Ps8.5

Psyllium Husk Research

39 peer-reviewed studies · Evidence score: 8.5/10

Galactomannans are the most effective soluble dietary fibers in type 2 diabetes: a systematic review and network meta-analysis

Juhász AE et al. • The American journal of clinical nutrition (2023)

Galactomannans were the most effective dietary fiber for reducing the levels of HbA1c, fasting blood glucose, triglycerides, and LDL cholesterol in patients with type 2 diabetes.

Galactomannans had the highest effect on reducing the levels of HbA1c (SUCRA: 92.33%) and fasting blood glucose (SUCRA: 85.92%).
With regard to fasting insulin level, HOMA-IR, β-glucans (SUCRA: 73.45%), and psyllium (SUCRA: 96.67%) were the most effective interventions.
Galactomannans were ranked first in reducing the levels of triglycerides (SUCRA: 82.77%) and LDL cholesterol (SUCRA: 86.56%).

Meta-Analysisn=2,685

DOI

Comparative effects of nutraceuticals on body weight in adults with overweight or obesity: A systematic review and network meta-analysis of 111 randomized clinical trials

Shahinfar H et al. • Pharmacological research (2023)

We conducted random-effects network meta-analysis with a Frequentist framework to estimate mean difference [MD] and 95% confidence interval [CI] of the effect of nutraceuticals on weight loss.

We conducted random-effects network meta-analysis with a Frequentist framework to estimate mean difference [MD] and 95% confidence interval [CI] of the effect of nutraceuticals on weight loss.
Supplementations with green tea (MD: -1.25 kg, 95%CI: -1.68, -0.82) and glucomannan (MD: -1.36 kg, 95%CI: -2.17, -0.54) demonstrated small weight loss, also the certainty of evidence was rated low.
Based on our findings, supplementations with nutraceuticals can result in a small weight loss in adults with overweight or obesity.

Meta-Analysisn=6,171

DOI

Conservative, physical and surgical interventions for managing faecal incontinence and constipation in adults with central neurological diseases

Todd CL et al. • The Cochrane database of systematic reviews (2024)

There remains little research on this common and, for patients, very significant issue of bowel management.

Conservative interventions may result in a large improvement in faecal incontinence (standardised mean difference (SMD) -1.85, 95% confidence interval (CI) -3.47 to -0.23; 3 studies; n = 410; low-certainty evidence).
We interpreted SMD ≥ 0.80 as a large effect.
Physical therapies may result in a moderate improvement in constipation symptoms (SMD -0.62, 95% CI -1.10 to -0.14; 9 studies; n = 431; low-certainty evidence).

Meta-Analysisn=1,598

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Systematic review and meta-analysis: Foods, drinks and diets and their effect on chronic constipation in adults

Van Der Schoot A et al. • Alimentary pharmacology & therapeutics (2024)

Fruits and rye bread may improve certain constipation-related outcomes.

High-mineral water resulted in higher response to treatment than low-mineral water (RR: 1.47, [1.20-1.81], n = 539).
Fruits and rye bread may improve certain constipation-related outcomes.
There is a scarcity of evidence on foods, drinks and diets in constipation and further RCTs are needed.

Meta-Analysisn=1,714

DOI

Plantago consumption significantly reduces total cholesterol and low-density lipoprotein cholesterol in adults: A systematic review and meta-analysis

Zhu R et al. • Nutrition research (New York, N.Y.) (2024)

Analysis used a random effects model to determine weighted mean difference and 95% confidence intervals.

Analysis used a random effects model to determine weighted mean difference and 95% confidence intervals.
Compared with the control group, Plantago consumption significantly reduced total cholesterol (TC) by 0.28 mmol/L and low-density lipoprotein cholesterol (LDL-C) by 0.35 mmol/L, correlating to an estimated 7% decrease in cardiovascular event risk.
Additionally, TC and LDL-C were significantly lower in participants consuming Plantago husk or psyllium, and soluble fiber intake was specifically effective in lowering TC, LDL-C, and triglycerides.

Meta-Analysisn=2,769

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The beneficial effects of psyllium on cardiovascular diseases and their risk factors: Systematic review and dose-response meta-analysis

Dehghan P et al. • Journal of Functional Foods (2023)

Psyllium significantly decreased LDL cholesterol, total cholesterol, systolic blood pressure, and HbA1c.

LDL-C reduced by 8.55 mg/dL
Total cholesterol reduced by 9.05 mg/dL
Systolic BP reduced by 2.24 mmHg

Meta-Analysisn=2,049

DOI

The Effect of Fiber Supplementation on Chronic Constipation in Adults: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

van der Schoot A et al. • The American journal of clinical nutrition (2022)

Fiber supplementation is effective at improving constipation.

