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Jenkins DJ, Wolever TM, Rao AV, Hegele RA, Mitchell SJ, Ransom TP, Boctor DL, Spadafora PJ, Jenkins AL, Mehling C. Effect on blood lipids of very high intakes of fiber in diets low in saturated fat and cholesterol. N Engl J Med 1993; 329:21-6. [PMID: 8389421 DOI: 10.1056/nejm199307013290104] [Citation(s) in RCA: 209] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND It is known that soluble fiber in the diet can lower blood lipid levels. It is less certain, however, that eating foods with soluble fiber will further lower blood lipids when the intake of saturated fat and cholesterol has already been reduced to very low levels. Furthermore, the mechanism of the lipid-lowering effect of fiber has not been elucidated. METHODS To address these questions, we studied 43 volunteers with hyperlipidemia in a crossover study involving two four-month dietary periods. The two metabolic diets contained foods high in either soluble or insoluble fiber and were separated by a two-month National Cholesterol Education Program Step 2 diet. The metabolic diets were low in saturated fat (< 4 percent of total calories) and cholesterol (< 25 mg per 1000 kcal), high in carbohydrate (> or = 60 percent of total calories), and very high in fiber (> 24 g per 1000 kcal). RESULTS Blood lipids fell to their lowest levels by week 4 of both study diets. When the soluble-fiber period was compared with the insoluble-fiber period, the subjects' total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol levels were found to be lower by a mean (+/- SE) of 4.9 +/- 0.9 percent (P < 0.001), 4.8 +/- 1.3 percent (P < 0.001), and 3.4 +/- 1.3 percent (P = 0.014), respectively. In contrast, the ratio of total to HDL cholesterol was not significantly different during the two dietary periods. The loss of fecal bile acids was 83 +/- 14 percent greater during the soluble-fiber period than during the insoluble-fiber period (P < 0.001) and was related to the differences in total and LDL cholesterol and apolipoprotein B levels (r = 0.42, P = 0.005; r = 0.49, P < 0.001; and r = 0.33, P = 0.035, respectively). The difference in serum cholesterol levels between the two dietary periods was greater among the men (7.5 +/- 1.2 percent, P < 0.001) than among the women (3.4 +/- 1.2 percent, P = 0.008). CONCLUSIONS Very high intakes of foods rich in soluble fiber lower blood cholesterol levels even when the main dietary modifiers of blood lipids--namely, saturated fat and cholesterol--are greatly reduced.
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Hegele RA, Little JA, Vezina C, Maguire GF, Tu L, Wolever TS, Jenkins DJ, Connelly PW. Hepatic lipase deficiency. Clinical, biochemical, and molecular genetic characteristics. ARTERIOSCLEROSIS AND THROMBOSIS : A JOURNAL OF VASCULAR BIOLOGY 1993; 13:720-8. [PMID: 8485124 DOI: 10.1161/01.atv.13.5.720] [Citation(s) in RCA: 179] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Hepatic lipase (HL) is an important enzyme in the metabolism of triglyceride-rich lipoproteins and high density lipoproteins. The clinical syndrome of HL deficiency is rare and difficult to identify. We studied carriers of mutant HL to ascertain whether there are distinctive clinical and/or biochemical characteristics of the heterozygous state. In an Ontario kindred, compound heterozygosity for two HL mutations, S267F and T383M, underlies the clinical syndrome of complete HL deficiency. We report that simple heterozygotes for either HL mutant do not have a discrete lipoprotein abnormality, except for relative triglyceride enrichment of lipoprotein fractions with d > 1.006 g/mL. Postheparin HL activity is depressed to a greater degree in carriers of S267F compared with carriers of T383M. Retinyl palmitate loading studies in a compound heterozygote revealed impaired clearance of chylomicron remnants. The dyslipoproteinemia in a compound heterozygote was ameliorated by lovastatin. There was no difference in the quantity and distribution of HL mRNA in the liver of a compound heterozygote when compared with that of a normal subject. Thus, HL deficiency associated with structural variation of the HL gene is characterized by premature atherosclerosis, triglyceride enrichment of lipoprotein fractions with d > 1.006 g/mL, the presence of circulating beta-very low density lipoproteins, and abnormal catabolism of postprandial triglyceride-rich lipoproteins.
