Effect of psyllium in hypercholesterolemia at two monounsaturated fatty acid intakes.
We performed two studies to determine whether the lipid-lowering effect of viscous soluble fiber was modified by monounsaturated fatty acid (MUFA). First, psyllium (1.4 g/MJ) was compared with wheat bran (control) in 1-mo metabolic diets by using a randomized crossover design (n = 32 hyperlipidemic subjects). The background diet contained approximately 6% of energy as MUFA (20% of total fat). The second study (n = 27 hyperlipidemic subjects) was similar to the first but the background diet contained approximately 12% MUFA (29% of total fat) because of the addition of canola oil. At both fat intakes, psyllium resulted in significant reductions in total, low-density-lipoprotein (LDL), and high-density-lipoprotein (HDL) cholesterol compared with the wheat bran control. For the psyllium diet at 6% compared with 12% MUFA, the decreases in LDL cholesterol were 12.3 +/- 1.5% (P < 0.001) and 15.3 +/- 2.4% (P < 0.001), respectively. With the higher-MUFA diet triacylglycerol fell significantly over the control phase (16.6 +/- 5.5%, P = 0.006) and the ratio of LDL to HDL cholesterol fell significantly over the psyllium phase (7.3 +/- 2.8%, P = 0.015). Psyllium and MUFA intakes were negatively related to the percentage change in the ratio of LDL to HDL cholesterol (r = -0.34, P = 0.019 and r = -0.44, P = 0.002, respectively). Chenodeoxycholate synthesis rate increased (30 +/- 13%, P = 0.038) with the psyllium diet in the 12 subjects in whom this was assessed. We conclude that psyllium lowered LDL- and HDL-cholesterol concentrations similarly at both MUFA intakes. However, there may be some advantage in combining soluble fiber and MUFA to reduce the ratio of LDL to HDL cholesterol.
Jenkins
D J
DJ
Clinical Nutrition and Risk Factor Modification Center, J Alick Little Core Lipid Laboratory, St Michael's Hospital, Toronto, Ontario, Canada. tina.perera@utoronto.ca
Wolever
T M
TM
Vidgen
E
E
Kendall
C W
CW
Ransom
T P
TP
Mehling
C C
CC
Mueller
S
S
Cunnane
S C
SC
O'Connell
N C
NC
Setchell
K D
KD
Lau
H
H
Teitel
J M
JM
Garvey
M B
MB
Fulgoni
V
V
Connelly
P W
PW
Patten
R
R
Corey
P N
PN
D001055:Apolipoproteins B / Q000097:blood; D001647:Bile Acids and Salts / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018592:Cross-Over Studies; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage / Q000627:therapeutic use*; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage*; D005243:Feces; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D011620:Psyllium / Q000008:administration & dosage / Q000627:therapeutic use*
D001055:Apolipoproteins B; D001647:Bile Acids and Salts; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004042:Dietary Fats, Unsaturated; D004043:Dietary Fiber; D005229:Fatty Acids, Monounsaturated; D011620:Psyllium; D002784:Cholesterol