SOLUBLE FIBER ENHANCES THE HYPOCHOLESTEROLEMIC EFFECT OF THE STEP-I DIET IN CHILDHOOD

Background: Psyllium, a water-soluble fiber, has been shown to have a cholesterol-lowering effect in studies of adults. A small number of st udies in children have produced variable results. Methods: A 12-week, randomized, single-blind, placebo-controlled, parallel clinical trial was conducted to test the effectiveness of psyllium in lowering total (TC) and low-density lipoprotein cholesterol (LDL-C) in 50 healthy 2 t o 11 year old children. Children with two baseline LDL-C levels greate r than or equal to 110 mg/dL were invited to participate in the trial, and were randomly assigned to follow a usual Step I (Control) diet of low dietary fat, saturated fat and cholesterol, or a Step I diet enri ched with psyllium. Children consumed two 1-oz boxes of cereal per day , with each box of psyllium-enriched cereal containing 3.2 g of solubl e fiber, and each box of placebo cereal containing less than 0.5 g of soluble fiber. Results: Greater reduction of total and LDL-cholesterol , and increase in HDL-cholesterol were noted after 12 weeks of the psy llium-enriched Step I diet compared to the Step I control diet. Total cholesterol decreased 21 mg/dL for the high fiber group compared with 11.5 mg/dL for the control group. LDL-C decreased 23 mg/dL for the hig h fiber group compared with 8.5 mg/dL for the control group. HDL-C inc reased 4 mg/dL for the high fiber group compared with 1 mg/dL for the controls. TC/HDL and LDL/HDL ratios decreased significantly more so fo r the high fiber group as well. Conclusions: In this 12-week study, so luble fiber (psyllium) provided added benefit to the Step I diet in th e treatment of hypercholesterolemia.