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Original Research Communication |
1 From the Clinical Nutrition and Risk Factor Modification Center, St Michael'sHospital, Toronto (DJAJ, CWCK, VV, EV, TP, DF, and CCM); the Departments of Nutritional Sciences (DJAJ, CWCK, VV, EV, SCC, and MAR) and Preventive Medicine and Biostatistics (PNC), Faculty of Medicine, University of Toronto; and the Department of Food Science Technology and Microbiology, Division of Human Nutrition, University of Milan, Milan, Italy (MG and GT).
Background: The US Food and Drug Administration (FDA) approved health claims for 2 dietary fibers, ß-glucan (0.75 g/serving) and psyllium (1.78 g/serving), on the assumption that 4 servings/d would reduce cardiovascular disease risk.
Objective: We assessed the efficacy of this dose of fibers in reducing serum lipid risk factors for cardiovascular disease.
Design: Sixty-eight hyperlipidemic adults consumed a test (high-fiber) and a control low-fat (25% of energy), low-cholesterol (<150 mg/d) diet for 1 mo each in a randomized crossover study. The high-fiber diet included 4 servings/d of foods containing ß-glucan or psyllium that delivered 8 g/d more soluble fiber than did similar, unsupplemented foods in the control diet. Fasting blood samples and blood pressure readings were obtained at baseline and weeks 2 and 4, and the subjects' weight was monitored weekly.
Results: Compared with the control diet, the high-fiber diet reduced total cholesterol (2.1 ± 0.7%; P = 0.003), total:HDL cholesterol (2.9 ± 0.8%; P = 0.001), LDL:HDL cholesterol (2.4 ± 1.0%; P = 0.015), and apolipoprotein B:A-I (1.4 ± 0.8%; P = 0.076). Applying the Framingham cardiovascular disease risk equation to the data confirmed a reduction in risk of 4.2 ± 1.4% (P = 0.003). Small reductions in blood pressure were found after both diets. The subjects reported no significant differences in palatability or gastrointestinal symptoms between the diets.
Conclusions: The reduction in serum lipid risk factors for cardiovascular disease supports the FDA'sapproval of a health claim for a dietary fiber intake of 4 servings/d. Although relatively small in terms of patient treatment, the reduction in cardiovascular disease risk is likely to be significant on a population basis.
Key Words: Soluble fiber • psyllium • oats • ß-glucan • LDL cholesterol • HDL cholesterol • coronary artery disease • National Cholesterol Education Program • Food and Drug Administration • health claim • functional foods
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