Skip to main content Accessibility help

Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial

  • Simone Augusta Ribas (a1), Diana Barbosa Cunha (a2), Rosely Sichieri (a2) and Luiz Carlos Santana da Silva (a3)


The present study investigated the LDL-cholesterol (LDL-C)-lowering effects of psyllium in Brazilian dyslipidaemic children and adolescents. A total of fifty-one individuals (6–19 years) with mild-to-moderate hypercholesterolaemia were evaluated by conducting a randomised, double-blind, placebo-controlled, parallel clinical trial. Over an 8-week trial period, the participants were randomly allocated to one of two groups (control: n 25 and psyllium: n 26) using a computer-generated random number sequence. Fasting blood samples, dietary records and anthropometric data were collected. Both groups were treated with the National Cholesterol Education Program Step 2 diet for 6 weeks before randomisation. After this run-in period, a daily supplement of 7·0 g psyllium was given to the intervention group, while an equivalent amount of cellulose was given to the control group. Statistically significant changes between the control and intervention groups over time were observed for total cholesterol (7·7 %; − 0·39 mmol/l; P= 0·003) and LDL-C (10·7 %; − 0·36 mmol/l; P= 0·01). None of the participants reported any aversion to the smell, taste, appearance or texture of psyllium. No serious adverse effects were reported during the study. In addition to causing a significant reduction in LDL-C concentrations, psyllium therapy was found to be both safe and acceptable for the treatment of hypercholesterolaemic children and adolescents.


Corresponding author

* Corresponding author: Professor S. A. Ribas, fax +55 21 2587 6494, email


Hide All
1 Guardamagna, O, Baracco, V, Abello, F, et al. (2009) Identification and management of dyslipidemic children. Minerva Pediatr 61, 391398.
2 Lima, SCV, Lyra, CO, Pinheiro, LGB, et al. (2011) Association between dyslipidemia and anthropometric indicators in adolescents. Nutr Hosp 26, 304310.
3 Ribas, SA & Silva, LCS (2009) Dyslipidemia in schoolchildren from private schools in Belém. Arq Bras Cardiol 292, 446451.
4 National Cholesterol Education Program (1992) Report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 89, Suppl. 1, 525584.
5 Giuliano, ICB, Caramelli, B, Pellanda, L, et al. (2005) I Diretriz Brasileira para a prevenção da aterosclerose na infância e na adolescência (Guideline for preventing atherosclerosis in childhood and adolescence). Arq Bras Cardiol 85, Suppl. 1, S4S36.
6 Kwiterovich, PO (2008) Recognition and management of dyslipidemia in children and adolescents. J Clin Endocrinol Metab 93, 42004209.
7 Wei, ZH, Wang, H, Chen, XY, et al. (2009) Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials. Eur J Clin Nutr 63, 821827.
8 Williams, CL, Bollella, M, Spark, A, et al. (1995) Soluble fiber enhances the hypocholesterolemic effect of the step I diet in childhood. J Am Coll Nutr 14, 251257.
9 Moreno, LA, Tresaco, B, Bueno, G, et al. (2003) Psyllium fibre and the metabolic control of obese children and adolescents. J Physiol Biochem 59, 235242.
10 de Bock, M, Derraik, JG, Brennan, CM, et al. (2012) Psyllium supplementation in adolescents improves fat distribution & lipid profile: a randomized, participant-blinded, placebo-controlled, crossover trial. PLOS ONE 7, e41735.
11 Singh, B (2007) Psyllium as therapeutic and drug delivery agent. Int J Pharm 334, 114.
12 Haney, E, Huffman, L, Bougatsos, C, et al. (2007) Screening and treatment for hypercholesterolemia in children and adolescents: systematic evidence review for the U.S. preventive services task force. Pediatrics 120, e180e214.
13 Spence, JD, Huff, MW, Heidenheim, P, et al. (1995) Combination therapy with colestipol and psyllium mucilloid in patients with hyperlipidemia. Ann Intern Med 123, 493499.
14 Van Rosendaal, GMA, Shaffer, EA, Edwards, AL, et al. (2004) Effect of time of administration on cholesterol-lowering by psyllium: a randomized cross-over study in normocholesterolemic or slightly hypercholesterolemic subjects. Nutr J 3, 17.
15 Malina, RM & Bouchard, C (1991) Growth, Maturation, and Physical Activity, 2nd ed. Champaign, IL: Human Kinetics Books.
16 World Health Organization (2007) WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age. Methods and Development. Nonserial Publication. Geneva: WHO.
17 Lohman, TG, Roche, A & Martorell, R (1988) Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics Books.
18 Slaughter, MH, Lohman, TG, Boileau, RA, et al. (1998) Skinfold equations for estimation of body fatness in children and youth. Hum Biol 60, 709723.
19 Pate, RR, Freedson, PS, Sallis, JF, et al. (2002) Compliance with physical activity guidelines: prevalence in a population of children and youth. Ann Epidemiol 12, 303308.
20 Institute of Medicine (2000) Dietary Reference Intakes: Applications in Dietary Assessment. Washington, DC: National Academy Press pp. 306.
21 Friedewald, WT, Levy, RI & Fredrickson, DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18, 499502.
22 Kwiterovich, PO (1995) The role of fiber in the treatment of hypercholesterolemia in children and adolescents. Pediatrics 96, 10051009.
23 Solà, R, Godàs, G, Ribalta, J, et al. (2007) Effects of soluble fiber (Plantago ovata husk) on plasma lipids, lipoproteins, and apolipoproteins in men with ischemic heart disease. Am J Clin Nutr 85, 11571163.
24 Kinosian, BP & Eisenberg, JM (1988) Cutting into cholesterol: cost-effective alternatives for treating hypercholesterolemia. JAMA 259, 22492254.
25 de Moura, SA, Pereira, RA, Yokoo, EM, et al. (2013) Most consumed foods in Brazil: National Dietary Survey 2008–2009. Rev Saúde Pública 47, Suppl. 1, 190S199S.
26 Theuwissen, E & Mensink, RP (2008) Water-soluble dietary fibers and cardiovascular disease. Physiol Behav 94, 285292.
27 Anderson, JW, Riddell-Mason, S, Gustafson, NJ, et al. (1992) Cholesterol-lowering effects of psyllium-enriched cereal as an adjunct to a prudent diet in the treatment of mild to moderate hypercholesterolemia. Am J Clin Nutr 56, 9398.
28 Pal, S & Radavelli-Bagatini, S (2012) Effects of psyllium on metabolic syndrome risk factors. Obes Rev 13, 10341047.
29 Davidson, MH, Dugan, LD, Burns, JH, et al. (1996) A psyllium-enriched cereal for the treatment of hypercholesterolemia in children: a controlled, double-blind, crossover study. Am J Clin Nutr 63, 96102.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed