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PubMed2006

A combination therapy including psyllium and plant sterols lowers LDL cholesterol by modifying lipoprotein metabolism in hypercholesterolemic individuals.

We conducted a randomized, double blind, crossover, placebo-controlled study to determine the effects of a combination therapy including plant sterols (PS) and psyllium (PSY), provided via cookies, on plasma lipids and on the size and subfraction distribution of VLDL, LDL, and HDL. Thirty-three healthy free-living individuals (11 males and 22 females), aged 35-65 y, with a BMI between 25 and 35 kg/m(2) and initial plasma LDL cholesterol (LDL-C) concentrations between 2.6 and 4.1 mmol/L (100 and 160 mg/dL), were randomly assigned to receive treatment cookies (7.68 g/d PSY and 2.6 g/d PS) or placebo cookies (0 g PSY+PS) for 4 wk. After a 3-wk washout period, subjects received the other cookies for an additional 4 wk. Plasma total cholesterol concentrations were significantly reduced for all subjects, from 5.65 +/- 0.72 mmol/L after the placebo period to 5.28 +/- 0.76 mmol/L after the PSY+PS cookie period (P < 0.01). These reductions were primarily in LDL-C, which decreased from 3.48 +/- 0.70 to 3.14 +/- 0.78 mmol/L after PSY+PS cookie consumption (P < 0.01). Intake of the PSY+PS cookie decreased the number of intermediate density lipoprotein (IDL), LDL, and HDL particles (P < 0.05) and plasma apo B concentrations (P < 0.01). The decreases in LDL and HDL particles were in the small subfractions. Because smaller LDL particles are associated with an increased risk of heart disease and because smaller HDL particles are indicative of diminished reverse cholesterol transport, we conclude that the combination therapy resulted in a less atherogenic lipoprotein profile. In addition, the evaluation of lipoprotein subfractions resulting from the action of the fiber and plant sterols in the intestinal lumen provides an insight on the secondary mechanisms of plasma LDL-C lowering.

Adult↗
PubMed1989

Occupational allergic rhinitis reaction to psyllium.

We report studies that document a specific rhinitic reaction that developed as a result of occupational exposure to a psyllium-based powdered laxative. This nurse had a nonatopic family history, personal evidence of atopy (skin test reactions to pollen, cat dander, and house dust), and a significant elevation of antipsyllium IgE. Measurements of nasal and lower airway resistance documented only nasal obstruction to brief inhalational challenge to the laxative. Symptomatic relief was achieved with prior treatment with cromolyn. We suggest that nasal airway challenge can document and assess treatment for occupational rhinitis.

Airway Resistance↗
PubMed1992

Effect of guar, pectin, psyllium, soy polysaccharide, and cellulose on breath hydrogen and methane in healthy subjects.

Different types of dietary fiber are fermented to various extents in vitro, but little is known about the effects of fiber on breath hydrogen and methane levels in vivo. Therefore, we studied the effects on breath hydrogen and methane of 15 g of guar, pectin, psyllium, soy polysaccharide, or cellulose in eight healthy subjects over a 12-h period. None of the fibers had a significant effect on breath hydrogen or methane concentrations, compared with the control (fasting). The four methane producers had lower breath hydrogen levels than the nonproducers 1 h after 15 g of lactulose (3 +/- 1 vs. 42 +/- 9, p less than 0.005) and 5-12 h after the different fibers (3.3 vs. 4.8 ppm; pooled SEM = 0.8; p less than 0.025). When the methane responses of the methane producers were expressed as increments relative to the control, there were small differences between treatments, with guar producing a larger response, 8.2 +/- 3.3 ppm, than cellulose, -2.9 +/- 2.3 ppm (p less than 0.05). The incremental methane responses of the different fibers in vivo were related to the previously reported production of propionic acid (r = 0.94, n = 5, p less than 0.02) and methane (r = 0.93, n = 4, NS) from in vitro fermentation of the same fibers. We conclude that methane producers have lower breath hydrogen levels than nonproducers. Purified fermentable and nonfermentable dietary fibers have no effect on breath hydrogen levels over 12 h in subjects previously consuming a normal diet. However, fermentable fibers may produce small increases in breath methane in methane-producing subjects.

Adult↗
PubMed1991

Flow characteristics of enteral feeding with psyllium hydrophilic mucilloid added.

