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Effects of soluble fiber (Plantago ovata husk) on plasma lipids, lipoproteins, and apolipoproteins in men with ischemic heart disease^1,2,3

¹ From the Unitat de Recerca de Lípids i Arteriosclerosi, Hospital Universitari de Sant Joan, Facultat de Medicina, Universitat Rovira i Virgili, IRCIS, Reus, Spain (RS, GG, JR, J-CV, JG, JS, and LM); Research Department Madaus SA, Barcelona, Spain (AA); Unite d'Expression des Genes Eucaryotes, Institut Pasteur, Paris, France (MAO); the Laboratorio de Biología Molecular. Hospital Miguel Servet-I+CS, Spain (DR); the Department of Vascular Biochemistry, Queen Elizabeth Building, Glasgow Royal Infirmary University NHS Trust, Glasgow, United Kingdom (MC); Servei d'Atenció Primària Reus-Altebrat, Institut Català de la Salut, Reus, Spain (FM-L); Unitat de Nutrició Humana, Hospital Universitari de Sant Joan, Facultat de Medicina, Universitat Rovira i Virgili, IRCIS, Reus, Spain (JS-S)

Background: New dietary strategies to reduce cardiovascular disease (CVD) risk include the addition of fiber to the diet. The effect of soluble-fiber consumption derived from Plantago ovata husk on lipid risk factors in patients with CVD is unknown.

Objective: We compared the effects of soluble fiber (P. ovata husk) with those of insoluble fiber (P. ovata seeds) on plasma lipid, lipoprotein, and apolipoprotein (apo) concentrations within a CVD secondary prevention program.

Design: In a randomized, crossover, controlled, single-blind design, 28 men with CVD (myocardial infarction or stable angina) and an LDL-cholesterol concentration 3.35 mmol/L consumed for 8 wk, under controlled conditions, a low-saturated-fat diet supplemented with 10.5 g P. ovata husk/d or 10.5 g P. ovata seeds/d. Fasting plasma lipid concentrations and polymorphisms of genes involved in lipid metabolism, such as apo A-IV, apo E, and fatty acid–binding protein, were measured.

Results: Plasma triacylglycerol decreased (6.7%; P < 0.02), the ratio of apo B 100 to apo A-I decreased (4.7%; P < 0.02), and apo A-I increased (4.3%; P < 0.01) in the P. ovata husk consumers. Compared with the intake of insoluble fiber, the intake of P. ovata husk increased HDL-cholesterol concentrations by 6.7% (P = 0.006) and decreased the ratio of total to HDL cholesterol and of LDL to HDL cholesterol by 10.6% (P = 0.002) and 14.2% (P = 0.003), respectively.

Conclusion: In the secondary prevention of CVD, P. ovata husk intake induces a more beneficial effect on the cardiovascular lipid risk-factor profile than does an equivalent intake of insoluble fiber.

Key Words: Dietary fiber • Plantago ovata (Ispaghula husk) • psyllium • secondary prevention of cardiovascular disease • blood lipids • low saturated fat • FABP2 gene • apo A-IV gene • apo E gene • polymorphism