Comparison of Psyllium Hydrophilic Mucilloid and Cellulose as Adjuncts to a Prudent Diet in the Treatment of Mild to Moderate Hypercholesterolemia

Levin, Eleanor

doi:10.1001/archinte.1990.00390200036007

Cited by 55 publications

(9 citation statements)

References 31 publications

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“…The reductions in LDL cholesterol seen in this study were in the order of reductions seen with soluble fibre supplements such as psyllium seed [14], guar gum [15] and oat bran [16]. The effect was smaller than reported with low doses of resins [17] or HMG CoA reductase inhibitors [18].…”

Section: Discussionmentioning

confidence: 48%

The effect of the gastrointestinal lipase inhibitor, orlistat, on serum lipids and lipoproteins in patients with primary hyperlipidaemia

Tonstad¹,

Pometta

Erkelens³

et al. 1994

Eur J Clin Pharmacol

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The effect of orlistat, a nonabsorbed inhibitor of gastric and pancreatic lipases, was examined in patients with primary hyperlipidaemia (serum cholesterol > or = 6.2 mmol.l-1 and triglycerides < or = 5.0 mmol.l-1) not responsive to dietary change alone. In a multicentre, randomised, double-blind study, 103 men and 70 women received 30, 90, 180, or 360 mg or orlistat or placebo for 8 weeks. Total and low-density lipoprotein cholesterol levels were reduced by 4% and 5% with 30 mg orlistat, by 7% and 8% with 90 mg orlistat, by 7% and 7% with 180 mg orlistat and by 11% and 10% with 360 mg orlistat compared to placebo. High density lipoprotein cholesterol levels significantly decreased in the 360 mg orlistat group. Triglyceride levels significantly increased in the placebo group but not in the drug groups. Body weight decreased by 1.2 kg with 360 mg orlistat, despite a weight maintenance diet. Decreases in vitamin E and D levels occurred, although both vitamins remained within the normal range. Adverse effects from the gastrointestinal tract were frequent, but led to discontinuation of therapy in only seven patients. Orlistat is a new therapeutic drug for the treatment of hyperlipidaemia that may be particularly useful among overweight patients. Its potential place in therapy will await long-term studies. Vitamin supplementation should be considered during treatment.

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Section: Discussionmentioning

confidence: 48%

The effect of the gastrointestinal lipase inhibitor, orlistat, on serum lipids and lipoproteins in patients with primary hyperlipidaemia

Tonstad¹,

Pometta

Erkelens³

et al. 1994

Eur J Clin Pharmacol

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“…The control group experienced a 3.9% decline in TC and a 4.6% decline in LDL-C. Thus, in each of the five studies cited [21][22][23][24][25], the addition of WSDF to a fat-modified diet yielded a signifi cant reduction in TC, principally the LDL-C subfraction, beyond that achieved by diet alone. These results are comparable to those observed in the current study with the WSDF mixture.…”

Section: Cholesterol-lowering Dietary Fibersmentioning

confidence: 95%

“…Levin et al [23] administered 10.2 g/day psyllium for 16 weeks to hypercholesterolemic subjects and produced a 5.6% reduction in TC and a 8.6% reduction in LDL-C beyond that of diet alone. The control group showed no significant changes.…”

Section: Cholesterol-lowering Dietary Fibersmentioning

confidence: 99%

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The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans.

