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The interest in gluten-free (GF) products has been growing since both the increase in prevalence of celiac disease and the preferences of GF diet. In this study, the contribution of psyllium powder (PP) to gluten-free (GF) bread quality, dough rheology and volatile compounds (VCs) profile was investigated throughout the frozen storage period of GF dough (-30 °C for 0, 7, 15, and 30 days). GF doughs containing 7.5% PP (PSY1) and 15% PP (PSY2) had lower tanδ value than GF control dough (p<0.05) according to the results obtained from fundamental rheological analysis. Frozen storage caused no effect on the tanδ value of PSY1 and PSY2 (p ≥ 0.05). PP addition increased the specific volume (SV) of GF breads (p<0.05). No significant effect of frozen storage on SV was shown for PSY2 while SV values of GF control bread (GFB) and PSY1 decreased (p<0.05). Lower crumb hardness was shown for PSY1 and PSY2 on day 0. Significant effect of frozen storage on crumb hardness was observed for PSY1 on day 30 while harder crumb structure was shown for GFB throughout the frozen storage (p<0.05). Psyllium addition led to a significant reduction in both L* value of crust and crumb color (p<0.05). In the VCs analysis performed by HS/GC-MS, ethanol and 1-butanol, 3-methyl from alcohol group, butanal, 3-methyl- and hexanal from aldehydes were common for GFB and GF breads containing psyllium. 1-butanol, 3-methyl-, butanal, 3-methyl- and hexanal were the VCs of PSY1 and they were also shown after frozen storage. This study suggested that quality deterioration due to frozen storage was less in gluten-free breads containing psyllium. [ABSTRACT FROM AUTHOR]

The article discusses the increase in U.S. herbal supplement sales in 2023, reaching an estimated $12.551 billion, indicating a market normalization post-pandemic, with consumers focusing on cardiovascular and cognitive health products. Topics include sales growth trends in various retail channels, the top-selling herbal ingredients like psyllium and beet root, and the health benefits associated with these supplements.

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There is equivocal evidence that psyllium can prevent or attenuate increases in fasting blood sugar. Therefore, this systematic review and meta-analysis sought to investigate the influence of psyllium on hemoglobin A1C (HbA1c), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA IR). We searched PubMed, ISI Web of Science (WOS), and Scopus for eligible publications, up to 15 July 2022, including randomized controlled trials (RCT) assessing the effect of psyllium on HbA1c, FBS, insulin, and HOMA IR levels in adults. Using a random effects model, we report the weighted mean differences (WMD) with 95% confidence intervals (CI). In this article, 19 RCT studies, consisting of 962 participants, were included. Psyllium significantly decreased FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo (FBS: WMD): -6.89; 95% CI: -10.62, -3.16; p <.001), HbA1c: (WMD: -0.75; 95% CI: -1.21, -0.29; p <.001), HOMA IR: (WMD: -1.17; 95% CI: -2.11, -0.23; p <.05), and insulin: (WMD: -2.08; 95% CI: -4.21, -0.035; p >.05)). Subgroup analyses illustrated differences in the effects of psyllium on FBS: dosages less than and more than 10 g/d showed significant differences (p value < 0.05). However, it was not significant in intervention durations less than 50 days (p value > 0.05). For HbA1c: psyllium consumption less than 10 g/d (p value > 0.05) was non-significant. For HOMA IR and insulin: no significant changes were noted with psyllium consumption less than vs. more than 10 g/d. In conclusion, we found that psyllium could significantly decrease FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo. [ABSTRACT FROM AUTHOR]

Plantago is rich in soluble fiber, known for its beneficial health effects. Given this, we hypothesized that Plantago consumption might positively influence blood lipid in adults. Researchers have conducted numerous randomized controlled trials (RCTs), revealing the impacts of Plantago consumption on various blood lipid parameters. However, findings regarding specific blood lipid parameters have shown variability. This study aimed to comprehensively assess the effect of Plantago consumption on blood lipid parameters. Eligible studies evaluating the effects of Plantago consumption on blood lipid were searched in 5 electronic databases published up to August 2023. Analysis used a random effects model to determine weighted mean difference and 95% confidence intervals. In total, 29 RCTs including 2769 participants were included. 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. Conversely, no substantial effects were observed on high-density lipoprotein cholesterol or triglycerides. Subgroup analyses of 29 RCTs revealed that TC concentrations were significantly lowered in studies that included male participants, those who were healthy, or had lipid disorders. 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. In conclusion, Plantago consumption can significantly lower TC and LDL-C concentrations. The findings will provide crucial insights into the potential of Plantago in dietary strategies for blood lipid management. • Plantago, known for its high soluble fiber content, offers significant nutritional benefits for humans. • Plantago significantly lowers total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). • Plantago husk and psyllium reduced TC and LDL-C, while soluble fiber decreased TC, LDL-C, and triglycerides. • The study elucidates the potential of Plantago as a dietary component in the management of blood lipid profiles. Plantago, rich in soluble fiber, has demonstrated potential in improving blood lipids. Despite existing research, variations in the effects on specific lipid parameters remain. The present systematic review and meta-analysis of 29 randomized controlled trials, with 2769 participants, revealed Plantago's effectiveness in lowering TC by 0.28 mmol/L and LDL-C by 0.35 mmol/L compared with control groups. Conversely, no substantial effects were observed on HDL-C or TG after Plantago consumption. Notably, components such as psyllium, Plantago husk, and soluble fiber were pivotal. The findings of this study could enhance dietary strategies for blood lipids management and the prevention of cardiovascular diseases. Abbreviations: HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TC, total cholesterol; TG, triglycerides. [Display omitted] [ABSTRACT FROM AUTHOR]

The purpose of reporting on selected cases is to increase the recognition and treatment of mechanical joint dysfunction (restrictions in movement at the joint level) in pediatric patients. The selected cases demonstrate a variety of clinical outcomes that are possible using manual therapy to improve mechanical joint dysfunction and chronic pain. The techniques used for these patents were performed by a physical therapist without formal manual therapy training to encourage more physical therapists to use manual therapy as an intervention to improve outcomes in pediatric patients. The hands-on treatment used to treat mechanical joint dysfunction improved participation and function in children of various ages with a variety of clinical issues. : Recognizing and treating mechanical joint restrictions that interfere with active movement in children may result in decreased pain and improved motor skills, balance, self-regulation, sleep hygiene, and social interactions. Clinicians should consider manual therapy as an intervention strategy for pediatric patients with mechanical joint restrictions. [ABSTRACT FROM AUTHOR]

