Variations in dietary intake and plasma concentrations of plant sterols across plant‐based diets among North American adults

Scope Phytosterols are bioactive compounds in plants with similar cholesterol‐lowering properties as vegetarian diets. However, information on phytosterol intake and plasma plant sterols among vegetarians is sparse. Methods and results We examined dietary intake and plasma concentration of plant sterols and cholesterol across five dietary patterns in the Adventist Health Study‐2 Calibration Sub‐study (n = 861, 66% females, average age 61 years). To measure intake and plasma concentrations of these compounds, we used 24‐h dietary recalls and gas‐liquid chromatography‐flame ionization detection, respectively. Mean (SD) total phytosterol and cholesterol intake were 363 (176) mg/day and 131 (111) mg/day; plasma β‐sitosterol, campesterol, and cholesterol were 3.3 (1.7) μg/mL, 4.2 (2.3) μg/mL, and 1.9 (0.4) mg/mL, respectively. Total phytosterol intake was lowest among non‐vegetarians (263 mg/day) and highest among vegans (428 mg/day) (p < 0.0001). Cholesterol intake was lowest among vegans (15.2 mg/day) and highest among non‐vegetarians (124.6 mg/day) (p < 0.0001). Plasma plant sterols and cholesterol did not differ by diet. Cholesterol‐adjusted plasma β‐sitosterol and campesterol were significantly higher in Blacks than Whites, though no ethnic differences were observed in dietary intake of these plant sterols. Conclusion Dietary intake but not plasma concentration of plant sterols and cholesterol varies across distinct plant‐based diets. Intake and plasma concentration of phytosterols and cholesterol are compared across plant‐based diets. Vegans have the highest and non‐vegetarians the lowest phytosterol intake; vegans have the lowest and non‐vegetarians the highest cholesterol intake. Plasma concentration of these compounds do not vary by diet. Plasma campesterol trends higher among Blacks than Whites but intake does not differ by ethnicity. Similar ethnicity trends are found for β‐sitosterol.