Jensen

Spiller

Gates

et al. 1993

Journal of the American College of Nutrition

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Water-soluble dietary fibers (WSDF) are generally thought to lower cholesterol. This study compared the cholesterol-lowering effects of a medium viscosity WSDF mixture (psyllium, pectin, guar gum and locust bean gum) with an equal amount of WSDF from acacia gum, which has a lower viscosity. Hypercholesterolemic males (n = 13) and females (n = 16) were randomly assigned to one of two WSDF treatments provided in a low-calorie powder form for mixing into beverages (< 4 kcal/serving). Subjects were instructed to mix powders into their usual beverages and to consume them three times daily (5 g WSDF/serving) for 4 weeks while consuming their typical fat-modified diets. Exercise and body weights were also held constant. The WSDF mixture yielded a 10% decrease in plasma total cholesterol (from 251 +/- 20 to 225 +/- 19 mg/dL; p < 0.01), and a 14% reduction in low-density lipoprotein cholesterol (from 167 +/- 14 to 144 +/- 14 mg/dL; p < 0.001). No significant changes in plasma high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol or triglycerides were observed. In contrast, the acacia gum-treated group showed no change in any plasma lipid parameters. The WSDF treatments did not produce significant changes in mean dietary intakes within or between treatment groups. These data support previous findings that a diet rich in select WSDF can be a useful cholesterol-lowering adjunct to a fat-modified diet, but that caution should be exercised in ascribing cholesterol-lowering efficacy to dietary fibers based solely on their WSDF classification. Finally, WSDF viscosity is a potential cholesterol-lowering factor to be explored further.

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“…As with glycemic control, the viscosity of a soluble fiber is a better predictor of efficacy for cholesterol lowering than quantity of fiber [17] . A PubMed search of the terms 'psyllium' and 'cholesterol' yielded 160 published articles, of which 21 were randomized, well-controlled clinical studies (totaling 1,568 subjects) that assessed the efficacy of psyllium (6-15 g/day; most studies 10 g/day) for lowering serum cholesterol [18,20,21,27,28,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] . Overall, these 21 studies show that total cholesterol was decreased 2% to 20% versus placebo, and LDL-cholesterol was decreased 6% to 24% versus placebo.…”

Section: Small Intestinementioning

confidence: 99%

A review of gastrointestinal physiology and the mechanisms underlying the health benefits of dietary fiber: Matching an effective fiber with specific patient needs

McRorie¹,

Fahey²

2013

Clinical Nursing Studies

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A primary function of the gastrointestinal tract is to provide the body with water, electrolytes and nutrients. It accomplishes this by ingestion, mechanical shearing, mixing and movement of the food through the gastrointestinal tract (motor events), secretion of digestive juices (≈ 6 liters per day) for degradation of complex nutrients into simple nutrients (e.g. complex carbohydrate into simple sugars), absorption of simple nutrients, water and electrolytes, and bacterial degradation of residue in the large bowel / elimination of waste. The small bowel is ≈ 7 meters long with a mucosa that is studded with millions of villi (each with microvilli), giving the small bowel a surface area approximately the size of a tennis court. Most digestion/absorption normally occurs early in the proximal small bowel. Non-digested/absorbed chyme arrives as a liquid in the cecum, and, under normal conditions, is gradually dehydrated as it slowly passes through the large bowel until it is eliminated as formed stool. Different types of dietary fiber can exert specific mechanical effects on each of these gastrointestinal functions, which can lead to local benefits (e.g. relief of constipation) as well as systemic benefits (e.g. cholesterol lowering, improved glycemic control). Three characteristics of fiber (solubility, viscosity and fermentation) are predictive of the health benefits of different fiber types. Based on these three characteristics, dietary fiber can be divided into four clinically meaningful designations that support recommendations to address the specific healthcare needs of each patient. This review will describe the four clinically meaningful designations for dietary fiber, and provide a summary of the clinical studies that support the health benefits for each.

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Comparison of Psyllium Hydrophilic Mucilloid and Cellulose as Adjuncts to a Prudent Diet in the Treatment of Mild to Moderate Hypercholesterolemia

Cited by 55 publications

References 31 publications

The effect of the gastrointestinal lipase inhibitor, orlistat, on serum lipids and lipoproteins in patients with primary hyperlipidaemia

The effect of the gastrointestinal lipase inhibitor, orlistat, on serum lipids and lipoproteins in patients with primary hyperlipidaemia

The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans.

A review of gastrointestinal physiology and the mechanisms underlying the health benefits of dietary fiber: Matching an effective fiber with specific patient needs

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