Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic men.

The effect of psyllium hydrophilic mucilloid on serum cholesterol levels was investigated in 26 men with mild to moderate hypercholesterolemia (range of cholesterol level, 4.86 to 8.12 mmol/L [188 to 314 mg/dL]) in a double-blind, placebo-controlled parallel study. Following a two-week baseline period, subjects were treated for eight weeks with 3.4 g of psyllium or cellulose placebo at mealtimes (three doses per day). All subjects maintained their usual diets, which provided less than 300 mg of cholesterol per day and approximately 20% of energy from protein, 40% from carbohydrate, and 40% from fat. Eight weeks of treatment with psyllium reduced serum total cholesterol levels by 14.8%, low-density lipoprotein (LDL) cholesterol by 20.2%, and the ratio of LDL cholesterol to high-density lipoprotein cholesterol by 14.8% relative to baseline values. The reductions in total cholesterol and LDL cholesterol became progressively larger with time, and this trend appeared to be continuing at the eighth week. Psyllium treatment did not affect body weight, blood pressure, or serum levels of high-density lipoprotein cholesterol, triglycerides, glucose, iron, or zinc. No significant changes in serum lipid levels, body weight, blood pressure, or other serum parameters were observed with placebo treatment. Subject adherence to psyllium treatment was excellent, and no adverse effects were observed. Results of this study show that psyllium is an effective and well-tolerated therapy for mild to moderate hypercholesterolemia.

Dietary fiber and diabetes: a comprehensive review and practical application.

Diabetes takes an enormous human and monetary toll each year. Current treatment too often revolves around insulin and drug therapy, neglecting diet and exercise. A comprehensive review was undertaken to assess and summarize the effects of dietary fiber on diabetes. Fiber supplement studies with guar, wheat bran, and apple fiber produced mixed results; some studies reported lowered fasting glucose and cholesterol values and less glycosuria. However, many available fiber supplements cause side effects. High-carbohydrate, high-fiber diets providing 55% to 60% of energy as carbohydrates, 15% to 20% as protein, and 20% to 25% as fat and including 50 gm or more fiber daily hold the most potential for long-term use. These diets reduce insulin requirements, improve glycemic control, lower fasting serum cholesterol and triglyceride values, and promote weight loss. Studies show good long-term adherence with these diets. Dietitians assume primary responsibility for educating individuals on the benefits and use of high-carbohydrate, high-fiber diets. Diets must be individualized, with special modifications for obesity, hyperlipidemia, or physiological states such as pregnancy and lactation. Widespread use of high-fiber diets will ultimately improve metabolic control and decrease health care costs for thousands of diabetic and non-diabetic individuals.

Practical aspects of implementing increased dietary fiber intake.

Two hundred twenty dietitians participated in a workshop conference on Health Implications of Dietary Fiber. They were given lectures to increase their knowledge base, and then in group sessions answered questions and wrote concensus opinions. The results are the content of this paper. The topics covered and responses are reported in four categories, diabetes and obesity, hyperlipidemia, hypertension and coronary heart disease, gut function and gastrointestinal disease, and cancer. Specific recommendation for implementing high fiber diets are made in each category. However, the dietitians expressed caution on accepting all of the conclusions expressed in the literature on the value of fiber and believed much education and instruction is needed in order to increase dietary fiber intake.