Sterols and Sterolins - a
Natural Health Supplement

From The Townsend Letter for Doctors & Patients, #197, December 1999

Article Copyright © 1999 by Dr. Morton Walker


Ingesting Sterols/Sitosterolins from Plant Fats Induce Potent Human Immunomodulatory Improvements

Morton Walker, D.P.M.

Located in Menlo Park, California, naturopathic physician Chris Morris, N.D., is clinic director of the treatment facility known as Transformational Health. Here he makes use of a certain phytonutrient lipid complex for inducing potent and positive immunomodulatory improvements in his patients. With these particular plant fats, Dr. Morris furnishes concentrated amounts of sterols and sitosterolins which are powerful factors in the immunological fight against human and animal diseases. Research studies have shown them to provide important protective and therapeutic physiological effects for helping to maintain a healthy immune system.

"I employ the sterols and sitosterolins to support my patients' endocrine systems. Such plant fats are especially useful for treating autoimmune diseases, which cause metabolic breakdowns. In this regard, sterols/sitosterolins definitely are remedial for autoimmune diseases," affirms Dr. Morris.

Autoimmune Diseases Responding to Sterols and Sitosterolins

"Probably the autoimmune condition responding most dramatically and consistently to my giving treatment with sterols and sitosterolins is systemic lupus erythematosis, Dr. Morris says. "For example, a forty-four-year-old, married, prediabetic female patient of mine, a formerly highly placed executive working in social services had been diagnosed with lupus erythematosis five years before. She also suffered severely from chronic fatigue syndrome, which forced her to discontinue working and file for disabled worker's compensation. This woman came to me while she was being prescribed eight different medications by three attending or consulting physicians. They had been using these drugs to treat her many complications associated with the lupus condition. The executive's complications involved almost daily bouts of migraine headaches, fibromyalgia, depression, and more.

"From my prescribing the sterols and sitosterolins, in thirty days this disabled social worker and incapacitated mother was able to discontinue using seven of her eight medications. Within just three weeks of her taking the phytosterols she had noticed improvements, but it took another two months before she was able to take back her life and be considered fully recovered. She has now gone off workman's disability and returned to work," Dr. Morris says. "Currently, my lupus patient is fine. Her energy is returned, muscles have stopped aching, and the cell sensitivity has disappeared. Her previously severe immune response to mosquito bites no longer is troublesome either. Even her butterfly rash from the lupus has lightened. I should mention that fibromyalgia as an autoimmune disease also responds well to the plant sterols/sitosterolins, and that's why my patient's muscle and joint pain stopped."/p>

The clinical experience of Dr. Morris has been verified by studies recorded in the medical literature 1 and by public announcement. For example, Patrick J.D. Bouic, Ph.D., professor of immunology and chief special scientist in the Department of Medical Microbiology at the University of Stellenbosch, Cape Town, South Africa, has demonstrated that plant sterols and sitosterolins are potent immune modulators capable of reversing abnormalities of the immune system.

On October 7, 1997, Dr. Bouic's university's press office announced: "The University of Stellenbosch Medical Faculty led by Professor Bouic in the Department of Medical Microbiology, and his colleagues in other departments, have conducted ten years of clinical trials in immune modulation, tuberculosis [TB], and HIV disease. By employing plant fats, patients affected by various autoimmune diseases such as rheumatoid arthritis, psoriasis, systemic lupus erythematosus, certain cancers, and other manifestations of dysfunctional immune systems have experienced dissipation of their health problems. TB patients have recovered from their illnesses more quickly. And infected HIV patients maintain their immune cells over extended periods with no overt signs of illness progression.

"I recognize that these sterols/sitosterolins are taking on functions just like those occurring from one's ingestion of the soybean isoflavones in which cellular receptors of hormone-related cancers become blocked. While I avoid treating any manifestation of immune disease such as cancer, I am helping my patients to prevent malignancy conditions by use of the phytosterols," says Dr. Morris. "Thus, if there is any family predisposition to cancer or any other degenerative disease for a patient, supplementation with sterols/sitosterolins would be beneficial as a means of prevention. But I'm not using the phytosterols just as protectors against some illness like cancer; instead, I apply them generally as a source of patient vitality.

"Another message I would want to leave with your readers is that all of us in the health professions recognize how many medical doctors are moving toward using hormone replacement therapy. Instead of proceeding in this manner, the first place all of us should look for hormonal treatment is the plant sterols. By their application, we do not interfere with any feedback loops in the female body as does occur with giving hormone supplementation. The sterols/sitosterolins allow the human body to manufacture its own building blocks," states Dr. Morris.

