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American Journal of Clinical Nutrition, Vol. 69, No. 1, 30-42, January 1999
© 1999 American Society for Clinical Nutrition


Original Research Communications

Cholesterol-lowering effects of dietary fiber: a meta-analysis1,2

Lisa Brown, Bernard Rosner, Walter W Willett and Frank M Sacks

Background: The effects of dietary soluble fibers on blood cholesterol are uncertain.

Objective: This meta-analysis of 67 controlled trials was performed to quantify the cholesterol-lowering effect of major dietary fibers.

Design: Least-squares regression analyses were used to test the effect on blood lipids of pectin, oat bran, guar gum, and psyllium. Independent variables were type and amount of soluble fiber, initial cholesterol concentration, and other important study characteristics.

Results: Soluble fiber, 2–10 g/d, was associated with small but significant decreases in total cholesterol [-0.045 mmol{bullet}L-1{bullet}g soluble fiber-1 (95% CI: -0.054, -0.035)] and LDL cholesterol [-0.057 mmol{bullet}L-1{bullet}g-1 (95% CI: -0.070, -0.044)]. The effects on plasma lipids of soluble fiber from oat, psyllium, or pectin were not significantly different. We were unable to compare effects of guar because of the limited number of studies using 2–10 g/d. Triacylglycerols and HDL cholesterol were not significantly influenced by soluble fiber. Lipid changes were independent of study design, treatment length, and background dietary fat content.

Conclusions: Various soluble fibers reduce total and LDL cholesterol by similar amounts. The effect is small within the practical range of intake. For example, 3 g soluble fiber from oats (3 servings of oatmeal, 28 g each) can decrease total and LDL cholesterol by <0.13 mmol/L. Increasing soluble fiber can make only a small contribution to dietary therapy to lower cholesterol. Am J Clin Nutr 1999;69:30–42.

Key Words: Meta-analysis • humans • controlled trials • total cholesterol • low-density-lipoprotein cholesterol • LDL cholesterol • high-density-lipoprotein cholesterol • HDL cholesterol • triacylglycerols • dose response • fiber




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