Weight Control

In addition to improved glycemic control and cholesterol lowering, both important factors in metabolic syndrome, a gel-forming fiber can also facilitate weight loss. A 6-month study assessed two soluble gel-forming fibers in 141 patients with the metabolic syndrome [15]. Patients were fed an American Heart Association step-2 diet alone (control group) or the same diet supplemented with psyllium or guar gum (3.5 g twice a day before breakfast and dinner). Both psyllium and guar gum showed significant improvement in fasting plasma glucose (-27.9%; -11.1%), insulin (-20.4%; -10.8%), and LDL-cholesterol (-7.9%; -8.5%), respectively [15]. Only psyllium exerted a significant improvement in plasma triglyceride concentration (-13.3%) and systolic (-3.9%) and diastolic blood pressure (-2.6%) [15]. Both the control diet and guar gum (readily fermented) showed an initial decrease in body weight, followed by weight regain (Fig. 23.1). In contrast to guar gum, psyllium (non-fermented) showed sustained weight loss across the entire 6-month test period. At the conclusion of the study, 12.5% of patients in the psyllium group no longer qualified for a diagnosis of the metabolic syndrome, versus 2.1% of patients in the guar gum group and none of the patients in the diet-control group [15]. It is important to recognize that the fermentation process results in calorie harvest (e.g., fatty acid production/absorption), so fermentable fibers are not calorie-free and may not be optimal for weight loss.

The figure shows mean subject weight over time for a 6-month study in patients with the metabolic syndrome. Only non-fermented psyllium plus diet showed continued weight loss over the 6-month treatment period.

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