Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health

Analysis of correlation between dietary fiber intake and risk of diabetic kidney disease in adults with type 2 diabetes mellitus: results from the United States National Health and Nutrition Examination Surveys 2009-2018

OBJECTIVE

Given the significant impact of diabetic kidney disease (DKD) on morbidity and mortality in patients with type 2 diabetes mellitus (T2DM) and the potential preventive role of dietary factors, particularly dietary fiber, this study aimed to investigate the relationship between dietary fiber intake and the risk of DKD in adults with T2DM.

METHODS

The medical records and other relevant data from patients with T2DM were retrieved from the United States National Health and Nutrition Examination Surveys (U.S. NHANES) from 2009 to 2018. Multivariate logistic regression and restricted cubic spline (RCS) regression were employed to investigate the relationship between dietary fiber intake and the risk of DKD in adult T2DM patients.

RESULTS

The study involved 4,520 T2DM patients with a mean age of 59.16 years, consisting of 2,346 male patients (51.9%) and 2,174 female patients (48.1%). The prevalence of T2DM patients with DKD was 37.92% in the overall population. Regression analyses, after adjusting for confounders, showed that dietary fiber intake was negatively correlated with the prevalence of DKD. RCS analysis demonstrated a nonlinear negative correlation between the level of dietary fiber intake and the prevalence of DKD, with a threshold inflection point of 13.96 g/day. Subgroup analyses revealed that age, gender, race, smoking status, body mass index, hypertension, diabetes duration, glycosylated hemoglobin, and ACEI/ARB medication use did not significantly affect the negative correlations (p > 0.05).

CONCLUSIONS

Dietary fiber intake was negatively correlated with the prevalence of DKD in T2DM patients.

Positive nutritional selection of adults with healthy lifestyle and high daily fiber consumption for the isolation of beneficial intestinal bacteria: The iTARGET cohort study protocol

Recent advances in the study of the gut microbiota has pointed to its under-utilized source of potentially beneficial bacteria, known as next generation probiotics, offering a promising avenue to restore or compensate impaired gut microbiota toward a healthy state. Aside from the difficulties to achieve in-lab adequate culture conditions, the use of beneficial bacterial isolates is also limited by their bioavailability in the donor itself. In the iTARGET study, we positively selected donors based on their diet enriched in fiber, that has been shown to increase the prevalence of bacterial species associated with health. The iTARGET study is a monocenter, prospective, observational study of adults with healthy lifestyle and high daily fiber consumption. We aim to recruit individuals in two phases, the first one for all individuals that will permit the identification of carriers for bacteria of interest and the second phase for a subset of individuals to allow for culture and isolation of previously identified potentially beneficial bacteria. Our primary outcome is the isolation and culture of at least one potentially beneficial isolate. The secondary outcomes comprised the high throughput metagenomic profiles of the intestinal microbiota and the characterization of the cultured isolates. The study was approved by the French Research Ethics Committees (Comité de Protection des Personnes Sud-Est I) under the National reference ID 2023-A01677-38. Study findings and results will be published in peer-reviewed Open Access journals. (Trial registration number on ClinicalTrials.gov: NCT06166810).

Impact of flour particle size and origin on the bread structure and the postprandial glycemic, insulinemic and appetite responses in healthy adults

Consumption of bakery products prepared with finely milled flour is associated with elevated postprandial glycemia, increased hunger, and reduced satiety. The milling process disrupts the plant cell walls of cereal grains and legumes, enhancing the accessibility of encapsulated starch to digestive enzymes. This study investigates the effects of flour origin (wheat and chickpea) and particle size in three wholemeal breads on physicochemical properties, postprandial glucose, insulin, glucagon-like peptide-1 (GLP-1) responses, and subjective appetite sensations in healthy individuals. In the test breads, 30% of refined wheat flour was substituted with cracked whole wheat (1.8-2.0 mm) to make whole grain bread (WGB), finely milled chickpea flour (CFM), or larger particle-chickpea flour (1.4-1.8 mm, CLP). Wheat bread (WB) served as the control. In all three test breads, 28% of refined wheat flour was substituted with wholemeal wheat flour. Compared to WB and WGB, CFM and CLP had a harder and more chewy texture, and a lower specific volume (p < 0.05). WGB, CFM, and CLP had reduced porosity and lightness (L*) compared to WB (p < 0.05). In a randomized crossover study (RCT), fifteen normoglycemic individuals participated in four separate sessions. The glucose incremental area under the curve (iAUC) was lower for CLP compared to those of both WB and CFM (p < 0.05). While insulin responses were similar across all breads, GLP-1 iAUC was significantly higher following CLP consumption compared to WB (p < 0.05), whereas no significant differences were observed among the other test breads in the postprandial GLP-1 response. CLP consumption resulted in a lower iAUC for hunger and desire to eat, and a higher iAUC for fullness, as evaluated using Visual Analogue Scales (VAS), compared to WB (p < 0.05). Incorporation of large-particle chickpea flour into bread can effectively reduce postprandial glycemia, increase GLP-1 secretion and contribute to the enhancement of satiety. Such formulations may offer promising dietary strategies for glycemic control and appetite regulation.