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Todesco T, Zamboni M, Armellini F, Bissoli L, Turcato E, Piemonte G, Rao AV, Jenkins DJ, Bosello O. Plasma acetate levels in a group of obese diabetic, obese normoglycemic, and control subjects and their relationships with other blood parameters. Am J Gastroenterol 1993; 88:751-5. [PMID: 8480742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Acetate is a short-chain fatty acid derived from colonic fermentation of carbohydrate and dietary fiber, and from endogenous glucose and fatty acid metabolism in the liver. An impaired acetate metabolism has been reported in diabetic subjects. The aim of the study was to evaluate plasma acetate levels in a group of obese diabetic subjects, compared with obese normoglycemic subjects and normal control subjects. Eleven noninsulin-dependent diabetic patients taking oral antidiabetic drugs, eight obese normoglycemic subjects, and seven control subjects were studied. Liver, kidney, and gut functions were normal in all subjects. Blood acetate, glucose, insulin, and C-peptide were evaluated in all subjects. Acetate levels were significantly higher in the diabetic subjects than in obese normoglycemic and normal subjects. Significant correlations between HbA1c, glucose, and acetate levels, but not between acetate and C-peptide or insulin, were also observed.
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Jenkins DJ, Hegele RA, Jenkins AL, Connelly PW, Hallak K, Bracci P, Kashtan H, Corey P, Pintilia M, Stern H. The apolipoprotein E gene and the serum low-density lipoprotein cholesterol response to dietary fiber. Metabolism 1993; 42:585-93. [PMID: 8388072 DOI: 10.1016/0026-0495(93)90217-c] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Our goal was to determine whether differences in apolipoprotein E (apo E) influenced the response to dietary changes aimed at reducing serum cholesterol levels, especially increases in fiber. Apo E phenotype and genotype were determined in 43 men and 24 women who had previously taken part in parallel 2-week metabolic dietary studies involving either wheat bran or oat bran supplementation at a level of 6.8 g fiber/1,000 kcal. Fasting blood lipid measurements had been made at the beginning and end of the 2-week metabolic period. Reductions in low-density lipoprotein (LDL) cholesterol levels across both oat and wheat bran diets were significantly different depending on the E allele (P = .048). The LDL cholesterol level reduction for E2 carriers (0.60 +/- 0.14 mmol/L, n = 13) was greater than that for E3 homozygotes (0.21 +/- 0.07 mmol/L, n = 38; P = .014) and E4 carriers (0.28 +/- 0.12 mmol/L, n = 16; P = .09). Only the change in dietary fiber on the oat bran diet was related significantly to the decrease in LDL cholesterol levels (r = -.47, P = .007; n = 32). No such relationship was seen on the wheat bran diet (r = -.010, P = .59; n = 33). Carriers of the E2 allele appear to be more responsive than noncarriers to a dietary change involving increased fiber intake. The data also support a lipid-lowering advantage of oat bran over wheat bran. Current dietary recommendations to reduce serum lipid levels may vary in effectiveness depending on distribution of apo E alleles in the different populations studied.
