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Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials
Open accessAbstract
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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“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]
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“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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“7%, respectively.(29) Regular use of PS (before meal for 6 weeks) by individuals suffering from type II diabetes reduces fasting plasma glucose, total cholesterol, LDL cholesterol and triglycerides levels with insignificant change in body weight.”
BackgroundViscous fibers, health claims, and strategies to reduce cardiovascular disease risk
Jenkins, D. J. A., Kendall, C. W. C., & Vuksan, V. V. V. (2000) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/71.2.401 · Cited by 77
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Viscous dietary fibre and metabolic effects
Jenkins, D. J. A., Marchie, A., Augustin, L. S. A., Ros, E., & Kendall, C. W. C. (2004) · Clinical Nutrition Supplements · doi:10.1016/j.clnu.2004.09.007 · Cited by 74
Dietary fiber prevents carbohydrate-induced hypertriglyceridemia
Anderson, J. W. (2000) · Current Atherosclerosis Reports · doi:10.1007/s11883-000-0055-7 · Cited by 74
Self-citationSatiety effects of psyllium in healthy volunteers
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“In a controlled, single-blind, crossover study (Figure 1) consisting of a 4-wk dietary adaptation period, the patients were randomly assigned to 2 different fiber-supplement periods of 8 wk each (4, 13).”
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“Previous studies have shown a small decrease by soluble fiber in serum total and LDL-cholesterol concentrations without a decreasing effect on HDL-cholesterol (Brown et al., 1999; Knopp et al., 1999; Anderson et al., 2000; Vuksan et al., 2000).”
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“Three metaanalyses,(31-33) 1 large multicentre RCT,(34) as well as a number of RCTs-DB(35-44) have shown that a diet containing 5 to 15 g soluble fibre resulted in reductions of TC and LDL-C by 2% to 12% and 5% to 20%, respectively.(31-33,35-44) There was no significant difference in the lipid-lowering effects between…”
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“Malabsorption of bile acid leads to a fall in LDL-cholesterol and a tendency to increase HDL-cholesterol [38] without changes in serum TG [39].”
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Trends in Dietary Fibre Research and Development
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Sex and hormonal status influence plasma lipid responses to psyllium
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Dietary Fibre and Gastrointestinal Function
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Metadata
- 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)
- 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
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › 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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