Psyllium fibre and the metabolic control of obese children and adolescents

Abstract

In children and adolescents from developed countries, obesity prevalence has strongly increased in the last decades and insulin resistance and impaired glucose tolerance are frequently observed. Some dietary components such as low glycemic index foods and dietary fibre could be used in order to improve glucose homeostasis in these children. Psyllium or ispaghula husk (the husk of the seeds of Plantago ovata) is a mixture of neutral and acid polysaccharides containing galacturonic acid with a ratio of soluble/insoluble fibre of 70/30. Some foods could potentially be enriched with psyllium, like breads, breakfast cereals, pasta and snack foods. The aim of this review was to assess the usefulness of psyllium in the management of obese children and adolescents with abnormalities of carbohydrate and lipid metabolism. After psyllium supplementation, the percentage change in postprandial glucose in type 2 diabetes patients, ranged from -12.2 to -20.2%. In hypercholesterolemic children, the effect of psyllium in LDL-cholesterol serum concentrations ranged from 2.78 to -22.8%; the effect in HDL-cholesterol from -4.16 to 3.05%; and the effect on triglycerides from 8.49 to -19.54%. The reviewed evidence seems to show that psyllium improves glucose homeostasis and the lipid and lipoprotein profile; however, more well controlled trials and further studies are needed to clarify it's effects and the mechanisms involved.

Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial

“…Previous studies have also indicated that this type of fibre has no effect on HDL-C or TAG concentrations when included in a diet low in saturated fat (9,10) . In accordance with the literature, the results of the present study showed that the …”

“…Although there is difficulty in obtaining a representative sample of hypercholesterolaemic children for an interventional study, especially in Brazil, all the published studies on this subject have used sample sizes that are similar to or smaller than that used in the present study. Most of the randomised controlled trials that have investigated the effect of psyllium on cholesterol concentrations in children (9) have used the NCEP Step 1 diet (4) . In the present study, by contrast, this diet was used for assessing the eligibility of participants and only those with LDL-C concentrations .…”

“…It is derived from the seed husk of Plantago ovata (11) and is considered a useful supplement to dietary therapy (National Cholesterol Education Program (NCEP) Step 1 and 2 diets) for the treatment of hypercholesterolaemic patients. Despite this, Haney et al (12) and Spence et al (13) have expressed certain doubts with regard to the dose -response relationship and long-term efficacy of the treatment.Although these positive effects have been clearly demonstrated in hypercholesterolaemic adults (7) , there are few, mostly old, published studies on the use of psyllium or other fibre mixtures in children or adolescents (9,10) and some (13,14) have reported inconclusive results.We hypothesised that psyllium supplementation exerts an additional lipid-lowering effect on serum LDL-C concentrations in dyslipidaemic paediatric subjects treated with the NCEP Step 2 diet. * Corresponding author: Professor S. A. Ribas, fax þ55 21 2587 6494, email ribasnut@yahoo.com.br…”

Using Psyllium to Prevent and Treat Obesity Comorbidities

“…This gel may hinder the access of glucose to the absorptive epithelium of the small intestine, thereby blunting postprandial glucose peaks [69]. In addition, soluble fiber may delay gastric emptying, thus slowing carbohydrate uptake [70].…”

Novel Insights into the Mechanisms of Regulation of Tyrosine Kinase Receptors by Ras Interference 1

“…Plants such as Cissus quadrangularis, Aralia mandshurica, Kochujang and psyllium showed a reduction in triglycerides and cholesterol levels in serum (Abidov et al, 2006;Ahn et al, 2006;Moreno et al, 2003;Oben et al, 2007).…”