Against the Grain

Man does not live by bread alone. But some new functional breads launched this summer may help him live longer. In September, two major bread manufacturers entered the heart-health market with items that contain natural plant sterols. Kroger's (Cincinnati) Active Lifestyle brand and George Weston Bakeries Inc.'s (Horsham, PA) Arnold and Brownberry brands now contain 0.4 g of sterols per serving.

According to a 2003 meta-analysis of 41 trials in the Mayo Clinic Proceedings, 2 g per day of sterols can reduce low-density lipoprotein (LDL) by up to 10%. Moreover, in 2006, the American Heart Association (AHA; Alexandria, VA) pointed out that a 10% drop in total cholesterol could result in a 30% reduction in the incidence of coronary heart disease.

In 2000, FDA permitted a health claim for low-fat items, linking consumption of 0.65 g of sterol esters or 1.7 g of stanol esters per serving to a reduced risk of heart disease. In 2003, the agency said it would allow the claim on products containing 0.4 g of free sterols.

Since manufacturers began using the FDA health claim, consumer awareness of sterols has increased significantly. European consumers tend to be better informed than Americans about the benefits of sterols, with about 10–15% of the population buying sterol products, says J. J. Mathieu, technical services manager at ADM (Decatur, IL), which supplies the CardioAid line of plant sterol ingredients.

"In America, sterol products have not had the same impact," Mathieu says, noting that a 2007 National Women's Health Center (Washington, DC) survey found that only 20% of Americans understand that sterols can lower LDL. On the other hand, other studies show that more than 80% of Americans at moderate risk for high cholesterol would prefer a nonprescription alternative to statin medications. "The people marketing sterol-containing food products have to do a better job of informing American consumers, and perhaps also physicians, about the benefits," Mathieu says.

American consumers may have some catching up to do with their European counterparts. But they are becoming more knowledgeable, says Laura Troha, marketing manager for Cognis Nutrition & Health (La Grange, IL), which supplies Vegapure sterols marketed under the consumer brand name Heart Choice. Troha says that in the United States, plant sterols have truly crossed over into the mainstream.

"Plant sterol awareness in the U.S. population has significantly increased," says Troha, noting that awareness rose from 3% in 2004 to 12% in 2008. She predicts that with major food brands incorporating sterols into their products and their extensive media campaigns on television, radio, and print, the trend will continue. "In 2007 alone, 40 new products launched with plant sterols, versus five in 2002," she says.

Consumer awareness in the United States is definitely on the upswing, agrees Pam Stauffer, global communications manager at Cargill (Minneapolis), which supplies CoroWise plant sterols. She notes that in 2007, total U.S. sales of sterols were about $85 million and accounted for 2600 metric tons, according to SRI Consulting (Menlo Park, CA). SRI predicts an average annual increase of 15% through 2012.

Cognis and Cargill both supplied the sterols used in several of the new bread items. George Weston Bakeries' Arnold and Brownberry breads contain Heart Choice, while Kroger's Active Lifestyle breads contain CoroWise. Kroger also includes CoroWise in its Active Lifestyle fat-free milk, which launched in 2007.

"Our goal is to deliver valuable health benefits without compromising taste, and Cognis helped us do just that with its naturally sourced Heart Choice plant sterols," says Jennifer Hartley, business director for George Weston Bakeries' Arnold and Brownberry brands. "In quantitative testing, we found that reducing cholesterol is one of the top five health benefits consumers prefer when purchasing bread. The challenge was to then find a health ingredient supplier that could meet our standards for quality, safety, and technical support. Cognis has proven to be an ideal partner from conception to product launch."

"Consumers continue to look for ways to manage heart health and cholesterol reduction naturally," adds Cargill's Stauffer. "Many new products have been launched containing CoroWise plant sterols to address this consumer need, such as Centrum Cardio multivitamins, Kroger Active Lifestyle milk and bread, and Giant Eagle milk, to name a few."

Because both Cognis and Cargill have devoted substantial resources to educating consumers about their Heart Choice and CoroWise brands, each of the new bread products sports a Heart Choice or CoroWise logo on their packaging.