Dietary fibers regulate intestinal barrier function; however, the precise mechanisms remain unclear. This study investigated the effects of psyllium fibers on antimicrobial protein expression, focusing on the type II immunity and tuft cell-group 2 innate lymphoid cell (ILC2) circuit in the small intestine of the mouse. Supplemental psyllium fiber upregulated antimicrobial proteins, such as small proline-rich protein 2A (SPRR2A) and resistin-like beta (RELMβ), in mouse small intestine, evidently affecting cecal microbiota composition. The psyllium fibers also increased the RNA and protein expression of molecules related to ILC2 and tuft cells, such as IL-13, IL-25, DCLK1, Gfi-1b, SH2 domain-containing protein 3C, and Spi-B. In addition, ILC2 inhibitor (disulfiram) and bitter taste receptor blocker administration reduced psyllium-induced SPRR2A and RELMβ expression. Collectively, psyllium supplementation upregulates antimicrobial proteins such as SPRR2A and RELMß via the type II immune response and tuft cell-ILC2 circuit in the mouse small intestine. [ABSTRACT FROM AUTHOR]

Nowadays, due to the environmental problems caused by packaging based on synthetic polymers, the use of producing edible films based on biopolymers like polysaccharides, proteins, and fats has been interested. According to all the useful features of psyllium seed hydrocolloid (PH), the aim of this study was to evaluate the possibility of antimicrobial biodegradable edible film production using pH, glycerol, nisin (0, 5000 and 10000 IU/g) and Ethylenediaminetetraacetic acid (EDTA), (0, 15 and 30 wt%). The diameter of the inhibition zones against pathogenic bacteria on medium surface were measured as antimicrobial activity of films. The results showed that films containing nisin and EDTA significantly inhibition of Staphylococcus aureus) and Salmonella typhimurium growth. With increasing concentration of nisin and EDTA the inhibitory power of film against pathogenic bacteria increased. Maximum inhibition was obtained at 3416.03 IU/g concentration of nisin and highest concentration of EDTA (30%). At the optimal point, the inhibition zone against S. aureus and S. typhimurium was 2.02±0.2 and 2.2±0.3 cm, respectively. Tensile and elongation of optimal film was 13.41 Mpa and 28.51%, respectively. According to results of this study, novel biodegradable antimicrobial PH film could be suggested as meat product packaging. [ABSTRACT FROM AUTHOR]

This study was performed to examine the effects of individual and combined usage of psyllium husk powder (PHP) with guar gum (GG) or locust bean gum (LBG) on the production of gluten-free Turkish-type noodles. For this purpose, six different formulations were created with the total amount of variables being 3%, and samples' physical, chemical, cooking, textural and sensorial properties were performed. The results revealed no significant decrease or increase in moisture, ash, protein and fat contents. On the other hand, although individual usage of psyllium caused a slight decrease in carbohydrate content, this did not reflect energy values. The lowest L* and hue and the highest a* values were observed in the samples where only psyllium was used, and there was no significant difference in b* and saturation index values. Regarding cooking quality and textural analysis, the results from these two analyses supported each other, and there is a significant difference between the samples. An additional disliking that can be considered significant was not determined by using psyllium with or without other gums in noodle formulation. As a result, the dual combined psyllium with other gums in gluten-free noodle production could be appropriate without adversely affecting the quality of the product. [ABSTRACT FROM AUTHOR]

Low-salt surimi production is crucial as it addresses health concerns related to sodium intake while maintaining the quality and shelf-life of seafood products. This research focused on optimizing the gelation conditions for silver carp surimi with the addition of psyllium husk powder at low salt concentrations (0.5% and 1%, w/w) to investigate the effects of psyllium husk powder concentration, temperature, and time on gel strength and water-holding capacity. The quality was assessed in terms of gel strength and water-holding capacity. Following a single-factor exploration, a three-level orthogonal experiment was designed to evaluate the influence of these three variables using a combined scoring system. Results indicated that psyllium husk powder levels between 0.1% and 0.3% (w/w) enhanced gel strength and water-holding capacity. The optimal conditions were identified as follows: 1% (w/w) NaCl with 0.2% (w/w) psyllium husk powder for 2.5 h at 35 °C, and 0.5% (w/w) NaCl with 0.3% (w/w) psyllium husk powder for 3 h at 35 °C. Texture profile analysis revealed that psyllium husk powder increased the hardness of the surimi gel, promoting myosin cross-linking and denser gel structure. Compared to traditional surimi gel, which relies on ionic bonds, the optimized gel showed higher levels of disulfide cross-linking and enhanced hydrophobic interactions, resulting in a stronger gel structure. Sensory evaluation suggested that surimi gels with psyllium husk powder were perceived as better than those without psyllium husk powder. The study concludes that selecting the appropriate psyllium husk powder quantity and thermal processing conditions based on salt concentration can significantly improve the quality of low-salt surimi gels. Error analysis using one-way ANOVA was performed on all experimental data and (p < 0.05) indicated the significant difference. [ABSTRACT FROM AUTHOR]

The article focuses on the decline in retail sales of herbal dietary supplements in the U.S. in 2022, marking the first decrease since 2003, attributed to the normalization of consumer spending after the record-breaking growth during the COVID-19 pandemic.

The presence of heavy metal ions and organic dyes in the industrial effluents has toxic effects on human and animal health. There is an urgent growing need for the economic and effective treatment of waste water. The carbon dots (CDs) being a fluorescent zero-dimensional material have active surface area capable of binding with toxic heavy metal ions and organic moieties in water. In this study, the CDs have been successfully synthesized from hemicellulose rich Psyllium husk by means of simple green microwave method. The successful formation of CDs and the chemical state of the CDs have been successfully evaluated. The active surface area of CDs arising due to the surface defects contributed by oxygen functionality on the surface has been assessed from FT-Raman and XPS reports. The fluorescence property of the CDs as extrapolated for the sensing of heavy metal ions confirmed the successful sensing of Cr(VI), Fe(II) and Fe(III) ions with a detection (concentration) limit of 0.06 mM, 0.1 M and 0.2 mM, respectively. The photo catalytic performance of the prepared CDs for the discolouration of organic dyes, especially, the cationic dyes is encouraging indicating the successful preparation of negatively charged CDs from the biowaste. Ultimately, the study provides a simple, economical and efficient microwave method for the conversion of biowaste to a smart zero-dimensional carbon material for heavy metal sensing and dye discoloration. [ABSTRACT FROM AUTHOR]