Dietary Fibres in Processed Meat: A Review on Nutritional Enhancement, Technological Effects, Sensory Implications and Consumer Perception

Meat is an essential source of nutrients in the human diet and a component of global food security. In the context of a growing demand for functional and healthy foods, the addition of non-meat ingredients, such as dietary fibres, is a promising strategy for improving the quality of meat products. This review aimed to identify and synthesise the available recent literature regarding the impact of fibre-rich ingredients on the properties of meat products, investigating how various plant sources (such as cereals, vegetables, legumes, and fruits) can be used in various forms of meat products, such as meat pastes, emulsified products, and minced and restructured meat products. Analyses of technological parameters revealed improvements in water-holding capacity, cooking losses, and an increased production yield. The addition of fibre has demonstrated a favourable effect on low-fat products, stabilising the emulsion and improving its physical texture properties. The chemical analysis highlighted an increase in dietary fibre and mineral content, as well as a decrease in fat content depending on the type and level of fibre added. Sensory changes included aspects related to the colour, aroma, texture, and overall acceptability of the products. The optimisation of the type and level of fibre is essential to obtain meat products with improved characteristics.

The gut microbiome and dietary fibres: implications in obesity, cardiometabolic diseases and cancer

Dietary fibres constitute a heterogeneous class of nutrients that are key in the prevention of various chronic diseases. Most dietary fibres are fermented by the gut microbiome and may, thereby, modulate the gut microbial ecology and metabolism, impacting human health. Dietary fibres may influence the occurrence of specific bacterial taxa, with this effect varying between individuals. The effect of dietary fibres on microbial diversity is a matter of debate. Most intervention studies with dietary fibres in the context of obesity and related metabolic disorders reveal the need for an accurate assessment of the microbiome to better understand the variable response to dietary fibres. Epidemiological studies confirm that a high dietary fibre intake is strongly associated with a reduced occurrence of many types of cancer. However, there is a need to determine the impact of intervention with specific dietary fibres on cancer risk, therapy efficacy and toxicity, as well as in cancer cachexia. In this Review, we summarize the mechanisms by which the gut microbiome can mediate the physiological benefits of dietary fibres in the contexts of obesity, cardiometabolic diseases and cancer, their incidence being clearly linked to low dietary fibre intake.

Beyond soluble and insoluble: A comprehensive framework for classifying dietary fibre's health effects

Despite evolving definitions, dietary fibre classifications remain simplistic, often reduced to soluble and insoluble types. This binary system overlooks the complexity of fibre structures and their diverse health effects. Indeed, soluble fibre is not just soluble but has important qualities such as fermentability, attenuating insulin secretion, and lowering serum cholesterol. However, this limited classification fails to account for dietary fibre diversity and predict their full range of physiological effects. This article proposes a holistic classification framework that accounts for different fibre types and can be used to accurately infer their physiological outcomes. This proposed classification framework comprises of five constituents: backbone structure, water-holding-capacity, structural charge, fibre matrix and fermentation rate. This model more accurately captures the structural and functional diversity of dietary fibres, offering a refined approach to predicting their health benefits.

Mycoprotein: A Healthy and Sustainable Source of Alternative Protein-Based Foods

Perhaps the most important challenge currently facing agrifood is how to ensure a more sustainable food system by changing the way we eat. Fermentation of fungi to produce mycoprotein can address this imperative by utilizing an age-old technology and a largely untapped natural resource. In this review, we look at the origins of mycoprotein, fermentation at scale, and downstream applications of mycoprotein as food. We review the advances in our understanding of the underpinning science from fermentation through to food development and the evidence base of research that provides insights into the impacts of diets rich in mycoprotein on both the health of our bodies and the environment. We show that mycoprotein has a valuable and future-facing role as a healthy new protein with a low environmental impact.

