Margarine to prevent a heart attack? It doesn’t sound right does it? In fact, there is an element of truth, but as with many food and health issues, it is more complicated than it sounds.
For some years, supermarkets have sold “cholesterol lowering” margarine and other products such as yoghurts or salad dressing bearing similar health enhancing claims. These products are “functional foods”; food products modified/enhanced in some way to bring additional health or nutrition benefits. Specifically, the cholesterol lowering functional foods contain plant derived substances called phytosterols or phytostanols, which have been clinically proven to lower low density lipoprotein (LDL) cholesterol (better known as “bad cholesterol”) and total cholesterol, by on average 10%. Stanols and sterols are found naturally in plants and thus in the human diet, but in quantities too small to have a cholesterol lowering effect.
High LDL cholesterol is a risk factor for coronary heart disease (CHD), the risk of which increases with age. Therefore many older people whose “bad” cholesterol is above recommended levels are advised by their GPs to make dietary and lifestyle changes in order to bring their cholesterol down, and reduce their risk of heart disease.
Dietary and lifestyle changes almost always mean reducing intake of saturated fats, increasing fruit and vegetable intake and often taking up some form of exercise too. This does not mean having to join a gym or start running marathons; simply walking more frequently can suffice. An older person facing the challenge of reducing their cholesterol might also consider adding a cholesterol lowering functional food to their diet.
My research report “Older people and functional foods” , which was published by ILC-UK this week, reviewed the scientific literature related to cholesterol lowering functional foods. In the paper I conclude that the scientific evidence is strong and that many older people with moderately elevated cholesterol could benefit from including one of these products in their normal diet. Even a person with more serious cholesterol problems, could consider a cholesterol lowering functional food alongside the statin treatment they are probably already receiving, as the cholesterol lowering effect of stanols and sterols works in addition to statins. Some studies have also shown that adding a cholesterol lowering functional food to the diet of a person on statin treatment can be more effective than increasing statin dosage.
However, it is important to note that cholesterol lowering functional foods are not a “magic pill” for cholesterol; they work in addition to rather than instead of a healthy heart lifestyle. It is also important to understand that it is necessary to consume 2 grams of stanols/sterols for an optimal cholesterol lowering effect; this equates to around 25 grams of cholesterol lowering margarine.
In addition, it is worth pointing out that the literature available on consumer behaviour towards functional foods (also reviewed in my paper), indicates that consumers of all ages will only buy a functional food if it is a food product they already consume. So there is no point recommending an older person who does not eat margarine to buy a cholesterol lowering version, but they might want to switch their salad dressing or yoghurt instead.
 To download the executive summary or the full version of the “older people and functional foods” report, please go to: http://www.ilcuk.org.uk/record.jsp?type=publication&ID=77