Effect of psyllium in hypercholesterolemia at two monounsaturated fatty acid intakes

• Published in: The American journal of clinical nutrition 1997-05, Vol.65 (5), p.1524-1533
• Main Authors: Jenkins, DJ, Wolever, TM, Vidgen, E, Kendall, CW, Ransom, TP, Mehling, CC, Mueller, S, Cunnane, SC, O’Connell, NC, Setchell, KD, Lau, H, Teitel, JM, Garvey, MB, Fulgoni, V, Connelly, PW, Patten, R, Corey, PN
• Format: Article
• Language: English
• Subjects: Apolipoproteins B - blood; Bile Acids and Salts - metabolism; Biological and medical sciences; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cross-Over Studies; Diet; Dietary Fats, Unsaturated - administration & dosage; Dietary fiber; Dietary Fiber - administration & dosage; Dietary Fiber - therapeutic use; Disorders of blood lipids. Hyperlipoproteinemia; Fatty Acids, Monounsaturated - administration & dosage; Feces; Female; Humans; Hypercholesterolemia - blood; Hypercholesterolemia - diet therapy; Lipids; Male; Medical sciences; Metabolic diseases; Middle Aged; Psyllium - administration & dosage; Psyllium - therapeutic use; Studies
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/65.5.1524

We performed two studies to determine whether the lipid-lowering effect of viscous soluble fiber was modified by monounsaturated fatty acid (MUFA). First, psyllium (1.4 g/MJ) was compared with wheat bran (control) in 1-mo metabolic diets by using a randomized crossover design (n = 32 hyperlipidemic subjects). The background diet contained approximately 6% of energy as MUFA (20% of total fat). The second study (n = 27 hyperlipidemic subjects) was similar to the first but the background diet contained approximately 12% MUFA (29% of total fat) because of the addition of canola oil. At both fat intakes, psyllium resulted in significant reductions in total, low-density-lipoprotein (LDL), and high-density-lipoprotein (HDL) cholesterol compared with the wheat bran control. For the psyllium diet at 6% compared with 12% MUFA, the decreases in LDL cholesterol were 12.3 +/- 1.5% (P < 0.001) and 15.3 +/- 2.4% (P < 0.001), respectively. With the higher-MUFA diet triacylglycerol fell significantly over the control phase (16.6 +/- 5.5%, P = 0.006) and the ratio of LDL to HDL cholesterol fell significantly over the psyllium phase (7.3 +/- 2.8%, P = 0.015). Psyllium and MUFA intakes were negatively related to the percentage change in the ratio of LDL to HDL cholesterol (r = -0.34, P = 0.019 and r = -0.44, P = 0.002, respectively). Chenodeoxycholate synthesis rate increased (30 +/- 13%, P = 0.038) with the psyllium diet in the 12 subjects in whom this was assessed. We conclude that psyllium lowered LDL- and HDL-cholesterol concentrations similarly at both MUFA intakes. However, there may be some advantage in combining soluble fiber and MUFA to reduce the ratio of LDL to HDL cholesterol.