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Cunnane SC, Ganguli S, Menard C, Liede AC, Hamadeh MJ, Chen ZY, Wolever TM, Jenkins DJ. High alpha-linolenic acid flaxseed (Linum usitatissimum): some nutritional properties in humans. Br J Nutr 1993; 69:443-53. [PMID: 8098222 DOI: 10.1079/bjn19930046] [Citation(s) in RCA: 230] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Although high alpha-linolenic acid flaxseed (Linum usitatissimum) is one of the richest dietary sources of alpha-linolenic acid and is also a good source of soluble fibre mucilage, it is relatively unstudied in human nutrition. Healthy female volunteers consumed 50 g ground, raw flaxseed/d for 4 weeks which provided 12-13% of energy intake (24-25 g/100 g total fat). Flaxseed raised alpha-linolenic acid and long-chain n-3 fatty acids in both plasma and erythrocyte lipids, as well as raising urinary thiocyanate excretion 2.2-fold. Flaxseed also lowered serum total cholesterol by 9% and low-density-lipoprotein-cholesterol by 18%. Changes in plasma alpha-linolenic acid were equivalent when 12 g alpha-linolenic acid/d was provided as raw flaxseed flour (50 g/d) or flaxseed oil (20 g/d) suggesting high bioavailability of alpha-linolenic acid from ground flaxseed. Test meals containing 50 g carbohydrate from flaxseed or 25 g flaxseed mucilage each significantly decreased postprandial blood glucose responses by 27%. Malondialdehyde levels in muffins containing 15 g flaxseed oil or flour/kg were similar to those in wheat-flour muffins. Cyanogenic glycosides (linamarin, linustatin, neolinustatin) were highest in extracted flaxseed mucilage but were not detected in baked muffins containing 150 g flaxseed/kg. We conclude that up to 50 g high-alpha-linolenic acid flaxseed/d is palatable, safe and may be nutritionally beneficial in humans by raising n-3 fatty acids in plasma and erythrocytes and by decreasing postprandial glucose responses.
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Constantine CC, Thompson RC, Jenkins DJ, Hobbs RP, Lymbery AJ. Morphological characterization of adult Echinococcus granulosus as a means of determining transmission patterns. J Parasitol 1993; 79:57-61. [PMID: 8437058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Host induced changes in morphological characters of the rostellar hooks of Echinococcus granulosus were used to determine the origin of infection in definitive hosts in rural areas of southeastern Australia where wild and domestic cycles of transmission may interact. The morphological characters studied vary depending on the species of intermediate host (macropod marsupials, sheep) in which protoscoleces develop, and these characters are retained in adult worms. It was therefore possible to determine whether definitive hosts (dingoes and foxes) acquired infection by consuming protoscoleces of E. granulosus from macropods or from sheep. The results correlated well with the known distribution of intermediate hosts and illustrate the practical value of such morphological markers in epidemiological studies.
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Constantine CC, Thompson RCA, Jenkins DJ, Hobbs RP, Lymbery AJ. Morphological Characterization of Adult Echinococcus granulosus as a Means of Determining Transmission Patterns. J Parasitol 1993. [DOI: 10.2307/3283277] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Jenkins DJ, Craig NA. The role of foxes Vulpes vulpes in the epidemiology of Echinococcus granulosus in urban environments. Med J Aust 1992; 157:754-6. [PMID: 1454000 DOI: 10.5694/j.1326-5377.1992.tb141276.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To survey the prevalence of intestinal worms, particularly Echinococcus granulosus, in foxes in Canberra. DESIGN The locations of foxes seen in Canberra during this study were recorded. Foxes and macropod marsupials killed on the roads of Canberra were collected and examined for the presence of intestinal helminths and hydatid cysts respectively. METHOD The intestinal contents of the foxes were washed through a fine sieve and examined microscopically. All helminths recovered were collected and identified. All the internal organs of the macropods were examined for any cystic lesions. RESULTS Forty-five foxes and 44 macropods were examined. Echinococcus granulosus was found in three of the foxes (7%). Hydatid cysts were not found in the internal organs of any of the macropods examined. CONCLUSIONS Echinococcus granulosus is present in the urban fox population of Canberra. This hitherto unreported aspect of the epidemiology of E. granulosus in Australia could be a potential public health risk to urban populations.