Overall, 311 of 473 (66%) participants responded to fiber treatment and 134 of 329 (41%) responded to control treatment [RR: 1.48 (95% CI: 1.17, 1.88; P = 0.001); I2 = 57% (P = 0.007)], with psyllium and pectin having significant effects.
Fiber increased stool frequency [SMD: 0.72 (95% CI: 0.36, 1.08; P = 0.0001); I2 = 86% (P < 0.00001)]; psyllium and pectin had significant effects, and improvement was apparent only with higher fiber doses and greater treatment durations (≥4 weeks).
Fiber improved stool consistency (SMD: 0.32; 95% CI: 0.18, 0.46; P < 0.0001), particularly with higher fiber doses.

Meta-Analysisn=1,251

DOI

The effect of psyllium on fasting blood sugar, HbA1c, HOMA IR, and insulin control: a GRADE-assessed systematic review and meta-analysis

Gholami M et al. • Nutrition & Diabetes (2024)

Psyllium significantly decreased fasting blood sugar, HbA1c, and HOMA-IR levels compared to placebo.

FBS reduced by 6.89 mg/dL
HbA1c reduced by 0.75%
Significant improvement in insulin resistance

Meta-Analysisn=962

DOI

Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review

Rao SSC et al. • The American journal of gastroenterology (2021)

Diarrhea, nausea, bloating, and abdominal pain were common adverse events, but no serious adverse events were reported.

Systematic review examining Psyllium Husk efficacy
Further research warranted to confirm findings

Systematic Reviewn=1,297

DOI

Psyllium is a natural nonfermented gel-forming fiber that is effective for weight loss: A comprehensive review and meta-analysis

Gibb RD et al. • Journal of the American Association of Nurse Practitioners (2023)

Six studies meeting inclusion criteria were identified (total n = 354).

Six studies meeting inclusion criteria were identified (total n = 354).
Further research warranted to confirm findings

Meta-Analysisn=354

DOI

The effect of psyllium consumption on anthropometric indices: a systematic review and dose-response meta-analysis of randomized controlled trials

Gholami Z et al. • Journal of health, population, and nutrition (2025)

In summary, this study found that psyllium significantly increased body weight.

The findings indicate that psyllium significantly increased body weight, with a WMD of 3.57 (95% confidence intervals: 1.43, 5.72; p-value < 0.05).
However, there was a non-significant decrease in BMI, with a WMD of -0.06 (95% confidence intervals: -0.68, 0.55; p-value > 0.05), and a non-significant decrease in WHR, with a WMD of -0.10 (95% confidence intervals: -0.34, 0.12; p-value > 0.05).
Additionally, there was a non-significant increase in WC, with a WMD of 0.72 (95% confidence intervals: -0.93, 2.37; p-value > 0.05).

Meta-Analysisn=27

DOI

Prebiotics for Induction and Maintenance of Remission in Inflammatory Bowel Disease: Systematic Review and Meta-Analysis

Limketkai BN et al. • Inflammatory bowel diseases (2025)

Prebiotics, particularly FOS and germinated barley foodstuff, show potential as effective and safe dietary supplements for induction and maintenance of remission in UC, respectively.

For induction of clinical remission in ulcerative colitis (UC), the fructooligosaccharide (FOS) kestose was effective (relative risk, 2.75, 95% confidence interval, 1.05-7.20; n = 40), but oligofructose-enriched inulin (OF-IN) and lactulose were not.
For maintenance of remission in UC, germinated barley foodstuff trended toward preventing clinical relapse (relative risk, 0.40; 95% confidence interval, 0.15-1.03; n = 59), but OF-IN, oat bran, and Plantago ovata did not.
Prebiotics, particularly FOS and germinated barley foodstuff, show potential as effective and safe dietary supplements for induction and maintenance of remission in UC, respectively.

Meta-Analysis

DOI

Kiwifruit and Kiwifruit Extracts for Treatment of Constipation: A Systematic Review and Meta-Analysis

Eltorki M et al. • Canadian journal of gastroenterology & hepatology (2022)

Among individuals with constipation, there is an overall low certainty of evidence indicating that kiwifruit may increase SBM when compared to placebo or psyllium.

