GPs told they can't be certain low-cholesterol spread can cut heart risks

GPs and nurses are told there is 'not enough evidence' to encourage patients to buy spreads, yoghurts and drinks designed to cut their cholesterol.

The two top-selling ranges in the UK are Flora pro.activ and Benecol.

The guidance issued earlier this week aims to help 1.5million patients reduce their cholesterol in an attempt to prevent 15,000 heart attacks and strokes each year.

Flora Proactiv: Doubts over health benefits

But lifestyle advice such as encouraging exercise and healthy eating will not include the use of foods shown to reduce the absorption-of cholesterol into the body. Instead patients at higher risk will be prescribed cholesterol-lowering statins, which require regular liver checks and can have other side-effects.

NICE, the National Institute for Health and Clinical Excellence which drew up the guidance, says patients can expect a GP or nurse to discuss the benefits and risks of drugs. But it says there is no proof that using products that lower cholesterol  -  which it does not dispute  -  will lead to a cut in heart disease risk.

It says: 'If you are at higher risk, your GP or nurse will not recommend that you use spreads, drinks or yoghurts containing plant sterols and stanols to lower cholesterol because there is not enough evidence at the moment that these products prevent cardiovascular disease.'

However, makers of cholesterol-blocking products such as Benecol and Flora said there was clinically proven evidence showing regular use could cut blood cholesterol levels.

For example, plant stanols act on the cholesterol consumed in foods as well as that produced by the body which results in a reduction in the amount of cholesterol it absorbs.

Professor Colette Shortt, nutritionist at McNeil Nutritionals, makers of Benecol, said: 'There is a wealth of evidence demonstrating the efficacy of plant stanols in the reduction of total and LDL (bad) cholesterol levels, which are universally accepted indicators for cardiovascular disease risk.'

She said the significant cholesterol-lowering effect of Benecol's unique plant stanol ester has been proven in more than 30 independent clinical studies.

A spokesman for Unilever, which makes Flora pro.activ, said: 'There are over 140 studies to show that plant sterols reduce cholesterol and over 40 studies to show that Flora pro.activ specifically reduces cholesterol.

'There is a great wealth of evidence that reducing cholesterol leads to reductions in risk of cardiovascular disease.

'Under current legislation it is not possible for a food to make disease risk reduction claims, and as such Flora pro.activ only makes claims about reducing cholesterol.' Victoria-Taylor, dietitian for the British Heart Foundation, said: 'Whilst there is evidence that plant sterols and stanols can help some people to lower their blood cholesterol levels, they are not a substitute for taking prescribed cholesterol-lowering medication or a balanced diet.

'The NICE guidelines highlight the need for more research on these products.'

A spokesman for NICE said: 'There is evidence that foods continuing plant sterols and stanols reduce cholesterol levels.

'It is generally supposed that reducing cholesterol levels leads to reductions in cardiovascular disease. However this is not necessarily always the case.

'With some cholesterol-lowering drugs such as statins there is clear evidence from large studies that individuals taking the drugs are less likely to develop cardiovascular disease.'