Background and Objectives: Strawberries are prone to spoilage post-harvest majorly due to the mold growth and decay, leading to a shortened shelf life. This study aimed to investigate storage of fresh strawberries using Plantago major seed mucilage incorporated with grapefruit essential oil as an edible coating. Materials and Methods: The study investigated storage of an edible coating prepared from Plantago major seed mucilage containing grapefruit essential oil on the physical and chemical characteristics (pH, acidity, total soluble solids and firmness), microbial quality (fungal count) and sensory attributes (color, odor, texture and overall acceptability) of refrigerated strawberries. Strawberries were coated with Plantago major seed mucilage alone or Plantago major seed mucilage with three various concentrations (0.2, 0.6 and 1%) of grapefruit essential oil and then stored at 4 °C for 10 d. Results: Microbial load increased significantly with prolonged storage time in all the treatments. While Plantago major seed mucilage coating alone modestly slowed microbial growth, combining Plantago major seed mucilage with 1% grapefruit essential oil substantially delayed microbial growth by 18%, compared to the control sample. By the end of the storage, fungal counts orderly included 4.80, 3.95, 3.83, 3.66 and 3.45 log CFU/ml for the control, Plantago major seed mucilage, Plantago major seed mucilage and 0.2% grapefruit essential oil, Plantago major seed mucilage and 0.6% grapefruit essential oil, and Plantago major seed mucilage and 1% grapefruit essential oil coated strawberries, respectively. Physicochemical and sensory characteristics (pH, acidity, total soluble solids, firmness, color, odor, texture and overall acceptability) of strawberries treated with the coating consistently outcarried out those of the untreated control. While Plantago major seed mucilage coating alone showed preservation benefits, combination of Plantago major seed mucilage with grapefruit essential oil was further effective. Conclusions: This study suggests that a Plantago major seed mucilage coating incorporating 1% of grapefruit essential oil can serve as a bioactive packaging solution to extend shelf life as well as serving as an alternative to pesticides. [ABSTRACT FROM AUTHOR]

Pankaj Garg’s story is an interesting one and is a source of inspiration for all physicians and budding innovators. He started his career as a community doctor about two decades back in the year 2001, then changed gears in between to become an avid researcher and innovator. He progressed to become a leading international figure in his field. Garg has exemplified three important points. First, with proper temperament, it is possible to achieve academic excellence and conduct research even in a primary care setting. Second, every specialist should fulfill the role of a family physician as well. While pursuing any specialty, the role of a “general physician” should never be ignored. Third, innovation is a state of mind, and big institutions and well-equipped laboratories with costly gadgets are not a prerequisite to it. This is clearly exemplified by Pankaj Garg’s story that it is possible to excel in research, academics, and clinical work at the global level without any research budget, big institute tag, or the help of government or non-government organizations. Garg has more than 175 publications in high-impact journals. He has 30 innovations to his name, in and outside his field of expertise, all of which have been published in international journals. The innovations include new operative procedures, successful non-operative management, the discovery of new anatomical spaces, new concepts in disease understanding and management, and finding non-operative treatment for diseases for which surgery is routinely performed. It is impressive that seven of his innovations are popularly known by his name - Garg classification, Garg space, Garg protocol, Garg cardinal principles, Garg scoring system, Garg phenomenon, and Garg incontinence scores. Due to 30 innovations done single-handedly, Garg has been certified as a “doctor with maximum innovations” by several record books. Due to his ability to think “out-of-the-box” and his immense contribution to advancements in the field of proctology, he is recognized as a global icon in his field. Garg is a master teacher. He has taught surgical skills and the art of scientific paper writing to hundreds of surgeons and doctors. In spite of limited resources at his disposal, Garg goes out of his way to help poor people. He performs about 30–40% of operations free of cost. He has successfully treated patients from 41 countries and several patients from royal families of the Gulf who offered him lucrative money to move to the Middle East. However, Garg flatly refused all offers because his priority was to serve his country and countrymen first. Hence, a simple doctor working in a small city was never discouraged by the lack of resources, and the fear of working alone in a small set-up and without any help from the government has carved out a tale that can motivate professionals in any corner of the world. Dr. Garg’s story provides immense inspiration to every practicing physician in the country to innovate whether he/she is practicing in a primary healthcare center or a rural area. [ABSTRACT FROM AUTHOR]

Background: One of the most common childhood abnormalities is constipation, typically affecting about 1 - 30% of children worldwide. Objectives: This study aimed to compare the effect of psyllium seed husk powder versus polyethylene glycol with and without probiotics on constipation in children. Methods: A total of 144 children in the age range of 2 - 12 years with acute functional constipation who met the inclusion criteria were included in this study. The subjects were randomly divided into four equal groups (n = 36 each). The first group received polyethylene glycol (A), the second group received polyethylene glycol with probiotics (B), the third group received psyllium (C),and the fourth group received psyllium with probiotics (D). Finally, the number of bowel movements and painless bowel movements were examined after three weeks. Results: After three weeks, the effects of polyethylene glycol with and without probiotics on the number of bowel movements and painless bowel movements were significantly different than psyllium with and without probiotics (P = 0.001). While no significant difference was observed between treatment groups A and B (P = 0.9), there was a significant difference between treatment groups C and D (P = 0.01). Conclusions: Polyethylene glycol had a greater effect on improving the symptoms of constipation in children compared to psyllium. Although fortification of polyethylene glycol with probiotics had no significant effect, fortification of psyllium with probiotics improved the symptoms of constipation in children compared to psyllium alone. [ABSTRACT FROM AUTHOR]

Background Chronic constipation is a prevalent disorder that remains challenging to treat. Studies suggest increasing fiber intake may improve symptoms, although recommendations on the fiber type, dose, and treatment duration are unclear. Objectives We investigated the effects of fiber supplementation on stool output, gut transit time, symptoms, and quality of life in adults with chronic constipation via a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods Studies were identified using electronic databases, backward citation, and hand searches of abstracts. RCTs reporting administration of fiber supplementation in adults with chronic constipation were included. Risks of bias (RoB) was assessed with the Cochrane RoB 2.0 tool. Results were synthesized using risk ratios (RRs), mean differences, or standardized mean differences (SMDs) and 95% CIs using a random-effects model. Results Sixteen RCTs with 1251 participants were included. 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. A higher response to treatment was apparent in fiber groups compared to control groups irrespective of the treatment duration, but only with higher fiber doses (>10 g/d). 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. Flatulence was higher in fiber groups compared to control groups(SMD: 0.80; 95% CI: 0.47, 1.13; P  < 0.00001). Conclusions Fiber supplementation is effective at improving constipation. Particularly, psyllium, doses >10 g/d and treatment durations of at least 4 weeks appear optimal, though caution is needed when interpreting the results due to considerable heterogeneity. These findings provide promising evidence on the optimal type and regime of fiber supplementation, which could be used to standardize recommendations to patients. The protocol for this review is registered at PROSPERO as CRD42020191404. [ABSTRACT FROM AUTHOR]

The International Diabetes Federation estimates that approximately 10 % of the adult population in Ukraine has prediabetes. According to many studies, prediabetes is observed in every second obese patient, and later prediabetes can progress to type 2 diabetes mellitus. Therefore, timely detection of early disorders of carbohydrate metabolism is very important, as well as implementation of recommendations for lifestyle changes, the use of modern drugs to prevent type 2 diabetes and cardiovascular diseases. In recent years, increasing attention is drawn to dietary fibers as an integral part of a healthy diet. They help prevent obesity, metabolic syndrome and adverse changes in the gut, and also help increase the population of beneficial bacteria in the gut. That is why nutritionists recommend that obese people include dietary fibers in their diet. One of the most famous dietary fibers is psyllium, which comes from the husk of plantain seeds (Plantago ovata). Numerous studies show that psyllium has a positive effect on the functioning of many organs and systems, including the pancreas, intestines and heart muscle. Psyllium also lowers glucose and cholesterol and is an effective way to lose weight for people who are overweight. Fibolex® plant complex contains dietary fibers (psyllium and natural wheat fibers) and green tea extract. Due to the combined herbal composition, Fibolex® can be used in obese people, patients with prediabetes, metabolic syndrome, type 2 diabetes and other metabolic disorders for the correction of eating habits in order to improve carbohydrate and lipid metabolism. [ABSTRACT FROM AUTHOR]