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Gasser RB, Jenkins DJ, Heath DD, Lawrence SB. Use of Echinococcus granulosus worm antigens for immunodiagnosis of E. granulosus infection in dogs. Vet Parasitol 1992; 45:89-100. [PMID: 1485424 DOI: 10.1016/0304-4017(92)90030-d] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Echinococcus granulosus worm excretory/secretory antigens (WES) were used in ELISA for diagnosis of E. granulosus infection in dogs and compared with protoscolex somatic antigens (PSM). Sera from 224 dogs were tested. There was no correlation between ELISA absorbance values and E. granulosus worm burdens using either antigen. There was a significant linear relationship between absorbance values of sera tested in the ELISA using WES (W-ELISA) and the ELISA using PSM (P-ELISA). However, there was a small but significant difference between the absorbance values of the sera tested against the two antigens. Western blot analysis of WES using sera from E. granulosus-infected and uninfected dogs revealed antigenic components of relative molecular mass (Mr) larger than 94,000, Mr 94,000-68,000 and Mr 43,000-39,000 in worms, and these were specific for E. granulosus and not identified in PSM; these antigenic differences may be responsible for differences in reactivity in ELISA. The sensitivities of W-ELISA and P-ELISA were 80.8% and 75.6%, respectively. The specificities of W-ELISA and P-ELISA were 93.7% and 97.9%, respectively. The reduced specificity in W-ELISA was mainly attributable to increased background reactivity of sera from Taenia hydatigena-infected dogs. Despite the reduction in specificity, both ELISAs are valuable epidemiological tools to determine the prevalence of antibody to E. granulosus in dog populations and to monitor the success of hydatid control campaigns.
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Wolever TM, Jenkins DJ, Vuksan V, Jenkins AL, Buckley GC, Wong GS, Josse RG. Beneficial effect of a low glycaemic index diet in type 2 diabetes. Diabet Med 1992; 9:451-8. [PMID: 1611833 DOI: 10.1111/j.1464-5491.1992.tb01816.x] [Citation(s) in RCA: 153] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Low glycaemic index foods produce low blood glucose and insulin responses in normal subjects, and improve blood glucose control in Type 1 and well-controlled Type 2 diabetic patients. We studied the effects of a low glycaemic index diet in 15 Type 2 diabetic patients with a mean fasting blood glucose of 9.5 mmol l-1 using a randomized, crossover design. Patients were given pre-weighed diets (59% energy as carbohydrate, 21% fat, and 24 g 1000-kcal-1 dietary fibre) for two 2-week periods, with a diet glycaemic index of 60 during one period and 87 during the other. On the low glycaemic index diet, the blood glucose response after a representative breakfast was 29% less than on the high glycaemic index diet (874 +/- 108 (+/- SE) vs 204 +/- 112 mmol min l-1; p less than 0.001), the percentage reduction being almost identical to the 28% difference predicted from the meal glycaemic index values. After the 2-week low glycaemic index diet, fasting serum fructosamine and cholesterol levels were significantly less than after the high glycaemic index diet (3.17 +/- 0.12 vs 3.28 +/- 0.16 mmol l-1, p less than 0.05, and 5.5 +/- 0.4 vs 5.9 +/- 0.5 mmol l-1, p less than 0.02, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Kashtan H, Stern HS, Jenkins DJ, Jenkins AL, Hay K, Marcon N, Minkin S, Bruce WR. Wheat-bran and oat-bran supplements' effects on blood lipids and lipoproteins. Am J Clin Nutr 1992; 55:976-80. [PMID: 1315121 DOI: 10.1093/ajcn/55.5.976] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
To compare the effects of oat-bran fiber on blood lipids, we studied 84 healthy middle-aged men and women who were placed on metabolic diets, for 2 wk, that were supplemented with either wheat bran (n = 42) or oat bran (n = 42). Fiber supplementation was 1.6 micrograms dietary fiber/J (6.8 g dietary fiber/1000 kcal) to a maximum of 16.4 g fiber/d. Significantly greater decrease with oat than with wheat were seen in total cholesterol (0.56 +/- 0.08 mmol/L and 0.29 +/- 0.08 mmol/L, P = 0.022) and low-density-lipoprotein cholesterol (0.39 +/- 0.07 mmol/L and 0.15 +/- 0.07 mmol/L, P = 0.024). No significant differences were seen in high-density lipoprotein, apolipoproteins A-1 and B, or triglyceride. We conclude that oat bran has an advantage over wheat bran in lowering serum lipids when tested in metabolic diets on large numbers of individuals with an initial mean serum cholesterol concentration above the desirable range, at 5.61 +/- 0.16 mmol/L.
