FOOD SUPPLEMENTS

AND FORTIFIED FOODS

SUPPLEMENTS
Food supplements (British English) = Dietary supplements (American English)
Definition:
concentrated sources of nutrients (i.e. minerals, vitamins) or other substances
with a nutritional or physiological effect
marketed in “dose” form (e.g. pills, tablets, capsules, liquids in measured doses)
They are not medicinal products and as such cannot exert a pharmacological,
immunological or metabolic action.
Therefore their use is not intended to treat or prevent diseases in humans or to
modify physiological functions
WHY DO WE NEED
THEM?
Changing culinary and social habits have led to low
intakes for some vitamins and minerals compared to those
being recommended for certain groups of the population
some argue that optimal health may depend on higher
levels of vitamins and minerals than those recommended
today on the basis of avoiding deficiencies.
As a result, products that contribute to the intake of
vitamins and minerals beyond the levels that would be
provided by the natural content of foods have increased
considerably on the market
These may be food supplements but also foods to which
vitamins and minerals have been added (fortified foods)
 FOOD
SUPPLEMEN
TS
REGULATION
As foods, so:
Supplements are not intended to treat, diagnose, prevent, or cure diseases!!!
Health claims:
1.The so-called 'Function Health Claims'
1. Relating to the growth, development and functions of the body
2. Referring to psychological and behavioural functions
3. On slimming or weight-control

2.The so-called 'Risk Reduction Claims' on reducing a risk factor in the development of a disease.
For example: "Plant stanol esters have been shown to reduce blood cholesterol. Blood cholesterol
is a risk factor in the development of coronary heart disease"
3.Health 'Claims referring to children's development' For example: "Vitamin D is needed for the
normal growth and development of bone in children”
EXAMPLE – VITAMIN D
Food supplement
Vitamin D contributes to:
normal absorption/use of calcium and
phosphate,
to maintain optimal blood calcium levels,
to maintain healthy bone structure,
to maintain healthy muscle function,
to maintain healthy teeth,
normal functioning of the immune system.
Medicine
To supplement vitamin D
In intensive growing stages
During pregnancy
In some diseases
To prevent Vitamin D insufficiency
To the complementary treatment of age-
related osteomalacia and osteoporosis
POSSIBLE
INGREDIENTS
Vitamins
Minerals
Amino acids
Enzymes
Probiotics
Essential fatty acids
Fibre
Plant and herbal extracts
VITAMINS AND
MINERALS
 MARKET OF FOOD
SUPPLEMENTS

https://ec.europa.eu/food/sites/food/files/safety/docs/labelling_nutrition-supplements-2008_2976_f_wd1_en.pdf
LIMIT OF VITAMINS AND
MINERALS
The levels of intake have been cause of concerns both for being potentially on the low
side but also because of the adverse effects that excessive intakes of certain vitamins and
minerals may cause.

Vitamins and minerals used in food supplements or
added to foods should result in a minimum amount
being present. Otherwise, the presence of too small
amount would not offer any benefit to
consumers, namely to supplement the normal diet
in the case of food supplements, and would be
misleading
The setting of maximum levels for vitamins and
minerals is becoming increasingly a pressing need
for the responsible authorities to ensure that the
potential sum of intakes from all sources on the
market should not threaten to undermine
human health
HOW MUCH IS
TOO MUCH?
We should know:
UL: Tolerable upper intake - The upper safe levels of each vitamin and mineral established by
scientific risk assessment based on generally accepted scientific data, taking into account, as
appropriate, the varying degrees of sensitivity of different consumer groups
For adults, the UL from all sources is established by scientific risk assessment when available. The children’s ULs are
derived from extrapolated values based on reference bodyweights for 4–6-year-old children

MHI: Mean habitual Intake - The intake of vitamins and minerals from all dietary sources (how to
measure this?)
The Mean Highest Intake (MHI) is the 97.5 percentile (P97.5) intake data from food sources (including fortified foods but
excluding food supplements) from male adults or 4–10-year-old male children

