Zusammenfassung
Zahlreiche Studien belegen, dass Plantago-ovata-Samenschalen (POS) effektiv den LDL-Cholesterinspiegel
senken, ohne das HDL-Cholesterin zu beeinflussen. 10 g POS/Tag senken das Cholesterin
um 5-10 %. Optimal ist die Aufnahme von zwei- bis dreimal täglich 5 g POS zu den Mahlzeiten,
in Kombination mit einer fettmodifizierten Kost (reich an einfach ungesättigten Fettsäuren).
Auch bei Kindern und Jugendlichen erweisen sich POS als sicheres und effektives Mittel
zur adjuvanten Behandlung der Hypercholesterinämie. Im Vergleich zu medikamentösen
Maßnahmen ist die Ernährungstherapie, unterstützt durch POS, kostengünstiger und nach
heutiger Kenntnis nicht mit Nebenwirkungen behaftet. Daneben sind POS zum Einsatz
bei zahlreichen gastrointestinalen Erkrankungen geeignet und senken den Blutglukose-Spiegel.
Summary
Cholesterol-lowering effects of psyllium
Several studies have shown that psyllium seed husk (PSH) is effective in reducing
low-density lipoprotein cholesterol without decreasing high-density lipoprotein cholesterol.
10 g PSH/d reduces total cholesterol levels by 5-10 %. The effect of diet supplementation
with PSH on plasma lipids is dependent on dosage, intake in combination or without
other foods, sex and hormonal status. Consumption of 2-3 servings of 5 g PSH per day,
taken with meals, in combination with a fat-reduced diet high in monounsaturated fatty
acids is effective. PSH is a safe and effective adjuvant drug in hyperlipidaemic children
and adolescents as well. Compared to medical treatment, the combination of PSH and
diet therapy is cost-saving and not afflicted with side-effects. Furthermore, PSH
is suited for treatment of several gastrointestinal disorders and diseases and can
decrease blood glucose levels.
Schlüsselwörter
Plantago-ovata-Samenschalen - Flohsamen - wasserlösliche Ballaststoffe - Hypercholesterinämie
- gastroenterologische Erkrankungen
Key words
Psyllium seed husk - ispaghula - Plantago ovata - soluble fiber - hypercholesterolaemia
- gastrointestinal disorders - review
Literatur
- 1
Anderson JW, Zettwoch N, Feldman T, et al.
Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic
men.
Arch Intern Med.
1988;
148
292-296
- 2
Anderson JW, Davidson MH, Blonde L, et al.
Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in
the treatment of hypercholesterolemia.
Am J Clin Nutr.
2000;
71
1433-1438
- 3
Anderson JW, Allgood LD, Lawrence A, et al.
Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men
and women with hypercholesterolemia: meta-analysis of 8 controlled trials.
Am J Clin Nutr.
2000;
71
472-479
- 4
Anderson JW, Allgood LD, Turner J, et al.
Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes
and hypercholesterolemia.
Am J Clin Nutr.
1999;
70
466-473
- 5
Anderson JW, Riddell-Mason S, Gustafson NJ, et al.
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.
1992;
56
93-98
- 6
Anderson JW, Tietyen-Clark JT.
Dietary fiber: hyperlipidemia, hypertension and coronary artery disease.
Am J Gastroenterol.
1986;
81
907-919
- 7
Anonymous.
Monograph Plantago: Plantago ovata (Psyllium).
Altern Med Rev.
2002;
7
155-159
- 8
Arlian LG, Vyszenski-Moher DL, Lawrence AT, et al.
Antigenic and allergenic analysis of psyllium seed components.
J Allergy Clin Immunol.
1992;
89
866-876
- 9
Barter P.
CETP and atherosclerosis.
Arterioscler Thromb Vasc Biol.
2000;
20
2029-2031
- 10
Bell LP, Hectorne KJ, Reynolds H, et al.
Cholesterol-lowering effects of soluble-fiber cereals as part of a prudent diet for
patients with mild to moderate hypercholesterolemia.
Am J Clin Nutr.
1990;
52
1020-1026
- 11
Bliss DZ, Jung HJ, Savik K, et al.
Supplementation with dietary fiber improves fecal incontinence.
Nurs Res.
2001;
50
203-213
- 12
Brock FE, Uehleke B.
Wirksamkeit von Psyllium-Granulat bei Patienten mit Hypercholesterinämie.
Z Allg Med.
1999;
75
106-111
- 13
Brown L, Rosner B, Willett WW, et al.
Cholesterol-lowering effects of dietary fiber: a meta-analysis.
Am J Clin Nutr.
1999;
69
30-42
- 14
Cavaliere H, Floriano I, Medeiros-Neto G.
Gastrointestinal side effects of orlistat may be prevented by concomitant prescription
of natural fibers (psyllium mucilloid).
Int J Obes.
2001;
25
1095-1099
- 15
Davidson MH, Dugan LD, Burns JH, et al.
A psyllium-enriched cereal for the treatment of hypercholesterolemia in children:
a controlled, double-blind, crossover study.
