Fiber supplement may substitute for cholesterol-lowering drugs

June 01, 2000

It may be possible for some patients battling high cholesterol to diminish or even eliminate their need for drug treatment by adding fiber to a healthy diet, according to results of a study by James W. Anderson, M.D., professor of medicine and clinical nutrition at the University of Kentucky College of Medicine.

Psyllium in the form of fiber supplements may reduce harmful cholesterol by as much as 5 percent, Anderson found. Published in the June issue of the American Journal of Clinical Nutrition, results of the new long-term study confirm findings from his previous studies.

"That translates into a 10 to 15 percent reduction in risk for heart attack, so it's clearly substantial," Anderson said. "That would put about 15 percent of people with high cholesterol into a lower, safer level." The Food and Drug Administration already allows fiber supplements to claim they have a cholesterol-lowering effect. The 250-patient multi-center study compared those taking Metamucil, a fiber supplement, to individuals getting an inactive substitute for six months. Both groups had elevated blood cholesterol levels and also were on reduced fat diets. The participants were told to mix their similar-tasting orange powders with liquid and drink them twice daily, before breakfast and dinner.

Anderson found the psyllium compound consistently put patients in lower cholesterol categories compared to the placebo treatment. The benefit particularly is striking for so-called low density lipoproteins. There Anderson says the reduction of these harmful chemicals is 10 percent, or about one-third to one-half what a person might expect from statins, which are cholesterol-reducing drugs.

"When people learn they have a high blood cholesterol, or if they have family histories of cholesterol concern, they should consider psyllium on a regular basis," Anderson said. His study was paid for by Procter & Gamble, Metamucil's manufacturer.

Although statins are considered powerful and safe cholesterol reducers, some patients don't tolerate them well, Anderson said, and others don't want to take medications. The study shows that combining psyllium with a healthy diet could be a logical substitute, although it can cause gas or a change in bowel patterns.

Psyllium apparently lowers cholesterol by dragging bile acids out of the body during bowel movements. These substances otherwise would be converted into cholesterol, Anderson said. Other foods, such as soy protein and oat bran, also can reduce cholesterol but they may not be as convenient or available as psyllium supplements.

University of Kentucky Medical Center

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