One therapy for managing diarrhea in patients in intensive care units who are receiving enteral nutrition is administration of psyllium hydrophilic mucilloid (PHM). This laboratory study was conducted to determine whether the addition of PHM (Metamucil) to enteral feeding formula (Entrition) adversely affected the flow characteristics of the feeding formula through a small-bore feeding tube. Descriptive data were obtained from 72 trials of feeding formula with varied infusion rates, formula osmolality and temperature, and PHM concentrations. Two thirds (n = 48) of the trials were successful (PHM did not clog the tubing and obstruct flow). The remaining one third of the trials (n = 24) were unsuccessful. Successful formula infusion was influenced by formula temperature and osmolality but not by infusion rate, PHM concentration, or flow interruption. If formula with PHM was followed by formula without PHM, the infusion was successful regardless of infusion rate or formula osmolality. Thus, the data from this laboratory study indicate that when therapeutic doses of PHM are prescribed, it is feasible for PHM to be mixed in room-temperature feeding formula and infused without clogging the feeding tube.

Administration, Oral↗
PubMedDate not supplied

[The effect of psyllium plantago in slightly to moderately hypercholesterolemic patients].

The hypocholesterolemic effect of psyllium plantago (PP) was evaluated in 14 individuals with polygenic hypercholesterolemia. Subjects with secondary dyslipidemias were excluded. Since their admission until the end of the study all the patients had to follow an isocaloric diet, with less than 10% of the calories provided as saturated fats, P/S relation greater than 1 and daily intake of less than 300 mgr of cholesterol. The study was divided in two stages; the first one, from week -6 to 0 evaluated exclusively the response to diet, and the stage II, from week 0 to +12, evaluated the response to PP. The PP in envelopes with 3.4 grs each, was taken dissolved in water three times daily before meals. In the weeks -6, 0, +4, +8 and +12 were done lipid profiles that included; total cholesterol, triglycerides, and high density cholesterol. Cholesterol of the low density lipoproteins was obtained with the formula of Friedewald modified by De Long. The use of PP produced at week 12 a reduction of 8% in total cholesterol and 11% in LDL cholesterol. With non significant changes in triglycerides and HDL-C. We conclude that PP can be used as a complement of diet in the management of polygenic hypercholesterolemia.

Adult↗
PubMed1995

Gender differences in response to dietary soluble fiber in guinea pigs: effects of pectin, guar gum, and psyllium.

Dietary soluble fiber significantly lowers plasma low density lipoprotein (LDL) cholesterol concentrations in humans and animals. In male guinea pigs, alterations in hepatic cholesterol homeostasis induced by dietary fiber in part account for the decrease in plasma LDL levels (Fernandez et al. 1994. Am. J. Clin. Nutr. 59: 869-878; 1995. 61: 127-134, and J. Lipid Res. 1995. 36: 1128-1138). To test whether dietary fiber elicited similar hypocholesterolemic responses in both genders, female guinea pigs were fed diets containing 12.5% pectin (PE), 12.5% guar gum (GG), 7.5% psyllium (PSY), or 12.5% cellulose (control diet). In addition, physiological (0.04%) (LC) or pharmacological (0.25%) (HC) amounts of cholesterol were tested with the fibers to determine whether dietary cholesterol altered the plasma cholesterol response. Significant reductions in plasma cholesterol were observed in females fed LC diets with PE, GG, or PSY (P < 0.01) while the responses to fiber with high cholesterol intake were more moderate. Hepatic cholesterol concentrations were reduced in the LC group (P < 0.001) with increased HMG-CoA reductase and cholesterol 7 alpha-hydroxylase and decreased acyl CoA:cholesterol acyltransferase (ACAT) activities accompanied by a reduction in hepatic cholesterol pools induced by fiber intake. In addition, plasma LDL lowering in animals fed the LC diets was associated with increases in hepatic LDL receptor Bmax values. Effects of fiber on hepatic cholesterol in animals fed HC diets were moderate and hepatic enzymes were not altered to the same extent as in the LC groups. For the LC groups there was no gender effect on the magnitude of plasma LDL lowering, depletion of hepatic cholesterol, or alterations in hepatic cholesterol metabolism, although hepatic HMG-CoA reductase and ACAT activities were lower in females compared to males (P < 0.01). In contrast, females fed the control HC diet had higher plasma LDL levels than males and dietary fiber did not reduce hepatic cholesterol concentrations nor alter hepatic enzyme activities as effectively as in males. These studies demonstrate that female, compared to male, guinea pigs are more responsive to a dietary cholesterol challenge and, that with this pharmacological perturbation, fiber effects are moderate compared to males. In contrast, with low cholesterol intakes, the cholesterol lowering effects of fiber are similar in both genders.

Animals↗
PubMed1995

Distinct mechanisms of plasma LDL lowering by dietary fiber in the guinea pig: specific effects of pectin, guar gum, and psyllium.

