title: A systematic review and meta-analysis of randomized controlled trials of the effect of konjac glucomannan, a viscous soluble fiber, on LDL cholesterol and the new lipid targets non-HDL cholesterol and apolipoprotein B.
abstract: Background:Evidence from randomized controlled trials (RCTs) suggests the consumption of konjac glucomannan (KJM), a viscous soluble fiber, for improving LDL-cholesterol concentrations. It has also been suggested that the cholesterol-lowering potential of KJM may be greater than that of other fibers. However, trials have been relatively scarce and limited in sample size and duration, and the effect estimates have been inconsistent. The effect of KJM on new lipid targets of cardiovascular disease (CVD) risk is also unknown.Objective:This systematic review and meta-analysis aimed to assess the effect of KJM on LDL cholesterol, non-HDL cholesterol, and apolipoprotein B.Design:Medline, Embase, CINAHL, and the Cochrane Central databases were searched. We included RCTs with a follow-up of ≥3 wk that assessed the effect of KJM on LDL cholesterol, non-HDL cholesterol, or apolipoprotein B. Data were pooled by using the generic inverse-variance method with random-effects models and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by the Cochran Q statistic and quantified by theI2statistic.Results:Twelve studies (n= 370), 8 in adults and 4 in children, met the inclusion criteria. KJM significantly lowered LDL cholesterol (MD: -0.35 mmol/L; 95% CI: -0.46, -0.25 mmol/L) and non-HDL cholesterol (MD: -0.32 mmol/L; 95% CI: -0.46, -0.19 mmol/L). Data from 6 trials suggested no impact of KJM on apolipoprotein B.Conclusions:Our findings support the intake of ∼3 g KJM/d for reductions in LDL cholesterol and non-HDL cholesterol of 10% and 7%, respectively. The information may be of interest to health agencies in crafting future dietary recommendations related to reduction in CVD risk. This study was registered at clinicaltrials.gov as NCT02068248.
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Hoang Vi Thanh
authors.initials: HVT
authors.lastname: Ho
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Elena
authors.initials: E
authors.lastname: Jovanovski
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Andreea
authors.initials: A
authors.lastname: Zurbau
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.|Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Canada.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Sonia
authors.initials: S
authors.lastname: Blanco Mejia
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: John L
authors.initials: JL
authors.lastname: Sievenpiper
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Fei
authors.initials: F
authors.lastname: Au-Yeung
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Jenkins
authors.affiliation: Clinic for Diabetes, Endocrinology and Metabolic Diseases Vuk Vrhovac, University Hospital Merkur, University of Zagreb, School of Medicine, Zagreb, Croatia; and.
authors.forename: Lea
authors.initials: L
authors.lastname: Duvnjak
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre.|Li Ka Shing Knowledge Institute.|Division of Endocrinology and Medicine, and.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Leiter
authors.affiliation: Clinical Nutrition and Risk Factor Modification Centre, v.vuksan@utoronto.ca.|Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Vladimir
authors.identifier: 0000-0001-8541-4058
authors.initials: V
authors.lastname: Vuksan
mesh_terms: D000328:Adult; D031056:Amorphophallus / Q000737:chemistry*; D000924:Anticholesteremic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001055:Apolipoproteins B / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D002648:Child; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D004043:Dietary Fiber / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008351:Mannans / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged
chemical_list: D000924:Anticholesteremic Agents; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004043:Dietary Fiber; D008351:Mannans; C022901:(1-6)-alpha-glucomannan; D002784:Cholesterol
keywords: CVD risk reduction; LDL cholesterol; konjac glucomannan; non-HDL cholesterol and apolipoprotein B; systematic review and meta-analysis