Plant sterols and stanol esters, collectively known as phytosterols (PSs), are bioactive compounds with a structural similarity to cholesterol found in plant cell membranes (
1). Phytosterols are naturally present in fruits, fresh vegetables, nuts, seeds, and plant oils such as canola, corn, flaxseed, olive, and sesame oil. There are no reports of adverse side effects associated with PSs, and they are generally considered safe (
2). A wide range of pharmacological and biological properties has been attributed to these plant sterols, including a reduced risk of cardiovascular diseases due to their LDL cholesterol-lowering effects, as well as anti-obesity, anti-inflammatory, hypoglycemic, and immunomodulatory activities. Due to their cholesterol- and LDL-lowering benefits, plant sterols have been approved for addition to foods by organizations such as the U.S. Food and Drug Administration (FDA) (
3), the European Food Safety Authority (EFSA) (
4), and other official health bodies [Reviewed in (
1)].
Studies on high-fat diet mice suggest that the hypolipidemic effect of PSs is linked to the regulation of cholesterol metabolism through modulation of gut microbiota (
5). In vitro and in vivo studies indicate that phytosterol-enriched diets improve gastrointestinal tract function by increasing beneficial microbiota species such as
Eubacterium halii and decreasing the abundance of
Firmicutes bacteria (
6), which are associated with enhanced calorie absorption and weight gain (
7). Furthermore, PSs contribute to reduced appetite and food intake by promoting dietary fiber fermentation and increasing the production of short-chain fatty acids such as acetate and butyrate. Additionally, they reduce the production of cholesterol metabolites (
8,
9). These findings highlight the therapeutic potential of PSs in addressing obesity, metabolic disorders, and gastrointestinal issues (
10).
Phytosterols also support colonic epithelial cells by providing more energy and play a preventive role against colon cancer (
8,
9). They improve immune responses in infants by modulating intestinal microbiota and increasing the diversity of bacterial genera such as
Anaerostipes,
Bacteroidetes,
Firmicutesin,
Staphylococcus, and
Streptococcus in breast milk (
9). Moreover, some studies report anticancer and antimicrobial activities of PSs (
1,
2).
Global research is increasingly focused on developing novel therapies to combat antimicrobial and antiviral resistance. According to various studies, β-sitosterol extracted from Parthenium
hysterophorus (
11), avocado (
12), the bark of Norway spruce (
Picea abies) (
13), and
Lycorisradiata (
14), as well as campesterol and its semi-synthetic derivatives (
15), and stigmasterol (
16), have demonstrated antibacterial activity. Pistachio nuts, in particular, are a rich source of healthy fats, fiber, protein, vitamins, and various phytochemicals, including anthocyanins, carotenoids, flavonoids, phenolic acids, and PSs (
17).