Association between apolipoprotein B and dietary fibers

Main Article Content

Almira Devina Gunawan
Saptawati Bardosono
Ninik Mudjihartini


Introduction Global awareness to the importance of natural fibers in vegetables and fruits are still generally very low. Indonesian people consume less fibers, which has been associated with the development of heart disease. Heart disease has been known as the leading cause of morbidity and mortality. Apolipoprotein B (ApoB) is a component of atherogenic particles that can be used as a marker for an increased risk of cardiovascular disease. Researches on apoB profile and its relationship with fiber intake has provided inconsistent results. This is an article review of the current literatures on the relationship between dietary fiber and serum apoB levels.
Methods: This is an article review of the current literatures on the relationship between dietary fiber and apoB. We searched PubMed and Google Scholar using keyword “dietary fibers” and “ApoB” to capture meta-analyses, observational and experimental studies. A total of 97 publication and abstracts were screened for this review. After careful screening, nine studies were finally included.
Results: Two studies did not find associations between dietary fiber and serum apoB, while other seven found the association. Dietary fiber has been reported to be involved in the metabolism of serum cholesterol and blood pressure; hence, the deficiency of dietary fiber intake is believed to contribute to the epidemic of cardiovascular diseases. Several factors including nutritional status, dietary diet pattern, age, gender, physical activity, and smoking habits might influence the relationship between dietary fiber and serum apoB.
Conclusion: More studies are required in the future for better understanding on the effect of dietary fiber on the apoB; hence, the risk of cardiovascular diseases.


Download data is not yet available.

Article Details



Slavin JL, Lloyd B. Health Benefits of Fruits and Vegetables. Adv Nutr. 2012; 3:506–16.

Arfines PP, Luglio HF, Kusumawardani N. Prevalence and Lifestyle Risk Factors of Overweight and Obesity Among Indonesian Adolescents: An Analysis of Global School-Based Health Survey 2007 and 2015. Adv Heal Sci Res 2019; 22:512–8.

Putri MF. The use of coconut dregs flour as food fiber and its application to oyster mushroom (reviewed from its nutrition). AIP Conf Proc 2018;1941(1):020026.

Bodhini D, Gaal S, Shatwan I, Ramya K, Ellahi B, Surendran S, et al. Interaction between TCF7L2 polymorphism and dietary fat intake on high density lipoprotein cholesterol. PLoS ONE 2017; 12(11): e0188382.

Komarayanti S, Suharso W, Herrianto E. Business of Local Fruit and Vegetables in Jember District as a Support of Food Security, Indonesia. Budapest Int Res Critics Inst Humanit Soc Sci 2018;1:208–24.

Kalmpourtzidou A, Eilander A, Talsma EF. Global Vegetable Intake and Supply Compared to Recommendations: A Systematic Review. Nutrients 2020; 12:1558.

Barber TM, Kabisch S, Pfeiffer AFH, Weickert MO. The Health Benefits of Dietary Fibre. Nutrients 2020; 12:3209.

Lockyer S, Spiro A, Stanner S. Dietary fibre and the prevention of chronic disease – should health professionals be doing more to raise awareness? Nutr Bull 2016; 41:214–31.

Sánchez-Muniz FJ. Dietary fibre and cardiovascular health. Nutr Hosp 2012; 27:31–45.

Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet 2019; 393:434–45.

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016;133(4):e38-360.

Kaptoge S, Pennells L, De Bacquer D, Cooney MT, Kavousi M, Stevens G, Riley LM, Savin S, Khan T, Altay S, et al. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Glob Heal 2019; 7:e1332–45.

Winoto PMP, Ahsan A, Nasution TH. Analysis of Risk Factors Related to Recurrence of Coronary Heart Disease. World J Adv Healthc Res 2019; 3:84–8.

Pencina MJ, Navar AM, Wojdyla D, Sanchez RJ, Khan I, Elassal J, D’Agostino RB, Peterson ED, Sniderman AD. Quantifying Importance of Major Risk Factors for Coronary Heart Disease. Circulation 2019; 139:1603–11.

Madhu K, Manjunath C, Rawal J, Irani P. Atherogenic dyslipidemia. Indian J Endocrinol Metab 2013; 17:969.

Sniderman AD, Islam S, McQueen M, Pencina M, Furberg CD, Thanassoulis G, Yusuf S. Age and cardiovascular risk attributable to apolipoprotein b, low-density lipoprotein cholesterol or non-high-density lipoprotein cholesterol. J Am Heart Assoc 2016; 5:7–9.

Sondermeijer BM, Rana JS, Arsenault BJ, Shah PK, Kastelein JJP, Wareham NJ, Boekholdt SM, Khaw K-T. Non-HDL cholesterol vs. Apo B for risk of coronary heart disease in healthy individuals: the EPIC-Norfolk prospective population study. Eur J Clin Invest 2013; 43:1009–15.

Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, Iqbal R, Kumar R, Wentzel-Viljoen E, Rosengren A, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 2017; 390:2050–62.

