The role of soluble fiber intake in patients under highly effective lipid-lowering therapy

Nutr J. 2011 Aug 2;10:80. doi: 10.1186/1475-2891-10-80.

Abstract

Background: It has been demonstrated that statins can increase intestinal sterol absorption. Augments in phytosterolemia seems related to cardiovascular disease.

Objective: We examined the role of soluble fiber intake in endogenous cholesterol synthesis and in sterol absorption among subjects under highly effective lipid-lowering therapy.

Design: In an open label, randomized, parallel-design study with blinded endpoints, subjects with primary hypercholesterolemia (n = 116) were assigned to receive during 12 weeks, a daily dose of 25 g of fiber (corresponding to 6 g of soluble fibers) plus rosuvastatin 40 mg (n = 28), rosuvastatin 40 mg alone (n = 30), sinvastatin 40 mg plus ezetimibe 10 mg plus 25 g of fiber (n = 28), or sinvastatin 40 mg plus ezetimibe 10 mg (n = 30) alone.

Results: The four assigned therapies produced similar changes in total cholesterol, LDL-cholesterol, and triglycerides (p < 0.001 vs. baseline) and did not change HDL-cholesterol. Fiber intake decreased plasma campesterol (p < 0.001 vs. baseline), particularly among those patients receiving ezetimibe (p < 0.05 vs. other groups), and β-sitosterol (p = 0.03 vs. baseline), with a trend for lower levels in the group receiving fiber plus ezetimibe (p = 0.07). Treatment with rosuvastatin alone or combined with soluble fiber was associated with decreased levels of desmosterol (p = 0.003 vs. other groups). Compared to non-fiber supplemented individuals, those treated with fibers had weight loss (p = 0.04), reduced body mass index (p = 0.002) and blood glucose (p = 0.047).

Conclusion: Among subjects treated with highly effective lipid-lowering therapy, the intake of 25 g of fibers added favorable effects, mainly by reducing phytosterolemia. Additional benefits include improvement in blood glucose and anthropometric parameters.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Azetidines / administration & dosage
  • Blood Glucose / analysis
  • Cholesterol / analogs & derivatives
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, HDL / drug effects*
  • Cholesterol, LDL / blood
  • Cholesterol, LDL / drug effects*
  • Dietary Fiber / administration & dosage*
  • Ezetimibe
  • Female
  • Fluorobenzenes / pharmacology
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / diet therapy
  • Intestinal Diseases / blood
  • Lipid Metabolism, Inborn Errors / blood
  • Male
  • Middle Aged
  • Phytosterols / adverse effects
  • Phytosterols / blood
  • Pyrimidines / pharmacology
  • Rosuvastatin Calcium
  • Sitosterols / administration & dosage
  • Sulfonamides / pharmacology
  • Triglycerides / blood

Substances

  • Azetidines
  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Dietary Fiber
  • Fluorobenzenes
  • Phytosterols
  • Pyrimidines
  • Sitosterols
  • Sulfonamides
  • Triglycerides
  • campesterol
  • gamma-sitosterol
  • Rosuvastatin Calcium
  • Cholesterol
  • Ezetimibe

Supplementary concepts

  • Sitosterolemia