Psyllium — fiber for constipation and cholesterol?

Aim of the study: Some studies indicate that psyllium supplementation may change lipid profile levels. This study assessed the impact of psyllium consumption on lipid profile (Low-Density Lipoprotein Cholesterol, Triglyceride, High-Density Lipoprotein Cholesterol, and cholesterol).

Results: Results showed that psyllium can significantly decrease Low-Density Lipoprotein Cholesterol and total cholesterol, can insignificantly decrease triglyceride, and can insignificantly increase High-Density Lipoprotein Cholesterol following psyllium consumption.

Aim of the study: To compare the effects of baked psyllium supplementation versus those who received a placebo on constipation symptoms, body weight, glycemic and lipids control in patients with type 2 diabetes (T2D) and chronic constipation.

Results: The psyllium group showed improvement in constipation symptoms, body weight, glucose and lipid values compared with the baseline and the placebo group. Body weight and FPG decreased from baseline in the psyllium group (P < 0.001 and P = 0.056, respectively). The differences (95% CI) of absolute change of body weight (-2.0 (-3.0, -1.0) kg; P < 0.001), FPG (-13.6 (-24.3, -2.9) mg/dl; P = .040), and HbA1c (-1.7 (-2.9, -0.5)); P = 0.002) between the groups were statistically significant. Cholesterol (-21.5 (-25.6, -14.4); P < 0.001), triglycerides (-20.0 (-32.3, -7.7); P = 0.021) and constipation symptoms (1.5 (0.4, 2.3); P < 0.001) decreased in the psyllium group. The compliance was good and no adverse effects were observed. In patients with T2D and chronic constipation, psyllium supplementation decreased constipation symptoms, body weight, glycemic, cholesterol, and increased HDLC levels.

Aim of the study: Both flaxseed and psyllium have previously been shown to reduce constipation symptoms, weight, glycemic and lipid levels, and we postulate that treatment with flaxseed and psyllium may have similar benefits. To compare constipation symptoms, weight, glycemia, and lipids in constipated patients with type 2 diabetes (T2D) who received baked flaxseed or psyllium versus those who received a placebo.

Results: The flaxseed appear to be superior to psyllium for improving constipation symptoms, weight, glycemic, and lipid control. The change from baseline of constipation symptoms (P = 0.002), stool consistency (P < 0.001), weight (P < 0.001), BMI (P < 0.001), FPG (P = 0.004), cholesterol (P = 0.010), LDLC (P = 0.031), and cholesterol/HDLC ratio (P = 0.019), was significantly improved in both flaxseed and psyllium groups than in the placebo group. The compliance was good and no adverse effects were observed. Although both flaxseed and psyllium may decrease constipation symptoms, weight, glycemic and lipid levels, treatment with flaxseed appear to be superior to psyllium.

Aim of the study: To evaluate the clinical efficacy of laxatives with different pharmacological effects in the combination therapy in patients with chronic constipation (CC) concurrent with obesity, hypertensive disease, and type 2 diabetes mellitus (DM).

Results: The patients taking psyllium to treat constipation showed an increasing frequency of defecations and normalization of stool consistency. Incorporating psyllium into combination therapy was accompanied by a significant decrease in the levels of total cholesterol and low-density lipoprotein cholesterol. A similar trend was observed for serum triglycerides. The patients receiving combination therapy including other laxatives displayed no significant differences between lipid metabolic parameters at the beginning and after the end of treatment. The whole complex of properties of psyllium (Mucofalk) can be fully realized in patients with comorbidity and chronic constipation, which is accompanied not only by the normalization of bowel emptying, but also by marked positive changes in the main lipid metabolic parameters and by a reduction in overweight.

Aim of the study: Despite known cholesterol lowering effects the use of psyllium husk (Plantaginis ovatae testa) in Germany for hypercholesterolemia is limited compared to their use as a laxative. To investigate whether use in hypercholesterolemia is limited due to adverse effects on the gastrointestinal system, a prospective observational study was conducted.

Results: Fifty-four of 62 patients enrolled in the study completed the study protocol with 4 subjects discontinuing due to adverse reactions associated with psyllium husks. Total cholesterol was significantly decreased from 252+/-39mg/dl before treatment to 239+/-37mg/dl after 3 weeks of treatment. Similarly, low density lipoprotein (LDL)-cholesterol decreased from 174+/-34 to 162+/-31mg/dl during the study. Triglycerides and high density lipoprotein (HDL) were unchanged. Gastrointestinal symptoms were rated lower at the end than at the beginning of the study. In week 1 most of the patients reported gastrointestinal symptoms and also gastrointestinal adverse reactions, which however, showed a decrease from week 1 to weeks 2 and 3 in the diaries. Patient response to study medication was positive for patients completing the study. Psyllium husk preparations may be a therapeutic option for patients with mild to moderately elevated cholesterol levels.

Aim of the study: Enduring misconceptions about the physical effects of fiber in the gut have led to misunderstandings about the health benefits attributable to insoluble and soluble fiber. This review will focus on isolated functional fibers (eg, fiber supplements) whose effects on clinical outcomes have been readily assessed in well-controlled clinical studies.

Results: In the large bowel, there are only two mechanisms that drive a laxative effect: large/coarse insoluble fiber particles (eg, wheat bran) mechanically irritate the gut mucosa stimulating water and mucous secretion, and the high water-holding capacity of gel-forming soluble fiber (eg, psyllium) resists dehydration. Both mechanisms require that the fiber resist fermentation and remain relatively intact throughout the large bowel (ie, the fiber must be present in stool), and both mechanisms lead to increased stool water content, resulting in bulky/soft/easy-to-pass stools. Soluble fermentable fibers (eg, inulin, fructooligosaccharide, and wheat dextrin) do not provide a laxative effect, and some fibers can be constipating (eg, wheat dextrin and fine/smooth insoluble wheat bran particles).

Aim of the study: This review was conducted to examine the promising health benefits of psyllium, its therapeutic potential in relation to various chronic diseases, its mechanisms, and its possible side effects or toxicity; to explore its applications in food systems; to identify the positive and negative effects of its consumption; and to provide perspectives for future research and development efforts for psyllium.

Results: Psyllium, also known as ispaghula, is a dietary fiber obtained from the shells of Plantago ovata seeds. The most abundant monosaccharides in its composition are xylose and arabinose. Psyllium is a natural alternative to the use of food additives such as gum and hydrocolloid to increase the fiber content in fortified foods. Psyllium may have therapeutic effects on various diseases. In recent years, its potential in the management of conditions such as hypertension, diabetes, and liver disease has been emphasized and multifaceted therapeutic applications have been introduced. Psyllium may help to regulate blood glucose, blood pressure and cholesterol levels. It may also increase feelings of fullness and reduce food intake. Furthermore, psyllium may promote bowel regularity and improve the composition of gut microbiota. Psyllium has been reported to exhibit antioxidant and antimicrobial properties, as well as reducing inflammatory mediators such as TNF-α and nitric oxide.