PSYLLIUM & GLUCIDES
letteratura - references
1. Frati Munari AC, Benitez Pinto W,
Ariza Andraca CR, Casarrubias M
Departamento de Medicina Interna, Hospital de Especialidades, Mexico,
D.F.
Lowering glycemic index of food by acarbose and Plantago psyllium
mucilage
Arch Med Res 1998;29(2):137-141
BACKGROUND: A study was designed to evaluate the effect of acarbose and Plantago psyllium mucilage on glycemic index (GI) of bread. METHODS: Twelve patients with non-insulin-dependent diabetes mellitus (NIDDM) and ten healthy volunteers were studied. Three meal tests with an intake of 90 g of white bread (50 g of carbohydrates) were performed on each subject. In one test, 200 mg of acarbose was given, while 15 g of P. psyllium mucilage was given in another test, and only bread was ingested in the control test. Serum glucose and insulin concentrations were measured every 30 min from 0-180 min. Net area under curve (AUC) concentrations of glucose and insulin, GI and insulinic index were calculated. RESULTS: In NIDDM patients, AUC-glucose in the test with acarbose (1.9 +/- 0.7 mmol/L) and with P. psyllium (4.3 +/- 1.2 mmol/L) were significantly lower than in the control test (7.4 +/- 1.5 mmol/L) (p < 0.01). GI of bread plus acarbose was 26 +/- 13, and of bread plus P. psyllium, 59 +/- 10 (p < 0.05). AUC-insulin and insulinic index behave similarly. In healthy individuals, AUC-glucose and GI did not significantly change with the treatments; however, insulinic index with acarbose was 17 +/- 16, and with P. psyllium was 68 +/- 15 (p < 0.05). Acarbose or P. psyllium decreased GI of bread in NIDDM patients and diminished insulinic index in NIDDM and in healthy subjects. CONCLUSIONS: Adding acarbose or P. psyllium to meals may reduce glycemic index of carbohydrate foods and may help diabetic control.
2. Pastors JG, Blaisdell PW, Balm TK,
Asplin CM, Pohl SL
Diabetes Center, University of Virginia, Charlottesville
Psyllium fiber reduces rise in postprandial glucose and insulin
concentrations in patients with non-insulin-dependent diabetes
Am J Clin Nutr 1991 Jun;53(6):1431-1435
The ability of psyllium fiber to reduce
postprandial serum glucose and insulin concentrations was studied in 18
non-insulin-dependent diabetic patients in a crossover design. Psyllium
fiber or placebo was administered twice during each 15-h crossover phase,
immediately before breakfast and dinner. No psyllium fiber or placebo
was given at lunch, which allowed measurement of residual or second-meal
effects. For meals eaten immediately after psyllium ingestion, maximum
postprandial glucose elevation was reduced by 14% at breakfast and 20%
at dinner relative to placebo. Postprandial serum insulin concentrations
measured after breakfast were reduced by 12% relative to placebo.