Psyllium is a natural, predominantly soluble isolated fiber that forms a gel when hydrated. The psyllium gel is not fermented and transits the entire gastrointestinal tract intact. In the small intestine, the psylliumgel increases chyme viscosity, which slows the degradation and absorption of nutrients, which significantly improves fasting blood glucose and hemoglobin A1c levels in individuals with metabolic syndrome and type 2 diabetes mellitus (eg, -37 mg/dL). This delay in nutrient absorption prolongs satiety/delays hunger, leading to decreased energy intake and weight loss in overweight and obese patients. In the distal small intestine (terminal ileum), psyllium becomes more concentrated as water is absorbed, and the highly viscous gel interferes with the active reuptake of bile acids, which are captured in the gel and eliminated via stool. This decrease in the bile acid pool stimulates the liver to produce more bile. As cholesterol is a component of bile, the liver expresses low-density lipoprotein (LDL) cholesterol receptors to harvest LDL-cholesterol from the blood, thereby lowering both LDL-cholesterol (up to 24%) and total cholesterol (up to 20%) levels without affecting high-density lipoprotein cholesterol level. The cholesterol-lowering benefit of psylliumis also additive to the effects of statin drugs, with an effect equivalent to doubling the statin dose. In the large intestine, the nonfermented psyllium gel has a paradoxical "stool normalizing" effect: psyllium softens hard stool in constipation, firms loose/liquid stool in diarrhea, and normalizes stool form/reduces symptoms in irritable bowel syndrome. Psylliumis the only fiber recommended for treatment of constipation and irritable bowel syndrome by the American College of Gastroenterology. Taken together, psyllium is the only fiber supplement that provides 5 of the major health benefits identified by the Food and Drug Administration (cholesterol lowering, improved glycemic control, decreased energy intake/weight loss, decreased blood pressure secondary to weight loss, and laxation/regularity). Psyllium has also been shown clinically to be effective in disease states (eg, hypercholesterolemia, type 2 diabetes, obesity, chronic constipation, chronic diarrhea, hemorrhoids, ulcerative colitis, enteral nutrition--induced diarrhea, fecal incontinence, and irritable bowel syndrome). Taken together, the clinical data support the conclusion that "Fiber needs to gel to keep your patients well." [ABSTRACT FROM AUTHOR]

The objective of the study was to investigate the suitability of the Plantago ovata (PO) husk as a pharmaceutical excipient. Various phytoconstituents of the husk were determined according to the standard test procedures. The Plantago ovata husk was evaluated for various pharmaceutical parameters related to flow, swelling index, and compressibility index. Orodispersible tablets (ODTs) were prepared, containing different concentrations (2.5, 3, 5, 7.5, 10, and 15% w / w) of the Plantago ovata husk. Before compression, all the formulations were evaluated for their flow. Compressed ODTs were evaluated for physical characteristics (physical appearance, weight and weight variation, thickness, and moisture content), mechanical strength (crushing strength, specific crushing strength, tensile strength, and friability), disintegration behavior (disintegration time and oral disintegration time), drug content, and in vitro drug release. Phytochemical evaluation of the Plantago ovata husk confirmed the presence of various phytoconstituents like alkaloids, tannins, glycosides, saponins, flavonoids, and phenols. SEM photograph of the Plantago ovata husk showed that it has a fibrous structure, with a porous and rough surface. The Plantago ovata husk had a high swelling index (380%) which decreased by pulverization (310%). Precompression evaluation of the powder blend for all the formulations of ODTs showed good flow properties, indicating that the Plantago ovata husk improved the rheological characteristics of the powder blend. Compressed ODTs had good mechanical strength, and their friability was within the official limits (<1%). Best disintegration was observed with formulation F-6 containing 10% w / w of the Plantago ovata husk. It is concluded that the Plantago ovata husk can be used as a disintegrant in the formulation of ODTs. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Psyllium and prunes are proven treatments for chronic constipation (CC). Asian studies suggest that kiwifruit may also benefit CC symptoms. We report a partially randomized, comparative effectiveness trial evaluating kiwifruit, psyllium, and prunes in US patients with CC. METHODS: Adults with CC at a USmedical center were randomized to 3 natural treatments. Eligible patients had ≤3 complete spontaneous bowel movements (CSBMs) per week and were partially randomized to green kiwifruit (2/d), prunes (100 g/d), or psyllium (12 g/d) for 4 weeks. The primary endpoint was the proportion of patients in each group reporting an increase of ≥1 CSBM per week compared with baseline for at least 2 of 4 treatment weeks. Key secondary outcomes included stool frequency, stool consistency, and straining assessed daily. Treatment satisfaction and adverse events (AEs) were also measured. Standard statistical methods were used, and a P < 0.05 was considered significant. RESULTS: Seventy-nine patients with CC (mean age = 42.7 years, 87% female, and 77% white) were partially randomized. Complete data were available for 75 patients (kiwifruit 29, prunes 24, and psyllium 22). For the primary endpoint, proportions of CSBM responders were similar for the treatments. For secondary outcomes comparing treatment weeks 3 and 4 to baseline, there was a significant increase in weekly CSBM rate with all 3 treatments (P £ 0.003); stool consistency significantly improved with kiwifruit (P = 0.01) and prunes (P = 0.049); and straining significantly improved with kiwifruit (P = 0.003), prunes (P < 0.001), and psyllium (P = 0.04). Patients randomized to the kiwifruit group reported significant improvement in bloating scores (P = 0.02). AEs were most common with psyllium and least common with kiwifruit. At the end of treatment, a smaller proportion of patients were dissatisfied with kiwifruit compared with prunes or psyllium (P = 0.02). DISCUSSION: Kiwifruit, prunes, and psyllium improve constipation symptoms in patients with CC. Kiwifruit was associated with the lowest rate of AEs and dissatisfaction with therapy. [ABSTRACT FROM AUTHOR]