Phytosterols for Immune Suppression in Long Distance Runners

"The sterols/sitosterolins offer a lot of pain reduction," Dr. Chris Morris adds. "After undergoing heavy workouts, athletes are known to use them for much faster muscle recovery time, less lactic acid buildup, diminished pain, and consistent comfort at the end of their exercise periods. The phytosterols provide marvelous biomarkers for all athletes such as long distance runners.

"Also, this combination of phytosterols works well in cases of stress as, for instance, the type of stress occurring in the bodies of strenuously competing athletes. Ingested before a ball game or another competitive athletic event, phytosterols compensate for the exerting body’s catabolic breakdown," Dr. Morris advises. "My finding is that they act as catalysts for the athlete’s body to manufacture its required hormones more efficiently. Lean body mass is created with overall tissue integrity improvement and a reduction of body fat. Ingesting plant fats seems to simulate the amino acid precursors (secretagogues) to human growth hormone (hGH) that you have written about, Dr. Walker. These secretagogues would include alanine, arginine, glutamic acid, glycine, lysine, and the many others [see the July 1999 Townsend Letter for Doctors & Patients].2

In their excellent 1999 book, The Immune System Cure, co-authors Lorna R. Vanderhaeghe and Patrick J.D. Bouic, Ph.D., state: "High-intensity exercise for extended periods causes immune suppression... The type of immune suppression that occurs after a marathon race may be attributed to the lack of regulatory factors being released by helper T-cells, especially the powerful antiviral agent gamma—interferon." 3

The sterols/sitosterolins, as indicated by the brandnamed product, Natur-Leaf ®, are shown to inhibit the radical physiological changes seen in the blood of marathoners by decreasing the inflammation and muscle pain associated with their excessive exercising.

In a placebo-controlled, double-blind clinical trial he conducted out of the immunology department at his university, Dr. Bouic confirmed the observations made by Dr. Chris Morris. He showed that a group of long distance runners displayed a significant reduction in their blood levels of interleukin-6 compared to the inactive placebo group of runners. lnterleukin-6 usually promotes inflammation with consequent tissue damage as a result of disproportionate physical stress. It also increases the release of cortisol, a steroid hormone made in the liver that is released during stress and which brings on immune suppression. By moving forward with his double-blind study, Dr. Bouic proved that long distance runners are subjected to much less immune suppression when they ingest the plant sterols and sitosterolins.4,5,6

What Are these Plant Sterols/Sitosterolins Anyway?

The same lipid intracellular materials in animals that scientists had long ago recognized as sterols (cholesterol being the best known) are present in plants as well. Indeed, plants possess fat substances that were identified only about sixty-seven years ago as sitosterols. While cholesterol is the main animal sterol, beta-sitosterol is the principal phytosterol (plant fat) found in vegetables and other higher plants. It makes up the chief ingredient in nearly all plant-derived food products. We eat large amounts of the lipids coming from plants daily, but the individual sitosterols do not permeate our blood serum and tissues in as large amounts as does cholesterol. A sitosterol’s concentration is 800 to 1000 times less than human endogenous cholesterol. Sitosterolin is the glucoside of sitosterol and is present in mammalian blood serum at even lower concentrations.7

After being identified in 1922, some decades later the National Cancer Institute (NCI) shot down further research on the sitosterols by declaring them not to be any kind of viable treatment for cancer. However, the NCI finding was flawed because the sitosterolin molecule is absorbed much better than a sitosterol alone. Karl H. Pegel, Ph.D., Professor in the Department of Chemistry and Applied Chemistry, University of Natal, Durban, South Africa, discovered that each sitosterol and its glucoside (sitosterolin) must be kept together molecularly in as close juxtaposition as possible to each other when using the plant fats therapeutically. This close juxtaposition is the way nature intended to have them synergistically react to create their full immune—enhancing response.8,9

Combined, the effects of sitosterols and sitosterolins on the human system offer much physiological benefit and no toxicity whatsoever. They have been shown to consist of a proportionately heavy molecular structure when joined, weighing 400 daltons (DAL). The sitosterol molecule looks like the cholesterol molecule. The two are analogues, but sitosterol has two extra carbon electrons on its side chain (see my interview with David Kritchevsky, Ph.D., below).