RDA: Recommended Daily Allowance - Reference intakes of vitamins and minerals for the
population
https://www.efsa.europa.eu/sites/default/files/assets/UL_Summary_tables.pdf
NATURAL INTAKE
The estimates of intakes are essentially derived through dietary surveys data
and relevant food composition data.
Household surveys record the food purchases of a household for a certain
period of time with estimates of individual intake.
In some cases there may also be information on the extremes of intakes both
the lower and higher levels and on intakes of specific population groups (e.g.
infants, adolescents, elderly).
The Recommended Daily Allowances (RDAs), are based on the principle that
individuals of a population (or a specific population group) should obtain an
adequate nutrient intake to satisfy their requirements. Such recommended
values are generally based on the principle of the average requirement.
These values were mainly determined on the basis of the concept of optimal
nutrition which implied that these values were determined to prevent
deficiencies, to optimise body stores and to reduce the risk of diseases.
 INTAKES

UL: up to this level it is safe

MHI: the actual intake in population

RDA: optimal dose

GROUPS BASED ON RISK
POTENCY
 
Group 1: risk assessments show no adverse effects and there are no safety concerns
about a nutrient, and when a UL cannot be established
Group 2 and 3: based on population safety index

Group 2: the “low risk of exceeding the UL”, is a PSI greater than 1.5 for both adults
and children,
Group 3: the “potential risk of excessive intakes”, is a PSI of 1.5 or less.
 GROUP 1: NO UPPER LIMIT

https://foodsupplementseurope.org/wp-content/themes/fse-theme/documents/publications-and-guidelines/fseriskmanagement.pdf
 CALCULATING MAXIMUM
LEVELS
 For vitamins:

For minerals:

https://foodsupplementseurope.org/wp-content/themes/fse-theme/documents/publications-and-guidelines/fseriskmanagement.pdf
 GROUP 2: LOW RISK

https://foodsupplementseurope.org/wp-content/themes/fse-theme/documents/publications-and-guidelines/fseriskmanagement.pdf
 GROUP 3: POTENTIAL RISK

https://foodsupplementseurope.org/wp-content/themes/fse-theme/documents/publications-and-guidelines/fseriskmanagement.pdf
MINIMUM AMOUNT
Vitamins or minerals may be declared in nutrition labelling, they have to be present
in a significant amount, which, as a rule, is the amount in 100 g or 100 ml of the
food representing 15% of the recommended daily allowance.
For example:
„This is a rich source of vitamin C”. (It is the same for foodstuff, too)
RDA of vitamin C is 80 mg.
80 mg x 15% = 12 mg
There should be at least 12 mg vitamin C in every 100 g/ml.
Here should go some examples of products, but there is so much
difference in the markets of countries, that I can not see the point
of showing some random Hungarian products.

EXAMPLES
AMINO ACIDS
AMINO ACIDS
IN FOOD
SUPPLEMENTS
Essential type – it needs to be included
in our diet
 Branched-chain amino acids (BCAA):
leucine, isoleucine, valine
Non-essential type – our body can
synthesize them
 Arginine
Proteins

Good news: no regulations and limits to

study!
Bad news: no regulations and limits
BCAA
They use it for:
growth or maintenance of muscle mass
attenuation of the decline in muscle power following exercise at high altitude
faster recovery from muscle fatigue after exercise
improvement of cognitive function after exercise
reduction in perceived exertion during sports
and “healthy immune system”
But this health claims are not proven!
 Google: arginine + food supplement

ARGININE
ARGININE
They try to distribute for:
erectile dysfunction (it can be found in many combination
products, too)
contribution to normal spermatogenesis
vasodilating for training and feel „pumped”

However:
These are not scientifically proven! so can not be health
claims
Actually, there are no valid health claims other than
preventing arginine insufficiency
PROTEINS
Main indication: to muscle weight gain, for athletes, vegans, vegetarians
Based on: proteins can help increasing and maintaining healthy muscle weight
Contain: only proteins or mixtures with vitamins and minerals, amino acids etc.
Sources:
milk protein (whey)
egg white
beef
vegetable based
ENZYMES
LACTASE
Use: breaking down lactose may be beneficial to the
health of individuals with symptomatic lactose
maldigestion
Origin: fungi
Kluyveromyces fragilis
Kluyveromyces lactis
Aspergillus niger
Aspergillus oryzae
Can be added directly to foods – see lactose free milk
PROBIOTICS
PRO- AND PREBIOTICS
The terms ‘probiotic’ and ‘ prebiotic’ are health claims themselves.
 Stating ‘contains probiotic’ (or similar) on a product is not the same as saying ‘contains ingredient X’.
It is more than just mentioning the product contains bacteria. It implies that the product contains a
substance that may be beneficial for health.

