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Soluble Fiber Effective
and Safe Additive for lowering LDL Cholesterol
posted June 20, 2005
Soluble fiber supplements are
recommended to reduce levels of low-density lipoprotein cholesterol (LDL-C)
Psyllium is a safe, effective, and well-tolerated add-on therapy for elevated
cholesterol. "Soluble fiber supplements are recommended to reduce levels of
low-density lipoprotein cholesterol (LDL-C)," write Abel E. Moreyra, MD, from
the Robert Wood Johnson Medical School, University of Medicine and Dentistry of
New Jersey in New Brunswick, and colleagues. "The cholesterol-lowering effect of
the soluble fiber in psyllium husk has been evaluated in several studies and was
found to lower serum cholesterol levels reproducibly.... The mechanism of
cholesterol lowering by psyllium is believed to lie in the ability to modify the
enterohepatic circulation of bile acids, increasing bile acid synthesis and
diverting hepatic cholesterol to bile acid production."
In a 12-week blinded study, 68 patients were randomized to receive 20 mg of
simvastatin plus placebo, 10 mg of simvastatin plus placebo, or 10 mg of
simvastatin plus 15 g of psyllium (Metamucil) daily. Total cholesterol, LDL-C,
high-density lipoprotein cholesterol (HDL-C), triglycerides, and apolipoprotein
B (Apo B) levels were measured after four and eight weeks of treatment.
All treatments were well tolerated. After eight weeks, mean LDL-C levels
decreased 55 mg/dL (1.42 mmol/L) from baseline in the group receiving 10 mg of
simvastatin plus placebo, and by 63 mg/dL (1.63 mmol/L) in the group receiving
10 mg of simvastatin plus psyllium (P = .03). Mean lowering of LDL-C in the
group receiving 20 mg of simvastatin plus placebo was statistically similar to
that in the group receiving 10 mg of simvastatin plus psyllium.
Findings were similar for Apo B and total cholesterol, and there were no
significant changes from baseline triglyceride or HDL-C levels.
Study limitations include small sample size and possible confounding effects
from sugars contained in the powders used.
"Dietary psyllium supplementation in patients taking 10 mg of simvastatin is as
effective in lowering cholesterol as 20 mg of simvastatin alone," the authors
write. "Psyllium soluble fiber should be considered as a safe and well-tolerated
dietary supplement option to enhance LDL-C and apolipoprotein B lowering."
Procter & Gamble supported this study and has financial arrangements with one of
its authors. Dr. Moreyra has filed a patent application for using psyllium in
combination with statins.
Source: Diabetes In Control.com: Arch
Intern Med. 2005;165:1161-1166.
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