In vivo, sitosterols/sitosterolins have been extensively tested in animal studies as well as on over 25,000 patients in clinical trials with no adverse drug events occurring. They are relatively inexpensive and can be used in conjunction with conventional therapies. Additionally, Professor Bouic reports that by taking these phytosterols, the side effects of chemotherapy and radiation therapy for cancer patients may be prevented or greatly reduced.10

Sources in Nature of the Sitosterols/Sitosterolins

As just one combined group of the many phytochemicals furnished in nature, seeds and sprouts are the richest sources of sitosterols/sitosterolins. Owing to food processing, however, humans don’t often consume sufficient quantities of these plant fats as part of their food intake. The many different refining processes applied in the food industry render such plant edibles useless for phytosterols because processors remove the sterols and sitosterolins to make their products more appealing to the eye. For example, the precipitation of fats in extracted oils from seeds—especially beta-sitosterol, the main plant lipid—is removed to give a clearness to the oil for furnishing the consumer with illusions of purity. If food oil manufacturers allowed lipid precipitates to remain in sunflower seed oil, sesame seed oil, or the other seed oils, there would be no lack of consumption of phytosterols.

The way food is prepared is a problem too. Freezing releases the plants’ enzymes, which destroy their phytosterol glucosides. Thus, sitosterolins, the more beneficial portions of plant fats become dissipated. Boiling vegetables cause plant fats to precipitate into the cooking water too, and then such nutrient-laden water gets thrown away so that phytosterols are lost.

But the awareness of nutrition scientists is changing for the better. It is the combination of sterols and sitosterolins, which in large measure have stimulated their research in recent years into the healing and protective effects of plant foods. Olive oil, for example, when incorporated into the diet tends to reduce the risk of developing cardiovascular disease and certain cancers. It’s the phytosterols in olive oil which provides such health benefits, and that's merely one illustration out of a possible thousand.

In the natural state, all phytosterols are bound to the fibers of the plant from which they originate, and the sterols become difficult to separate from such fibers. An effective way to ingest sitosterols/sitosterolins, therefore, is to eat quantities of the foods I have selected for listing in Table A. Please realize, however, that almost all plant foods contain the sitosterols and sitosterolins. The listed edible plants that follow are merely examples.

Table A
FOOD Combined Sitosterols/Sitosterolins
Nuts & Seeds mg per 100 Grams of edible portion
Almonds 122
Cashews 130
Chestnuts 18
Coconuts, meat 27
Pecans 88
Pine nuts 84
Pistachios 90
Sesame seeds 443
Sunflower seeds 349
Walnuts 87
Vegetables mg per 100 Grams of edible portion
Asparagus 14
Barley 98
Beetroot 13
Brussels sprouts 17
Cabbage 7
Carrots 7
Cauliflower 12
Cucumbers 14
Gingerroot 10
Squash, white 89
Lettuce, romaine 21
Melons 16
Okra 15
Onions 15
Peas 108
Peppers, red 7
Potatoes, sweet 8
Potatoes, white 40
Pumpkin 12
Radish greens 22
Soybeans 30
Taro 11
Turnip greens 9
Yams 7
Vegetable Oils mg per 100 Grams of edible portion
Cocoa butter 59
Flaxseed 46
Olive (France) 91
Olive (Italy) 84
Safflower 52
Soybean 53
Sunflower 60
Wheat germ 67
Fruits mg per 100 Grams of edible portion
Apples 11
Apricots 16
Bananas 11
Cherries 12
Figs 27
Grapefruit 13
Lemons 8
Oranges, navel 17
Peaches 6
Pears 7
Pomegranates 16
Strawberries 10
Beans & Legumes mg per 100 Grams of edible portion
Azuki 37
Broad 95
Kidney 91
Mung 13
Peanuts 142
Spices, Dry mg per 100 Grams of edible portion
Ginger 56
Oregano 177
Paprika 119
Clove 242
Fenugreek 100
Thyme 152

Dr. Atif Awad Uncovers Cancer Inhibition by Plant-Based Fats

Atif Awad, Ph.D., Associate Professor in the Department of Physical Therapy, Exercise and Nutrition Sciences in the School of Health Related Professions, State University of New York at Buffalo, and his colleagues participated in two significant in vitro studies on plant-based sterols. Dr. Awad, who is director of the University of Buffalo’s Nutrition Program, uncovered that a main player among the innumerable plant fats, beta-sitosterol, abundant in the diets of vegetarians, inhibits the growth of prostate cancer, breast cancer, and colon cancer. This is the likely reason that Seventh Day Adventists, who are strict vegetarians, exhibit a much lower incidence of these three cancers than any other population group living in the United States.

