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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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Clinical nutrition: 7. Functional foods -- more than just nutrition
Can. Med. Assoc. J., June 1, 2002; 166(12): 1555 - 1563.
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J. Nutr.Home page
A. L. Romero, K. L. West, T. Zern, and M. L. Fernandez
The Seeds from Plantago ovata Lower Plasma Lipids by Altering Hepatic and Bile Acid Metabolism in Guinea Pigs
J. Nutr., June 1, 2002; 132(6): 1194 - 1198.
[Abstract] [Full Text] [PDF]


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Am. J. Clin. Nutr.Home page
D. J. Jenkins, C. W. Kendall, V. Vuksan, E. Vidgen, T. Parker, D. Faulkner, C. C Mehling, M. Garsetti, G. Testolin, S. C Cunnane, et al.
Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial
Am. J. Clinical Nutrition, May 1, 2002; 75(5): 834 - 839.
[Abstract] [Full Text] [PDF]


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J. Nutr.Home page
E. B. Feldman
The Scientific Evidence for a Beneficial Health Relationship Between Walnuts and Coronary Heart Disease
J. Nutr., May 1, 2002; 132(5): 1062S - 1101.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
E. A. Lucas, R. D. Wild, L. J. Hammond, D. A. Khalil, S. Juma, B. P. Daggy, B. J. Stoecker, and B. H. Arjmandi
Flaxseed Improves Lipid Profile without Altering Biomarkers of Bone Metabolism in Postmenopausal Women
J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1527 - 1532.
[Abstract] [Full Text] [PDF]


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J. Nutr.Home page
B. M. Davy, C. L. Melby, S. D. Beske, R. C. Ho, L. R. Davrath, and K. P. Davy
Oat Consumption Does Not Affect Resting Casual and Ambulatory 24-h Arterial Blood Pressure in Men with High-Normal Blood Pressure to Stage I Hypertension
J. Nutr., March 1, 2002; 132(3): 394 - 398.
[Abstract] [Full Text] [PDF]


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JAMAHome page
A. Jula, J. Marniemi, R. Huupponen, A. Virtanen, M. Rastas, and T. Ronnemaa
Effects of Diet and Simvastatin on Serum Lipids, Insulin, and Antioxidants in Hypercholesterolemic Men: A Randomized Controlled Trial
JAMA, February 6, 2002; 287(5): 598 - 605.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
S. Liu, J. E. Buring, H. D. Sesso, E. B. Rimm, W. C. Willett, and J. E. Manson
A prospective study of dietary fiber intake and risk of cardiovascular disease among women
J. Am. Coll. Cardiol., January 2, 2002; 39(1): 49 - 56.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
W. D. Rosamond
Dietary fiber and prevention of cardiovascular disease
J. Am. Coll. Cardiol., January 2, 2002; 39(1): 57 - 59.
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Diabetes CareHome page
M. J. Franz, J. P. Bantle, C. A. Beebe, J. D. Brunzell, J.-L. Chiasson, A. Garg, L. A. Holzmeister, B. Hoogwerf, E. Mayer-Davis, A. D. Mooradian, et al.
Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications
Diabetes Care, January 1, 2002; 25(1): 148 - 198.
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CMAJHome page
J. Hoey
Clinical nutrition: a new series
Can. Med. Assoc. J., November 1, 2001; 165(10): 1343 - 1343.
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Am. J. Clin. Nutr.Home page
S. Vega-Lopez, R. L. Vidal-Quintanar, and M. L. Fernandez
Sex and hormonal status influence plasma lipid responses to psyllium
Am. J. Clinical Nutrition, October 1, 2001; 74(4): 435 - 441.
[Abstract] [Full Text] [PDF]


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J. Am. Coll. Nutr.Home page
V. Vuksan, J. L. Sievenpiper, Z. Xu, E. Y. Y. Wong, A. L. Jenkins, U. Beljan-Zdravkovic, L. A. Leiter, R. G. Josse, and M. P. Stavro
Konjac-Mannan and American Ginsing: Emerging Alternative Therapies for Type 2 Diabetes Mellitus
J. Am. Coll. Nutr., October 1, 2001; 20(90005): 370S - 380.
[Abstract] [Full Text]


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Am. J. Clin. Nutr.Home page
E. Obarzanek, F. M Sacks, W. M Vollmer, G. A Bray, E. R Miller III, P.-H. Lin, N. M Karanja, M. M Most-Windhauser, T. J Moore, J. F Swain, et al.
Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial
Am. J. Clinical Nutrition, July 1, 2001; 74(1): 80 - 89.
[Abstract] [Full Text] [PDF]


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J. Nutr.Home page
I. Bourdon, B. Olson, R. Backus, B. D. Richter, P. A. Davis, and B. O. Schneeman
Beans, as a Source of Dietary Fiber, Increase Cholecystokinin and Apolipoprotein B48 Response to Test Meals in Men
J. Nutr., May 1, 2001; 131(5): 1485 - 1490.
[Abstract] [Full Text]