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Spiller GA, Jenkins DJ, Cragen LN, Gates JE, Bosello O, Berra K, Rudd C, Stevenson M, Superko R. Effect of a diet high in monounsaturated fat from almonds on plasma cholesterol and lipoproteins. J Am Coll Nutr 1992; 11:126-30. [PMID: 1315812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The effect of almonds as part of a low saturated fat, low cholesterol, high-fiber diet was studied in 26 adults (13 men, 13 women). The baseline diet was modified in a similar way for all subjects by limiting meat, fatty fish, high-fat milk products, eggs, and saturated fat. Grains, beans, vegetables, fruit, and low-fat milk products were the foundation of the diet. During the almond diet period, raw almonds (100 mg/day) supplied 34 g/day of monounsaturated fatty acid (MUFA), 12 g/day of polyunsaturated fatty acid, and 6 g/day of saturated fatty acid. Almond oil was the only oil allowed for food preparation. There was a rapid and sustained reduction in low-density lipoprotein cholesterol without changes in high-density lipoprotein cholesterol. This was reflected in a total plasma cholesterol decrease from (means +/- SEM) 235 +/- 5.0 at baseline to 215 +/- 5.0 at 3 weeks, and to 214 +/- 5.0 mg/dl at 9 weeks (p less than 0.001). When the consumption of nuts high in MUFA increases the fat content of the diet, reduction rather than elevation of plasma cholesterol has to be expected, possibly due to the MUFA content of these nuts.
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Wolever TM, Jenkins DJ, Vuksan V, Jenkins AL, Wong GS, Josse RG. Beneficial effect of low-glycemic index diet in overweight NIDDM subjects. Diabetes Care 1992; 15:562-4. [PMID: 1499480 DOI: 10.2337/diacare.15.4.562] [Citation(s) in RCA: 145] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether low-glycemic index (GI) diets have clinical utility in overweight patients with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS Six patients with NIDDM were studied on both high- and low-GI diets of 6-wk duration with metabolic diets with a randomized crossover design. Both diets were of similar composition (57% carbohydrate, 23% fat, and 34 g/day dietary fiber), but the low-GI diet had a GI of 58 compared with 86 for the high-GI diet. RESULTS Small and similar amounts of weight were lost on both diets: 2.5 kg on high-GI diet and 1.8 kg on low-GI diet. On the low-GI diet, the mean level of serum fructosamine, as an index of overall blood glucose control, was lower than on the high-GI diet by 8% (P less than 0.05), and total serum cholesterol was lower by 7% (P less than 0.01). CONCLUSIONS In overweight patients with NIDDM, reducing diet GI improves overall blood glucose and lipid control.
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Kashtan H, Stern HS, Jenkins DJ, Jenkins AL, Thompson LU, Hay K, Marcon N, Minkin S, Bruce WR. Colonic fermentation and markers of colorectal-cancer risk. Am J Clin Nutr 1992; 55:723-8. [PMID: 1312764 DOI: 10.1093/ajcn/55.3.723] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to determine the effect of soluble fiber on indexes of colon-cancer risk in postpolypectomy and nonpolyp patients. Forty-five postpolypectomy and 49 nonpolyp volunteers completed 2-wk metabolic studies where half of the group received oat-bran supplements and the other half took wheat-brain supplements. Colonic biopsies taken before and after the intervention showed no difference in the index of thymidine colonic-crypt-cell labeling, thymidine-labeling pattern, or nuclear aberrations. Nevertheless, fecal pH was significantly reduced by 0.23 +/- 0.07 pH units (P less than 0.002) as an index of increased colonic fermentation on oat bran. This was not associated with increased basal breath hydrogen concentrations; fecal butyrate concentrations were higher on wheat bran. We conclude that soluble fiber as oat brain appears to have no advantage over wheat bran in modifying putative risk factors for colonic cancer.