Seven RCTs, including 399 participants (82% female; mean age: 42 years (SD 14.6)), were included.
Compared with placebo (n = 95), kiwifruit extracts might increase the weekly frequency of SBM (MD: 1.36; 95% CI: -0.44, 3.16) with low certainty of evidence; moreover, it had an uncertain effect on BSS (SMD: 1.54; 95% CI: -1.33, 4.41) with very low certainty of evidence.
Additionally, compared with placebo (n = 119), kiwifruit or its extracts reduced abdominal pain (SMD: -1.44, 95% CI -2.83, -1.66) with moderate certainty of the evidence and improved frequency of straining (SMD: -0.29; 95% CI: -1.03, 0.47).

Meta-Analysisn=399

DOI

The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD-A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Stachowska E et al. • Nutrients (2020)

More prospective, controlled studies should be conducted to reveal specific details regarding the fiber type, dosage, and duration for optimal intervention.

These effects suggest the potential benefits of fiber consumption for NAFLD populations.
More prospective, controlled studies should be conducted to reveal specific details regarding the fiber type, dosage, and duration for optimal intervention.
Further research warranted to confirm findings

Meta-Analysisn=242

DOI

[Phytotherapeutic recommendations in medical guidelines for the treatment of gastroenterological diseases - a systematic review]

Utz S et al. • Zeitschrift fur Gastroenterologie (2024)

Some clear recommendations for the use of phytotherapeutics to treat gastroenterological diseases show their great potential.

Some clear recommendations for the use of phytotherapeutics to treat gastroenterological diseases show their great potential.
Due to their wide range of effects, phytotherapeutics can be used very well as a complement to conventional medicines in case of complex regulatory disorders.
However, further methodologically well-conducted impact studies would be helpful in order to be able to make further recommendations.Thieme.

Systematic Review

DOI

The effects of foods on LDL cholesterol levels: A systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials

Schoeneck M et al. • Nutrition, metabolism, and cardiovascular diseases : NMCD (2021)

Several foods distinctly modify LDL cholesterol levels.

Several foods distinctly modify LDL cholesterol levels.
The results may aid future guidelines and dietary advice for hypercholesterolemia.
Further research warranted to confirm findings

Meta-Analysisn=37

DOI

A systematic review and meta-analysis of the efficacy of medical treatments for the management of solitary rectal ulcer syndrome

Qari Y et al. • Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association (2020)

The majority of patients receiving medical treatment for the management of SRUS experience resolution of their ulcers.

The pooled effect estimate of treatment efficacy revealed that, of the patients receiving medical treatment, 57% had resolution of their ulcers (PP 0.57; 95% CI; 0.41 to 0.73).
Statistically significant heterogeneity was observed (I2 = 63%; τ2 = 0.64, P= <0.01).
The majority of patients receiving medical treatment for the management of SRUS experience resolution of their ulcers.

Meta-Analysisn=216

DOI

Efficacy and safety of laxatives for chronic constipation in long-term care settings: A systematic review

Alsalimy N et al. • Journal of clinical pharmacy and therapeutics (2018)

Considering the short duration of the trials, the lack of trials including newer laxatives and the low quality of some of the included trials, the long-term efficacy and safety of these laxatives are not conclusive.

Considering the short duration of the trials, the lack of trials including newer laxatives and the low quality of some of the included trials, the long-term efficacy and safety of these laxatives are not conclusive.
There is a need to conduct more robust RCTs that include newer agents to evaluate long-term outcomes.
Further research warranted to confirm findings

Systematic Reviewn=444

DOI

What is the efficacy of dietary, nutraceutical, and probiotic interventions for the management of gastroesophageal reflux disease symptoms? A systematic literature review and meta-analysis

Martin Z et al. • Clinical nutrition ESPEN (2022)

Evidence to guide the dietary management of GERD symptoms is limited in scope, quality, and feasibility.

Ginger-containing supplements could be meta-analyzed, and improved incidence of GERD symptom alleviation (n = 2 studies, OR: 7.50 [95%CI: 3.62-15.54], GRADE: high).
No clinically and/or statistically significant effects were found for the remaining n = 16 highly heterogenous interventions.
Evidence to guide the dietary management of GERD symptoms is limited in scope, quality, and feasibility.

Meta-Analysisn=21

DOI

Are all dietary fibers equal for patients with inflammatory bowel disease? A systematic review of randomized controlled trials

Peters V et al. • Nutrition reviews (2022)

Although the evidence is sparse, GBF and inulin seem propitious and merit further exploration.

Although the evidence is sparse, GBF and inulin seem propitious and merit further exploration.
Evidence on wheat bran and psyllium is still too limited.
Adequately powered long-term human RCTs with objective outcomes are needed to improve dietary advice on types of fiber in IBD.

Systematic Review

DOI

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