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Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia^1,2,3

¹ From the University of Kentucky and the Veterans Affairs Medical Center, Lexington; the Chicago Center for Clinical Research; the Ochsner Clinic, New Orleans; the Medlantic Research Institute, Washington, DC; the Department of Medicine, College of Physicians and Surgeons, Columbia University, New York; and The Procter & Gamble Company, Cincinnati.

Background: Hypercholesterolemia is a major risk factor for coronary heart disease and nutrition management is the initial therapeutic approach.

Objective: This multicenter study evaluated the long-term effectiveness of psyllium husk fiber as an adjunct to diet in the treatment of persons with primary hypercholesterolemia.

Design: Men and women with hypercholesterolemia were recruited. After following an American Heart Association Step I diet for 8 wk (dietary adaptation phase), eligible subjects with serum LDL-cholesterol concentrations between 3.36 and 4.91 mmol/L were randomly assigned to receive either 5.1 g psyllium or a cellulose placebo twice daily for 26 wk while continuing diet therapy.

Results: Serum total and LDL-cholesterol concentrations were 4.7% and 6.7% lower in the psyllium group than in the placebo group after 24–26 wk (P < 0.001). Other outcome measures did not differ significantly between groups.

Conclusions: Treatment with 5.1 g psyllium twice daily produces significant net reductions in serum total and LDL-cholesterol concentrations in men and women with primary hypercholesterolemia. Psyllium therapy is an effective adjunct to diet therapy and may provide an alternative to drug therapy for some patients.

Key Words: Psyllium • dietary fiber • hypercholesterolemia • total cholesterol • LDL cholesterol • men • women

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