Effect of plant sterols and dietary fiber among Filipino adults with moderately raised serum cholesterol levels

Filipino dietary patterns are shifting toward a "Westernized" diet—high in saturated fats, sugars, and ultra-processed meats, but low in fruits and vegetables. Driven by rapid urbanization and rising incomes, this transition has fueled an alarming increase in total cholesterol (TC) and LDL-cholesterol (LDL-c) among adults. As cardiovascular disease (CVD) remains the leading cause of death in the Philippines. Dietary interventions using plant sterols and fiber are critical preventive strategies. This study evaluated the effects of plant sterols, dietary fiber, and their combination on the lipid profiles of Filipino adults with moderately raised serum cholesterol. A double-blind, randomized, placebo-controlled trial was conducted with 75 participants divided into four groups: plant sterol (n=18), dietary fiber (n=19), combined sterol and dietary fiber (n=19), and placebo (n=19). For four weeks, groups consumed products containing either 1.2g of plant sterols, 3.5g of dietary fiber, a combination of both, or a placebo. TC and LDL-c were assessed at baseline and endline. After four weeks, the plant sterol group showed significant reductions in TC (7.2%) and LDL-c (12.1%) (p<0.0001$). The combined group also saw significant TC and LDL-c reductions of 4% and 6.4%, respectively (p<0.0001). While dietary fiber was less effective at lowering LDL-c (0.6%), both the fiber and combined groups showed significantly higher HDL-c levels (11%) compared to the placebo (p<0.05). Plant sterols are highly effective at reducing TC and LDL-c, while dietary fiber significantly improves HDL-c levels among this group of Filipino adults.