Objective: Gluten-free (GF) cookies are usually deficient in dietary fibers as compared to traditional wheat cookies. So, we aimed to formulate GF cookies with different levels of psyllium husk (fiber) from oats flour. Methods: Three types of GF cookies were made; T0, T1, and T2 containing 0%, 2.5%, and 5% psyllium husk respectively. Analysis of functional properties of the dough, physicochemical and sensory characteristics of the cookies was performed. Results: Addition of 5% psyllium husk (T2) led to enhanced functional properties of dough (% swelling capacity SC =635.0±15.00, % water absorption capacity WAC =132.33±2.51, % oil absorption capacity OAC =28.00±2.00, % emulsion activity =59.93±0.25, % emulsion stability =60.23±0.25) and the most desirable spread factor (8.71±0.572). The total fiber content of T2 cookies was 19.41%. The mean sensory evaluation score for the overall acceptability of T2 cookies (6.32±1.096) was significantly (P=0.050) higher than the T1 cookies (5.49±0.785). 5% psyllium husk cookies (T2) surpassed 0% and 2.5% psyllium husk cookies in all parameters under study. Conclusion: The integration of psyllium husk into oat-based GF cookies resulted in excellent properties and acceptability and it can be added as a healthy snack option in diets of people with gluten intolerance. [ABSTRACT FROM AUTHOR]

Objective: Polysaccharide-based biomaterials are extensively used in wound care healing due to their unique liquid absorption, gelling properties and biocompatibility properties. They play an important role in controlling infections of highly exuding hard-to-heal wounds. The main objective of this study was to develop silver-containing polysaccharide-based tricomponent antibacterial fibres for use in these complex wounds. Method: The fibres were developed by coating silver-containing alginate and psyllium fibres with hydrolysed chitosan. Dope solution containing alginate, psyllium and silver carbonate was extruded into a coagulation bath containing calcium chloride and hydrolysed chitosan. The developed fibres were tested for liquid absorption, swelling and antibacterial properties against a control fibre (of alginate and psyllium). Results: The developed fibres showed comparatively better liquid absorption, gelling and antibacterial properties than the control fibres. Conclusion: The study concluded that developed fibres could be a preferred choice for application on hard-to-heal wounds with high levels of exudate, to support infection control and faster healing. [ABSTRACT FROM AUTHOR]

Arabic bread (khubuz) made from white flour is the staple food in the Arabic countries but has now become popular all over the world. A different approach of producing high fiber bread with improved quality can be produced using white flour with added mill fractions, but the addition of mill fractions has been shown to adversely affect the dough characteristics. Therefore, the effect of adding mill fractions on the rheological characteristics of dough was investigated using Brabender Farinograph and Extensograph with the major objective of eliminating their deleterious effects on dough quality, mainly by using psyllium husk, and also reported as an excellent source of soluble dietary fiber. Addition of fine bran, coarse bran, and raw wheat germ decreased the extensibility and resistance to extension and area under curve, lower dough stability, but enhanced water absorption and peak time. Addition of psyllium husk, though reduced the extensibility, but did not affect the area under the curve adversely, thus overcame some of the negative effects on rheological characteristics of the white flour dough. It was concluded that the use of psyllium husk will evidently help the bakers to produce nutritious and acceptable quality Arabic bread. [ABSTRACT FROM AUTHOR]

Psyllium is an important medicinal plant cultivated in India, Pakistan, and Iran. The psyllium seed's husk is rich in arabinoxylans, and this component is used for treating certain gastrointestinal problems. It is also used as an ingredient in foods to improve their fiber content, texture, and rheological and sensory characteristics. Large doses of psyllium can give rise to flatulence and bloating. Also, in rare cases, psyllium husk can cause skin sensitivity and respiratory allergy in sensitive individuals after prolonged exposure. [ABSTRACT FROM AUTHOR]

The US Food and Drug Administration (FDA) received a petition from a company requesting that FDA issue an authorized health claim for the relationship between psyllium husk and a reduced risk of type 2 diabetes. After an initial assessment of the available scientific evidence, FDA determined that significant scientific agreement was lacking for this substance-disease relationship, whereupon the company agreed to have its petition reviewed as a qualified health claim. This article describes the process FDA used in conducting an evidence-based review of the science underpinning the proposed claim and addresses certain safety issues associated with psyllium husk that FDA considered in its review of the petition. Of the 6 studies from which scientific conclusions could be drawn, as identified through FDA's review, psyllium husk significantly improved plasma glucose levels and insulin sensitivity in only 1 study. Therefore, FDA's enforcement discretion letter for this qualified health claim stated: "Psyllium husk may reduce the risk of type 2 diabetes, although the FDA has concluded that there is very little scientific evidence for this claim." [ABSTRACT FROM AUTHOR]

Background Wheat bran, nopal, and psyllium are examples of particulate, viscous and particulate, and viscous fibers, respectively, with laxative properties yet contrasting fermentability. Objectives We assessed the fermentability of these fibers in vitro and their effects on intestinal function relevant to laxation in vivo using MRI. Methods Each fiber was predigested prior to measuring gas production in vitro during 48-h anaerobic incubation with healthy fecal samples. We performed a randomized, 3-way crossover trial in 14 healthy volunteers who ingested 7.5 g fiber twice on the day prior to study initiation and once with the study test meal. Serial MRI scans obtained after fasting and hourly for 4 h following meal ingestion were used to assess small bowel water content (SBWC), colonic volumes, and T1 of the ascending colon (T1AC) as measures of colonic water. Breath samples for hydrogen analysis were obtained while patients were in the fasted state and every 30 min for 4 h following meal ingestion Results In vitro, the onset of gas production was significantly delayed with psyllium (mean ± SD: 14 ± 5 h) compared with wheat bran (6 ± 2 h, P  = 0.003) and was associated with a smaller total gas volume (P  = 0.01). Prefeeding all 3 fibers for 24 h was associated with an increased fasting T1AC (>75% of values >90th centile of the normal range). There was a further rise during the 4 h after psyllium (0.3 ± 0.3 s P  = 0.009), a fall with wheat bran (−0.2 ± 0.2 s; P  = 0.02), but no change with nopal (0.0 ± 0.1 s, P  = 0.2). SBWC increased for all fibers; nopal stimulated more water than wheat bran [AUC mean (95% CI) difference: 7.1 (0.6, 13.8) L/min, P  = 0.03]. Breath hydrogen rose significantly after wheat bran and nopal but not after psyllium (P  < 0.0001). Conclusion Both viscous and particulate fibers are equally effective at increasing colonic T1 over a period of 24 h. Mechanisms include water trapping in the small bowel by viscous fibers and delivery of substrates to the colonic microbiota by more fermentable particulate fiber. This trial was registered at clinicaltrials.gov as NCT03263065. [ABSTRACT FROM AUTHOR]

