Soluble Fiber Supplementation and Serum Lipid Profile: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials.

Abed Ghavami, Rahele Ziaei, Sepide Talebi, Hanieh Barghchi, Elyas Nattagh-Eshtivani, Sajjad Moradi, Pegah Rahbarinejad, Hamed Mohammadi, Hatav Ghasemi-Tehrani, Wolfgang Marx, Gholamreza Askari

Journal: Advances in nutrition (Bethesda, Md.) 2023;14(3):465-474

PMID: 36796439

Free Full Text on Elsevier Science View on PubMed

Plain Language Summary

Dyslipidaemia is considered an important risk factor for cardiovascular disease incidence, characterised by elevated circulating concentrations of blood lipids such as cholesterol and triglycerides (TG). Dietary fibre, particularly water-soluble fibres, has demonstrated efficacy and tolerability in serum lipid management. The aim of this study was to synthesise data from individual investigations and to determine the overall treatment effect of soluble fibre on serum blood lipids. This study is a comprehensive systematic review and a dose-response meta-analysis of 181 studies with 220 treatment arms, including 14,505 participants (7348 cases and 7157 controls). Results show that soluble fibre supplementation improved serum TG, total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein-B concentrations. However, it did not alter serum high-density lipoprotein cholesterol and apolipoprotein-A levels. Furthermore, the meta-analysis showed a significant effect of soluble fibre supplementation on serum TG, total cholesterol, and high-density lipoprotein cholesterol in 15 g/d and low-density lipoprotein cholesterol in 10 g/d. Authors conclude that increasing fibre intake using soluble fibre supplementation could be an effective intervention in the prevention and management of dyslipidaemia, and consequently may contribute to the risk reduction of cardiovascular diseases.

Abstract

To present a comprehensive synthesis of the effect of soluble fiber supplementation on blood lipid parameters in adults, a systematic search was undertaken in PubMed, Scopus, and ISI Web of Science of relevant articles published before November 2021. Randomized controlled trials (RCTs) evaluating the effects of soluble fibers on blood lipids in adults were included. We estimated the change in blood lipids for each 5 g/d increment in soluble fiber supplementation in each trial and then calculated the mean difference (MD) and 95% CI using a random-effects model. We estimated dose-dependent effects using a dose-response meta-analysis of differences in means. The risk of bias and certainty of the evidence was evaluated using the Cochrane risk of bias tool and the Grading Recommendations Assessment, Development, and Evaluation methodology, respectively. A total of 181 RCTs with 220 treatment arms (14,505 participants: 7348 cases and 7157 controls) were included. There was a significant reduction in LDL cholesterol (MD: -8.28 mg/dL, 95% CI: -11.38, -5.18), total cholesterol (TC) (MD: -10.82 mg/dL, 95% CI: -12.98, -8.67), TGs (MD: -5.55 mg/dL, 95% CI: -10.31, -0.79), and apolipoprotein B (Apo-B) (MD: -44.99 mg/L, 95% CI: -62.87, -27.12) after soluble fiber supplementation in the overall analysis. Each 5 g/d increase in soluble fiber supplementation had a significant reduction in TC (MD: -6.11 mg/dL, 95% CI: -7.61, -4.61) and LDL cholesterol (MD: -5.57 mg/dl, 95% CI: -7.44, -3.69). In a large meta-analysis of RCTs, results suggest that soluble fiber supplementation could contribute to the management of dyslipidemia and the reduction of cardiovascular disease risk.

Address: Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.; Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.; Nutrition, Food Sciences and Clinical Biochemistry Department, School of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.; Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.; School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia.; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: [email protected].

DOI: 10.1016/j.advnut.2023.01.005