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Jenkins DJ, Ocana A, Jenkins AL, Wolever TM, Vuksan V, Katzman L, Hollands M, Greenberg G, Corey P, Patten R. Metabolic advantages of spreading the nutrient load: effects of increased meal frequency in non-insulin-dependent diabetes. Am J Clin Nutr 1992; 55:461-7. [PMID: 1734685 DOI: 10.1093/ajcn/55.2.461] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The acute effect of increasing meal frequency as a model of slow absorption was studied for 1 d in 11 patients with non-insulin-dependent diabetes. On 1 d they took 13 snacks (the nibbling diet) and on another day the same diet was taken as three meals and one snack (the three-meal diet). The nibbling diet reduced mean blood glucose, serum insulin, and C peptide concentrations over the 9.5 h of observation and 24-h urinary C peptide output by 12.7 +/- 3.7% (mean +/- SE) (P = 0.0062), 20.1 +/- 5.8% (P = 0.0108), 9.2 +/- 2.6% (P = 0.0073), and 20.37 +/- 8.12% (P = 0.039), respectively, compared with the three-meal diet. Serum triglyceride concentrations were lower by 8.5 +/- 3.2% (P = 0.037). Despite lower insulin concentrations on the nibbling diet, the concentrations of free fatty acids, 3-hydroxybutyrate, and the insulin-sensitive branched-chain amino acids responded similarly on both treatments. Metabolic benefits seen with increased meal frequency may explain the success of similar agents that prolong absorption, including fiber and enzyme inhibitors.
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Steinhart AH, Jenkins DJ, Mitchell S, Cuff D, Prokipchuk EJ. Effect of dietary fiber on total carbohydrate losses in ileostomy effluent. Am J Gastroenterol 1992; 87:48-54. [PMID: 1309407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Studies were performed in three ileostomate subjects to determine the effect of intake of various carbohydrate-containing foods on the ileostomy losses of macronutrients. The percent recovery of available carbohydrate in ileostomy effluent varied between 1.09% and 22.63% for the various foods. Available carbohydrate recovery (%) was positively correlated with fiber (r = 0.91) and protein (r = 0.46) intake, but negatively with available carbohydrate intake (r = -0.66). Stepwise regression indicated that dietary fiber intake was the principal factor determining the amount of available carbohydrate in ileostomy effluent. Fiber intake was negatively correlated with water concentration of the effluent (r = -0.61). This study demonstrates that although fiber has been considered the chief substrate available for colonic fermentation, as the fiber intake increases, so the total fermentable load entering the colon is likely to increase due to losses of available carbohydrates in addition to fiber. Simple assessment of dietary fiber is likely to grossly underestimate the fermentable load on high-fiber, high-carbohydrate diets.
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Deplazes P, Gottstein B, Eckert J, Jenkins DJ, Ewald D, Jimenez-Palacios S. Detection of Echinococcus coproantigens by enzyme-linked immunosorbent assay in dogs, dingoes and foxes. Parasitol Res 1992; 78:303-8. [PMID: 1409530 DOI: 10.1007/bf00937088] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of Echinococcus coproantigens in fecal samples from dogs, dingoes or foxes infected with either E. granulosus or E. multilocularis. The ELISA was based on protein-A-purified polyclonal antibodies [anti-E. granulosus excretory/secretory (E/S) antigens]. The specificity of the assay as determined in 155 samples derived from carnivores that were free of helminth infection (n = 37) or infected with non-Echinococcus cestodes (n = 76) or with various nematodes (n = 42) was found to be 98% overall. The diagnostic sensitivity was strongly dependent on the homologous worm burden. All 13 samples from foxes harboring greater than 1,000 E. multilocularis worms and 13 of 15 (87%) samples from dogs or dingoes containing greater than 200 E. granulosus worms were ELISA-positive, whereas 34 of 46 samples from foxes harboring less than 1,000 E. multilocularis and 9 of 10 samples from dogs or dingoes bearing less than 200 E. granulosus tested negative. Experimental prepatent infections of dogs with E. granulosus revealed positive ELISA reactions within the prepatent period (10-20 days post-infection) for six animals bearing greater than 1,000 E. granulosus each; a low worm burden (less than 1,000 tapeworms/animal) resulted in ELISA positivity in only 2 of 3 animals at 30 days post-infection at the earliest. All five dogs that had been experimentally infected with E. multilocularis tested positive in the coproantigen ELISA as early as on day 5 post-infection.