There are no other approved health claims for probiotics!

But! Medicines with probiotics have many beneficial effects, and they are effective for
 the treatment of acute GIT infections
 and to restore bacterial flora after antimicrobial therapy.
Many clinical trials to treat autoimmune diseases.
PRO- AND PREBIOTICS
Can contain:
 bacterial strains of Lactobacillus and Bifidobacterium
 yeasts such as Saccharomyces boulardii
 prebiotics like fructooligosaccharides (FOS) or inulin

Quantitative comparability:
 CFU= colony forming units = number of live cells
ESSENTIAL FATTY
ACIDS
LINOLEIC ACID (LA)
AND ALPHA-
LINOLENIC ACID
(ALA)
Structure: Ω-6 and Ω-3 fatty acids
Origin: LA in vegetable oils, nuts, ALA in linseed oil, chia seeds
Authorised health claims:
Essential fatty acids are needed for normal growth and development of children.
BUT: beneficial effect is obtained with a daily intake of 2 g of α-linolenic acid (ALA) and a daily
intake of 10 g of linoleic acid (LA)
POLY UNSATURATED FATTY
ACIDS (PUFAS)
Structure: Ω-3 fatty acids
Origin: seafood, like predatory fish or krill
Problem: predatory fish not only accumulate oil, but other
environmental toxins, too
For instance:
 mercury,
 dioxins, and
 polychlorinated biphenyls

The quality control of this products is a must!!!

POLY UNSATURATED
FATTY ACIDS (PUFAS)
For adults:
DHA contributes to the maintenance of normal vision
DHA contributes to maintenance of normal brain function
 at least 40 mg of DHA per 100 g and per 100 kcal. The effect is obtained with a
daily intake of 250 mg of DHA.
DHA and EPA contributes to the maintenance of normal blood triglyceride levels
 at least 2 g of DHA and EPA daily, but not to exceed a supplemental daily intake of
5 g of EPA and DHA combined.

DHA and EPA contribute to the maintenance of normal blood pressure

 a daily intake of 3 g of EPA and DHA, but not to exceed a supplemental daily intake
of 5 g of EPA and DHA combined.
POLY UNSATURATED
FATTY ACIDS (PUFAS)
For infants and pregnant women:
DHA maternal intake contributes to the normal brain development of the foetus and
breastfed infants.
 with a daily intake of 200 mg of DHA in addition to the recommended daily intake for
omega-3 fatty acids for adults, i.e.: 250 mg DHA and EPA. The only for food which
provides a daily intake of at least 200 mg DHA
DHA intake contributes to the normal visual development of infants up to 12 months of age.
 with a daily intake of 100 mg of DHA. When the claim is used on follow-on formula, the
food shall contain at least 0,3 % of the total fatty acids as DHA.

DHA maternal intake contributes to the normal development of the eye of the foetus and
breastfed infants.
 with a daily intake of 200 mg of DHA in addition to the recommended daily intake for
omega-3 fatty acids for adults, i.e.: 250 mg DHA and EPA. The claim can be used only for
food which provides a daily intake of at least 200 mg DHA.
FIBRE
FIBRES
Structure: is the portion of plant-derived food (usually
carbohydrates or lignin) that cannot be completely broken down
by human digestive enzymes
Soluble fibres: can swell in water forming viscous mucus
 delays gastric emptying which can result in an extended feeling
of fullness
 generally fermented in the colon by gut bacteria, and thus have
prebiotic effect
 e.g.: beta-glucans (in oats, barley, and mushrooms), psyllium
(nonfermented fibre), pectin

Insoluble fibre:
 Coarsely ground insoluble fibre triggers the secretion of mucus
in the large intestine, providing bulking
 Finely ground insoluble fibre does not have this effect and can
actually have a constipating effect.
 e.g.: wheat bran, cellulose, and lignin
FIBRES – REDUCING BLOOD
CHOLESTEROL
Beta-glucans
 contribute to the maintenance of normal blood cholesterol levels
 at least 1 g of beta-glucans from oats, oat bran, barley, barley bran, or from mixtures of
these sources per quantified portion
 a daily intake of 3 g of beta-glucans from oats, oat bran, barley, barley bran, or from
mixtures of these beta-glucans.