Fiber in the Treatment of Dyslipidemia in Pediatric Patients

Dietary fiber is present in many food categories (fruits, cereals, vegetables, legumes), and is considered a beneficial component of adult and children's diets. It is now well-established that dietary intervention is the first line of treatment for childhood dyslipidemia, both as a curative intervention (Familial Hyperchylomicronemia Syndrome, Sitosterolemia) and as an appropriate lifestyle aimed at improving the lipid profile in dyslipidemia, which is associated with early atherosclerosis and an increased risk of cardiovascular disease in adulthood (Familial Hypercholesterolemia, overweight- and obesity-related dyslipidemia). In this paper, we reviewed the main consensus documents to determine the current indications for its use in children and adolescents, and analyzed the few specific papers on the subject in the literature to assess how fiber is currently used in the treatment of pediatric dyslipidemia, what precautions should be taken, and what the main benefits of fiber are on the lipid profile and cardiovascular risk.

Dietary fibre intake in the adult Swiss population: a comprehensive analysis of timing and sources

Recommended dietary fibre consumption is rarely met in high-income countries. Detailed analysis of fibre consumption patterns is essential to identify strategies for increasing intake. This study investigated the timing and sources of fibre intake in Switzerland, using data from the Swiss Nutrition Survey, menuCH (n = 2057, 18-75 years). Dietary characteristics were summarised for the adult population and for subgroups stratified by absolute (< 15 g/day, 15-<30 g/day, and >=30 g/day) and relative (< 10 g/1000 kcal/day, 10-<14 g/1000 kcal/day, and >=14 g/1000 kcal/day) fibre intake. Mean fibre intake of both 24 HDRs for each individual and contribution of food groups and timing (before breakfast, breakfast, during the morning, lunch, during the afternoon, dinner, after dinner/at night) was calculated. Fibre was mainly consumed at breakfast (4.1 g/day), lunch (6.0 g/day), and dinner (6.4 g/day). Intake at breakfast differed between the lowest and highest fibre intake groups by 6.4 g/day (absolute) and 4.3 g/day (relative). Breakfast skipping was more frequent among low-fibre intake groups (29% for absolute intake, 19% for relative intake) than in the overall population (15%). The main sources of dietary fibre were grain products (35.6%), followed by vegetables (18.3%) and fruits (18.2%), with whole grains accounting for 17.5% of grain intake. Legumes contributed only to 1% of total fibre intake. Public health efforts encouraging regular breakfast consumption, and intake of whole grains and legumes are recommended to improve fibre intake.

Translation and Cross-Cultural Adaptation of a Validated Questionnaire to Assess Dietary Fiber Intake Among the Italian Population

Background/Objectives: Regular consumption of dietary fiber (DF) has been associated with non-communicable disease prevention and health benefits. As a result, having the ability to quickly and correctly estimate DF intake would allow the identification of at-risk groups and the development of public programs aimed at improving their intake. In this study, the authors translate and cross-culturally adapt a validated short food frequency questionnaire for the assessment of DF intake, thus adapting it to the Italian population. Methods: The process followed a six-step standardized protocol, and the pre-final version was tested among 40 volunteers. Six experts in nutrition performed the content validity study: Scale-level Content Validity Indexes based on Average (S-CVI/Ave) and Universal Agreement (S-CVI/UA) were calculated (cut-off = 0.83). Results: Both S-CVI/Ave and S-CVI/UA were 1.00 ± 0.0, higher than the cut-off value. The preliminary qualitative analysis showed an average DF intake of 21.5 ± 7.2 g/day, which is below the suggested national and international dietary targets, and mainly derives from fruits, vegetables, bread, and cereals. Based on their DF intake, subjects were classified as low (40%), moderate (37.5%), and high (22.5%) consumers. Conclusions: The translation and cross-cultural adaptation of a validated short food frequency questionnaire to assess DF intake provided us with a tool suitable for the Italian population. Its application in a real case has enabled the identification of three consumption classes, which can support the design of future studies and interventions.