One of Dr. Awad’s two studies, presented during the April 1999 annual meeting of the Federation of American Societies of Experimental Biology, turned up that 13-sitosterol dramatically reduces numbers of breast-cancer cells grown in a laboratory setting by 66 percent, compared to controls.12

A second study undertaken by the Awad research team revealed that this same B-sitosterol also enhances the workings of an intracellular signaling system, which tells cells not to divide, even with the presence of those certain cells predisposed to mutating into prostate cancer. ‘This phytosterol replaces some of the cell membrane’s cholesterol, which changes the membrane lipid composition in such a way that signal transduction (secondary messenger activity) is stimulated. And that activation inhibits cell growth," Dr. Awad explains.13

On August 18,1999, I did interview Atif Awad, Ph.D. at the University of Buffalo. Sitting in his office he affirms, "The effect of 13-sitosterol apparently varies with the type of tissue. If cell proliferation can be stopped before it becomes uncontrolled, cancer can be contained. When we treated prostate cancer cells with phytosterols, cell proliferation was inhibited. We have found the same effect in vitro with breast cancer and colon cancer cells."

The work of Dr. Awad and colleagues is grounded in epidemiological studies showing that prostate cancer is less common in Asian countries where diets are primarily vegetarian. Among these people massive amounts of plant fats are consumed. However, the rates of colon cancer, prostate cancer and breast cancer increase markedly for them when same type of Asians migrate to western societies where diets are primarily animal-based.

I learned that the Awad-led University of Buffalo researchers not only performed in vitro laboratory testing but also they did investigations in vivo—on rats. The rat experiments were vital, because after five days of trials on the laboratory animals, results showed there were 28 percent fewer cancer cells from 13-sitosterol treatment, compared to tissue cultures supplemented with animal cholesterol. cycle, thus increasing its inhibitory action on prostate cancer, breast cancer, and colon cancer.

"The phytosterols are nontoxic chemicals. Eating quantities of these plant fats lowers human blood cholesterol, an effect accomplished by inhibiting the absorption of cholesterol from the gut," says Dr. Atif Awad. "This is nearly the same mechanism by which hypercholesterolemic drugs such as Lovestatin work to produce an anticholesterolemic effect."

And this statement about the anticholesterol effect of phytosterols from Dr. Awad brings us to the work of David Kritchevsky, Ph.D., Professor of Nutrition Science at the Wistar Institute in Philadelphia, Pennsylvania.

How B-Sitosterol Fools the Gut and Lowers Blood Cholesterol

Inasmuch as sitosterol has only two extra carbon electrons on its side chain, making it an analogue of cholesterol, it fools the human gastrointestinal system and inhibits the absorption of cholesterol. Sitosterol/sitosterolin takes cholesterol’s place molecularly in the micelles [colloid particles] and then they do not cross the gut’s mucosal barrier to the blood stream," says Dr. Kritchevsky. ‘The phytosterol blocks any gut absorption of cholesterol. Metaphorically, the situation is like a lock with changed tumblers. The key may be inserted into the lock with no problem, but you can’t turn it."

Numbers of researchers have reported that sitosterol is absorbed less efficiently on the order of only one-tenth that of cholesterol when given at the oral dose of between 3 and 30 grams.14 The normal daily dietary supply of plant sterols at 200 to 240 mg containing 130 to 160 mg of sitosterol even has an effect on reducing cholesterol serum levels.15,16 For this reason, sitosterol is used in some countries for the treatment of mild cases of hypercholesterolemia.17,18,19 No serious side effects occur with even from very high doses of sitosterol other than occasional mild constipation or diarrhea.

"In 1957, Eli Lilly introduced B-sitosterol as a cholesterol-lowering pharmaceutical agent called Cytellin. It was manufactured as B-sitosterol suspension in a red strawberry-flavored syrup. But Cytellin was not successful as a marketed drug for reducing cholesterol in the United States. On the other hand, B-sitosterol sells well in Finland in the form of margarines substituting for butter," Dr. Kritchevsky says. ""Researchers from the University of Helsinki had conducted a yearlong clinical trial involving 153 volunteers with mildly elevated cholesterol. Sure enough, the Finns’ total cholesterol dropped by an average of 10.2 percent in the group consuming the plant sterol spread.20

"Now the margarine product is marketed under two labels, ‘Benecol’ and ‘Take Control’. Although the two branded margarines interfere with absorption of cholesterol from food, that represents a relatively small proportion of the cholesterol that ends up in the blood. Most cholesterol is produced by the liver, which may pump out too much because of excessive saturated fat in the diet or too little exercise," adds Dr. Kritchevsky. "But realize that B-sitosterol is not a spreadable fat; rather, it’s a crystalline chemical that must be mixed into the margarine. A main problem is that B-sitosterol is hardly soluble."