Second-meal effects after lunch showed a 31% reduction in postprandial
glucose elevation relative to placebo. No significant differences in
effects were noted between patients whose diabetes was controlled by
diet alone and those whose diabetes was controlled by oral hypoglycemic
drugs. Results indicate that psyllium as a meal supplement reduces
proximate and second-meal postprandial glucose and insulin
concentrations in non-insulin-dependent diabetics
Publication Types: Clinical trial; Randomized controlled trial
3. Wolever TM, Vuksan V, Eshuis H,
Spadafora P, Peterson RD, Chao ES, Storey ML, Jenkins DJ, Department of
Nutritional Sciences, Faculty of Medicine, University of Toronto,
Ontario, Canada
Effect of
method of administration of psyllium on glycemic response and
carbohydrate digestibility
J Am Coll Nutr 1991 Aug;10(4):364-371
To determine whether there was any advantage to taking a soluble fiber supplement separate from food, as opposed to incorporated into a food, we used psyllium as a model, either taken in water just before a flaked bran cereal test meal, sprinkled on top of the cereal, or actually incorporated into the flake. In normal subjects, psyllium reduced the glycemic response when sprinkled onto or incorporated into the cereal, but not when taken before the cereal. Varying the amount of psyllium incorporated into the cereal from 0 to 20% resulted in a linear dose-dependent reduction of the glycemic index (GI) (GI = 101 -2.2 x % psyllium; r = 0.950; p less than 0.002). In subjects with diabetes, the blood-glucose-lowering effect of the psyllium flake cereal was similar to that in normal subjects. Mixing psyllium with the cereal or incorporating it into the cereal reduced the rate of digestion of bran flakes in vitro but was not associated with increased breath hydrogen levels in vivo as an index of rapid colonic fermentation. The bran flakes with psyllium incorporated was rated as no less palatable than the bran flakes cereal alone, and significantly more palatable (p less than 0.05) than taking psyllium in water before the cereal or sprinkling psyllium onto the cereal. These studies confirm earlier reports that viscous fibers must be intimately mixed with the food to have the effect of reducing blood glucose responses, and that the mechanism of action relates to a reduced rate of digestion rather than carbohydrate malabsorption.
4. Rodriguez-Moran M, Guerrero-Romero F,
Lazcano-Burciaga G, Mexican Social Security Institute and Research Group
on Diabetes and Chronic Illnesses, Durango.
Lipid- and glucose-lowering efficacy of Plantago Psyllium in type II
diabetes
J Diabetes Complications 1998 Sep-Oct;12(5):273-8
The beneficial effect of dietary fiber in the management of type II diabetes is still controversial and has not been totally demonstrated. The purpose of this study was to determine the plasma-lowering effects of 5 g t.i.d. of Plantago Psyllium, as an adjunct to dietary therapy, on lipid and glucose levels, in patients with type II diabetes. Patients were randomly selected from an outpatient clinic of primary care to participate in a double-blind placebo-controlled study in which Plantago Psyllium or placebo was given in combination with a low fat diet. One hundred twenty-five subjects were included in the study that consisted in a 6-week period of diet counseling followed by a 6-week treatment period. Fasting plasma glucose, total plasma cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels were measured every 2 weeks. The test products (Psyllium or placebo) were supplied to subjects in identically labeled foil packets containing a 5-g dose of product, to consume three doses per day (of 5 g each one), before regular meals. There was an excellent tolerance to Psyllium, without significant adverse effects. No significant changes were observed in the patient's weight for both groups (not significant). Fasting plasma glucose, total cholesterol, LDL cholesterol, and triglycerides levels, showed a significant reduction (p < 0.05), whereas HDL cholesterol increased significantly (p < 0.01) following Psyllium treatment. Our results show that 5 g t.i.d. of Psyllium is useful, as an adjunct to dietary therapy, in patients with type II diabetes, to reduce plasma lipid and glucose levels, resolving the compliance conflict associated with the ingest of a great amount of fiber in customary diet.
5. Anderson JW, Allgood LD, Turner J,
Oeltgen PR, Daggy BP, Veterans Affairs Medical Center, the University of
Kentucky, Lexington, and The Procter & Gamble Company, Cincinnati
Effects of psyllium on glucose and serum lipid responses in men
with type 2 diabetes and hypercholesterolemia
Am J Clin Nutr 1999 Oct;70(4):466-473
BACKGROUND: Water-soluble dietary fibers
decrease postprandial glucose concentrations and decrease serum
cholesterol concentrations. This study examined the effects of
administering psyllium to men with type 2 diabetes.
OBJECTIVE: The objective was to evaluate the safety and effectiveness of psyllium husk fiber used adjunctively to a traditional
diet for diabetes in the treatment of men with type 2 diabetes and
mild-to-moderate hypercholesterolemia. DESIGN: After a 2-wk dietary
stabilization phase, 34 men with type 2 diabetes and mild-to-moderate
hypercholesterolemia were randomly assigned to receive 5.1 g psyllium or cellulose placebo twice daily for 8 wk. Serum lipid and glycemic
indexes were evaluated biweekly on an outpatient basis and at weeks 0
and 8 in a metabolic ward. RESULTS: In the metabolic ward, the psyllium group showed significant improvements in glucose and lipid values
compared with the placebo group. Serum total and LDL-cholesterol
concentrations were 8.9% (P < 0.05) and 13.0% (P = 0.07) lower,
respectively, in the psyllium than in the placebo group.