Pectin (PE), guar gum (GG), and psyllium (PSY) lower plasma low density lipoprotein (LDL) cholesterol concentrations in guinea pigs with different orders of magnitude by inducing defined alterations in hepatic cholesterol homeostasis (Fernandez et al. 1994. Am. J. Clin. Nutr. 59: 869-879; 61: 127-134 and 1995. J. Lipid Res. 36: 1128-1138). To further explore specific mechanisms responsible for the differences in plasma and hepatic cholesterol lowering, the effects of these fibers were evaluated on cholesterol absorption, hepatic cholesterol 7 alpha-hydroxylase activity, the rate-limiting enzyme of bile acid synthesis, and in vivo LDL transport to target specific primary and secondary mechanisms accounting for the observed responses. Fibers were fed with physiological (0.04%), low cholesterol (LC), or pharmacological high cholesterol (HC) (0.25%) levels to assess whether cholesterol intake influences plasma LDL lowering mechanisms. Intake of PE, GG, or PSY with LC or HC diets lowered plasma and hepatic cholesterol concentrations (P < 0.001). PE and PSY up-regulated 7 alpha-hydroxylase activity 3-fold with LC and PE by 5-fold with HC diets. In contrast, GG intake had no effect on 7 alpha-hydroxylase activity. Cholesterol absorption was reduced 30% by PE intake while no differences were found between control and PSY groups. GG reduced cholesterol absorption only with HC diets. Intake of PE, GG, or PSY with HC diets resulted in faster plasma LDL fractional catabolic rates (FCR) (P < 0.01) with no effect on LDL apoB flux rates (FR) or pool size, suggesting that fiber reduced LDL cholesterol concentration without decreasing the number of LDL particles. In addition to reducing LDL apoB FR, PE and PSY increased LDL FCR with HC diets while GG effects were limited to lowering LDL apoB FR. These results indicate that the distinctive reductions in hepatic cholesterol induced by PE, GG, and PSY associated with plasma cholesterol lowering result from different mechanisms specific to each fiber and that the levels of dietary cholesterol contribute to the different metabolic responses.

Analysis of Variance↗
PubMed2004

The gel-forming polysaccharide of psyllium husk (Plantago ovata Forsk).

The physiologically active, gel-forming fraction of the alkali-extractable polysaccharides of Plantago ovata Forsk seed husk (psyllium seed) and some derived partial hydrolysis products were studied by compositional and methylation analysis and NMR spectroscopy. Resolving the conflicting claims of previous investigators, the material was found to be a neutral arabinoxylan (arabinose 22.6%, xylose 74.6%, molar basis; only traces of other sugars). With about 35% of nonreducing terminal residues, the polysaccharide is highly branched. The data are compatible with a structure consisting of a densely substituted main chain of beta-(1-->4)-linked D-xylopyranosyl residues, some carrying single xylopyranosyl side chains at position 2, others bearing, at position 3, trisaccharide branches having the sequence L-Araf-alpha-(1-->3)-D-Xylp-beta-(1-->3)-l-Araf. The presence of this sequence is supported by methylation and NMR data, and by the isolation of the disaccharide 3-O-beta-D-xylopyranosyl-L-arabinose as a product of partial acid hydrolysis of the polysaccharide.

Arabinose↗
PubMed1999

Pectin and psyllium decrease the susceptibility of LDL to oxidation in guinea pigs.

These studies were undertaken to determine whether pectin (PE) and psyllium (PSY) intake affect the circulating levels of alpha-tocopherol and the susceptibility of low density lipoprotein (LDL) to oxidation. For that purpose, male Hartley guinea pigs were fed 19 g/100 g of a fat mix with a 2:1:1 ratio of saturated:polyunsaturated:monounsaturated fatty acids and 35 g/100 g total carbohydrate with 80% of the carbohydrate energy contributed by sucrose. Diets were identical in composition except for the fiber source: cellulose (control diet), PE, or PSY. Guinea pigs fed PE or PSY had 36% and 67% lower plasma cholesterol concentrations, respectively, compared with controls (P < 0.001). This plasma cholesterol lowering was associated with both very low density lipoproteins and LDL cholesterol fractions. Intake of PE or PSY resulted in 54% lower plasma triacylglycerol (TAG) concentrations compared with the control group (P < 0.001). LDL from PE and PSY fed guinea pigs contained fewer molecules of cholesteryl ester, and alpha-tocopherol concentrations in this particle were 49% and 66% higher, respectively, compared with controls. In addition, LDL from guinea pigs fed soluble fiber exhibited less susceptibility to oxidation than those from the control group, as determined by thiobarbituric acid-reactive substances formation. Hepatic free and esterified cholesterol were 32% lower and hepatic TAG was 25% lower in guinea pigs fed PE and PSY compared with controls. The data from these studies confirm that PE and PSY reverse the hyperlipidemia associated with high fat-sucrose diets and demonstrate a potential antioxidant effect of soluble fiber on circulating LDL.

Journal Article↗