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The effects of 12-week psyllium fibre supplementation or healthy diet on blood pressure and arterial stiffness in overweight and obese individuals

  • Sebely Pal (a1), Alireza Khossousi (a1), Colin Binns (a1), Satvinder Dhaliwal (a1) and Simone Radavelli-Bagatini (a1)...

Endothelial dysfunction and increased arterial stiffness occur early in the pathogenesis of the metabolic syndrome and they are both powerful independent predictors of cardiovascular risk. A high-fibre diet has been correlated with lower BMI and a lower incidence of hyperlipidaemia, CVD, hypertension and diabetes. The present randomised, parallel-design study compared the effects of fibre intake from a healthy diet v. fibre supplement diets on blood pressure (BP) and vascular function over 12 weeks. Overweight and obese adults were randomised to one of three groups: control (with placebo), fibre supplement (FIB) or healthy eating group with placebo (HLT). Systolic blood pressure (SBP) was lower in the FIB group compared with the control group at week 6, but not at week 12. However, SBP was lower in the HLT group compared with control group at week 12. At week 6, the FIB group presented lower diastolic blood pressure and augmentation index compared with the control group, but this result did not persist to the end of the study. The present study did not show any improvements in BP or vascular function in overweight and obese individuals with psyllium fibre supplementation over 12 weeks of intervention. However, a healthy diet provided the greatest improvements in BP in overweight and obese subjects. Further research with hypertensive individuals is necessary to elucidate whether increased fibre consumption in the form of psyllium supplementation may provide a safe and acceptable means to reduce BP, vascular function and the risk of developing CVD.

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*Corresponding author: Associate Professor S. Pal, fax +61 8 9266 2258, email
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1 WHO (2002) Nutrition: Controlling the Global Obesity Epidemic. Geneva: World Health Organization.
2 Popkin BM (2001) The nutrition transition and obesity in the developing world. J Nutr 131, 871S873S.
3 Isomaa B, Almgren P, Tuomi T, et al. (2001) Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24, 683689.
4 Grundy SM (2004) Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab 89, 25952600.
5 Cook S, Hugli O, Egli M, et al. (2003) Clustering of cardiovascular risk factors mimicking the human metabolic syndrome X in eNOS null mice. Swiss Med Wkly 133, 360363.
6 Appel LJ, Brands MW, Daniels SR, et al. (2006) Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 47, 296308.
7 Streppel MT, Arends LR, van't Veer P, et al. (2005) Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med 165, 150156.
8 Greger JL (1999) Nondigestible carbohydrates and mineral bioavailability. J Nutr 129, 1434S1435S.
9 Coudray C, Demigne C & Rayssiguier Y (2003) Effects of dietary fibers on magnesium absorption in animals and humans. J Nutr 133, 14.
10 He J, Klag MJ, Whelton PK, et al. (1995) Dietary macronutrients and blood pressure in southwestern China. J Hypertens 13, 12671274.
11 Stamler J, Caggiula AW & Grandits GA (1997) Relation of body mass and alcohol, nutrient, fiber, and caffeine intakes to blood pressure in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial. Am J Clin Nutr 65, 338S365S.
12 Birketvedt GS, Aaseth J, Florholmen JR, et al. (2000) Long-term effect of fibre supplement and reduced energy intake on body weight and blood lipids in overweight subjects. Acta Medica (Hradec Kralove) 43, 129132.
13 Eliasson K, Ryttig KR, Hylander B, et al. (1992) A dietary fibre supplement in the treatment of mild hypertension. A randomized, double-blind, placebo-controlled trial. J Hypertens 10, 195199.
14 Streppel MT, Arends LR, van 't Veer P, et al. (2005) Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med 165, 150156.
15 Ascherio A, Rimm EB, Giovannucci EL, et al. (1992) A prospective study of nutritional factors and hypertension among US men. Circulation 86, 14751484.
16 WHO (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Geneva: World Health Organization and FAO.
17 Burke V, Hodgson JM, Beilin LJ, et al. (2001) Dietary protein and soluble fiber reduce ambulatory blood pressure in treated hypertensives. Hypertension 38, 821826.
18 Whelton SP, Hyre AD, Pedersen B, et al. (2005) Effect of dietary fiber intake on blood pressure: a meta-analysis of randomized, controlled clinical trials. J Hypertens 23, 475481.
19 Solum TT, Ryttig KR, Solum E, et al. (1987) The influence of a high-fibre diet on body weight, serum lipids and blood pressure in slightly overweight persons. A randomized, double-blind, placebo-controlled investigation with diet and fibre tablets (DumoVital). Int J Obes 11, Suppl. 1, 6771.
20 Schlamowitz P, Halberg T, Warnoe O, et al. (1987) Treatment of mild to moderate hypertension with dietary fibre. Lancet 2, 622623.
21 Singh RB, Rastogi SS, Singh NK, et al. (1993) Can guava fruit intake decrease blood pressure and blood lipids? J Hum Hypertens 7, 3338.