According to Hartley, George Weston Bakeries believes that the image "enables stronger communication of the sterol content and helps differentiate the product on the store shelf." Similarly, Stauffer points out that Cargill has collected extensive market research to develop the CoroWise brand. "Cargill is an ideal partner for manufacturers looking to include plant sterols into new products, as we offer customers marketing, applications, and regulatory support," she says. "We also support the brand with a comprehensive healthcare professional outreach program in addition to direct-to-consumer programs."

While the new breads stress their sterol content, other heart-healthy ingredients could be added to breads in the near future.

"Baked goods are ideal vehicles for plant sterols, since people generally eat these at every meal," says ADM's Mathieu. "Sterol-containing baked products can also be combined with other ingredients known to reduce cholesterol, such as soluble fibers and soy protein." Moreover, in the February 2005 issue of the American Journal of Clinical Nutrition, researchers reported that it was possible to achieve cholesterol reductions approaching those observed with the use of lovastatin by combining viscous fibers, soy protein, plant sterols, and nuts, Mathieu adds.

Other ingredients, such as barley betafiber and omega-3 fatty acids, are also thought to confer cardiovascular benefits. Stauffer says that Cargill's Barliv betafiber, a high-purity, reduced-molecular-weight beta-glucan soluble fiber, has been shown to reduce cholesterol. Meanwhile, omega-3s, long recognized for their contribution to cardiovascular health, have already appeared in baked goods. For instance, Ocean Nutrition Canada's (Dartmouth, NS, Canada) MEG-3 DHA/EPA was featured in the Arnold brand's Grains & More Double Omega bread in September.

Sterols are versatile enough to be added to a wide range of food applications without causing manufacturing problems. While bread and beverages are the primary vehicles for the current crop of sterol products, other foods are in the works.

"Plant sterols generally have little or no impact on product flavor or texture, except that plant sterols are insoluble in aqueous systems," Mathieu says. "As a result, clear or transparent beverages cannot be formulated with sterols. We currently have many customers that are developing or considering developing new sterol-containing products, and we look forward to seeing our sterols used in all of our 19 approved product categories."

Other products with a similar theme include spreads, such as McNeil Nutritionals LLC's (Ft. Washington, PA) Benecol, which contains stanol esters; Mars Inc.'s (McLean, VA) CocoaVia snack bars, which contain sterols, cocoa flavanols, and B vitamins; and Corazonas Foods Inc.'s (Los Angeles) Heart-Healthy Whole Grain Tortilla Chips, which contain 18 g of whole grains, 3 g of fiber, and whole oats, in addition to plant sterols.

Sterols are also a popular contribution to dietary supplements, such as Natrol's (Chatsworth, CA) newly launched Cholest Intercept. The supplement combines Heart Choice sterols with other nutrients, according to Michael Yatcilla, PhD, Natrol's vice president of research and development.

"Cholest Intercept contains B vitamins, which have been shown to help maintain normal homocysteine levels that are already in the normal range," Yatcilla says.

With growing numbers of consumers who are concerned about heart disease and cholesterol, sterol-enriched foods may become an important health strategy in the years ahead. Findings from the International Food Information Council's (IFIC; Washington, DC) 2007 Consumer Attitudes Toward Functional Foods Survey suggest that while awareness of sterols remains relatively low compared with other ingredients, consumers are receptive to the idea of food-based approaches to cholesterol management.

According to the survey, 80% of U.S. consumers "believe in benefits offered by foods and beverages, including improving heart health." Moreover, 53% cite heart disease as their top health concern. Perhaps more tellingly, the number of people who are concerned about cholesterol more than doubled from 5% in 2000 to 13% in 2007.

Finally, another encouraging sign for functional food manufacturers is the fact that consumers who are looking for health benefits seem to prefer the types of foods that lend themselves to sterol applications-including some mentioned in this article. According to the survey, 94% of consumers are interested in eating cereals and breads to experience health benefits, and 91% of consumers would like to receive health benefits from dairy products. Salad dressings and beverages were also favored by more than half of Americans.

While the United States still has a way to go before it catches up with Europe-some insurance companies there began covering sterol purchases as early as 2005, says Mathieu-new retail launches are propelling it forward. "Once American consumers become fully aware of the benefits of plant sterols," Mathieu says, "increased demand for sterol-containing products will follow."