Water-soluble dietary fibers have been shown to improve lipid profile and glucose metabolism in diabetes. The aim of this study was to review the effects of psyllium consumption on weight, body mass index, lipid profiles, and glucose metabolism in diabetic patients in randomized controlled trials. A comprehensive systematic search was performed in PubMed/MEDLINE, Web of Sciences, Cochrane, and Scopus by two independent researchers up to August 2019 without any time and language restrictions. The DerSimonian and Laird random-effects model method performed to calculate the pooled results. Inclusion criteria were randomized controlled trial design, adult subjects, and studies reporting the mean differences with the 95% confidence interval for outcome. Eight studies containing nine arms with 395 participants were identified and included in final analysis. Combined results found a significant reduction in triglycerides, low-density lipoprotein, fasting blood sugar, and hemoglobin A1c following psyllium consumption (weighted mean differences [WMD]: -19.18 mg/dl, 95% CI [-31.76, -6.60], I2 = 98%), (WMD: -8.96 mg/dl, 95% CI [-13.39, -4.52], I2 = 97%), (WMD: -31.71 ml/dl, 95% CI [-50.04, -13.38], I2 = 97%), and (WMD: -0.91%, 95% CI [-1.31, -0.51], I2 = 99%), respectively. There was no significant change in high-density lipoprotein, body mass index, cholesterol, and weight. In conclusion, the results demonstrated a significant reduction in triglycerides, low-density lipoprotein, fasting blood sugar, and hemoglobin A1c by psyllium intervention among diabetic patients. [ABSTRACT FROM AUTHOR]

Constipation seems like a ubiquitous condition, something people of all ages experience and many complain about. It is often associated with infrequent bowel movements; however, in reality, constipation has a wide array of symptoms including hard stools, feeling of incomplete evacuation, abdominal discomfort, bloating, distension, excessive straining, sensation of anorectal blockage, or need for manual maneuvers during defecation. Determining the cause of the constipation is essential to ensure the appropriate treatment approach. The patient evaluation consists of collecting subjective and objective information. Constipation has many different treatment options, with many treatments available as over-the-counter products as well as prescription medications. For most types of constipation, nonpharmacological and dietary changes are typically recommended as first-line treatment. Prescription medications are available with indications for specific types of constipation. Both nonpharmacological and pharmacological interventions have a key role, and follow-up is important to ensure treatment is appropriate and adequate. [ABSTRACT FROM AUTHOR]

A twelve year old mule was presented with complaint of abdominal pain. Rectal examination revealed semi solid faeces and wavy sound was obtained on auscultation of lower quadrants of abdomen. The case was diagnosed as sand colic due to presence of sand particles in the faecal matter. The mule was treated with analgesics, psyllium husk, liquid paraffin and fluids. The mule recovered after one week. [ABSTRACT FROM AUTHOR]

Background: Previous studies reported inconsistent findings regarding the effects of psyllium supplementation on obesity measures. This systematic review and meta-analysis was performed to summarize data from available randomized clinical trials (RCTs) on the effect of psyllium supplementation on body weight, body mass index (BMI), and waist circumference (WC) in adults.Methods: PubMed, SCOPUS, Cochrane Library, and Google Scholar were searched to identify relevant articles up to August 2018. The effect sizes were presented as weighted mean difference (WMD) and 95% confidence intervals (CI) by using random effects model. To detect dose-response relationships, we used fractional polynomial modeling.Results: A total of 22 RCTs were included. Meta-analysis did not find any significant effect of psyllium supplementation on body weight (MD: -0.28 kg, 95% CI: -0.78, 0.21, p = 0.268), BMI (MD: -0.19 kg/m2, 95% CI: -0.55, 0.15, p = 0.27) and WC (MD: -1.2 cm, 95% CI: -2.6, 0.2, p = 0.09). Subgroup analysis showed that psyllium dosage, kind of psyllium administration, duration of trial, study design, sample size, and gender were potential sources of heterogeneity. Moreover, there was nonlinear association between duration of psyllium consumption, BMI and WC.Conclusion: Psyllium supplementation does not reduce body weight, BMI, and WC significantly. [ABSTRACT FROM AUTHOR]

The present study was concerned with to optimize the formulation of whey protein concentrate (WPC) and psyllium husk for development of protein-fiber rich orange fleshed sweet potato (OFSP) bread using response surface methodology. The variables considered for the study were WPC (03–09%) and psyllium husk (02–06%) while the responses were protein content (%), fiber content (%), overall acceptability, loaf weight (g), loaf volume (cm3), specific volume (cm3/g) and oven spring (cm). Bread was prepared using 30% OFSP flour and 70% wheat flour. WPC and psyllium husk were used as source of protein and fiber respectively. The level of alone WPC significantly affects (p < 0.05) on protein content whereas psyllium husk on fiber content of OFSP bread. There was significant effect of psyllium husk and non significant effect of WPC on overall acceptability. Moreover, the loaf volume and specific volume of bread was significantly affected by both the factors. The WPC was significantly and psyllium fiber non significantly affects on oven spring of OFSP bread. The optimization was carried out on WPC and psyllium husk in order to know which of the combination will give best protein-fiber content and overall acceptability with quality physical properties. The optimized bread sample was also evaluated for biofunctional (total carotenoids, total phenols, total flavonoids and antioxidant activity) components, and estimated glycemic index (EGI). The optimized OFSP bread containing 09% WPC and 06% psyllium husk was found most acceptable by consumers and it provides 17.72% protein and 8.02% fiber. The estimated glycemic index was found lower 52.58. The total carotenoid, total phenols, total flavonoids and DPPH inhibition of OFSP bread was found as 3.78 (mg/100 g), 51.32 (mg GAE/100 g), 26.80 (mg QE/100 g) and 43.53% respectively. The optimized sample of bread was found superior in carotene, protein and fiber content. [ABSTRACT FROM AUTHOR]

Background/Aim: Solitary rectal ulcer syndrome (SRUS) is a benign, poorly understood disorder that is difficult to manage. Medical interventions such as sucralfate, sulfasalzine, human fibrin, and a high fibre diet are reported as the first line of treatment. The aim of this study is to perform a systematic review and meta-analysis of the efficacy of medical treatments for SRUS. Materials and Methods: Databases including PubMed, Cochrane, and Embase were searched for randomised clinical trials (RCT) and observational studies that evaluated medical treatments for SRUS. Two authors independently performed selection of eligible studies based on eligiblity criteria. Data extraction from potentially eligible studies was carried out according to predefined data collection methods. Medical treatments, including sucralfate, sulfasalzine, human fibrin, a high fibre diet, and psyllium powder as a single or combination therapy were compared to placebo alone or combined with other treatments. The primary outcome was the proportion of patients with ulcer remission; this was presented as pooled prevalence (PP) with a 95% confidence interval (CI). The I2 value and Q statistic test were used to test for heterogeneity. In the presence of heterogeneity, a random-effects model was applied. Results: A total of 9 studies with 216 patients (males = 118, females = 98) diagnosed with SRUS were analysed in the final meta-analysis. 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 scarcity of RCTs comparing medical treatments with other interventions was a major limitation. Conclusions: The majority of patients receiving medical treatment for the management of SRUS experience resolution of their ulcers. [ABSTRACT FROM AUTHOR]