Regarding the two margarines referred to by Dr. Kritchevsky, a columnist for the Townsend Letter for Doctors & Patients, Joseph M. Mercola, D.O. of Schaumburg, Illinois, writes about Take Control in particular. Dr. Mercola says: "Never forget, margarine is liquid plastic. Your brain is 50 percent fat. Do you want liquid plastic incorporated into your brain?21

Preferable to eating plastic margarine with the potential for producing Alzheimer’s disease, cancer, and other illnesses coming from free radicals formed by the butter substitute, probably it’s preferable to utilize a nutritional food supplement. Such a supplement is the newly encapsulated commercial product, Natur-Leaf ®, which contains elevated amounts of sterols/sterolins and enzymes (described below).

Dr. David Kritchevsky continued our discussion. "Back in 1981, co-authored with O.J. Pollack, I wrote, Sitosterol, the first-and-only-book published on the subject of plant sterols, issued by the Karger Company, a publishing house based in Basil, Switzerland," Dr. Kritchevsky says. ‘The book is now out of print. In 1956, my co-author was the first person to feed the sitosterols/sitosterolins to humans for lowering serum cholesterol. He went on to write a definitive clinical journal article on his group’s experiences. It was published in 1957 in the peer reviewed publication, Circulation."

B-Sitosterol/B-Sitosterolin Is Effective for Tuberculosis

To evaluate the adjuvant treatment efficacy of B-sitosterol together with its necessary glucoside, B-sitosterolin, for culture-proven, sputum-smear-positive pulmonary tuberculosis, medical scientists in the Department of Pediatrics and Child Health, University of Stellenbosch, Tygerberg, South Africa conducted a double-blinded, randomized, placebo-controlled trial for six months. Results of this study follow:

Receiving the white powdered phytosterols as real therapy was a group of nineteen tubercular sputum positive patients. Alternatively, receiving a talcum powder placebo was a second group of eighteen infected patients. Recorded monthly were findings about the two groups’ sputum culture positivity, chest radiology findings, weight gain, Mantoux test response, routine hematology, and liver functions. When the study’s double-blind code was broken by the medical researchers the results turned out as might be expected:

  • Weight gain was significantly greater in the patients receiving sitosterols than in those receiving the placebo.
  • The change in lymphocyte counts and eosinophil counts from baseline values was higher in the sitosterol group.
  • The Mantoux test responses were the same; speed of achieving no activity in cultures were the same; radiological improvements were similar in the two groups.22

Sterols/Sterolins for Controlling Rheumatoid Arthritis

Publishing in the Townsend Letter for Doctors & Patients, Professor Patrick J.D. Bouic tells us that sterols/sterolins are effective for the control of rheumatoid arthritis. ‘They do this by reversing the immune abnormality at the site of the disease and by preventing damage caused by inflammation. They target the abnormality and correct its immune dysfunction," he writes.23

In agreement with Dr. Bouic, Professor Karl Pegel said in an interview, "I would simply advise any person with arthritis to supplement their diet with sitosterolins."

A basic research study using laboratory animals (rats) was performed to determine whether sterols had any therapeutic properties such as reducing inflammation for rheumatoid arthritis. It was demonstrated that sterols do possess potent anti-inflammatory properties similar to cortisone. The study showed that sterols reduce experimentally produced edema too, but there were no forms of pain reduction or analgesic properties.24

Phytosterols Are Therapeutic for Benign Prostatic Hyperplasia

Medical treatments and herbal remedies (which are even more effective than drugs) have become available for benign hypertrophy of the prostate. Some of these include alpha-receptor blocking agents and 5-alpha-reductase inhibitors. The herbal agents, for which almost no precise mechanism of action has been described, are widely used for benign prostatic hypertrophy (BPH) in Europe, especially in the Balkan countries, Switzerland, Germany, and Austria. Now we hear from South Africa about the success with BPH treatment using phytosterols by the medical staff members of the University of Stellenbosch and the privately administered Tygerberg Hospital.

In a randomized, double-blind, placebo-controlled multi-centered study, 200 patients were recruited between April and October 1993 for treatment of their symptomatic BPH. They were divided into two groups and administered either 20 mg of B-sitosterol (which also contained a mixture of other phytosterols) or a placebo. The men with BPH were to take their remedies three times a day. The primary end-point for this study was a difference of modified Boyarsky score between treatment groups after six months; secondary end-points were changes in the International Prostate Symptom Score (IPSS), urine flow, and prostate volume.

Pertaining to the study results, the following findings were recorded and published in the medical literature:

  • The patients’ modified Boyarsky score decreased significantly with a mean of —6.7 points in the phytosterol-treated group versus —2.1 points in the placebo group.
  • There was a decrease in IPSS, which was down —7.4 points in the phytosterol-treated group versus —2.1 points in the placebo group.
  • Changes in urine flow parameters occurred with the phytosterol treatment resulting in increasing peak flow to 15.2 ml from 9.9 ml.
  • A decrease of mean residual urinary volume occurred dramatically for the phytosterol-treated group from 65.8 ml to 30.4 ml.
  • None of these parameters changed in the placebo group. No relevant reduction of prostatic volume was observed in either group.

