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Cited by 337Lipoproteins and Cardiovascular HealthFood composition and propertiesNatural Products and Biological Research

Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials

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Anderson, James W, Allgood, Lisa D, Lawrence, Ann, Altringer, Linda A, Jerdack, George R, Hengehold, David A, Morel, Jorge G·2000·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/71.2.472
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Abstract

Background Soluble fibers, including those from psyllium husk, have been shown to augment the cholesterol-lowering effects of a low-fat diet in persons with hypercholesterolemia. As evidence of this, the US Food and Drug Administration recently authorized the use of health claims on food products containing soluble fiber from psyllium that state that they are associated with a decreased risk of coronary heart disease. Objective This meta-analysis was conducted to more precisely define the hypolipidemic effects and safety of psyllium when used adjunctive to a low-fat diet in men and women with hypercholesterolemia. Design The 8 studies in the meta-analysis included a total of 384 and 272 subjects receiving psyllium or cellulose placebo, respectively. All studies evaluated the hypocholesterolemic effects of 10.2 g psyllium/d adjunctive to a low-fat diet for >/=8 wk in individuals with mild-to-moderate hypercholesterolemia after a low-fat diet lead-in phase lasting >/=8 wk. The safety and adverse events associated with psyllium consumption were summarized from pooled data of 19 clinical studies ranging from 6 wk to 6 mo in duration. Results Consumption of 10.2 g psyllium/d lowered serum total cholesterol by 4% (P < 0.0001), LDL cholesterol by 7% (P < 0.0001), and the ratio of apolipoprotein (apo) B to apo A-I by 6% (P < 0.05) relative to placebo in subjects already consuming a low-fat diet, with no effect on serum HDL or triacylglycerol concentrations. Conclusions Psyllium supplementation significantly lowered serum total and LDL-cholesterol concentrations in subjects consuming a low-fat diet. Psyllium is well tolerated and safe when used adjunctive to a low-fat diet in individuals with mild-to-moderate hypercholesterolemia.

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  • The LDL-C lowering effect of 5-10% of each of the 4 core food components can be considered additive.

    “These data provide confirmation that the LDL-C lowering effect of 5-10% [14][15][16][17][18] of each of the 4 core food components can be considered additive, [8][9][10][11][12][13]”

    From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [15]

    The Abstract reports that psyllium lowered LDL cholesterol by 7% relative to placebo in people already consuming a low-fat diet, supporting a 5–10% effect for psyllium. The paper does not establish that each of four core food components has that effect or that their effects are additive. (LLM, conf=0.85)

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  • Controlled feeding trials of the Portfolio dietary pattern demonstrated that each of the components had an LDL-C lowering effect of 5-10%.

    “Controlled feeding trials of the portfolio dietary pattern demonstrated that each of the components had a low-density lipoprotein cholesterol (LDL-C) lowering effect of 5-10% [14][15][16][17][18] and that the effect was additive when combined as part of this dietary pattern.[8][9][10][11][12][13]”

    From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [15]

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Research works printed but not linked: 2

  1. Weingand KW, Le N-A, Kuzmak B, et al. Effects of psyllium on cholesterol and low-density lipoprotein metabolism in subjects with hypercholesterolemia. Endocrinol Metab 1997;4:141-50.
  2. Food and Drug Administration. Food labeling: health claims; solu- ble fiber from certain foods and corouary heart disease. Fed Regist 1998;63:8103.

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Authors
Anderson, J. W., Allgood, L. D., Lawrence, A., Altringer, L. A., Jerdack, G. R., Hengehold, D. A., & Morel, J. G.
Affiliations
University of Kentucky (US)
ORCID
Anderson, James W
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2000-02
Volume
71
Issue
2
Pages
472-479
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/71.2.472
OpenAlex
W2134391068
Cited by
337
References
45
Citations by year
2026: 5 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 17 · 2019: 10 · 2018: 14 · 2017: 21 · 2016: 13 · 2015: 12 · 2014: 16 · 2013: 14 · 2012: 15
FWCI
3.81
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
  • Health Sciences › Medicine › Surgery › Natural Products and Biological Research
Keywords
psyllium, hypercholesterolemia, LDL cholesterol, total cholesterol, soluble dietary fiber, low-fat diet, dietary supplementation, hypolipidemic effect, safety and tolerability, coronary heart disease prevention
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Hypolipidemic Agents, Combined Modality Therapy, Female, Humans, Hypercholesterolemia, Lipids, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Psyllium, Sex Factors, Triglycerides, Controlled Clinical Trials as Topic

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