French food agency sceptical about the benefits of cholesterol-reducing foods

Many readers will be familiar with cholesterol reducing ‘functional foods’ such as
margarines and yoghurt drinks. These foods and ‘enriched’ with ‘stanols’ or ‘sterols’: substances that have a similar chemical structure to cholesterol, and help inhibit its absorption from the digestive tract into the bloodstream, These substances do indeed have some capacity to reduce cholesterol levels, a fact that is recognised by and ratified by the European Food Standards Agency (EFSA). However, the kicker is there is absolutely no evidence at all that stanols or sterols benefit health. In fact, there is quite some evidence that stanols may have adverse effects on health. Here’s a previous blog post about some of the pertinent science.

It seems I’m not the only one to have noticed distinct lack of evidence for the supposed benefits of these compounds, either. Here you see find a story concerning France’s food standards agency (ANSES). It has recently issued its opinion of foods ‘enriched’ with stanols and sterols. It, like the EFSA, acknowledges the fact that these foodstuffs can reduce cholesterol, but otherwise remains very unenthusiastic about them. In its report, it points out that:

  • Higher levels of stanols in the bloodstream (this can happen as a result of eating stanols) have ‘unquantified cardiovascular consequences’ and further study is required. Studies have, by the way, linked higher levels of sterols in the bloodstream with heightened risk of cardiovascular disease.
  • That these products are not recommended for children, though the products are available to children.
  • That sterol/stanols consumption should be accompanied by an increase in fruit and vegetables consumption, to compensate for the fact that stanols and sterols can lead to a reduction in levels of nutrients known as ‘carotenoids’ in the body.
  • That reducing cholesterol levels in the bloodstream does not necessarily translate into a reduction in risk of heart disease.

And in summary, ANSES tells us that: “…as regards public health, the available data do not make it possible to consider foods fortified with phytosterols/stanols as a suitable way of preventing cardiovascular disease.” You can find a pdf of the full report here. Perhaps not surprisingly, Unilever (manufacturers of sterol-enriched Flora pro.activ) has retorted that French position is counter to “the current scientific consensus and all regulatory approvals already obtained.”

However, regulatory approvals regarding these foods are based on their ability to lower cholesterol, the assumption being that this translates to benefits for health. But, as we know, this is an assumption too far (dietary reduction of cholesterol and several cholesterol-reducing drugs have been shown to be ineffective for the purposes of enhancing health, and some drugs have even been found to kill people). By focusing on cholesterol, rather than health, the food (and pharmaceutical) industry has been able to divert our attention away from what is truly important (health). My personal opinion is that ratification of these food products has been the result of regulatory agencies being too stupid or corrupt (or both) to do the right thing.

The French position, I think, is an example of what happens when individuals refuse to swallow food company rhetoric whole without thinking, and focus on the most important thing of all: not the impact stanols/sterol-enriched foods have on cholesterol, but on health.

13 Responses to French food agency sceptical about the benefits of cholesterol-reducing foods

  1. jean humphreys 11 July 2014 at 6:58 pm #

    As a non-scientist, these products lost it for me when the adverts started saying “two out of three people have raised cholesterol” – why would I want to buy your little pots of chemical substances in order to become one in the minority?

    The thing to do in such cases is to turn it around – two out of three people have raised cholesterol. Therefore, one out of three people has low cholesterol. Which is most likely to be normal? Also, how have our bodies managed to get us through so many millennia of evolution, with this fatal flaw? Me, I embrace my cholesterol – it oils my brain for a start,

    Good for the French!

    • Vicente 11 July 2014 at 10:52 pm #

      May be 1000 years ago cholesterol was not such high because we were not eating so much carbs. I don’t agree with your “I am normal” argument.

      I believe having a low HDL, high TG and a pattern B LDL are bad omens, even if it is the new “normal”.

      Don’t get me wrong, I eat LCHF and I have never eaten cholesterol-reducing foods. I am not afraid of dietary cholesterol.

  2. Kate 11 July 2014 at 7:58 pm #

    What took them so long? As long ago as 2002, Dr Briffa made the point in his book “Ultimate Health”(p72) that most of the cholesterol in the bloodstream comes not from the diet, but is made in the liver, especially when stimulated by insulin and in the presence of insulin resistance. Cholesterol in any case is only a symptom, a bystander in the process of inflammation leading to arterial disease. Very low cholesterol is probably more dangerous to health than high cholesterol.

