Dennis L. Sprecher, MD; Betsy V. Harris, MEd; Anne C. Goldberg, MD; E. Carl Anderson, PA; Linda M. Bayuk, BS; Betsy S. Russell, BS; Debbie S. Crone, CMA; Catherine Quinn, MS; Joyce Bateman, BS; Barbara R. Kuzmak, PhD; Lisa D. Allgood, MSc
To determine the efficacy of psyllium in reducing serum cholesterol levels in patients on high- or low-fat diets.
Double-blind, placebo-controlled, 16-week parallel trial. The study included an 8-week baseline period and an 8-week treatment period.
Healthy men and women, 21 to 70 years old, with primary hypercholesterolemia (total serum cholesterol 5.7 mmol/L [220 mg/dL]). Thirty-seven participants followed a high-fat diet and 81 participants followed a low-fat diet.
Participants were randomly assigned to either psyllium, 5.1 g twice a day, or placebo.
Fasting lipid and apolipoprotein concentrations, including direct low-density lipoprotein (LDL) cholesterol quantification; nutritional analyses of 4 days of 7-day food records to monitor dietary compliance; and physical examinations, clinical chemistry and hematologic studies, and urinalysis to assess treatment safety.
Psyllium recipients in both the high- and low-fat diet groups showed small but significant decreases (P < 0.05) in total cholesterol and low-density lipoprotein (LDL) cholesterol levels. Total cholesterol and LDL cholesterol levels decreased 5.8% and 7.2%, respectively, in psyllium recipients on high-fat diets and 4.2% and 6.4%, respectively, in psyllium recipients on low-fat diets. No significant difference was seen in LDL cholesterol response when psyllium recipients on low- and high-fat diets were compared (P > 0.2). No significant reductions in lipid levels were observed in placebo recipients. Based on the National Cholesterol Education Program LDL cholesterol classification system, 39% of the psyllium recipients improved in LDL cholesterol classification (P < 0.0001) compared with 20.3% of placebo recipients (P > 0.2).
Psyllium produces a modest but significant improvement in total cholesterol and LDL cholesterol levels in persons on either low-fat or high-fat diets. Psyllium, when added to a prescribed low-fat diet, may obviate the need for typical lipid-lowering medications or may prove to be a valuable adjunct to other treatments in patients with moderately elevated LDL cholesterol levels.
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Sprecher DL, Harris BV, Goldberg AC, Anderson EC, Bayuk LM, Russell BS, et al. Efficacy of Psyllium in Reducing Serum Cholesterol Levels in Hypercholesterolemic Patients on High- or Low-Fat Diets. Ann Intern Med. 1993;119:545–554. doi: 10.7326/0003-4819-119-7_Part_1-199310010-00001
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Published: Ann Intern Med. 1993;119(7_Part_1):545-554.
Cardiology, Coronary Risk Factors, Dyslipidemia, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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