Background: Treatment guidelines for chronic idiopathic constipation (CIC) recommend an "increase in fiber intake" as a first-line therapy, but most epidemiologic studies fail to support an association between a high-fiber diet and a reduced risk of constipation. Furthermore, randomized controlled clinical studies show that most isolated fibers (e.g., supplements) are not different from placebo for a laxative effect, and several may be constipating. Objectives: The objective of this review was to compare the effects of two isolated fibers, coarse wheat bran and psyllium, on stool output and stool water content in patients with CIC. This review will also address misconceptions about fiber that are perpetuated by treatment guidelines. Data sources: A comprehensive literature review was conducted with the use of the Scopus, SciFinder, and PubMed scientific databases, limited to the previous 50 years (1968-2018; latest date included, December 31, 2018). Conclusions: In patients with CIC, nonfermented gel-forming psyllium was 3.4 times more effective than insoluble wheat bran for increasing stool output. Both psyllium and coarse wheat bran increased stool water content, a stoolsoftening effect, but finely ground wheat bran decreased stool water content, a stool-hardening effect. Implications for practice: It is amisconception that dietary fiber and all isolated fibers provide a laxative effect in patients with CIC. Our analysis suggests that treatment guidelines for CIC should make specific evidence-based recommendations as it pertains to fiber. To do otherwise takes the risk of perpetuating myth and misunderstanding and depriving patients of an effective therapy for CIC. A generic recommendation to "increase fiber intake" is akin to a recommendation to "increase pill intake" without regard to therapeutic or adverse effects. [ABSTRACT FROM AUTHOR]

Background: Diarrhea in enteral tube-fed patients is not uncommon and can lead to unfavorable outcomes. Fiber in enteral nutrition (EN) formula might play a role in postfeeding diarrhea. Theoretically, soluble fiber is beneficial for both prevention and treatment of postfeeding diarrhea, but different types of soluble fiber may not provide the same effect. This study aims to determine whether supplementation with psyllium in standard EN reduces the incidence of diarrhea in tube-fed patients.Methods: We conducted a prospective, randomized, double-blind, controlled study in general medical wards patients who were expected to receive EN for ≥5 days. Exclusion criteria were hemodynamic instability, known significant gastrointestinal problems, and recent pancreatitis. Eligible patients were randomized to receive either Mucilin SF (15.2 g/L)-added Blendera (psyllium-added formula: Psyllium group [PG]) or Blendera (fiber-free formula: Control group [CG]). All patients were given EN for 10 days or until discharge/oral intake/death. Bowel movements (BMs) were monitored using King's Stool Chart.Results: Eighty-three patients were enrolled, 42 in the PG and 41 in the CG. Baseline characteristics were similar. The proportion of patients with ≥1 day of diarrhea (King's stool score ≥15) was comparable (42.9% vs 31.7%; P = 0.41, in PG and CG, respectively). There were no significant differences in the frequency of daily BMs and the median diarrhea score between PG and CG (3 vs 2, P = 0.06 and 3.8 vs 2.4, P = 0.42, respectively).Conclusion: Supplementation with psyllium showed no beneficial effect on reducing incidence of diarrhea in general medical patients receiving EN. This study was registered on Thai Clinical Trials Registry (http://www.clinicaltrials.in.th: TCTR identification number TCTR20170821004). [ABSTRACT FROM AUTHOR]

Vascular dementia (VaD) develops through a pre-VaD step during which blood vessels narrow due to atherosclerosis attributed to risk factors, including hyperlipidemia. This is followed by a VaD progression step during which inadequate blood supply results in white matter damage and consequent cognitive impairment. Furthermore, administration of arabinoxylan attenuated white matter damage in a rat model of VaD. Thus, we hypothesized that consumption of psyllium seed husk (PSH), containing a high level of arabinoxylan (~60%), could inhibit the VaD progression step. To test this hypothesis, rats were supplemented with PSH at various dosages for 33 days in a model of bilateral common carotid artery occlusion. PSH supplementation decreased astrocytic and microglial activation in the optic tract (opt) and, consequently, attenuated white matter damage in the opt. Attenuation of white matter damage resulted in improvement of pupillary light reflex, an indicator reflecting intactness of the opt. In addition, PSH treatment improved survival of glial cells cultured under hypoxic and glucose-deprived conditions by inhibiting both apoptosis and autophagy. These findings indicate that PSH consumption can inhibit the VaD progression step through a decrease of white matter damage. Therefore, these results support our hypothesis that PSH consumption prevents VaD due to the high arabinoxylan content in the rat model. PSH consumption has already been shown to reduce risk factors, thereby inhibiting the pre-VaD step. Consequently, PSH consumption can contribute to the prevention of VaD by inhibiting both the pre-VaD and VaD progression steps. In conclusion, our rat study suggests that PSH might be a candidate to explore its use in clinical studies to reduce VaD. [ABSTRACT FROM AUTHOR]

To circumvent the problems (such as volatilization, photolytic decomposition, chemical instability, easy permeability through the skin) associated with low molecular weight antimicrobial agents, our strategy employed graft copolymerization of cationic monomer with the polymeric substrate viz. psyllium husk. The surface graft concentration of quaternary ammonium ion on psyllium was optimized by measuring the extent of grafting in the microwave-induced process. The surface modification of graft copolymers was evident by different physico–chemical techniques like 13C nuclear magnetic resonance (NMR), Fourier-transform infrared spectroscopy (FTIR), scanning electron microscope (SEM), X-ray diffractometer (XRD), differential scanning calorimetry (DSC), Thermo gravimeteric analysis (TGA), and viscometric study. The synthesized water soluble product resulted good antibacterial activity against Gram positive Staphylococcus aureus and Bacillus anthracis but failed to produce any antibacterial activity against Gram negative Salmonella typhi and Escherichia coli. The reason to failure has been explained on the basis of differences in the electrokinetic property between Gram-positive and Gram-negative bacteria. Optimum minimum inhibitory concentration (MIC) for the polymeric grade which showed good biocidal effect evaluated by both zone of inhibition and absorbance is found at 1000 µg/ml. [ABSTRACT FROM AUTHOR]