Barley beta-glucans
 lower/reduce blood cholesterol. High cholesterol is a risk factor in the development of
coronary heart disease.
 daily intake of 3 g of barley beta-glucan. The claim can be used for foods which provide at
least 1 g of barley beta-glucan per quantified portion.
FIBRES – REDUCING BLOOD
SUGAR
Arabinoxylan produced from wheat endosperm
 contributes to a reduction of the blood glucose rise after that meals
 at least 8 g of arabinoxylan (AX)-rich fibre produced from wheat endosperm (at least 60 %
AX by weight) per 100 g of available carbohydrates in a quantified portion as part of the
meal.

Beta-glucans
 Consumption of beta-glucans from oats or barley as part of a meal contributes to the
reduction of the blood glucose rise after that meal
 at least 4 g of beta-glucans from oats or barley for each 30 g of available carbohydrates in a
quantified portion as part of the meal.
FIBRES - DIGESTION
Barley, Oat, Sugar beet grain fibre
 contribute to an increase in faecal bulk
 at least 6 g of fibre per 100 g or at least 3 g of fibre per 100 kcal

Rye:
 Rye fibre contributes to normal bowel function

Wheat bran:
 Wheat bran fibre contributes to an acceleration of intestinal transit
 contributes to an increase in faecal bulk
 a daily intake of at least 10 g of wheat bran fibre.
PECTIN
Pectin
 Consumption of pectins with a meal contributes to the reduction of the blood glucose rise after that
meal
 Pectins contribute to the maintenance of normal blood cholesterol levels
 10 g of pectins per quantified portion

Warning of choking to be given for people with swallowing difficulties or when

ingesting with inadequate fluid intake - advice on taking with plenty of water to
ensure substance reaches stomach.
PLANT MATERIAL AND
HERBAL EXTRACTS
POSSIBLE INGREDIENTS
Protected
species

Plants in
dietary All plants
Novel
supplement
foods

Negative
list
PROTECTED PLANTS
Over 38,700 species – including roughly 5,950 species of animals and 32,800
species of plants – are protected by CITES against over-exploitation through
international trade. They are listed in the three CITES Appendices.
NOVEL
FOODS
See next lectures!
Novel Food is defined as food
that had not been consumed to
a significant degree by humans
in the EU before 15 May 1997,
when the first Regulation on
novel food came into force.
NEGATIVE LIST
EFSA’s Compendium of Botanicals
Database of botanicals that are reported to contain naturally occurring substances of
possible concern for human health when present in food

The presence of a substance of concern in a botanical does not necessarily mean that the substance will
also be present in a botanical preparation and, if so, at a dosage that could cause a health concern.
This would depend largely on the plant part used, the preparation method and the conditions of
use. Eg. Poppy seeds are free from alkaloids

The absence of a botanical species from the compendium does not mean the species is devoid of
compounds hazardous to human health.
NEGATIVE LIST
 type 1: generally toxic
 type 2: can be used in medicines under stricter regulations, controlled dose
etc.
 has toxic side effects in the case of overdose or inproper use
 needs medical supervision when used
 has interactions with other medications
 type 3: the indication can not be the maintenance of a healthy condition,
only the treatment of diseases
 type 4: limited information about the safety
 type 5: psychogenic, hallucinogenic
GENERALLY
TOXIC PLANTS
Just a few examples:
Aconitum sp. – toxic alkaloids
Acorus sp. – toxic essential oil
components
Adonis sp. – toxic cardiac glycosides
Aristolochia sp- toxic aristolochic acid
PLANTS ALLOWED TO
USE IN MEDICINES BUT
NOT IN SUPPLEMENTS
St. John’s Worth
 indication: treatment of mild depression – not health
maintenance!
 interactions: induce CYP enzymes, can decrease the blood
level of other medications
Bearberry
 hepatotoxicity if used chronically

Motherwort
 indication: treatment of heart failure

Ivy
 indication: treatment of productive cough

Comfrey
 side effects: internally carcinogenic, can be used only
externally
PSYCHOACTI
VE PLANTS
Betel palm – piperidin alkaloids
Atropa sp, Datura sp – tropane alkaloids
(toxic anyway)
Ayahuasca – indol alkaloids
Cannabis sp – the oil of the seeds can be
used (THC content 10 mg/kg at
maximum)
Ephedra sp – ephedrine
Erythroxylon coca - cocaine
 PLANTS IN FOOD
SUPPLEMENTS AND
MEDICINES
Plants that can be only used in medicines
Plants that can be distributed as both
Vitamins, minerals, enzymes, etc.