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J. Nutr.Home page
R. M. Krauss, R. H. Eckel, B. Howard, L. J. Appel, S. R. Daniels, R. J. Deckelbaum, J. W. Erdman Jr, P. Kris-Etherton, I. J. Goldberg, T. A. Kotchen, et al.
AHA Scientific Statement: AHA Dietary Guidelines: Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
J. Nutr., January 1, 2001; 131(1): 132 - 146.
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StrokeHome page
R. M. Krauss, R. H. Eckel, B. Howard, L. J. Appel, S. R. Daniels, R. J. Deckelbaum, J. W. Erdman Jr, P. Kris-Etherton, I. J. Goldberg, T. A. Kotchen, et al.
AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Stroke, November 1, 2000; 31(11): 2751 - 2766.
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J. Nutr.Home page
D. M. Deming, A. C. Boileau, C. M. Lee, and J. W. Erdman Jr.
Amount of Dietary Fat and Type of Soluble Fiber Independently Modulate Postabsorptive Conversion of {beta}-Carotene to Vitamin A in Mongolian Gerbils
J. Nutr., November 1, 2000; 130(11): 2789 - 2796.
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CirculationHome page
R. M. Krauss, R. H. Eckel, B. Howard, L. J. Appel, S. R. Daniels, R. J. Deckelbaum, J. W. Erdman Jr, P. Kris-Etherton, I. J. Goldberg, T. A. Kotchen, et al.
AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Circulation, October 31, 2000; 102(18): 2284 - 2299.
[Full Text] [PDF]


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J. Am. Coll. Nutr.Home page
J. W. Anderson, E. C. Konz, and D. J. A. Jenkins
Health Advantages and Disadvantages of Weight-Reducing Diets: A Computer Analysis and Critical Review
J. Am. Coll. Nutr., October 1, 2000; 19(5): 578 - 590.
[Abstract] [Full Text] [PDF]


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Arch Intern MedHome page
R. E. Patterson, A. R. Kristal, J. C. Peters, M. L. Neuhouser, C. L. Rock, L. J. Cheskin, D. Neumark-Sztainer, and M. D. Thornquist
Changes in Diet, Weight, and Serum Lipid Levels Associated With Olestra Consumption
Arch Intern Med, September 25, 2000; 160(17): 2600 - 2604.
[Abstract] [Full Text] [PDF]


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Am. J. Clin. Nutr.Home page
J. A Lovegrove, A. Clohessy, H. Milon, and C. M Williams
Modest doses of {beta}-glucan do not reduce concentrations of potentially atherogenic lipoproteins
Am. J. Clinical Nutrition, July 1, 2000; 72(1): 49 - 55.
[Abstract] [Full Text] [PDF]


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NEJMHome page
M. Chandalia, A. Garg, D. Lutjohann, K. von Bergmann, S. M. Grundy, and L. J. Brinkley
Beneficial Effects of High Dietary Fiber Intake in Patients with Type 2 Diabetes Mellitus
N. Engl. J. Med., May 11, 2000; 342(19): 1392 - 1398.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
S. A. Smith-Warner, P. J. Elmer, T. M. Tharp, L. Fosdick, B. Randall, M. Gross, J. Wood, and J. D. Potter
Increasing Vegetable and Fruit Intake: Randomized Intervention and Monitoring in an At-Risk Population
Cancer Epidemiol. Biomarkers Prev., March 1, 2000; 9(3): 307 - 317.
[Abstract] [Full Text]


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J. Nutr.Home page
B. Sandström, S. Bügel, B. A. McGaw, J. Price, and M. D. Reid
A High Oat-Bran Intake Does Not Impair Zinc Absorption in Humans When Added to a Low-Fiber Animal Protein-Based Diet
J. Nutr., March 1, 2000; 130(3): 594 - 599.
[Abstract] [Full Text]


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J. Nutr.Home page
S. Roy, S. Vega-Lopez, and M. L. Fernandez
Gender and Hormonal Status Affect the Hypolipidemic Mechanisms of Dietary Soluble Fiber in Guinea Pigs
J. Nutr., March 1, 2000; 130(3): 600 - 607.
[Abstract] [Full Text]


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Am. J. Clin. Nutr.Home page
D. J. Jenkins, C. W. Kendall, and V. Vuksan
Viscous fibers, health claims, and strategies to reduce cardiovascular disease risk1
Am. J. Clinical Nutrition, February 1, 2000; 71(2): 401 - 402.
[Full Text] [PDF]


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J. Am. Coll. Nutr.Home page
D. J.A. Jenkins and C. W.C. Kendall
Plant Sterols, Health Claims and Strategies to Reduce Cardiovascular Disease Risk
J. Am. Coll. Nutr., December 1, 1999; 18(6): 559 - 562.
[Full Text] [PDF]


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Am. J. Clin. Nutr.Home page
A S. Truswell
Meta-analysis of the cholesterol-lowering effects of dietary fiber
Am. J. Clinical Nutrition, November 1, 1999; 70(5): 942 - 943.
[Full Text]


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Am. J. Clin. Nutr.Home page
L. Brown, B. Rosner, W. Willett, and F. M Sacks
Reply to AS Truswell
Am. J. Clinical Nutrition, November 1, 1999; 70(5): 943 - 943.
[Full Text]




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