*Limitations*

The main limitation of the study was its cross-sectional nature, as a result of which causal inferences cannot be drawn. Another limitation was the use of a single 24-h recall method, which may not reflect the usual pattern of food consumption. To reduce the possibility of bias, subjects who described their diet as atypical were excluded.

The strengths of this study are its representativeness to the Polish population and the assessment of diet quality, which may act synergistically with plant sterols, which has not been studied before. To minimize the synergistic effect of plant sterols on the association with CVD, the results were adjusted for the Healthy Diet Index (HDI) score. A strength of the study was its consideration of phytosterol-enriched foods.

#### **5. Conclusions**

This study suggests that habitual dietary intake of plant sterols may be associated with a lower chance of developing CVD, particularly in men. However, this finding should be treated with caution because of the difficulty in separating the effects of plant sterols from the effects of other dietary components that may have synergistic effects.

**Author Contributions:** Conceptualization, A.W. and A.M.W.; methodology, A.M.W., A.W. and M.E.Z.; software, A.W., A.M.W. and A.C.-M.; validation, A.W., A.M.W. and A.C.-M.; formal analysis, A.C.-M. and A.W.; investigation, A.W. and A.M.W.; resources, A.M.W., A.W., M.E.Z., I.M.-C. and W.D.; data curation, A.W. and A.M.W.; writing—original draft preparation, A.M.W.; writing—review and editing, A.W., M.E.Z., I.M.-C., A.C.-M. and W.D.; visualization, A.W., A.C.-M. and A.M.W.; supervision, A.W., A.M.W. and W.D.; project administration, A.M.W. and A.W.; funding acquisition, A.W. and A.M.W. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was funded by the National Institute of Cardiology (Grant no. 2.20/I/20) and Medical University of Bialystok (Grant no. SUB/1/DN/22/001/3317).

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Bioethics Committee of the National Institute of Cardiology (protocol code 1344, date of approval 5 November 2012, and protocol code 1837, date of approval 14 January 2020).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** All data in this study are made available upon request to the authors at the following e-mail address: anna.witkowska@umb.edu.pl or awaskiewicz@ikard.pl.

**Conflicts of Interest:** The authors declare no conflict of interest.