  3. Jerry White 11 July 2014 at 9:37 pm #

    What do you think of beta – sitosterol for help2 urinary activity? Am I hurting myself?
    Seems to work for me.

  4. Jennifer 11 July 2014 at 9:56 pm #

    Exactly Kate—-well said.

    The message about inflammation seems not to be getting through, sadly— the public still is

    buying into the low Cholesterol myth, thinking Statins will protect their Heart,

  5. Mark Johnson 11 July 2014 at 11:39 pm #

    The link below points to a chart plotting total cholesterol levels vs mortality data from 164 countries. The “sweet spot” in terms of what level of cholesterol = the lowest all cause mortality is in the region of 200 – 240 mg/dl = 5.2 – 6.2 mmol/L.

    So, based on the above, why would the NHS say that the cholesterol levels for “healthy” adults should be 5.0 mmol/l or lower? The average in the UK is actually around 5.5 mmol/l for men and 5.6 mmol/l for women, right in the sweet spot.

    • M. Cawdery 12 July 2014 at 10:59 am #

      Indeed, I have seen this before but when I drew a stanol/sterol consumer’s attention to it his comment was “is that all you have got?”

      There are many brainwashed people out there!

    • Bill UK 14 July 2014 at 7:54 am #


      That is a very interesting set of stats and I am surprised that it is published by the BHF. It would appear to contradict their official line on cholesterol.



    • Bill UK 14 July 2014 at 9:49 am #


      Have you asked the BHF why this information is no longer available on their website.

      It would appear to contradict the official line of the BHF.

  6. William L. Wilson, M.D. 12 July 2014 at 4:37 am #

    Stanol, shnanol. We have yet to invent a modern food that reverses disease or improves health. Mother Nature has been doing experiments for billions of years so I suspect it’t not a good idea to go against her wisdom by throwing our meager inventions into the food supply.

  7. M. Cawdery 12 July 2014 at 10:52 am #

    I emailed both Benecol and Flora and both kindly sent me published reports proving that their products lowered cholesterol. I then requested evidence of clinical benefit, for example in heart disease. Result: a dismal silence from both companies.

    In view of the financial benefits that would accrue from such evidence, I assume that research has been done but was negative. More hidden data!

    I would also point out that these sterols and stanols have the same basic role in plants that cholesterol has in mammals, namely to protect cells. As plants neither talk or walk, I prefer cholesterol which provides neurones with protection and synapse activity (talking, thinking, etc) and flexibility of muscle cells (and other cells) to allow movement (walking etc).

    There is also a condition called Sitosterolemia a rare (as yet??) disease.

    Thaank you, I prefer to stick with cholesterol which has been successful back to our cenancestor 2.5 billion years ago

  8. ivor cummins 13 July 2014 at 3:21 pm #

    gram for gram, plant-world phytosterols are more atheroschlorotic than our proper animal world ones. I would take the cholesterol lowering effect observed as a danger sign. For quick ref see Dr. Peter Attia’s “The Straight Dope on Cholesterol”

  9. sten 13 July 2014 at 3:55 pm #

    Great thank you to the French and Dr Briffa!
    One thing not mentioned is that these fats are based on omega-6 vegetable oils. Inflammatory because they oxidize sooner than monosaturated and saturated fats.
    When modern research points to that LDL becomes dangerous when it is “sugarcoated” or renders useless through glycation in i similar way to hemoglobin, why lower cholesterol instead of the culprit, blood sugar?
    Some new British research was made about glycated LDL but was presented as if “a new dangerous LDL particle” was discovered ! As soon as blood sugar goes too high , gycation takes place, which makies glycated particles sticky. When stycky they can easily stick and create plaque. Some omega 6 is often the dominating fat in plaque according to Swedish tests.

    Reduce blood sugar is the obvious route to prevent CVD, but also reverse CVD as William Davis has shown time after time in his clinical practice in the US.
    A 3 meal per day high carb diet creates 3 blood sugar spikes, spikes that tend to become longer and higher with age… Hence exercising during the days can be good for many things, but the cardiovascular inflammation takes place in the two hours after each meal. Hence exercise is not a fool proof way to prevent CVD which too many still believe.

    And it is not a coincidence that Diabetes -2 patients have some 300% higher rate of cardiovascular disease than on average.

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