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Wolever TM, Jenkins DJ, Jenkins AL, Josse RG. The glycemic index: methodology and clinical implications. Am J Clin Nutr 1991; 54:846-54. [PMID: 1951155 DOI: 10.1093/ajcn/54.5.846] [Citation(s) in RCA: 682] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
There is controversy regarding the clinical utility of classifying foods according to their glycemic responses by using the glycemic index (GI). Part of the controversy is due to methodologic variables that can markedly affect the interpretation of glycemic responses and the GI values obtained. Recent studies support the clinical utility of the GI. Within limits determined by the expected GI difference and by the day-to-day variation of glycemic responses, the GI predicts the ranking of the glycemic potential of different meals in individual subjects. In long-term trials, low-GI diets result in modest improvements in overall blood glucose control in patients with insulin-dependent and non-insulin-dependent diabetes. Of perhaps greater therapeutic importance is the ability of low-GI diets to reduce insulin secretion and lower blood lipid concentrations in patients with hypertriglyceridemia.
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Todesco T, Rao AV, Bosello O, Jenkins DJ. Propionate lowers blood glucose and alters lipid metabolism in healthy subjects. Am J Clin Nutr 1991; 54:860-5. [PMID: 1951157 DOI: 10.1093/ajcn/54.5.860] [Citation(s) in RCA: 123] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Incorporation of 3.3 g sodium propionate per 50 g available carbohydrate portion of bread reduced acutely the blood glucose response area in six healthy volunteers by 47.6 +/- 12.1% Similarly, in vitro digestibility was reduced by 47.4 +/- 1.1% (P less than 0.01). One week of dietary supplementation with 9.9 g sodium propionate in bread/d reduced the blood glucose area in comparison with standard propionate-free bread by 38.0 +/- 8.7% (P less than 0.05), but increased fecal bulk by 28.3 +/- 8.7% (P less than 0.05) and anaerobic microflora by 0.564 +/- 0.165 X 10(6)/g feces (P less than 0.05), specifically as bifidobacteria. Day-long breath hydrogen concentrations did not increase after 1 wk on propionate bread but methane production increased in the three methane producers. Although lipid changes were not significant, five subjects showed reduced high-density-lipoprotein and increased triglyceride concentrations, both of which correlated with increased fecal weight (P less than 0.05). Because propionate reduces the rate of starch digestion, studies using oral propionate must take into account its action as an enzyme inhibitor.
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Wolever TM, Vuksan V, Eshuis H, Spadafora P, Peterson RD, Chao ES, Storey ML, Jenkins DJ. Effect of method of administration of psyllium on glycemic response and carbohydrate digestibility. J Am Coll Nutr 1991; 10:364-71. [PMID: 1654354 DOI: 10.1080/07315724.1991.10718164] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To determine whether there was any advantage to taking a soluble fiber supplement separate from food, as opposed to incorporated into a food, we used psyllium as a model, either taken in water just before a flaked bran cereal test meal, sprinkled on top of the cereal, or actually incorporated into the flake. In normal subjects, psyllium reduced the glycemic response when sprinkled onto or incorporated into the cereal, but not when taken before the cereal. Varying the amount of psyllium incorporated into the cereal from 0 to 20% resulted in a linear dose-dependent reduction of the glycemic index (GI) (GI = 101 -2.2 x % psyllium; r = 0.950; p less than 0.002). In subjects with diabetes, the blood-glucose-lowering effect of the psyllium flake cereal was similar to that in normal subjects. Mixing psyllium with the cereal or incorporating it into the cereal reduced the rate of digestion of bran flakes in vitro but was not associated with increased breath hydrogen levels in vivo as an index of rapid colonic fermentation. The bran flakes with psyllium incorporated was rated as no less palatable than the bran flakes cereal alone, and significantly more palatable (p less than 0.05) than taking psyllium in water before the cereal or sprinkling psyllium onto the cereal. These studies confirm earlier reports that viscous fibers must be intimately mixed with the food to have the effect of reducing blood glucose responses, and that the mechanism of action relates to a reduced rate of digestion rather than carbohydrate malabsorption.(ABSTRACT TRUNCATED AT 250 WORDS)
