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James W. Anderson, MD; Tammy L. Floore, RN; Patti Bazel Geil, MS, RD; Donna Spencer O'Neal; Timothy K. Balm

Arch Intern Med. 1991;151(8):1597-1602.

Abstract
Hypercholesterolemia is a significant risk factor for coronary heart disease, and the hypocholesterolemic effects of psyllium are well established. This placebo-controlled, parallel study compared psyllium with methylcellulose, calcium polycarbophil, and placebo as dietary adjuncts in treating mild to moderate hypercholesterolemia. Of 163 men and women recruited with serum cholesterol levels above 5.17 mmol/L (200 mg/dL), 105 completed 8 weeks of an American Heart Association step I diet and then augmented the diet with one of the fiber supplements for 8 additional weeks. Incremental differences from placebo for low-density lipoprotein cholesterol were -8.8% for psyllium, - 3.2% for methylcellulose (not significant), and + 8.7% for calcium polycarbophil; and for total cholesterol the differences were - 4.3% for psyllium (not significant), -1.4% for methylcellulose (not significant), and + 5.9% for calcium polycarbophil. Compliance was 94% to 96%, and only mild gastrointestinal side effects were observed. In managing mild to moderate hypercholesterolemia, methylcellulose and calcium polycarbophil provide little or no additional benefit, while psyllium significantly enhances the American Heart Association diet effects.

(Arch Intern Med. 1991;151:1597-1602)

Author Affiliations
From the Metabolic Research Group at the University of Kentucky, Lexington (Dr Anderson and Mss Floore, Geil, and O'Neal), Veterans Administration Medical Center, Lexington (Dr Anderson), and The Procter & Gamble Co, Cincinnati, Ohio (Mr Balm).

Footnotes
Accepted for publication December 31, 1990.

Reprint requests to Veterans Administration Medical Center, Cooper Dr (111C), Lexington, KY 40511 (Dr Anderson).

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