Am J Clin Nutr.
1996;
63
96-102
- 16
Davidson MH, Maki KC, Kong JC, et al.
Long-term effects of consuming foods containing psyllium seed husk on serum lipids
in subjects with hypercholesterolemia.
Am J Clin Nutr.
1998;
67
367-376
- 17
Everson GT, Daggy BP, McKinley C, et al.
Effects of psyllium hydrophilic mucilloid on LDL-cholesterol and bile acid synthesis
in hypercholesterolemic men.
J Lipid Res.
1992;
33
1183-1192
- 18
Fernandez-Banares F, Hinojosa J, Sanchez-Lombrana JL, et al.
Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with
mesalamine in maintaining remission in ulcerative colitis.
Am J Gastroenterol.
1999;
94
427-433
- 19
Fernandez ML, Vergara-Jimenez M, Conde AK, et al.
Regulation of apolipoprotein B-containing lipoproteins by dietary soluble fiber in
guinea pigs.
Am J Clin Nutr.
1997;
65
814-822
- 20
Fernandez ML, Ruiz LR, Conde AK, et al.
Psyllium reduces plasma LDL in guinea pigs by altering hepatic cholesterol homeostasis.
J Lipid Res.
1995;
36
1128-1138
- 21
Fernandez ML.
Distinct mechanisms of plasma LDL lowering by dietary fiber in the guinea pig: specific
effects of pectin, guar gum, and psyllium.
J Lipid Res.
1995;
36
2394-2404
- 22
Freeman GL.
Psyllium hypersensitivity.
Ann Allergy.
1994;
73
490-492
- 23
Garvin JE, Forman OT, Eiseman WR, et al.
Lowering of human serum cholesterol by an oral hydrophilic colloid.
Proc Soc Exp Biol Med.
1965;
120
744-746
- 24
Gupta RR, Agrawal CG, Singh GP, et al.
Lipid-lowering efficacy of psyllium hydrophilic mucilloid in non insulin dependent
diabetes mellitus with hyperlipidaemia.
Indian J Med Res.
1994;
100
237-241
- 25
Hensel A, Hose S.
Indische Flohsamenschalen.
Deutsche Apotheker Zeitung.
2001;
141
55-63
- 26
Hotz J, Enck P, Goebell H, et al.
Konsensusbericht Reizdarmsyndrom - Definition, Diagnosesicherung, Pathophysiologie
und Therapiemöglichkeiten. Konsensus der Deutschen Gesellschaft für Verdauungs- und
Stoffwechselkrankheiten.
Z Gastroenterol.
1999;
37
685-700
- 27
Jenkins DJA, Kendall CWC, Vuksan V, et al.
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.
2002;
75
834-839
- 28
Jenkins DJA, Wolever TMS, Vidgen E, et al.
Effect of psyllium in hypercholesterolemia at two monounsaturated fatty acid intakes.
Am J Clin Nutr.
1997;
65
1524-1533
- 29
Jenkins DJA, Kendall CWC, Axelsen M, et al.
Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates,
blood lipids an dcoronary heart disease.
Curr Opin Lipidol.
2000;
11
49-56
- 30
Kay RM, Strasberg SM.
Origin, chemistry, physiological effects and clinical importance of dietary fibre.
Clin Invest Med.
1978;
1
9-24
- 31
Kreft D.
Flohsamen - lösliche Ballaststoffe zur Therapie der chronischen Obstipation.
Ernährungs-Umschau.
2001;
48
482-489
- 32
Levin EG, Miller VT, Muesing RA, et al.
Comparison of psyllium hydrophilic mucilloid and cellulose as adjuncts to a prudent
diet in the treatment of mild to moderate hypercholesterolemia.
Arch Intern Med.
1990;
150
1822-1827
- 33
Marlett JA, Kajs TM, Fischer MH.
An unfermented gel component of psyllium seed husk promotes laxation as a lubricant
in humans.
Am J Clin Nutr.
2000;
72
784-789
- 34
Marteau P, Flourie B, Cherbut C, et al.
Digestibility and bulking effect of ispaghula husks in healthy humans.
Gut.
1994;
35
1747-1752
- 35
Matheson HB, Colon IS, Story JA.
Cholesterol 7 alpha-hydroxylase-activity is increased by dietary modification with
psyllium hydrocolloid, pectin, cholesterol and cholestyramine in rats.
J Nutr.
1995;
125
454-458
- 36
McBurney MI, Thompson LU.
In vitro fermentabilities of purified supplements.
J Food Sci.
1989;
54
347-350
- 37
McMahon M, Carless J.
Ispaghula husk in the treatment of hypercholesterolemia: a double-blind controlled
study.
J Cardiovasc Risk.
1998;
5
167-172
- 38
Neal GW, Balm TK.
Synergistic effects of psyllium in the dietary treatment of hypercholesterolemia.
Southern Med J.
1990;
83
1131-1137
- 39
Nishina PM, Freedland RA.
The effects of dietary fiber feeding on cholesterol metabolism in rats.
