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

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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.

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