Soluble fiber enhances the hypocholesterolemic effect of the step I diet in childhood.
BACKGROUND
Psyllium, a water-soluble fiber, has been shown to have a cholesterol-lowering effect in studies of adults. A small number of studies in children have produced variable results.


METHODS
A 12-week, randomized, single-blind, placebo-controlled, parallel clinical trial was conducted to test the effectiveness of psyllium in lowering total (TC) and low-density lipoprotein cholesterol (LDL-C) in 50 healthy 2 to 11 year old children. Children with two baseline LDL-C levels > or = 110 mg/dL were invited to participate in the trial, and were randomly assigned to follow a usual Step I (Control) diet of low dietary fat, saturated fat and cholesterol, or a Step I diet enriched with psyllium. Children consumed two 1-oz boxes of cereal per day, with each box of psyllium-enriched cereal containing 3.2 g of soluble fiber, and each box of placebo cereal containing less than 0.5 g of soluble fiber.


RESULTS
Greater reduction of total and LDL-cholesterol, and increase in HDL-cholesterol were noted after 12 weeks of the psyllium-enriched Step I diet compared to the Step I control diet. Total cholesterol decreased 21 mg/dL for the high fiber group compared with 11.5 mg/dL for the control group. LDL-C decreased 23 mg/dL for the high fiber group compared with 8.5 mg/dL for the control group. HDL-C increased 4 mg/dL for the high fiber group compared with 1 mg/dL for the controls. TC/HDL and LDL/HDL ratios decreased significantly more so for the high fiber group as well.


CONCLUSIONS
In this 12-week study, soluble fiber (psyllium) provided added benefit to the Step I diet in the treatment of hypercholesterolemia.
Williams
C L
CL
American Health Foundation, New York Medical College, Valhalla, USA.
Bollella
M
M
Spark
A
A
Puder
D
D
D000924:Anticholesteremic Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood*; D002791:Cholesterol, Dietary / Q000008:administration & dosage / Q000494:pharmacology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage / Q000494:pharmacology; D004043:Dietary Fiber / Q000008:administration & dosage / Q000592:standards*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy*; D011620:Psyllium / Q000494:pharmacology* / Q000627:therapeutic use; D012044:Regression Analysis; D016037:Single-Blind Method
D000924:Anticholesteremic Agents; D002791:Cholesterol, Dietary; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004041:Dietary Fats; D004043:Dietary Fiber; D011620:Psyllium; D002784:Cholesterol