The effect of viscous soluble fiber on blood pressure: A systematic review and meta-analysis of randomized controlled trials

Khan, Khurram; Jovanovski, Elena; Ho, H V T; Marques, Anna-Raquel; Zurbau, Andreea; Mejía, Sonia Blanco; Sievenpiper, John L.; Vuksan, Vladimir

doi:10.1016/j.numecd.2017.09.007

Cited by 116 publications

(81 citation statements)

References 33 publications

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“…Previous studies in the general population suggested that dietary fibre is predictive of lower blood pressure (29) , which might be due to the improved postprandial glucose excursions, insulin resistance (30) and endothelial dysfunction (31) . Our data indicated a positive association of fibre intake and DBP at baseline and during follow-up.…”

Section: Discussionmentioning

confidence: 99%

Dietary fibre and mortality risk in patients on peritoneal dialysis

Yuan

et al. 2019

Br J Nutr

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Higher fibre intake reduced all-cause and cardiovascular mortality among healthy population, but such data in dialysis patients are limited. We aimed to examine these associations in patients on peritoneal dialysis (PD). This single-centre prospective cohort study enrolled 881 incident PD patients between October 2002 and August 2014. All patients were followed until death, transfer to haemodialysis, renal transplantation or until being censored in June 2018. Demographic data were collected at baseline. Biochemical, dietary and nutrition data were examined at baseline and thereafter at regular intervals to calculate the average values throughout the study. The outcomes were defined as all-cause and cardiovascular death. Cox proportional regression models were applied to explore the relationship between fibre intake and outcomes. Participants with higher fibre intake were more likely to be younger, male and have better residual renal function and serum lipids at baseline. They were prone to maintain better nutrient status, higher blood pressure and lower inflammatory status at baseline and afterwards. Neither baseline nor time-averaged fibre intake did show protective effects on all-cause mortality after multivariate adjustment in the whole cohort. Among non-diabetic PD patients, an independent association between fibre intake and all-cause mortality was found, in which each 1 g/d increase in time-averaged fibre intake correlated to 13 % of reduction in all-cause mortality. We did not observe any benefits of fibre intake in the CVD mortality for both whole cohort and subgroups. The present study revealed that higher dietary fibre intake appeared to have a protective effect on all-cause mortality in non-diabetic PD patients, which suggest that PD patients should be encouraged to eat a diet rich in fibres.

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Section: Discussionmentioning

confidence: 99%

Dietary fibre and mortality risk in patients on peritoneal dialysis

Yuan

et al. 2019

Br J Nutr

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“…Guar gum is a well characterised source of galactomannan that we used as a control. On the other hand, the β-glucan was selected because it is one of the main water-soluble polysaccharides found in oat, and has been proposed to be the cause of many of its health benefits, such as prevention of cardiovascular diseases, diabetes, obesity, cancer, and hypertension ( Khan et al, 2018 ; Martínez-Villaluenga & Peñas, 2017 ; Rebello, O'Neil, & Greenway, 2016 ; Surampudi, Enkhmaa, Anuurad, & Berglund, 2016 ). In addition, water-soluble extracts isolated from oat flakes, flour, and bran (BG32) were collected to determine their impact on the stability of emulsions.…”

Section: Introductionmentioning

confidence: 99%

Influence of oat components on lipid digestion using an in vitro model: Impact of viscosity and depletion flocculation mechanism

