The other sterol: high cholesterol can be a killer. Science and nature join forces in a battle for the heart.

High cholesterol is a major accomplice to America's No. 1 killer, coronary heart disease. And nearly 20 percent of American adults have elevated cholesterol, according to the American Heart Association. While the pharmaceutical industry offers a class of drugs called stains to get cholesterol levels in check, the natural products industry has some answers of its own--plant sterol and stanol esters.

These compounds are widely recognized for their propensity to lower total and LDL ("bad") cholesterols.

Plant sterols and stanols are essential plant cell components that occur naturally in fruits, vegetables, seeds, legumes and nuts. But it's hard to absorb enough of them from food to significantly affect cholesterol levels. Here's where science stepped in: To make plant sterols and stanols more available and useful, researchers attached or "esterified" these compounds to fatty acids, creating sterol esters--and found that the resulting plant sterol or stanol esters helped lower LDL.

In September 2000, the US Food and Drug Administration agreed that the esters are effective, and it approved a health claim saying that adding 1.3g of sterol esters or 3.4g of stanol esters daily to a low-fat diet can reduce the risk of heart disease by lowering cholesterol. These dosages are very well researched, and additional investigation has shown no added benefits--or increased risks--from daily doses of up to 9g of sterol esters or 5.1g of stanol esters.

Because these esters inhibit the absorption of cholesterol, scientists worded that high doses of sterol esters might inhibit the absorption of vital fat-soluble nutrients as well. But researchers at the Chicago Center for Clinical Research reported in the August 2001 issue of the Journal of the American College of Nutrition that people taking up to 9g per day of sterol esters maintained normal blood levels of fat-soluble vitamins such as A, D, K and E, except for some forms of vitamin A. ...