Impact of Fortified Whole Grain Infant Cereal on the Nutrient Density of the Diet in Brazil, the UAE, and the USA: A Dietary Modeling Study

BACKGROUND/OBJECTIVES

Complementary feeding (CF) influences future health outcomes. The aim of this study was to evaluate the impact of fortified whole grain infant cereal (WGIC), a complementary food, among 6- to 12-month-old infants on the nutrient density of the diet in three diverse settings: Brazil, the United Arab Emirates (UAE), and the US.

METHODS

Data from the Feeding Infants and Toddler Study (FITS), a collection of dietary intake studies based on 24-h-dietary recalls, from said countries was utilized. Nutrient intakes were calculated for infant cereal (IC) consumers and non-consumers. Diet modeling was applied to IC consumers to substitute their regular fortified IC with WGIC with improved fortifications. The study estimated the average nutrient density, mean adequacy ratio (MAR), and percentage inadequacy of the diet in both IC consumers and non-consumers.

RESULTS

The analyses indicated that infants who consumed IC had higher intakes of calcium, zinc, magnesium, iron, and vitamin D in the three countries. Reduced micronutrient inadequacies were observed among IC consumers, particularly in Brazil and the U.S. Diet modeling with WGIC revealed a significantly higher density of choline, magnesium, zinc, iron, fiber, and protein, as well as reduced inadequacies. The MAR was significantly improved in the three countries.

CONCLUSIONS

This study underscores the potential of fortified WGIC in increasing the nutrient density of the complementary diet. The intrinsic nutrients in whole grain infant cereals (WGICs) significantly enhance the nutrient density of the complementary diet. Given that whole grains play a role in preventing childhood obesity, their inclusion during CF may be crucial.

Effects of NatureKnit™, a Blend of Fruit and Vegetable Fibers Rich in Naturally Occurring Bound Polyphenols, on the Metabolic Activity and Community Composition of the Human Gut Microbiome Using the M-SHIME® Gastrointestinal Model

This study evaluated the impact of a proprietary blend of fruit and vegetable fibers rich in naturally occurring bound polyphenols (commercially marketed as NatureKnitTM), compared to purified fibers (inulin and psyllium), on the human gut microbiome using the validated M-SHIME® gastrointestinal model. A short-term single-stage colonic M-SHIME® experiment (with fecal inoculum from three healthy human donors) was used to evaluate the test products compared to a negative control. Samples were assessed for pH, gas pressure, short-chain fatty acid (SCFA) production, lactate, and ammonium from 0 h to 48 h. Microbial community composition was assessed at 0 h (negative control only), 24 h, and 48 h (lumen) or 48 h (mucosal). All test products were fermented well in the colon as demonstrated by decreases in pH and increases in gas pressure over time; these changes occurred faster with the purified fibers, whereas NatureKnit™ demonstrated slow, steady changes, potentially indicating a gentler fermentation process. SCFA production significantly increased over the course of the 48 h experiment with all test products versus negative control. SCFA production was significantly greater with NatureKnit™ versus the purified fibers. Shifts in the microbial community composition were observed with all test products versus negative control. At the conclusion of the 48 h experiment, the absolute bacterial abundance and the richness of observed bacterial taxa in the lumen compartment was significantly greater with NatureKnit™ compared with inulin, psyllium, and negative control. Overall, NatureKnit™ demonstrated greater or similar prebiotic effects on study measures compared with established prebiotic fibers.

The effect of chitosan supplementation on liver function, hepatic steatosis predictors, and metabolic indicators in adults with non-alcoholic fatty liver disease: a randomized, double-blinded, placebo-controlled, clinical trial

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is a disease with high complications. An increment in dietary fiber consumption is an approach to NAFLD management, and chitosan as dietary fiber can play a role in the management of NAFLD. Thus, the present study aimed to investigate the effect of chitosan supplementation on liver function, hepatic steatosis predictors, and metabolic indices in adults with NAFLD.

