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Soluble fibre (Plantago ovata husk) reduces plasma low-density lipoprotein (LDL) cholesterol, triglycerides, insulin, oxidised LDL and systolic blood pressure in hypercholesterolaemic patients: A randomised trial

      Abstract

      The objective was to evaluate whether the soluble fibre Plantago ovata (Po)-husk improves cardiovascular disease (CVD) risk biomarkers including low-density lipoprotein cholesterol (LDL-C).

      Methods

      In a multi-centred, double-blind, placebo-controlled, parallel, randomised trial conducted in primary care-clinics in Spain, France and Holland, mild-moderate hypercholesterolaemic patients (age range: 43–67 years) received 14 g/d of Po-husk (n = 126) or placebo (microcrystalline-cellulose 14 g/d; n = 128) in a low saturated fat diet for 8 weeks. Subsequently, if LDL-C remained ≥3.35 mmol/L [130 mg/dL], participants proceeded with the fibre plus simvastatin (20 mg/d) for further 8 weeks. Lipid profile, blood pressure (BP), insulin, oxidised LDL and some gene polymorphisms involved in CVD risk were measured.

      Results

      Relative to placebo, Po-husk reduced plasma LDL-C by −6% (P < 0.0002), total cholesterol (TC) by −6%, triglycerides (TG) by −21.6%, apolipoprotein (Apo) B-100 by −6.7%, oxidised LDL by a mean of −6.82 U/L (95%CI: 3.15–10.48), insulin by −4.68 pmol/L (95%CI: 0.68–8.67) and systolic BP by −4.0 mm Hg (95%CI; 1.2–6.7) (P < 0.05). The TG-lowering effect in the Po-husk group was magnified by variants in plasminogen-activator-inhibitor (PAI-1; rs1799768) and fatty acid-binding protein (FABP-2; rs1799883) genes. At 16 weeks, the intra-group action of simvastatin (20 mg/d) added to Po-husk or placebo was a similar LDL-C reduction.

      Conclusions

      Po-husk, apart from lowering LDL-C, also reduced TG, TG related to certain gene variants, TC, Apo B-100, oxLDL, insulin-resistance and systolic BP in mild-moderate hypercholesterolaemic individuals.
      Thus, the target patients to receive Po-husk would be those who present a cluster of various CVD risk factors, such as metabolic syndrome.

      Keywords

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      References

        • Graham I.
        • Atar D.
        • Borch-Johnsen K.
        • et al.
        European guidelines on cardiovascular disease prevention in clinical practice: executive summary.
        Eur Heart J. 2007; 28: 2375-2414
        • Grundy S.M.
        Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines.
        JACC. 2004; 44: 720-732
        • Anderson J.W.
        • Baird P.
        • Davis Jr., R.H.
        • et al.
        Health benefits of dietary fiber.
        Nutr Rev. 2009; 67: 188-205
        • Sierra M.
        • García J.J.
        • Fernández N.
        • Diez M.J.
        • Calle A.P.
        Farmafibra group. Therapeutic effects of psyllium in type 2 diabetic patients.
        Eur J Clin Nutr. 2002; 56: 830-842
        • Brown L.
        • Rosner B.
        • Willett W.W.
        • Sacks F.M.
        Cholesterol-lowering effects of dietary fiber: a meta-analysis.
        Am J Clin Nutr. 1999; 69: 30-42
        • Solà R.
        • Godàs G.
        • Ribalta J.
        • et al.
        Effects of soluble fiber (Plantago ovata husk) on plasma lipids, lipoproteins, and apolipoproteins in men with ischemic heart disease.
        Am J Clin Nutr. 2007; 85: 1157-1163
        • Galisteo M.
        • Morón R.
        • Rivera L.
        • et al.
        Plantago ovata husks-supplemented diet ameliorates metabolic alterations in obese Zucker rats through activation of AMP-activated protein kinase. Comparative study with other dietary fibers.
        Clin Nutr. 2009; ([Epub ahead of print])
        • Anderson J.W.
        • Randles K.M.
        • Kendall C.W.C.
        • Jenkins D.J.A.
        Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence.
        J Am Coll Nutr. 2004; 23: 5-17
        • Salas-Salvadó J.
        • Farrés X.
        • Luque X.
        • et al.
        Effect of two doses of a mixture of soluble fibres on body weight and metabolic variables in overweight or obese patients: a randomised trial.
        Br J Nutr. 2008; 99: 1380-1387
        • Ordovas J.M.
        • Tai E.S.
        Why study gene–environment interactions?.
        Curr Opin Lipidol. 2008; 19: 158-167
        • Friedewald W.T.
        • Levy R.I.
        • Fredrickson D.S.
        Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.
        Clin Chem. 1972; 18: 499-502
        • Matthews D.R.
        • Hosker J.P.
        • Rudenski A.S.
        • et al.
        Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.
        Diabetologia. 1985; 28: 412-419
        • Brunzell J.D.
        • Hypertriglyceridemia
        N Engl J Med. 2007; 357: 1009-1017
        • Meisinger C.
        • Baumert J.
        • Khuseyinova N.
        • Loewel H.
        • Koenig W.
        Plasma oxidized low-density lipoprotein, a strong predictor for acute coronary heart disease events on apparently healthy, middle-aged men from the general population.
        Circulation. 2005; 112: 651-657
        • Fitó M.
        • Guxens M.
        • Corella D.
        • et al.
        Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial.
        Arch Intern Med. 2007; 167: 1195-1203
        • Whelton S.P.
        • Hyre A.D.
        • Pedersen B.
        • et al.
        Effect of dietary fiber intake on blood pressure: a meta-analysis of randomized, controlled clinical trials.
        J Hypertens. 2005; 23: 475-481
        • Landmesser U.
        • Drexler H.
        Endothelial function and hypertension.
        Curr Opin Cardiol. 2007; 22: 316-320
        • Guxens M.
        • Fitó M.
        • Martínez-González M.A.
        • et al.
        Hypertensive status and lipoprotein oxidation in an elderly population at high cardiovascular risk.
        Am J Hypertens. 2009; 22: 68-73
        • Ceriello A.
        Possible role of oxidative stress in the pathogenesis of hypertension.
        Diabetes Care. 2008; 31: S181-S184
        • Morgan T.O.
        • Anderson A.I.
        • MacInnis R.J.
        ACE inhibitors, beta-blockers, calcium blockers, and diuretics for the control of systolic hypertension.
        Am J Hypertens. 2001; 14: 241-247
        • Tuan C.-Y.
        • Abbasi F.
        • Lamendola C.
        • McLaughlin T.
        • Reaven G.
        Usefulness of plasma glucose and insulin concentrations in identifying patients with insulin resistance.
        Am J Cardiol. 2003; 92: 606-610
        • Holvoet P.
        • Lee D.H.
        • Steffes M.
        • Gross M.
        • Jacobs Jr., D.R.
        Association between circulating oxidized low-density lipoprotein and incidence of the metabolic syndrome.
        JAMA. 2008; 299: 2287-2293
        • Moreyra A.E.
        • Wilson A.C.
        • Koraym A.
        Effect of combining psyllium fiber with simvastatin in lowering cholesterol.
        Arch Intern Med. 2005; 165: 1161-1166