22 He J, Streiffer RH, Muntner P, et al. (2004) Effect of dietary fiber intake on blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 22, 7380.
23 Galisteo M, Sanchez M, Vera R, et al. (2005) A diet supplemented with husks of Plantago ovata reduces the development of endothelial dysfunction, hypertension, and obesity by affecting adiponectin and TNF-{alpha} in obese Zucker rats. J Nutr 135, 23992404.
24 Obata K, Ikeda K, Yamasaki M, et al. (1998) Dietary fiber, psyllium, attenuates salt-accelerated hypertension in stroke-prone spontaneously hypertensive rats. J Hypertens 16, 19591964.
25 Li J, Wang J, Kaneko T, et al. (2004) Effects of fiber intake on the blood pressure, lipids, and heart rate in Goto Kakizaki rats. Nutrition 20, 10031007.
26 He J & Whelton PK (1999) Effect of dietary fiber and protein intake on blood pressure: a review of epidemiologic evidence. Clin Exp Hypertens 21, 785796.
27 Alaimo K, McDowell MA, Briefel RR, et al. (1994) Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988–91. Adv Data 128.
28 Marlett JA, McBurney MI & Slavin JL (2002) Position of the American Dietetic Association: health implications of dietary fiber. J Am Diet Assoc 102, 9931000.
29 State of Victoria (2008) Fibre in Food. Victoria, Australia: Department of Primary Industries.
30 National Health and Medical Research Council (2005) Nutrient reference values for Australia and New Zealand [NHaMR Council , editor]. Canberra: National Health and Medical Research Council.
31 Hense HW (2004) Once at risk–forever at risk? The long-term impact of cardiovascular risk factors on death. Eur J Epidemiol 19, 409410.
32 Wilkinson IB, Prasad K, Hall IR, et al. (2002) Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia. J Am Coll Cardiol 39, 10051011.
33 Blacher J & Safar ME (2005) Large-artery stiffness, hypertension and cardiovascular risk in older patients. Nat Clin Pract Cardiovasc Med 2, 450455.
34 Safar ME (2001) Systolic blood pressure, pulse pressure and arterial stiffness as cardiovascular risk factors. Curr Opin Nephrol Hypertens 10, 257261.
35 Tomiyama H, Hashimoto H, Hirayama Y, et al. (2006) Synergistic acceleration of arterial stiffening in the presence of raised blood pressure and raised plasma glucose. Hypertension 47, 180188.
36 Qureshi G, Brown R, Salciccioli L, et al. (2007) Relationship between aortic atherosclerosis and non-invasive measures of arterial stiffness. Atherosclerosis 195, e190e194.
37 Casey DP, Pierce GL, Howe KS, et al. (2007) Effect of resistance training on arterial wave reflection and brachial artery reactivity in normotensive postmenopausal women. Eur J Appl Physiol 100, 403408.
38 Greenwald SE (2007) Ageing of the conduit arteries. J Pathol 211, 157172.
39 McEniery CM, Wilkinson IB & Avolio AP (2007) Age, hypertension and arterial function. Clin Exp Pharmacol Physiol 34, 665671.
40 Ostmark E, Harrisson S, Wooley KL, et al. (2007) Comb polymers prepared by ATRP from hydroxypropyl cellulose. Biomacromolecules 8, 11381148.
41 McEniery CM & Cockcroft JR (2007) Does arterial stiffness predict atherosclerotic coronary events? Adv Cardiol 44, 160172.
42 Safar ME, Thomas F, Blacher J, et al. (2006) Metabolic syndrome and age-related progression of aortic stiffness. J Am Coll Cardiol 47, 7275.
43 Izzo JL Jr & Shykoff BE (2001) Arterial stiffness: clinical relevance, measurement, and treatment. Rev Cardiovasc Med 2, 2934, 37–40.
44 Scuteri A, Najjar SS, Muller DC, et al. (2004) Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness. J Am Coll Cardiol 43, 13881395.
45 Arnett DK, Tyroler HA, Burke G, et al. (1996) Hypertension and subclinical carotid artery atherosclerosis in blacks and whites. The Atherosclerosis Risk in Communities Study. ARIC Investigators. Arch Intern Med 156, 19831989.
46 Amar J, Ruidavets JB, Chamontin B, et al. (2001) Arterial stiffness and cardiovascular risk factors in a population-based study. J Hypertens 19, 381387.
47 Benetos A, Waeber B, Izzo J, et al. (2002) Influence of age, risk factors, and cardiovascular and renal disease on arterial stiffness: clinical applications. Am J Hypertens 15, 11011108.
48 Jenkins DJ, Kendall CW, Axelsen M, et al. (2000) Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease. Curr Opin Lipidol 11, 4956.
49 Salas-Salvado J, Bullo M, Perez-Heras A, et al. (2006) Dietary fibre, nuts and cardiovascular diseases. Br J Nutr 96, Suppl. 2, S46S51.
50 Jenkins DJ, Wolever TM, Rao AV, et al. (1993) Effect on blood lipids of very high intakes of fiber in diets low in saturated fat and cholesterol. N Engl J Med 329, 2126.
