Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials

Jovanovski, Elena; Yashpal, Shahen; Komishon, Allison; Zurbau, Andreea; Mejía, Sonia Blanco; Ho, Hoang Vi Thanh; Li, Dandan; Sievenpiper, John L.; Duvnjak, Lea; Vuksan, Vladimir

doi:10.1093/ajcn/nqy115

Cited by 61 publications

(29 citation statements)

References 48 publications

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“…Additionally, although a subgroup analysis of just two studies found that psyllium intervention for a duration of greater than 10 weeks did reduce levels of total cholesterol, the primary meta‐analysis of all available data revealed no such effect. Previous meta‐analyses have demonstrated the hypocholesterolemic attributes of psyllium (Anderson et al, ; Brum, Ramsey, McRorie, Bauer, & Kopecky, ; Jovanovski et al, ), but the present review builds upon these by focusing on the efficacy of this fiber specifically in diabetic cohorts.…”

Section: Discussionmentioning

confidence: 99%

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

Xiao

Chen

Deng³

et al. 2020

Phytotherapy Research

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Water-soluble dietary fibers have been shown to improve lipid profile and glucose metabolism in diabetes. The aim of this study was to review the effects of psyllium consumption on weight, body mass index, lipid profiles, and glucose metabolism in diabetic patients in randomized controlled trials. A comprehensive systematic search was performed in PubMed/MEDLINE, Web of Sciences, Cochrane, and Scopus by two independent researchers up to August 2019 without any time and language restrictions. The DerSimonian and Laird random-effects model method performed to calculate the pooled results. Inclusion criteria were randomized controlled trial design, adult subjects, and studies reporting the mean differences with the 95% confidence interval for outcome. Eight studies containing nine arms with 395 participants were identified and included in final analysis. Combined results found a significant reduction in triglycerides, low-density lipoprotein, fasting blood sugar, and hemoglobin A1c Abbreviations: BMI, body mass index; HDL, high-density lipoprotein; LDL-C, low-density lipoprotein cholesterol; TG/TAG, triglycerides.Hui Chen is the co-first author.

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Section: Discussionmentioning

confidence: 99%

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

Xiao

Chen

Deng³

et al. 2020

Phytotherapy Research

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“…The evidence also suggests effectiveness of fibre on risk factors of CVD. Meta-analyses on supplementation studies using viscous soluble fibres, β-glucan, psyllium or konjac glucomannan also reported statistically significant reductions in both total and LDL-cholesterol concentrations (162)(163)(164) . Similarly, a systematic review revealed that a breakfast based on oats, barley or psyllium may lower cholesterol concentrations (165) .…”

Section: Fibrementioning

confidence: 96%

Dietary Approaches to Stop Hypertension (DASH): potential mechanisms of action against risk factors of the metabolic syndrome

Akhlaghi

2019

Nutr. Res. Rev.

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The metabolic syndrome is a cluster of disorders dominated by abdominal obesity, hypertriacylglycerolaemia, low HDL-cholesterol, high blood pressure and high fasting glucose. Diet modification is a safe and effective way to treat the metabolic syndrome. Dietary Approaches to Stop Hypertension (DASH) is a dietary pattern rich in fruits, vegetables and low-fat dairy products, and low in meats and sweets. DASH provides good amounts of fibre, K, Ca and Mg, and limited quantities of total fat, saturated fat, cholesterol and Na. Although DASH was initially designed for the prevention or control of hypertension, using a DASH diet has other metabolic benefits. In the present review, the effect of each dietary component of DASH on the risk factors of the metabolic syndrome is discussed. Due to limited fat and high fibre and Ca content, individuals on the DASH diet are less prone to overweight and obesity and possess lower concentrations of total and LDL-cholesterol although changes in TAG and HDL-cholesterol have been less significant and available evidence in this regard is still inconclusive. Moreover, high amounts of fruit and vegetables in DASH provide great quantities of K, Mg and fibre, all of which have been shown to reduce blood pressure. K, Mg, fibre and antioxidants have also been effective in correcting glucose and insulin abnormalities. Evidence is provided from cross-sectional investigations, cohort studies and randomised controlled trials, and, where available, from published meta-analyses. Mechanisms are described according to human studies and, in the case of a lack of evidence, from animal and cell culture investigations.

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“…Two recent meta-analyses [40,41] found that daily intake of 10.2 g psyllium significantly lowered LDL-C by −0.28 mmol/L (95% CI: −0.21 to −0.31) [39] and -0.33 mmol/L (95% CI: −0.38 to −0.27) [40]; non-HDL-C was found to be lowered by −0.39 mmol/L (95% CI: −0.50 to −0.27) [41]. No clear dose-response relationship was observed, suggesting that the cholesterol-lowering benefit of psyllium intakes of ≥10 g/day will not result in bigger LDL-C lowering [41]. The recommended intake of psyllium for an optimal cholesterol-lowering and heart health benefit is 7 g/day SF from 10.2 g psyllium husk, based on the approved US FDA health claim.…”

Section: Effect Of Specific Df On Blood Lipids and Cvd Risk And Undermentioning

confidence: 99%

The Role of Specific Components of a Plant-Based Diet in Management of Dyslipidemia and the Impact on Cardiovascular Risk

2020

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Convincing evidence supports the intake of specific food components, food groups, or whole dietary patterns to positively influence dyslipidemia and to lower risk of cardiovascular diseases (CVD). Specific macro- and micro-components of a predominantly plant-based dietary pattern are vegetable fats, dietary fibers, and phytonutrients such as phytosterols. This review summarizes the current knowledge regarding effects of these components on lowering blood lipids, i.e., low-density lipoprotein cholesterol (LDL-C) and on reducing CVD risk. The beneficial role of a plant-based diet on cardiovascular (CV) health has increasingly been recognized. Plant-based dietary patterns include a Mediterranean and Nordic diet pattern, the dietary approaches to stop hypertension (DASH), and Portfolio diet, as well as vegetarian- or vegan-type diet patterns. These diets have all been found to lower CVD-related risk factors like blood LDL-C, and observational study evidence supports their role in lowering CVD risk. These diet patterns are not only beneficial for dyslipidemia management and prevention of CVD but further contribute to reducing the impact of food choices on environmental degradation. Hence, the CV health benefits of a predominantly plant-based diet as a healthy and environmentally sustainable eating pattern are today recommended by many food-based dietary as well as clinical practice guidelines.

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Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials

Abstract: Psyllium fiber effectively improves conventional and alternative lipids markers, potentially delaying the process of atherosclerosis-associated CVD risk in those with or without hypercholesterolemia. This trial is registered at www.clinicaltrials.gov as NCT03346733.

Cited by 61 publications

References 48 publications

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

Dietary Approaches to Stop Hypertension (DASH): potential mechanisms of action against risk factors of the metabolic syndrome

The Role of Specific Components of a Plant-Based Diet in Management of Dyslipidemia and the Impact on Cardiovascular Risk

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