J Nutr.
1990;
120
800-805
- 40
Oliver SD.
The long-term safety and tolerability of ispaghula husk.
J R Soc Health.
2000;
120
107-111
- 41
Olson BH, Anderson SM, Becker MP, et al.
Psyllium-enriched cereals lower blood total cholesterol and LDL-cholesterol, but not
HDL-cholesterol, in hypercholesterolemic adults: results of a meta-analysis.
J Nutr.
1997;
127
1973-1980
- 42
Paulini I, Mehta T, Hargis A.
Intestinal structural changes in African green monkeys after long term psyllium or
cellulose feeding.
J Nutr.
1987;
117
253-266
- 43
Roberts DCK, Truswell AS, Bencke A, et al.
The cholesterol-lowering effect of a breakfast cereal containing psyllium fibre.
Med J Aust.
1994;
161
660-664
- 44
Rodriguez-Moran M, Guerrero-Romero F, Lazcano-Burciaga G.
Lipid- and glucose-lowering efficacy of Plantago Psyllium in type II diabetes.
J Diabetes Complications.
1998;
12
273-278
- 45
Salyers AA, Harris CJ, Wilkins TD.
Breakdown of psyllium hydrocolloid by strains of Bacteroides ovatus from the human
intestinal tract.
Can J Microbiol.
1978;
24
336-338
- 46
Sohn KS, Fakler TM, Maxwell CV.
Effect of Psyllium fed during late gestation and lactation period on reproductive
performance and stool consistency.
J Anim Sci.
1992;
70 (Suppl 1)
19
- 47
Spence DJ, Huff MW, Heidenheim P, et al.
Combination therapy with colestipol and psyllium mucilloid in patients with hyperlipidemia.
Ann Intern Med.
1995;
123
493-499
- 48
Sprecher DL, Harris BV, Goldberg AC, et al.
Efficacy of psyllium in reducing serum cholesterol levels in hypercholesterolemic
patients on high- or low-fat diets.
Ann Intern Med.
1993;
119
545-554
- 49
Sussman GL, Dorian W.
Psyllium anaphylaxis.
Allergy Proc.
1990;
11
241-242
- 50
Terpstra AHM, Lapre JA, de Vines H, et al.
Dietary pectin with high viscosity lowers plasma and liver cholesterol concentration
and plasma cholesteryl ester transfer protein activity in hamsters.
J Nutr.
1998;
128
1944-1949
- 51
Turley SD, Daggy BP, Dietschy JM.
Psyllium augments the cholesterol-lowering action of cholestyramine in hamsters by
enhancing sterol loss from the liver.
Gastroenterology.
1994;
107
444-452
- 52
US Department of Commerce, National Technical Information Service .
Evaluation of the Health Aspects of Oat Gum, Okra Gum, Quince Seed Gum and Psyllium
Seed Husk Gum as Food Ingredients.
NITS Report PB82192923.
1982;
- 53
US Food and Drug Administration: Food Labelling .
Health Claims; Soluble Fiber from Certain Foods and Coronary Heart Disease.
Fed Regist.
1998;
63
(Docket no. 96)
0338
- 54
Vega-López S, Vidal-Quintanar RL, Fernandez ML.
Sex and hormonal status influence plasma lipid responses to psyllium.
Am J Clin Nutr.
2001;
74
435-441
- 55
Vega-López S, Conde-Knape K, Vidal-Quintanar RL, et al.
Sex and hormonal status influence the effects of psyllium on lipoprotein remodeling
and composition.
Metabolism.
2002;
51
500-507
- 56
Vergara-Jimenez M, Conde K, Erickson SK, et al.
Hypolipidemic mechanisms of pectin and psyllium in guinea pigs fed high fat-sucrose
diets: alterations on hepatic cholesterol metabolism.
J Lipid Res.
1998;
39
1455-1465
- 57 Watzl B, Leitzmann C. Bioaktive Substanzen in Lebensmitteln. Hippokrates Verlag
2 Stuttgart; 1999: 158-181
- 58
Williams CL, Bollella M, Spark A, et al.
Soluble fiber enhances the hypocholesterolemic effect of the Step I diet in childhood.
Am J Coll Nutr.
1995;
14
251-257
- 59
Wolever TMS, Jenkins DJA, Mueller S, et al.
Method of administration influences the serum cholesterol-lowering effect of psyllium.
Am J Clin Nutr.
1994;
59
1055-1059
- 60
Wolever TMS, Jenkins DJA, Mueller S, et al.
Psyllium reduces blood lipids in men and women with hyperlipidemia.
Am J Med Sci.
1994;
307
269-273
- 61
Richter WO, Jacob BG, Schwandt P.
Interaction between fibre and lovastatin.
Lancet.
1991;
338
706
Dipl. oec. troph. Katrin Raschke
Sven-David Müller-Nothmann
Die Gesellschaft für Ernährungsmedizin
und Diätetik e.V.
Mariahilfstr. 9
52062 Aachen
eMail: info@ernaehrungsmed.de