Herbal Food
medicines supplements
DIFFERENCE BETWEEN
MEDICINES AND FOOD
SUPPLEMENTS
Herbal medicines Food supplements
Indications: keeping healthy state AND Only can state health claims
treating symptoms, diseases
E.g. „Ginkgo Naturally Supports Brain,
E.g. Ginkgo leaf medicines containing Nervous System and Memory”
the dry extract can be used to improve
the age-related cognitive impairment
(worsening of mental abilities) and
quality of life of adults with mild
dementia
DIFFERENCE BETWEEN
MEDICINES AND FOOD
SUPPLEMENTS
Herbal medicines Food supplements
Must be proven: Health claims are checked, but
 safety marketing labels are not
 effectiveness Safety and quality are not checked
 quality No regulations for herbal preparations.
CASE STUDIES ON THE
QUALITY OF FOOD
SUPPLEMENTS
https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-222
 45 preparations of 31 different manufacturers have been tested,
containing nominally extracts of one of the following species:

Vaccinium vitis Vaccinium macrocarpon Vaccinium coribosum Vaccinium myrtillus

https://www.ncbi.nlm.nih.gov/pubmed/27625778
 Formulations:
• Powder
• Capsule
• Tablet
• Liquid extract
• Dried fruit

Preparation of an
aqueous extract

Analysis of anthocyanin
profile by HPLC-DAD
+
Measurement of
anthocyanin content
(mg/100g)
https://www.ncbi.nlm.nih.gov/pubmed/27625778
 ANTHOCYANIN PROFILE OF
PREPARATIONS CONTAINING
NOMINALLY CRANBERRIES
Original cranberry

cyanidin

Supplements

peonidin

1) cyanidin-3-galactoside, 2 ) cyanidin-3-glucoside, 3 ) cyanidin-3-arabinoside

4 ) peonidin-3-galactoside 5 ) peonidin-3-glucoside 6) peonidin-3-arabinoside

https://www.ncbi.nlm.nih.gov/pubmed/27625778
RESULTS:
14 preparations (30%) did not contain the labeled Vaccinium extract
The anthocyanin content ranged from 0 (n = 6) to 10704.7 mg / 100g
None of the liquid formulations contained anthocyanins

The authors' conclusion: better to eat fruit

instead of dietary supplements

https://www.ncbi.nlm.nih.gov/pubmed/27625778
 „Safe dietary supplement against
hypertension”

Side effects:
collapses, loss of
consciousness
Crataegus monogyna Olea europea

Fumaria officinalis Capsella bursa-pastoris

https://www.ncbi.nlm.nih.gov/pubmed/24013031
 Analysis of Olivis with HPLC-DAD-MS/MS

62
https://www.ncbi.nlm.nih.gov/pubmed/24013031
 Compounds that are not constituents of any of the indicated plants were also
detected

Fractionation, isolation
reserpine

NMR (COSY, TOCSY, HMQC)

ajmaline

The use in dietary supplements is

prohibited due to the strong
pharmacological effect!

Adulteration with Rauwolfia root

https://www.ncbi.nlm.nih.gov/pubmed/24013031
 Main constituents
• Ginkgolides
• Bilobalide
• Flavonoid glycosides EGb 761
• Flavonoid aglycones
• Biflavonoids
Ginkgo biloba L.

2. 3. 4.
1.

Ginkgotoxin Bilobalide Ginkgolide B Rutin

5. 6. 7.

Quercetin Kaempferol Ginkgetin 64

PAMPA (PARALLEL ARTIFICIAL
MEMBRANE PERMEABILITY ASSAY)
Non-cellular model for in vitro modeling of passive diffusion through

biological barriers (e.g. blood-brain barrier).