Significant improvement in symptoms and urinary flow parameters indicate that there is significant effectiveness of B-sitosterol in the treatment of benign prostatic hyperplasia.25

In another randomized placebo-controlled study conducted by a German BPH-phytosterol study group involving 177 men with enlarged prostate glands, the study was designed to assess the safety and efficacy of beta-sitosterol in treating this condition. Over the six-month duration of treatment, individuals received 130 mg of B-sitosterol daily.

Parameters used to monitor the effectiveness of this treatment included post-void residual urinary flow rate (PVR), peak urinary flow rate (Qmax), and qualitative determinators provided by the IPSS, plus changes for these men in the quality of their life index value.

Statistically significant results over the placebo control group were noted and the following information has been published:

  • Qmax values increased by 4.5 ml.
  • mproved PVR values were noted at an average decrease of 33.5 ml.
  • Quality of life scores and IPSS values also showed a statistically significant improvement.

Such results indicate that beta-sitosterol is an effective treatment option for men with BPH.26

Immunomodulation by Plant Sterols/Sterolins in HIV/AIDS

Professor Pegel, who may be considered the foremost authority in the world on sterols/sterolins, addresses the concept of immunomodulation. In an interview, Dr. Pegel said: "In order to prevent cancer formation, sitosterol and its sterolin are actually essential... because they stimulate the immune system. They will improve the quality of life of a cancer patient. There is evidence that sterols counter the ill effects of radiation therapy. They also reduce the ill effects of chemotherapy. So, simply put, these substances are very important as an excellent treatment for people who undergo cancer treatment. They make their life more bearable."

In a review article by Dr. P.J.D. Bouic from the Department of Medical Microbiology, University of Stellenbosch, he discusses both animal and human experiments performed in South Africa on the disease progression of human immunodeficiency virus (HIV). The main thrust of Dr. Bouic’s report reads as follows: "plant sterols/sterolins have immunomodulatory activities and can be used as adjuvants in the management of HIV-infected patients, especially in those who do not have easy access to registered antivirals."

Two pilot studies were done on cats infected with retrovirus FIV, which is considered the equivalent to HIV. In both studies the cats receiving the sterols/sterolins mixture maintained stable CD4 lymphocyte counts and suffered no deaths due to FIV even after three years had passed. These positive results prompted the research group to conduct an open trial of 80 HIV patients over a three-year period, with clinical monitoring every three months.

The results for CD4 lymphocyte counts in these AIDS patients remained stable over 27 months with no significant declines, similar to the results of the cat study. Moreover, the CD4 lymphocytes in typical HIV populations actually declined slightly. The pro-inflammatory lymphokine, interleukin-6 has been implicated in the induction of HIV replication in infected cells. Thus, this study has shown a significant decrease in interleukin-6 levels in the sterols/sterolins-treated group leading to a decrease in viral load levels.

Although the sterols/sterolins have no antiviral activity, this immunomodulatory activity on interleukin-6 levels leads indirectly to lower viral load levels. Please note that this study which took place in September 1997 is strictly preliminary, but it suggests an important role of plant sterols/sterolins in the multistage treatment of HIV.27

Professor Karl Pegel confirms Dr. Bouic’s investigative findings. Dr. Pegel states: "There is not any evidence that sterols would actually cure HIV infection, but the patient seems to be able to cope with it and not develop from HIV infection to full-blown AIDS. They seem to stop the progress of the disease."

Sterols/Sitosterolins in Capsule Form

Dietary sterols are absorbed by all animals. Most of those laboratory and domestic animals investigated (the dog, pig, mouse, rat, and sheep) contain about 10 to 20 times more plant sitosterol in their blood serum and tissues than do humans.28,29,30,31,32,33 In humans, in fact, the absorption of cholesterol is approximately 50 percent of food intake while that of sitosterol from plants is about 5 percent.34,35 A small percentage of people are hyperabsorbers of plant sterols (called phytosterolemics), with five to ten times the normal amount of sitosterols in their blood.