BACKGROUND The combined effect of variously chemically modified lotus rhizome starch, whey protein concentrate, psyllium husk and glycerol was evaluated on developed biodegradable films. RESULTS: Dual‐modified lotus rhizome starch composite films presented minimum solubility and water vapor permeability and maximum tensile strength among native and modified starch composite films. Elongation at break of dual‐modified starch composite films (FLCOS1, FLCOS2) was found to be a maximum, whereas a decrease was observed for FLCOS3. Oxidized lotus rhizome starch composite films were the most transparent among native and modified starch composite films, whereas crosslinked lotus rhizome starch composite films were the least transparent. Scanning electron microscopy indicated a homogeneous compact surface of oxidized starch composite films, whereas troughs were observed in crosslinked and dual‐modified starch composite films. Using whey protein concentrate, psyllium husk and glycerol without any phase separation, smoother films and with compact microstructures were produced. Fourier transform infrared analysis revealed additional peaks for modified starch films, confirming greater interaction among starch and film‐forming components, whereas amorphous structure was indicated from X‐ray diffraction results of modified starch composite films. CONCLUSIONS: Owing to various properties of modified starches, these films find application in edible contact packages and can better be used for products where higher structural integrity and lower water vapor transmission are needed. © 2019 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Background: Studies have identified viscous dietary fiber as potentially attenuating cholesterol, including psyllium, which reduces LDL cholesterol and thus may complement cardiovascular disease (CVD) treatment. Objectives: The aims of this study were to update evidence on the effect of psyllium on LDL cholesterol and to provide an assessment of its impact on alternate markers: non-HDL cholesterol and apolipoprotein B (apoB). Design: Medline, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials were searched through 3 October 2017. Independent reviewers extracted relevant data and assessed risk of bias. We included randomized controlled trials with a duration of =3 wk that assessed the effect of psyllium on blood lipids in individuals with or without hypercholesterolemia. Data were pooled by using the generic inverse variance method with random-effects models and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by Cochran's Q statistic and quantified by the I2 statistic. Overall quality of the evidence was assessed by using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Results: We included 28 trials in our analysis (n = 1924). Supplementation of a median dose of ~10.2 g psyllium significantly reduced LDL cholesterol (MD = -0.33 mmol/L; 95% CI: -0.38, -0.27 mmol/L; P < 0.00001), non-HDL cholesterol (MD = -0.39 mmol/L; 95% CI: -0.50, -0.27 mmol/L; P < 0.00001), and apoB (MD = -0.05 g/L; 95% CI: -0.08, -0.03 g/L; P < 0.0001). Effect estimates for LDL cholesterol and non-HDL cholesterol were graded as moderate quality on the basis of downgrades for inconsistency and graded as high quality for apoB. Conclusion: Psyllium fiber effectively improves conventional and alternative lipids markers, potentially delaying the process of atherosclerosis-associated CVD risk in those with or without hypercholesterolemia. This trial is registered at www.clinicaltrials.gov as NCT03346733. [ABSTRACT FROM AUTHOR]

Psyllium leaves polysaccharides were physicochemically characterized and evaluated for antioxidant, free-radical scavenging and anticancer activities. The polysaccharide comprised of arabinose, rhamnose, xylose, galactose, and glucose. FTIR and NMR study exhibited the presence of key functional groups whereas morphological study revealed that crude polysaccharides are aggregates of irregular shape, non-porous, and smooth surface, while the purified products are porous and fibrous in nature. Extracted polysaccharides were thermally stable and exhibited the characteristic diffraction curve with a higher viscosity and size distribution. Biochemical analyses demonstrated the higher antioxidant and scavenging activities. In vitro anticancer assay showed the maximum inhibitory effect about 33% on Huh7 and about 30% on HeLa cell lines. The study confirmed the presence of high antioxidant and free-radical scavenging activities with a potential anticancer activity. The polysaccharide could be developed as a potential natural antioxidant and anticancer agents after comprehensive studies on experimental animal models. [ABSTRACT FROM AUTHOR]

Abstract: Background: In functional gastrointestinal disorders a lack of objective biomarkers limits evaluation of underlying mechanisms. We aimed to demonstrate the utility of magnetic resonance imaging for this task using psyllium, an effective constipation treatment, in patients and controls. Methods: Two crossover studies: (i) adults without constipation (controls, n = 9) took three treatments in randomized order for 6 days – maltodextrin (placebo), psyllium 3.5 g t.d.s and 7 g t.d.s., (ii) adults with chronic constipation (patients, n = 20) took placebo and psyllium 7 g t.d.s. for 6 days. MRI was performed fasting and postprandially on day 6. Measurements included small bowel and ascending colon water content, colonic volume, transit time, and MR relaxometry (T1, T2) to assess colonic chyme. Stool water percentage was measured. Results: 7 g psyllium t.d.s. increased fasting colonic volumes in controls from median 372 mL (IQR 284‐601) to 578 mL (IQR 510‐882), and in patients from median 831 mL (IQR 745‐934) to 1104 mL (847‐1316), P < .05. Mean postprandial small bowel water was higher in controls and patients after 7 g psyllium t.d.s. vs placebo. Whole gut transit was slower in patients than controls (P < .05). T1 of the descending colon chyme (fasting) was lower in patients (213 ms, 176‐420) than controls (440 ms, 352‐884, P < .05) on placebo, but increased by 7 g psyllium t.d.s. (590 ms, 446‐1338), P < .001. Descending colon T1 correlated with baseline stool water content and stool frequency on treatment. Conclusions and Inferences: MRI measurements can objectively demonstrate the mode of action of therapy targeting intestinal fluid content in constipation. [ABSTRACT FROM AUTHOR]

Enteropathy associated with sand accumulation in the large colon of horses has been reported worldwide. Intestinal sand accumulations are commonly treated medically, but randomised controlled clinical trials on horses are scarce. This prospective study evaluated the efficacy of an enterally administered combination of psyllium and magnesium sulphate (MgSO 4 ) for the removal of large colonic sand accumulations in horses without clinical signs of acute colic. The two groups comprised 20 untreated control horses and 20 horses treated with 1 g/kg bodyweight (bwt) of psyllium and 1 g/kg bwt of MgSO 4 administered by nasogastric intubation once daily for 4 days. Both groups had no access to soil during the study period. The amounts of accumulated sand were evaluated radiographically before and after treatment. Significantly more treated horses cleared their sand accumulations than horses in the control group. This clearance was determined by observing the estimated quantity by area of sand remaining in the large colon ( P < 0.001) and by comparing the numbers of successfully treated horses ( P = 0.004) between the two groups after 4 days of treatment. However, there were unexplained individual variations in the clearance of sand accumulation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare effects of a moderate carbohydrate diet supplemented with psyllium with those of a lower carbohydrate diet supplemented with placebo powder on glycemic control in patients with type 2 diabetes (T2D). In an open randomized controlled trial, 37 patients with T2D with body mass index (BMI) 25-35 kg/m2 received either a low-energy, moderate carbohydrate diet plus 7 grams of psyllium powder (MoCyllium group) or a low-energy, lower carbohydrate diet plus placebo powder (LoCarb group) for 2 weeks. Fasting and 2-hour postprandial plasma glucose, insulin, and tumor necrosis factor-α (TNF-α) as well as the homeostasis model assessment of insulin resistance (HOMA-IR) were determined at the beginning and end of the 2-week period. Postprandial samples were obtained after ingestion of a standardized breakfast meal in both groups. Body weight change did not differ between the two groups. There was no significant intervention effect on fasting plasma glucose. Fasting plasma insulin and TNF-α significantly decreased from baseline in the MoCyllium group (p =.01). The differences of absolute change of insulin and TNF-α between the groups were statistically significant (p =.002 and p =.017, respectively). Insulin sensitivity, evaluated by HOMA-IR, increased significantly in the MoCyllium group (p =.016), and comparison of absolute change between the groups showed a trend toward statistical significance. No statistical differences were detected among postprandial glucose, insulin, and TNF-α concentrations. The finding supports the concept that in diabetic patients with cultural preferences to a higher carbohydrate diet, an increase in soluble fiber intake should be encouraged. [ABSTRACT FROM AUTHOR]