Benefits
Supports healthy LDL cholesterol levels
Several meta-analyses agree that glucomannan lowers total and LDL cholesterol. In a meta-analysis of 12 randomized trials (370 people), about 3 g/day lowered LDL by 0.35 mmol/L (about 10%) and non-HDL cholesterol by about 7%, with no change in apolipoprotein B. The most recent pooled analysis called the change too small to matter clinically on its own. The EU authorises a cholesterol claim at 4 g/day.
Body weight within an energy-restricted diet
Results are small and inconsistent. One meta-analysis of 14 trials found 0.79 kg more weight loss than control; another, limited to 8 trials in overweight or obese participants, found no significant difference. Placebo-controlled trials in 53 adults (8 weeks) and 96 children (12 weeks) found no effect on weight or BMI. The EU claim applies to 3 g/day within an energy-restricted diet.
Fasting and post-meal blood sugar
A meta-analysis of 14 trials found fasting glucose about 7.4 mg/dL lower than control, although people with impaired glucose metabolism benefited less. In 6 trials of 440 people with type 2 diabetes, fasting and 2-hour post-meal glucose were lower. In 53 overweight adults, 4 g/day for 8 weeks changed no glucose value. This is more limited evidence than for cholesterol.
Bowel regularity and gut bacteria
In 7 constipated adults on a controlled low-fiber diet, 1.5 g three times daily raised weekly bowel movements from 4.1 to 5.3 and increased fecal lactobacilli and short-chain fatty acids. In 3 trials of 122 constipated children it added about 1.4 bowel movements a week but did not change stool consistency. In elite male athletes with constipation it improved symptom scores versus placebo.
Mechanism of action
Gel viscosity and water holding
Glucomannan holds a great deal of water, forms highly viscous solutions and expands rapidly to many times its original size. This viscosity is thought to underlie its effects on blood lipids and on how quickly food moves through the gut. Fullness is often assumed to follow, but in a placebo-controlled trial that rated hunger and fullness, 4 g/day for 8 weeks changed neither.
Bile acid binding and cholesterol
Viscous fibers are proposed to trap bile acids in the small intestine so fewer are reabsorbed. The liver then uses cholesterol to make new bile acids, which lowers LDL in the blood. For glucomannan this step is inferred from its viscosity: the trials cited here measured blood lipids, not bile acids.
Gut hormones: proposed, with thin human data
Viscous fibers are proposed to influence gut hormones involved in appetite, such as GLP-1 and ghrelin. Human data for glucomannan are sparse. In an uncontrolled 12-week study of konjac foods in 26 people with type 2 diabetes, GLP-1 only tended to rise (p = 0.071). A small study in type 2 diabetes reported that glucomannan taken before a glucose drink enhanced the fall in ghrelin.
Clinical trials
Systematic review and meta-analysis of 14 randomized controlled trials. (Sood et al. 2008, Am J Clin Nutr)
531 participants pooled from 14 randomized trials.
Glucomannan lowered total cholesterol by 19.3 mg/dL, LDL cholesterol by 16.0 mg/dL, triglycerides by 11.1 mg/dL, body weight by 0.79 kg (95% CI 0.05 to 1.53 kg) and fasting glucose by 7.4 mg/dL versus control. HDL cholesterol and blood pressure did not change. Children, people already on dietary changes, and people with impaired glucose metabolism did not benefit to the same degree. A later meta-analysis of 8 trials in overweight or obese participants found no significant weight difference.
Systematic review and meta-analysis of 12 randomized controlled trials lasting at least 3 weeks. (Ho et al. 2017, Am J Clin Nutr)
370 participants pooled from 12 randomized trials, 8 in adults and 4 in children.
About 3 g/day of konjac glucomannan lowered LDL cholesterol by 0.35 mmol/L (95% CI 0.25 to 0.46), roughly 10%, and non-HDL cholesterol by 0.32 mmol/L, about 7%, versus control. Data from 6 trials showed no effect on apolipoprotein B.