et al. 2018

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Depletion flocculation is a well-known instability mechanism that can occur in oil-in-water emulsions when the concentration of non-adsorbed polysaccharide exceeds a certain level. This critical flocculation concentration depends on the molecular characteristics of the polysaccharide molecules, such as their molecular weight and hydrodynamic radius. In this study, a range of analytical methods (dynamic shear rheology, optical microscopy, and static light-scattering) were used to investigate the interaction between lipid droplets and polysaccharides (guar gum and β-glucans) of varying weight-average molecular weight and hydrodynamic radius, and concentration. The aim of this work was to see if the health benefits of soluble fibers like β-glucans could be explained by their influence on the structure and digestibility of lipid emulsions. The apparent viscosity of the emulsions increased with increasing polysaccharide concentration, molecular weight, and hydrodynamic radius. Droplet flocculation was observed in the emulsions only at certain polysaccharide concentrations, which was attributed to a depletion effect. In addition, the water-soluble components in oat flakes, flour, and bran were extracted using aqueous solutions, to examine their impact on emulsion stability and properties. Then, the rate and extent of lipolysis of a sunflower oil-in-water emulsion in the presence of these oat extracts were monitored using the pH-stat method. However, the inhibition of lipolysis was not linearly related to the viscosity of the oat solutions. The water-soluble extracts of β-glucan collected from oat flakes had a significant inhibitory effect on lipolysis. The results of this study increase our understanding of the possible mechanisms influencing the impact of oat constituents on lipid digestion. This work also highlights the importance of considering the molecular properties of polysaccharides, and not just their impact on solution viscosity.

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“…Intake of viscous fibers, such as psyllium, concomitantly produces a modest effect on weight management/reduction via a satiety linked mechanism, in addition to reductions in blood pressure being linearly correlated with reductions in body mass [51,52]. Moreover, Khan et al [53] suggested that blood pressure reductions may be dependent on starting body weight, which may conceivably account for the larger reductions observed in hypertensive individuals. However, it is probable that numerous pathways contribute to the observed reduction in blood pressure, and further mechanistic studies are needed to elucidate the putative pathways and mechanism of action.…”

Section: Discussionmentioning

confidence: 99%

“…Whilst Kahn et al [53] was the first study to report that supplementation of psyllium fiber can significantly lower SBP, the present meta-analysis highlighted a number of novel findings; meta-regression of the data showed that higher baseline DBP leads to higher reductions of blood pressure after psyllium supplementation, which agrees with the subgroup analysis in which hypertensive patients showed significant reductions in blood pressure in comparison to normotensive/ patients with elevated blood pressure, in addition to longer duration and high-quality studies showed a significant reduction of blood pressure. Whilst contrary to Khan et al [53], who included low quality studies in addition to reporting substantial heterogeneity in the analysis of SBP and DBP, which remained unexplained by sensitivity analyses, we found no heterogeneity in the present meta-analysis (for both SBP and DBP); thereby enabling us to assert our findings as firm evidence for the SBP-lowering effect of psyllium supplementation. A further strength of the present meta-analysis is that the findings are generalizable, given trials included participants that were both healthy and non-healthy (hypertensive).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials

Clark

Salek

Aghabagheri

et al. 2020

Korean J Intern Med

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Background/Aims: Global incidence of hypertension is estimated to be, in excess of, one billion people, and given the efficacy of soluble dietary fibers, in particular, Psyllium, to positively impact blood pressure in patients with hypertension, it is of clinical importance that consensus on its supplementation be established. Therefore, the aim of the study was systematically review and meta-analyze the effect of psyllium supplementation on blood pressure of hypertensive patients in randomized controlled trials. Methods: We searched six universal databases including; Pubmed/Medline, Ovid, Cochrane Library, Google Scholar, Embase, and Scopus until November 2018. Both combined and stratified analyzes were conducted. A fixed-effects or random-effects model was used to assess the mean effect sizes. Results: An eventual 11 trials with 592 participants were considered as eligible for inclusion in the present meta-analysis. The meta-analysis revealed a significant reduction of 2.04 mmHg in systolic blood pressure (weighted mean difference, -2.04; 95% confidence interval, -2.82 to -1.63; p < 0.001). Whilst meta-regression highlighted that the hypotensive effect of psyllium was stronger in subjects with higher baseline blood pressure. Conclusions: Given the overarching benefits and lack of reported side effects, particularly for hypertensive patients, health care providers and clinicians should consider the use of psyllium supplementation for the treatment or abatement of hypertension, or hypertensive symptoms.

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The effect of viscous soluble fiber on blood pressure: A systematic review and meta-analysis of randomized controlled trials

Cited by 116 publications

References 33 publications

Dietary fibre and mortality risk in patients on peritoneal dialysis

Dietary fibre and mortality risk in patients on peritoneal dialysis

Influence of oat components on lipid digestion using an in vitro model: Impact of viscosity and depletion flocculation mechanism

The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials

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