All-day and postlunch postprandial glucose concentrations were 11.0% (P
< 0.05) and 19.2% (P < 0.01) lower in the psyllium than in the placebo group. Both products were well tolerated, with no
serious adverse events related to treatment reported in either group.
CONCLUSION: The addition of psyllium to a traditional diet
for persons with diabetes is safe, is well tolerated, and improves
glycemic and lipid control in men with type 2 diabetes and
hypercholesterolemia.
6.
Eur J Clin Nutr 2001 Apr;55(4):235-43
Effects of ispaghula husk and guar gum on postprandial glucose
and insulin concentrations in healthy subjects.
Sierra M, Garcia JJ, Fernandez N, Diez MJ, Calle AP, Sahagun AM
Department of Pharmacology, Toxicology and Nursing, University of Leon,
Leon, Spain.
OBJECTIVE:
The aim of this study was to evaluate, under the same experimental
conditions and in the same subjects, the effects of ispaghula husk and guar gum on postprandial glucose and insulin concentrations in
healthy female subjects. DESIGN: An oral glucose load with and without
fiber was administered in the morning after an overnight fast. The study
of the fiber effect was planned according to a randomized and cross-over
design. SETTING: The study was performed at the Department of
Pharmacology, Toxicology and Nursing at the University of Leon (Spain).
SUBJECTS: Ten healthy female volunteers aged 30-48 y with normal body
mass indices participated in this study. RESULTS: A significant decrease
in mean serum insulin concentrations was observed from 30 to 90 min in
the presence of both fibers. The area under the insulin curve was
significantly reduced by 36.1% for ispaghula husk and 39.4% for guar gum. The area under the glucose curve was
reduced by 11.1% (significant difference) for ispaghula husk and 2.6% for guar gum (no significant difference). CONCLUSIONS:
According to the results obtained in this study, the administration of ispaghula husk may be beneficial due to its ability to reduce glucose postprandial
concentration and especially insulin requirements. Individualization of
the treatment would be advisable due to large individual variations
observed in glycemic and insulinemic postprandial responses.European
Journal of Clinical Nutrition (2001) 55, 235-243
7. Eur J Clin Nutr 2002
Sep;56(9):830-42
Therapeutic effects of psyllium in type 2 diabetic patients.
Sierra M, Garcia JJ, Fernandez N, Diez MJ, Calle AP
Department of Pharmacology, Toxicology and Nursing, University of Leon,
Leon, Spain. dftmsv@unileon.es
OBJECTIVE:
The aim of this study was to evaluate the effects of psyllium in type 2
diabetic patients. DESIGN: The study included three phases: phase 1 (1
week), phase 2 (treatment, 14 g fibre/day, 6 weeks) and phase 3 (4 weeks).
At the end of each phase a clinical evaluation was performed after the
ingestion of a test breakfast of 1824.2 kJ (436 kcal). Measurements
included concentrations of blood glucose, insulin, fructosamine, GHbA(1c),
C-peptide and 24 h urinary glucose excretion. In addition, uric acid,
cholesterol and several mineral and vitamin concentrations were also
evaluated. SETTING: The study was performed at the Department of
Pharmacology, Toxicology and Nursing at the University of Leon (Spain).
SUBJECTS: Twenty type 2 diabetic patients (12 men and 8 women)
participated in the study with a mean age of 67.4 y for men and 66 y for
women. The mean body mass index of men was 28.2 kg/m(2) and that of
women 25.9 kg/m(2). RESULTS: Glucose absorption decreased significantly
in the presence of psyllium (12.2%); this reduction is not associated
with an important change in insulin levels (5%). GHbA(1c), C-peptide and
24 h urinary glucose excretion decreased (3.8, 14.9 and 22.5%,
respectively) during the treatment with fibre (no significant
differences) as well as fructosamine (10.9%, significant differences).
