Efficacy of psyllium in reducing serum cholesterol levels in hypercholesterolemic patients on high- or low-fat diets.
OBJECTIVE
To determine the efficacy of psyllium in reducing serum cholesterol levels in patients on high- or low-fat diets.


METHODS
Double-blind, placebo-controlled, 16-week parallel trial. The study included an 8-week baseline period and an 8-week treatment period.


METHODS
Healthy men and women, 21 to 70 years old, with primary hypercholesterolemia (total serum cholesterol > or = 5.7 mmol/L [220 mg/dL]). Thirty-seven participants followed a high-fat diet and 81 participants followed a low-fat diet.


METHODS
Participants were randomly assigned to either psyllium, 5.1 g twice a day, or placebo.


METHODS
Fasting lipid and apolipoprotein concentrations, including direct low-density lipoprotein (LDL) cholesterol quantification; nutritional analyses of 4 days of 7-day food records to monitor dietary compliance; and physical examinations, clinical chemistry and hematologic studies, and urinalysis to assess treatment safety.


RESULTS
Psyllium recipients in both the high- and low-fat diet groups showed small but significant decreases (P < 0.05) in total cholesterol and low-density lipoprotein (LDL) cholesterol levels. Total cholesterol and LDL cholesterol levels decreased 5.8% and 7.2%, respectively, in psyllium recipients on high-fat diets and 4.2% and 6.4%, respectively, in psyllium recipients on low-fat diets. No significant difference was seen in LDL cholesterol response when psyllium recipients on low- and high-fat diets were compared (P >  0.2). No significant reductions in lipid levels were observed in placebo recipients. Based on the National Cholesterol Education Program LDL cholesterol classification system, 39% of the psyllium recipients improved in LDL cholesterol classification (P < 0.0001) compared with 20.3% of placebo recipients (P > 0.2).


CONCLUSIONS
Psyllium produces a modest but significant improvement in total cholesterol and LDL cholesterol levels in persons on either low-fat or high-fat diets. Psyllium, when added to a prescribed low-fat diet, may obviate the need for typical lipid-lowering medications or may prove to be a valuable adjunct to other treatments in patients with moderately elevated LDL cholesterol levels.
Sprecher
D L
DL
University of Cincinnati, Ohio.
Harris
B V
BV
Goldberg
A C
AC
Anderson
E C
EC
Bayuk
L M
LM
Russell
B S
BS
Crone
D S
DS
Quinn
C
C
Bateman
J
J
Kuzmak
B R
BR
Allgood
L D
LD
D000328:Adult; D000368:Aged; D001055:Apolipoproteins B / Q000097:blood; D002784:Cholesterol / Q000097:blood / Q000145:classification; D008078:Cholesterol, LDL / Q000097:blood; D003131:Combined Modality Therapy; D004041:Dietary Fats / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011620:Psyllium / Q000627:therapeutic use*
D001055:Apolipoproteins B; D008078:Cholesterol, LDL; D004041:Dietary Fats; D011620:Psyllium; D002784:Cholesterol