51 Brown L, Rosner B, Willett WW, et al. (1999) Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 69, 3042.
52 Bingham SA, Day NE, Luben R, et al. (2003) Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet 361, 14961501.
53 Ferrara LA, Guida L, Iannuzzi R, et al. (2002) Serum cholesterol affects blood pressure regulation. J Hum Hypertens 16, 337343.
54 Creager MA, Cooke JP, Mendelsohn ME, et al. (1990) Impaired vasodilation of forearm resistance vessels in hypercholesterolemic humans. J Clin Invest 86, 228234.
55 Laurenzi M, Mancini M, Menotti A, et al. (1990) Multiple risk factors in hypertension: results from the Gubbio study. J Hypertens Suppl 8, S7S12.
56 Hayakawa H & Raij L (1999) Relationship between hypercholesterolaemia, endothelial dysfunction and hypertension. J Hypertens 17, 611619.
57 Vallance P, Collier J & Moncada S (1989) Effects of endothelium-derived nitric oxide on peripheral arteriolar tone in man. Lancet ii, 9971000.
58 Anderson JW, Zeigler JA, Deakins DA, et al. (1991) Metabolic effects of high-carbohydrate, high-fiber diets for insulin-dependent diabetic individuals. Am J Clin Nutr 54, 936943.
59 Fukagawa NK, Anderson JW, Hageman G, et al. (1990) High-carbohydrate, high-fiber diets increase peripheral insulin sensitivity in healthy young and old adults. Am J Clin Nutr 52, 524528.
60 Ferrannini E, Buzzigoli G, Bonadonna R, et al. (1987) Insulin resistance in essential hypertension. N Engl J Med 317, 350357.
61 Pal S, Khossousi A, Binns C, et al. (2011) The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals. Br J Nutr 105, 90100.
62 Khossousi A, Binns CW, Dhaliwal SS, et al. (2008) The acute effects of psyllium on postprandial lipaemia and thermogenesis in overweight and obese men. Br J Nutr 99, 10681075.
63 Blackwood AD, Salter J, Dettmar PW, et al. (2000) Dietary fibre, physicochemical properties and their relationship to health. J R Soc Promot Health 120, 242247.
64 Lee YM, Skurk T, Hennig M, et al. (2007) Effect of a milk drink supplemented with whey peptides on blood pressure in patients with mild hypertension. Eur J Nutr 46, 2127.
65 Wilkinson IB, Franklin SS, Hall IR, et al. (2001) Pressure amplification explains why pulse pressure is unrelated to risk in young subjects. Hypertension 38, 14611466.
66 Galisteo M, Duarte J & Zarzuelo A (2008) Effects of dietary fibers on disturbances clustered in the metabolic syndrome. J Nutr Biochem 19, 7184.
67 Reeves RA (1991) A review of the stability of ambulatory blood pressure: implications for diagnosis of hypertension. Clin Invest Med 14, 251255.
68 Brown DE, James GD & Nordloh L (1998) Comparison of factors affecting daily variation of blood pressure in Filipino-American and Caucasian nurses in Hawaii. Am J Phys Anthropol 106, 373383.
69 Jenkins DJ, Kendall CW, Vuksan V, et al. (2002) Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial. Am J Clin Nutr 75, 834839.
70 Harriss LR, English DR, Powles J, et al. (2007) Dietary patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study. Am J Clin Nutr 86, 221229.
71 Coudray CDC & Rayssiguier Y (2003) Effects of dietary fibers on magnesium absorption in animals and humans. J Nutr 133, 14.
72 Greger J (1999) Nondigestible carbohydrates and mineral bioavailability. J Nutr 129, 1434S1435S.
73 Bessesen D (2001) The role of carbohydrates in insulin resistance. J Nutr 131, 2782S2786S.
74 Ferrannini E, Haffner SM, Mitchell BD, et al. (1991) Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia 34, 416422.
75 King DE, Mainous AG III, Egan BM, et al. (2005) Fiber and C-reactive protein in diabetes, hypertension, and obesity. Diabetes Care 28, 14871489.
76 Qi L, Rimm E, Liu S, et al. (2005) Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care 28, 10221028.
77 Henry RM, Kostense PJ, Spijkerman AM, et al. (2003) Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study. Circulation 107, 20892095.
78 Schram MT, Henry RM, van Dijk RA, et al. (2004) Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study. Hypertension 43, 176181.
79 Seals DR, Moreau KL, Gates PE, et al. (2006) Modulatory influences on ageing of the vasculature in healthy humans. Exp Gerontol 41, 501507.
80 Brock DW, Davis CK, Irving BA, et al. (2006) A high-carbohydrate, high-fiber meal improves endothelial function in adults with the metabolic syndrome. Diabetes Care 29, 23132315.
81 Wilkinson IB, Qasem A, McEniery CM, et al. (2002) Nitric oxide regulates local arterial distensibility in vivo. Circulation 105, 213217.
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