Psyllium is also used as a cholesterol-lowering agent, usually as an adjunct to a low-fat diet (Reid et al 2002). Soluble fibres, such as psyllium husk, increase the cholesterol-lowering effect of a low-fat diet in people with elevated cholesterol

(Anderson et al 2000). A meta-analysis of eight studies evaluating the cholesterol-lowering effects of psyllium (10.2 g/day) as an adjunct to a low-fat diet for at least 8 weeks found it lowered serum total cholesterol by 4%, LDL-cholesterol by 7% and the ratio of apolipoprotein (apo) B to apo A-l by 6% relative to placebo. It has also been used with some success in the paediatric population and is easy to incorporate into various foods (Davidson et al 1996).

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