) mg/dL. Mean (95% CI) plasma sitosterol was significantly higher in vegans 4.6 (4.3–4.9) μg/ML compared to non‐vegetarians 3.9 (3.8–4.0) μg/ML and semi‐vegetarians 3.8 (3.4–4.2) μg/ML. Plasma campesterol or the non‐plant sterols (cholesterol, cholestenol, and lathosterol) did not differ across diets. Mean β‐stitosterol intake in mg/d among vegans (105.2), lacto ovo‐vegetarians (85.5), and pesco‐vegetarians (85.0) each was higher compared to non‐vegetarians (61.9) (each comparison, p<.0001). Range of intake (from non‐vegetarian to vegan) was 16.7–23.3 mg/d for campesterol, and 10.0–14.8 mg/d for stigmasterol. Compared to non‐vegetarians, intake of each of these phytosterols was significantly higher among pesco‐vegetarians, lacto ovo‐vegetarians, and vegans (each comparison, p<.0001). Conclusion We provide evidence that intake and plasma concentration of plant sterols may be higher among a variety of plant‐based diets compared to a non‐vegetarian diet. Support or Funding Information Funding for this project was made possible by Unilever. Collection of blood and dietary recalls was funded by the National Cancer Institute.