Soliman GA. Dietary Fiber, Atherosclerosis, and Cardiovascular Disease. Nutrients 2019; 11:1155.

Ramos SC, Fonseca FA, Kasmas SH, Moreira FT, Helfenstein T, Borges NC, Moreno RA, Rezende VM, Silva FC, Izar MC. The role of soluble fiber intake in patients under highly effective lipid-lowering therapy. Nutr J 2011; 10:1–8.

Frondelius K, Borg M, Ericson U, Borné Y, Melander O, Sonestedt E. Lifestyle and dietary determinants of serum apolipoprotein A1 and apolipoprotein B concentrations: Cross-sectional analyses within a Swedish Cohort of 24,984 individuals. Nutrients 2017; 9:1–13.

Creswell JW, Poth CN. Qualitative Inquiry & Research Design. 2017.

Phillips GO, Cui SW. An introduction: Evolution and finalisation of the regulatory definition of dietary fibre. Food Hydrocoll 2011; 25:139–43.

Dhingra D, Michael M, Rajput H, Patil RT. Dietary fibre in foods: a review. J Food Sci Technol 2012; 49:255–66.

Vella F. Advanced nutrition and human metabolism. Biochem. Educ.2013; 20:63.

Clerc F, Reiding KR, Jansen BC, Kammeijer GSM, Bondt A, Wuhrer M. Human plasma protein N-glycosylation. Glycoconj J 2016; 33:309–43.

Doonan LM, Fisher EA, Brodsky JL. Can modulators of apolipoproteinB biogenesis serve as an alternate target for cholesterol-lowering drugs? Biochim Biophys Acta - Mol Cell Biol Lipids 2018; 1863:762–71.

Andersen LH, Miserez AR, Ahmad Z, Andersen RL. Familial defective apolipoprotein B-100: A review. J Clin Lipidol 2016; 10:1297–302.

Andreo U, Guo L, Chirieac D V., Tuyama AC, Montenont E, Brodsky JL, Fisher EA. Insulin-Stimulated Degradation of Apolipoprotein B100: Roles of Class II Phosphatidylinositol-3-Kinase and Autophagy. PLoS One 2013; 8:e57590.

Disterer P, Al-Shawi R, Ellmerich S, Waddington SN, Owen JS, Simons JP, Khoo B. Exon Skipping of Hepatic APOB Pre-mRNA With Splice-switching Oligonucleotides Reduces LDL Cholesterol In Vivo. Mol Ther 2013; 21:602–9.

Lo CC, Coschigano KT. ApoB48 as an Efficient Regulator of Intestinal Lipid Transport. Front Physiol 2020; 11.

Randolph GJ, Miller NE. Lymphatic transport of high-density lipoproteins and chylomicrons. J Clin Invest 2014; 124:929–35.

Feingold KR, Grunfeld C. Introduction to Lipids and Lipoproteins. 2000.

Morita S. Metabolism and Modification of Apolipoprotein B-Containing Lipoproteins Involved in Dyslipidemia and Atherosclerosis. Biol Pharm Bull 2016; 39:1–24.

Dominiczak MH, Caslake MJ. Apolipoproteins: Metabolic role and clinical biochemistry applications. Ann Clin Biochem 2011; 48:498–515.

Amaya-Montoya M, Pinzón-Cortés JA, Silva-Bermúdez LS, Ruiz-Manco D, Pérez-Matos MC, Jiménez-Mora MA, Mendivil CO. ApoE and apoC-III-defined HDL subtypes: a descriptive study of their lecithin cholesterol acyl transferase and cholesteryl ester transfer protein content and activity. Lipids Health Dis 2020; 19:106.

Contois JH, McConnell JP, Sethi AA, Csako G, Devaraj S, Hoefner DM, Warnick GR. Apolipoprotein B and cardiovascular disease risk: Position statement from the AACC lipoproteins and vascular diseases division working group on best practices. Clin Chem 2009; 55:407–19.

Kwan BCH, Kronenberg F, Beddhu S, Cheung AK. Lipoprotein Metabolism and Lipid Management in Chronic Kidney Disease. J Am Soc Nephrol 2009; 18:1246–61.

Trajkovska KT. High-density lipoprotein metabolism and reverse cholesterol transport: strategies for raising HDL cholesterol. Anatol J Cardiol 2017.

Fan J, Liu Y, Yin S, Chen N, Bai X, Ke Q, Shen J, Xia M. Small dense LDL cholesterol is associated with metabolic syndrome traits independently of obesity and inflammation. Nutr Metab (Lond) 2019; 16:7.

Ouimet M, Barrett TJ, Fisher EA. HDL and Reverse Cholesterol Transport. Circ Res 2019; 124:1505–18.

Marques LR, Diniz TA, Antunes BM, Rossi FE, Caperuto EC, Lira FS, Gonçalves DC. Reverse Cholesterol Transport: Molecular Mechanisms and the Non-medical Approach to Enhance HDL Cholesterol. Front Physiol 2018; 9.