Psyllium also reduced total and LDL cholesterol (7.7 and 9.2%,
respectively, significant differences), and uric acid (10%, significant
difference). Minerals and vitamins did not show important changes,
except sodium that increased significantly after psyllium administration.
CONCLUSIONS: The results obtained indicate a beneficial therapeutic
effect of psyllium (Plantaben) in the metabolic control of type 2
diabetics as well as in lowering the risk of coronary heart disease. We
also conclude that consumption of this fibre does not adversely affect
either mineral or vitamin A and E concentrations. Finally, for a greater
effectiveness, psyllium treatment should be individually evaluated.
Expert's comment:
Gli
effetti della somministrazione di PSY in soggetti con diabete mellito di
tipo 2 sono stati studiati in 3 fasi: fase I 1 settimana; fase II
trattamento con 14 g di fibre/die per 6 settimane; fase III di 4
settimane.
PROCEDURA.
in 20 soggetti diabetici di tipo 2 di cui 12 maschi,di età media 67
anni. Al termine di ogni fase
si eseguono valutazioni biochimiche dopo l’ingestione di una
colazione-test di 436 kcal e cioè Hb glicosilata (HbA1c), C-peptide,
glicemia e insulinemia, fruttosamina e glicosuria/24 ore.
RISULTATI:
l’assorbimento del glucosio si riduce del 12,2% in presenza di PSY
senza modificazioni significative dell’insulinemia. L’HbA1c,
il C-peptide e la glicosuria diminuiscono del 3,8, 14,9 e 22,5 %
rispettivamente (statisticamente le variazioni non sono
significative);la fruttosamina invece diminuisce significativamente
(10,9%) durante la fase II così come la colesterolemia totale e
LDL (7,7 e 9,2%) e l’uricemia (10%). I livelli ematici di
vitamine (A e E) e di oligoelementi non si modificano; solo la sodiemia
aumeta durante la fase II.
Pertanto
la presenza di PSY (12,2%) nella dieta migliora i marker metabolici del
diabete mellito riducendo anche il rischio coronarico, senza
alterare il pattern vitaminico e minerale. Per un’efficacia ottimale
la somministrazione di PSY dovrebbe essere valutata clinicamente in ogni
singolo caso.
J
Med Food. 2005 Winter;8(4):508-11.
Effects of flax fiber on laxation and glycemic response in healthy volunteers.
Dahl
WJ, Lockert
EA, Cammer
AL, Whiting
SJ.
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon,
Saskatchewan, Canada.
We investigated whether a flax supplement taken orally or baked in a bakery
product would effect the physiological responses characteristic of soluble and
insoluble fiber, i.e., laxation and glycemic response, respectively. In Study 1,
26 healthy young adults consumed up to 15 g of fiber from a proprietary flax
fiber supplement or as a psyllium supplement for 2 weeks once usual fecal
weights were established. Changes in dietary fiber intake and acceptability of
both products were evaluated. An increase in fecal weight was found with both
fiber treatments. Supplemental fiber at intakes of 9.0 g/day (flax) and 10.4
g/day (psyllium) gave fecal bulking capacity of about 2.9 and 4.8 g of fecal
weight/g of fiber, respectively. In Study 2, the effect of flax bread versus
control white bread on glycemic response was studied. Eleven fasting subjects
completed four test periods (duplicate trials of each bread) under standardized
glycemic testing conditions. Paired t tests were used to analyze test compared
with control peak blood glucose values (6.6 +/- 0.9 mmol/L compared with 6.9 +/-
0.7 mmol/L, P < .05, respectively) and area under the curve (AUC) (669 +/- 53
compared with 693 +/- 57, P = .015, respectively). Peak blood glucose values and
AUC were improved by ingestion of flax fiber
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