Abstract
BACKGROUND: Some studies indicate that psyllium supplementation may change lipid profile levels. This study assessed the impact of psyllium consumption on lipid profile (Low-Density Lipoprotein Cholesterol, Triglyceride, High-Density Lipoprotein Cholesterol, and cholesterol). MAIN TEXT: We started searching articles using Scopus, Institute for Scientific Information Web of Science, and PubMed to identify eligible publications from March 15, 2022 to August 2, 2025. The effect of psyllium on lipid profiles in adults was evaluated through Randomized Controlled Trials. We calculated Weighted Mean Differences with 95% Confidence Intervals using a random effects model. In this study, 41 Randomized Controlled Trials articles and 2049 participants were included. Psyllium showed a significant decrease in Low-Density Lipoprotein Cholesterol and total Cholesterol, a nonsignificant reduction in Triglyceride, and an insignificantly increase in High-Density Lipoprotein Cholesterol; cholesterol: (Weighted Mean Differences: -9.05; 95% Confidence Intervals: -13.71, -4.40; p-value < 0.05), High-Density Lipoprotein Cholesterol: (Weighted Mean Differences: 0.57; 95% Confidence Intervals: -0.88, 2.04; p-value > 0.05), Triglyceride: (Weighted Mean Differences: -5.29; 95% Confidence Intervals: -12.14, 1.54; p-value > 0.05), and Low-Density Lipoprotein Cholesterol: (Weighted Mean Differences: -8.55; 95% Confidence Intervals: -12.92, -4.19; p < 0.001). Considerable heterogeneity was found for cholesterol: (I-squared index = 89.30%, p-value < 0.001), High-Density Lipoprotein Cholesterol: ( I-squared index = 77.96%, p-value < 0.001), Low-Density Lipoprotein Cholesterol: (I-squared index = 88.46%, p-value < 0.001); and Triglyceride: (I-squared index = 83.25%, p-value < 0.001) and duration and dosage of psyllium had a nonsignificant linear influence on lipid profiles. CONCLUSION: Results showed that psyllium can significantly decrease Low-Density Lipoprotein Cholesterol and total cholesterol, can insignificantly decrease triglyceride, and can insignificantly increase High-Density Lipoprotein Cholesterol following psyllium consumption. REGISTRATION: The study was approved by the Medical Ethics Committee of Isfahan University of Medical Sciences (IR.MUI. RESEARCH: REC.1402.017, Grant number: 140206). This research was registered in the PROSPERO system (CRD42023402987). CLINICAL TRIAL NUMBER: Not applicable.