On average, from 5 to 40 mg of plant sterols are contained in 100 grams of fresh vegetables of all types. And, since vegetables contain about 80 percent water, this sterol average can increase to 100 mg per gram of dried vegetable product. Fresh fruit contains from 2 to 30 mg of plant sterols per 100 grams of any fruit type. All seeds are rich in plant sterols when mature, ranging from 22 to 714 mg per 100 grams. But their sterol content may reduce markedly and become less valuable as food if the seeds are ingested in an immature state.36,37

The seed sterol content of mature seeds just beginning to sprout are even higher, rising to no less than 120 mg per 100 G of all sprout types. Eating sprouted seeds offers the most quantitative and qualitative phytosterols; otherwise, at each meal an individual would need to eat between 500 and 700 grams (24.7 ounces) of fresh vegetables and fruit, about 200 grams (7 oz) of whole grain flour products without additives, or about 250 grams (8.82 oz) of potatoes.

The sterols and their B-D-glucosides (also known as sterolins, as I had mentioned) and their characteristic 6’-O-esters now are available in capsule form throughout North America. Each capsule contains 300-mg sterols/sterolins blend plus 50 mg of enzymes.

The manufacturer of these capsules, Lifeline, Inc. of Albuquerque, New Mexico, has created the brandnamed Natur-Leaf ® Enzyme-Enhanced Sterols/Sitosterolins. All phytosterols in this Natur-Leaf ® product come from prime sprout ingredients, which include:

  • Oilseed Plant sprouts
  • Wild Barley Sprouts
  • Wild African Potato Sprouts
  • Wheat Sprouts
  • Lupine Sprouts
  • Soybean Sprouts
  • Fenugreek Sprouts
  • African Sunflower Sprouts

These phytosterols have a bioavailability of 80 percent to 90 percent guaranteed by Natal University. They may be used to replace those overly large amounts of vegetables, fruits, flour products, and potatoes cited above. It’s no longer required that the phytosterols with their individual sterols, sterolins, and esters be eaten in bulk.

Obtained from the highest nutritional sources, the seeds, which furnish the optimal sterol-to-glucoside ratio, are sprouted. But the sprouts are not allowed to grow in order to avoid their changing into molecules of sugar. Then these newly emerging sprouts go through a freeze-drying stabilization process for preserving the sterols and glucosides in their most natural form. They are never altered owing to extraction methods such as heat or chemicals. Professor Pegel advises us, "The optimum ratio of glucosides to sterols would be about 1:10 or better.’ While other products posses a ratio of 1:100, Natur-Leaf ® offers an ideal 1:6 ratio of glucosides to sterols in every capsule.

In conclusion, a product such as Natur-Leaf ® contains plant fats, which could almost be classified as "vitamins." Clearly they are essential nutrients. Dr. Pegel points out, that "there are a lot of seemingly healthy people who actually are rather sick. While sterols and sterolins are not the answers to all ills, they certainly may be classified in the same category with vitamins C and E or magnesium. Sterols/sterolins are really among the essential ingredients to keep the [human] machinery working. You should go back to the RDA in America and decide that they need to be added to your country’s list of recommended daily allowances."


1. Bouic, P.J.D., "Press release." University of Stellenbosch, Cape Town, South Africa, E-mail:, 7 October 1997.

2. Walker, M. "Ingesting hGH Secretagogues to be Young AgainTM." Townsend Letter for Doctors & Patients 192:70-74, July 1992.

3. Vanderhaeghe, L.R. and Bouic, P.J.D. The Immune System Cure: Optimize Your Immune System in 30 Days—The Natural Way! (New York City: Kensington Books, 1999), p. 205.

4. Ibid., p. 206.

5. Bouic, P.J.D., et al. "Beta-sitosterol and beta-sitosterol glucoside stimulate human peripheral blood lymphocyte proliferation: Implications for their use as an immunomodulatory vitamin combination." International Journal of Immunopharmacology 18:693-700, 1996.

6. Hoffman-Goetz, L. and Pedersen, B.K. "Exercise and the immune system: A model of the stress response." Immunology Today 15:382-387, 1994.

7. Pegel, K.H. "The importance of sitosterol and sitosterolin in human and animal nutrition." South African Journal of Science 93:263-268, June 1997.

8. Op. cit., Vanderhaeghe, L.R. & Bouic, P.J.D., p. 7.

9. Op. cit., Pegel, K.H., 1997.

10. Op. cit., Bouic, P.J.D., "Press release." University of Stellenbosch.

11. Op. cit., Vanderhaeghe, L.R. & Bouic, P.J.D., pp. 48-50.

12. Awad, A. Press release: "Plant-based fat inhibits growth of breast-cancer cell line, UB researchers show." University of Buffalo, April 29,1999.

13. Awad, A. Press release: "Plant-based fat inhibits cancer-cell growth by enhancing cell’s signaling system, UB researchers show." University of Buffalo, April 29,1999.