Chiesa ST, Charakida M. High-Density Lipoprotein Function and Dysfunction in Health and Disease. Cardiovasc Drugs Ther 2019; 33:207–19.

Klop B, Elte JWF, Cabezas MC. Dyslipidemia in Obesity: Mechanisms and Potential Targets. Nutrients 2013; 5:1218–40.

Anggadiredja K, Ufamy N, Amalia L. Ameliorating Effects of Four-Week Fiber-Multivitamin Combination Treatment on Low-Density Lipoprotein Cholesterol, Total Cholesterol, and Apolipoprotein B Profiles in Hypercholesterolemic Participants. J Diet Suppl 2020; 17:173–83.

Anagnostis P, Stevenson JC, Crook D, Johnston DG, Godsland IF. Effects of gender, age and menopausal status on serum apolipoprotein concentrations. Clin Endocrinol (Oxf) 2016; 85:733–40.

Jain RB. Impact of smoking on the observed levels of apolipoprotein B: Data from NHANES 2007–2012. Environ Toxicol Pharmacol 2017; 53:227–33.

Wang Y, Xu D. Effects of aerobic exercise on lipids and lipoproteins. Lipids Health Dis 2017; 16:1–8.

Yazdani R, Marefati H, Shahesmaeili A, Nakhaei S, Bagheri A, Dastoorpoor M. Effect of Aerobic Exercises on Serum Levels of Apolipoprotein A1 and Apolipoprotein B, and Their Ratio in Patients with Chronic Obstructive Pulmonary Disease. Tanaffos 2018; 17:82–9.

Ross I. Plantago ovata Forsk. Dalam: Thau A, editor. Medicinal Plants of the World: Chemical Constituents, Traditional and Modern Medicinal Uses. Humana Press Inc 2009; :426.

Boyd S. Krauss Food and The Nutrition Process. 2011.

Yulia RN, Tambunan V, Prijanti AR. Pengaruh Suplementasi Serat Psyllium husk dan Diet Rendah Kalori Seimbang terhadap Kadar Apo B Penyandang Obes I. Arsip Gizi dan Pangan 2016; 1:121–8.

Ho HVT, Jovanovski E, Zurbau A, Blanco Mejia S, Sievenpiper JL, Au-Yeung F, Jenkins AL, Duvnjak L, Leiter L, Vuksan V. A systematic review and meta-analysis of randomized controlled trials of the effect of konjac glucomannan, a viscous soluble fiber, on LDL cholesterol and the new lipid targets non-HDL cholesterol and apolipoprotein B. Am J Clin Nutr 2017; 105:1239–47.

Antoniazzi L, Arroyo-Olivares R, Bittencourt MS, Tada MT, Lima I, Jannes CE, Krieger JE, Pereira AC, Quintana-Navarro G, Muñiz-Grijalvo O, et al. Association of dietary components with dyslipidemia and low-grade inflammation biomarkers in adults with heterozygous familial hypercholesterolemia from different countries. Eur J Clin Nutr 2019; 73:1622–5.

Ho HVT, Sievenpiper JL, Zurbau A, Blanco Mejia S, Jovanovski E, Au-Yeung F, Jenkins AL, Vuksan V. The effect of oat β -glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials. Br J Nutr 2016; 116:1369–82.

Rakvaag E, Fuglsang-Nielsen R, Bach Knudsen KE, Landberg R, Johannesson Hjelholt A, Søndergaard E, Hermansen K, Gregersen S. Whey Protein Combined with Low Dietary Fiber Improves Lipid Profile in Subjects with Abdominal Obesity: A Randomized, Controlled Trial. Nutrients 2019; 11:2091.

Jovanovski E, Yashpal S, Komishon A, Zurbau A, Blanco Mejia S, Ho HVT, Li D, Sievenpiper J, Duvnjak L, Vuksan V. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2018; 108:922–32.

Kohli-Lynch CN, Thanassoulis G, Moran AE, Sniderman AD. The clinical utility of apoB versus LDL-C/non-HDL-C. Clin Chim Acta 2020; 508:103–8.

Sniderman AD, Thanassoulis G, Glavinovic T, Navar AM, Pencina M, Catapano A, Ference BA. Apolipoprotein B Particles and Cardiovascular Disease. JAMA Cardiol 2019; 4:1287.

Sniderman AD, Couture P, Martin SS, DeGraaf J, Lawler PR, Cromwell WC, Wilkins JT, Thanassoulis G. Hypertriglyceridemia and cardiovascular risk: a cautionary note about metabolic confounding. J Lipid Res 2018; 59:1266–75.

Langlois MR, Nordestgaard BG, Langsted A, Chapman MJ, Aakre KM, Baum H, Borén J, Bruckert E, Catapano A, Cobbaert C, et al. Quantifying atherogenic lipoproteins for lipid-lowering strategies: consensus-based recommendations from EAS and EFLM. Clin Chem Lab Med 2020; 58:496–517.

Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, Chapman MJ, De Backer GG, Delgado V, Ference BA, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020; 41:111–88.