**Dietary Plant Sterols and Phytosterol-Enriched Margarines and Their Relationship with Cardiovascular Disease among Polish Men and Women: The WOBASZ II Cross-Sectional Study**

**Anna Maria Witkowska 1,\*,†, Anna Wa´skiewicz 2,†, Małgorzata Elzbieta Zujko ˙ 1, Alicja Cicha-Mikołajczyk 2, Iwona Miro ´nczuk-Chodakowska <sup>1</sup> and Wojciech Drygas 2,3**


**Abstract:** Dietary cholesterol has been suggested to increase the risk of cardiovascular disease (CVD). Phytosterols, present in food or phytosterol-enriched products, can reduce cholesterol available for absorption. The present study aimed to investigate the association between habitual intake of total and individual plant sterols (β-sitosterol, campesterol, and stigmasterol) or a diet combined with phytosterol-enriched products and CVD in a cross-section of Polish adults, participants of the Multicenter National Health Survey II (WOBASZ II). Among men (*n* = 2554), median intakes of plant sterols in terciles ranged between 183–456 mg/d and among women (*n* = 3136), 146–350 mg/d in terciles. The intake of phytosterols, when consumed with food containing phytosterols, including margarine, ranged between 184–459 mg/d for men and 147–352 mg/d for women. Among both men and women, beta-sitosterol intake predominated. Plant sterol intake was lower among both men and women with CVD (*p* = 0.016) compared to those without CVD. Diet quality, as measured by the Healthy Diet Index (HDI), was significantly higher in the third tercile of plant sterol intake for both men and women and the entire study group (*p* < 0.0001). This study suggests that habitual dietary intake of plant sterols may be associated with a lower chance of developing CVD, particularly in men.

**Keywords:** cardiovascular diseases; diabetes mellitus; humans; adult; phytosterols; diet; margarine