14. Bjorkhem, I. and Boberg, K.M. "Inborn errors in bile and biosynthesis and storage of sterols other than cholesterol." In The Metabolic and Molecular Bases of Inherited Disease Vol. 2, 7th Edition, Eds. C/P. Scriver; A.L. Beauce; W.S. Sly; D. Valle. (London: McGraw-Hill, 1995), pp. 2073-2099.

15. Miettinen, T.A. "Regulation of serum cholesterol by cholesterol absorption." Agents Actions 25:53-65, 1988.

16. Heinemann, T.; Axtmann, G.; von Bergmann, K. "Comparison of intestinal absorption of cholesterol with different plant sterols in man." European Journal of Clinical Investigation 23:827-831, 1993.

17. Pollack, O.J. "Effect of plant sterols on serum lipids and atherosclerosis. Pharmaceutical Therapeutics 31:177-208, 1985.

18. Lang, W.H. and Jones, P.J.H. "Dietary phytosterols: A review of metabolism benefits and side effects." Life Sciences 57:195-206, 1995.

19. Leib, 0. and von Bergmann, K. "Diatetische und medikamentose Behandlung der Hyperlipoproleinamien." Akt. Neurol. 11:129-133, 1984.

20. Hiser, E. "New spreads help lower cholesterol." Albuquerque Journal, pp. Cl & C2, August 18,1999.

21. Mercola, J.M. "Current health news you can use: FDA clears a medicinal margarine." Townsend Letter for Doctors & Patients 1993/194:166-168, August/September 1999.

22. Donald, P.R.; Lamprecht, J.H.; Freestone, M.; Albrecht, C.F.; Bouic, P.J.D.; Kotze, D.; van Jaarsveld, P.P. "A randomized placebo-controlled trial of the efficacy of beta-sitosterol and its glucoside as adjuvants in the treatment of pulmonary tuberculosis." International Journal of Tuberculosis and Lung Disease 1 (5):51 8-522, July 1997.

23. Bouic, P.J.D. "Sterols/sterolins, natural, nontoxic immunomodulators and their role in the control of rheumatoid arthritis." Townsend Letter for Doctors & Patients 193/194:51-52, Aug/Sept. 1999.

24. Gupta, M.B.; Nath, R.; Srivastava, N.; Shanker, K.; Kishor, K.; Bhargava, K.P. "Anti-inflammatory and antipyretic activities of B-sitersterol." Planta medica (Journal of Medicinal Plant Research) 39:157-163, 1980.

25. Berges, P.R., et al. "Randomized, placebo-controlled, double-blind clinical trial of f3-sitosterol in patients with benign prostatic hyperplasia." Lancet 345(8964), June 1995.

26. Klippel, K.F.; Hitti, D.M.; Schipp, B. "A mulicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia." British Journal of Urology 80(3):427-432, Sept. 1997.

27. Bouic, P.J.D. "lmmunomodulation in HIV/AIDS: The TygerbergStellenbosch University experience." AIDS Bulletin published by the Medical Research Council of South Africa 6(3):18-20, Sept. 1997.

28. Kuksis, A.; Marais, L.; Myner, J.J.; Geher, K. "Identification of plant sterols in plasma and red blood cells of man and experimental animals." Lipids 11:581-585, 1976.

29. D’Hollander, F. and Chevalier, F. "Qualitative and quantitative estimation of free and essential sterols in whole rat and in 23 of its tissues and organs." Biochemistry and Biophysics Acta 176:146-162, 1969.

30. Strandberg, T.E.; Tilvis, R.S.; Miettinen, T.A. "Effects of cholestyramine and squalene on hepatic and serum plant sterols in the rat." Lipids 24:705-708,1989.

31. Sugano, M.; Morioka, H.; Kida, Y.; lkeda, l."The distribution of plant sterols in serum lipoproteins and liver subcellular fractions of rats."Lipids 13:427-432,1978.

32. Agaater, I.B. and Llewellyn, J.W. "Determination of f3-sitosterol in meats, soya and other protein products." Food Chemistry 8:41-49, 1982.

33. Morton, G.M.; Lee, S.M.; Buss, D.H.; Lawrence, P. "Intakes and major dietary sources of cholesterol and phytosterols in the British diet." Journal of Human Nutrition and Dietetics 8:429-440,1995.

34. Op. cit., Bjorkhem, I. And Boberg, K.M.

35. Salen, G.; Ahrens, E.H.; Grundy, S.M. "Metabolism of B-sitosterol in man." Journal of Clinical Investigation 49:952-967, 1970.

36. Weihrauch, J.L. and Gardner, J.M. "Sterol content of foods of plant origin." Journal of the American Dietetic Association 73:39-47,1978.

37. Mudd, J.B. "Sterol interconversions." Biochemistry of Plants 4:509-534,1980.

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