Donor

Lipid membrane

Acceptor

Judit Müller: Gyógyszerhatóanyagok felszívódásának és szöveti megoszlásának modellezése in vitro nem sejtes módszerekkel (PhD dissertation)

65
 Donor side

Absorbance (mAu)
EGb 761

83 compounds

Retention time (min)

Acceptor side
Absorbance (mAu)

EGb 761

19 compounds

Retention time (min)

Rendes Kata: Ginkgo biloba kivonatok vér-agy gát specifikus permeabilitási profiljának vizsgálata PAMPA-BBB/LC-MS segítségével
 Rutin Donor side
Dietary supplement

Absorbance (mAu)
12 compounds

Retention time (min)

Acceptor side
Absorbance (mAu)

Dietary supplement

0 compounds

Retention time (min)

Hosszú Levente: Gyógynövény kivonatok komponenseinek szövetspecifikus permeabilitás vizsgálata PAMPA módszerekkel
 ADULTERATION

Ginkgo biloba L. Styphnolobium japonicum L.

• with cheaper plant extract

(Styphnolobium japonicum L.)
•   with pure active ingredient
(rutin, quercetin)
CONCLUSIONS
If there is a choice of between a food
supplement and an herbal medicine with the
sample plant material, always choose the herbal
medicine!
FORTIFIED
FOODS
FORTIFIED FOODS
Fortification: the practice of deliberately increasing the content of an essential
micronutrient, i.e.. vitamins and minerals (including trace elements) in a food, so as
to improve the nutritional quality of the food supply and to provide a public health
benefit with minimal risk to health.

Legislation: same as food supplements and foods

Level of vitamins and minerals: same as food supplements
Why we need them?
 to begin decreasing the incidence of nutrient deficiencies at the global level
 Undernutrition and nutrient deficiency is estimated globally to cause the deaths of between 3 and 5
million people per year
TYPES
The most commonly fortified foods:
 cereals and cereal-based products;
 milk and dairy products;
 fats and oils;
 accessory food items;
 tea and other beverages;
 and infant formulas
PROBLEMS AND
CRITICISM
Consumers have the right to choose if they want
fortified products or not
The fortified product still can be junk food not
replacing a healthy and balanced diet
Isolated nutrients added back into a processed
food that has had many of its nutrients removed,
does not always result in the added nutrients being
as bioavailable as they would be in the original,
whole food e.g. adding folate for white bread
IODISED SALT
Problems to prevent:
 goiters
 congenital cretinism, mental retardation
 hypothyroidism

1995 WHO: every salt should be iodised (except for kosher salt)

RDA of iodine:
 150 ug/day for adult, 220 ug/day for pregnant women, 290 ug/day in lactation

Foods containing iodine:

 fish, seafood – in Hungary the diet is severely iodine insufficient

https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/
FOLIC ACID
Problems to prevent:
 neural tube defects during pregnancy
 e.g. spina bifida, anencephaly
 supplementing pregnant women decreased the incidence by 72%

RDA of folic acid:

 400 ug/day for adult, 600 ug/day for pregnant women, 500 ug/day in
lactation

Foods containing iodine:

 dark green vegetables
 fruits

1998, the U.S. Food and Drug Administration (FDA) began requiring
manufacturers adding 140 ug folic acid/100 g to enriched breads,
cereals, flours, cornmeals, pastas, rice, and other grain products to
reduce the risk of neural tube defects
https://ods.od.nih.gov/search.aspx?zoom_query=folic%20acid
NIACIN
Problems to prevent:
 pellagra (amongst the poor eating mainly corn based diet)

Niacin has been added to bread in the US since 1938

RDA of iodine:
 14-16 mg/day for adult, 18 mg/day for pregnant women, 17
mg/day during lactation

Foods containing iodine:

 poultry, beef, fish -5-10 mg/portion, plant-based foods 2-5
mg/serving
 in many food in a bound form, not bioavailable (see corn)

https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/#h4
VITAMIN D
Problems to prevent:
 rickets
 osteoporosis

Vitamin D is fat soluble, thus can be only added to vegetable oils, margarins, milk.
RDA of vitamin D:
 highly depends on the country and organization!!!
 from 400 IU to 2000 IU for adults

Foods containing iodine:

 fish
 milk
 egg

https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h2
PHYTOSTEROLS
Problems to prevent:
 high cholesterol level

Phytosterols can lower total cholesterol and LDL levels, based

on clinical trials.
 Dietary phytosterols in moderate and high doses favorably
alter whole-body cholesterol metabolism in a dose-dependent
manner.
 A moderate phytosterol intake (459 mg/d) can be obtained in
a healthy diet without supplementation.
 Phytosterol supplementation of 2 g/d is recommended by the
National Cholesterol Education Program to reduce LDL
cholesterol