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Jenkins DJ, Wolever TM, Jenkins A, Brighenti F, Vuksan V, Rao AV, Cunnane SC, Ocana A, Corey P, Vezina C. Specific types of colonic fermentation may raise low-density-lipoprotein-cholesterol concentrations. Am J Clin Nutr 1991; 54:141-7. [PMID: 2058575 DOI: 10.1093/ajcn/54.1.141] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
To assess the effects of increased colonic fermentation on serum lipids, eight healthy volunteers were placed on two identical 2-wk metabolic diets, one of which was supplemented with lactulose (18-25 g/d). Lactulose raised day-long concentrations of breath hydrogen and serum glutamine as indicators of increased colonic fermentation by 78 +/- 13% (P less than 0.001) and 24.7 +/- 9.5% (P less than 0.05), respectively). Unexpectedly, however, fasting serum total and low-density-lipoprotein cholesterol and apolipoprotein B concentrations were higher at 2 wk by 8.9 +/- 1.5% (P less than 0.001), 10.9 +/- 2.2% (P less than 0.005), and 18.9 +/- 5.9% (P less than 0.02), respectively, compared with the control diet. With lactulose, mean free fatty acid concentrations were reduced over the day by 19.5 +/- 5.9% (P less than 0.02), with no change in mean day-long blood glucose, serum insulin, or C-peptide concentrations. We conclude that certain rapidly fermented substrates may raise rather than lower serum lipids, possibly through increasing the amount of acetate absorbed from the colon.
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Brighenti F, Ciappellano S, Vuksan V, Rao AV, Wolever TM, Jenkins A, Jenkins DJ, Testolin G. Is colonic fermentation minimized by increasing meal frequency? Eur J Clin Nutr 1991; 45:221-6. [PMID: 1879386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
It has been suggested that, although increasing meal frequency has metabolic advantages in terms of carbohydrate and lipid metabolism, the efficiency of small intestinal absorption may be enhanced, thus reducing the extent of colonic fermentation. Since this may be undesirable, we have tested whether increasing meal frequency reduces the amount of carbohydrate fermented into the colon. Accordingly, seven healthy male volunteers took, in random order, two identical 2-week metabolic diets divided into either seventeen or three meals daily. On day 13 of each period measurements were made throughout the day of breath H2 and serum acetate, as markers of colonic fermentation. Mean levels of both breath H2 and acetate were similar on both diets, being lower on nibbling by 3.2 +/- 0.8 ppm and 25 +/- 9 mumols/l respectively (not significant). This study failed to demonstrate an effect of more efficient carbohydrate absorption with increased meal frequency.
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Jenkins DJ, Gasser RB, Romig T, Zeyhle E. Antibody responses against natural Taenia hydatigena infection in dogs in Kenya. Int J Parasitol 1991; 21:251-3. [PMID: 1869360 DOI: 10.1016/0020-7519(91)90017-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Antibody responses (IgG) against Taenia hydatigena infection in dogs in Kenya were analysed in ELISA using excretory/secretory products of T. hydatigena scoleces derived from goat cysticercus cysts. Helminth infections of individual dogs were confirmed at autopsy. T. hydatigena worms were found in 89.5% of 143 dogs, and positive anti-T. hydatigena antibody levels were detected in 58.7% of infected dogs. Positive antiscolex antibody levels were detected in 40.0% of Turkana dogs uninfected with T. hydatigena, suggesting previous infection. Antibody was not detected in 34.4% of infected dogs. There was no relationship between individual T. hydatigena worm burdens and absorbance values for sera in ELISA. It was not possible to distinguish between sera from T. hydatigena-infected and uninfected dogs.
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Jenkins DJ, Morris B. Unusually heavy infections of Echinococcus granulosus in wild dogs in south-eastern Australia. Aust Vet J 1991; 68:36-7. [PMID: 2018455 DOI: 10.1111/j.1751-0813.1991.tb09844.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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