METHODS

Seventy-two adults with NAFLD were randomly assigned to consume either 1.5 g/day chitosan or placebo along with a low-calorie (- 500 kcal/day) diet for 8 weeks in a parallel, randomized, double-blinded, placebo-controlled, clinical trial. Participants were assessed for dietary intake, physical activity, and anthropometric indices. Blood samples were taken to measure fasting blood sugar (FBS), cholesterol, triglycerides, high- and low-density lipoprotein (HDL and LDL). Liver function indices including alanine aminotransferase (ALT), aspartate transaminase (AST), and gamma-glutamyltransferase (GGT) were evaluated using blood samples as the primary outcomes. Fatty liver index (FLI), hepatic steatosis index (HSI), and triglyceride-glucose index (TyG) were calculated as hepatic steatosis predictors' indices.

RESULTS

After 8 weeks of study, 66 participants finished the study. In comparison with placebo, chitosan supplementation reduced weight (P = 0.041), waist circumference (P = 0.049), AST (P = 0.040), ALT (P = 0.001), and GGT (P = 0.028). Although the reduction of FBS, triglycerides, cholesterol, LDL, FLI, HSI, and TyG, and increment in HDL was higher in the chitosan group, the results were not significant (P > 0.05).

CONCLUSIONS

Eight-week supplementation with 1.5 g/day chitosan along with a low-calorie diet could possibly reduce weight, waist circumference, AST, ALT, and GGT, and ameliorate NAFLD. Further investigations are recommended. Trial registration The trial was registered at IRCT.ir as IRCT20140502017522N4 (March 2023).

The Role of the Planetary Diet in Managing Metabolic Syndrome and Cardiovascular Disease: A Narrative Review

Introduction: The planetary health diet, introduced by the EAT-Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, including prevention and management of abdominal obesity, carbohydrate metabolism disorders, dyslipidemia, and elevated blood pressure. These metabolic disorders are components of metabolic syndrome, a cluster of risk factors for cardiovascular disease. Objectives: This narrative review aims to gather the most recent findings on the impact of the planetary diet on individual components of metabolic syndrome and on the prevention and treatment of cardiovascular disease. Methods: The available research on the topic was identified via searches in PubMed, Scopus, and Google Scholar. Results: Abdominal obesity, a major risk factor for a range of chronic diseases, can be effectively mitigated by adhering to plant-based dietary patterns, which have been shown to reduce waist circumference and improve overall cardiometabolic health. Furthermore, the planetary diet plays a crucial role in reducing the risk of type-2 diabetes and improving glycemic control, with specific dietary components such as whole grains and fiber, demonstrating positive effects on blood glucose levels. This diet is additionally associated with favorable lipid profiles, including lower levels of LDL cholesterol and total cholesterol, which are critical in the prevention of atherosclerosis and cardiovascular diseases. Conclusions: These multiple benefits highlight that the planetary diet may be an effective strategy for managing and preventing metabolic syndrome and cardiovascular disease. However, further research is needed to confirm its long-term efficacy and applicability across diverse populations.

Strawberry dietary intervention influences diversity and increases abundances of SCFA-producing bacteria in healthy elderly people

The gut microbiome is amenable to dietary interventions, and polyphenol-rich diets have been shown to enhance abundances of bacteria associated with short-chain fatty acid (SCFA) production. We examined the effects of a strawberry-based intervention on the gut microbiome of 69 healthy elderly German adults. Participants in five groups consumed varying amounts of strawberries, freeze-dried strawberries, and capers in olive oil over 10 weeks as part of a randomized controlled trial. 16S rRNA sequencing was used to analyze differences in microbial composition, diversity, phenotypes, differential abundance, and functional pathways. The intervention group featuring the highest amounts of fresh and freeze-dried strawberries without capers in olive oil (group 4) showed changes in gut microbial diversity and differential abundance that could be linked to improved health. Beta diversity, based on weighted UniFrac distances, increased significantly (P = 0.0035), potentially pathogenic bacteria decreased (P = 0.04), and abundances of SCFA-producing genera Faecalibacterium and Prevotella increased significantly. Other findings included a significant reduction of CAG-352, Preveotellaceae_NK3B31-group, and Eubacterium coprostanoligenes (group 2), and a trend of lowered Firmicutes-to-Bacteroidetes ratio (P = 0.067) and a reduction in Ruminococcaceae (group 3). Our findings suggest that a dietary intervention based on strawberries can positively alter the gut microbiota of healthy elderly people as seen in an enrichment of SCFA-producing genera, increased diversity, and a reduction in potentially pathogenic bacteria.IMPORTANCEAging is often associated with changes in the gut microbiome, including a decline in beneficial bacteria and an increase in potentially pathogenic species. Addressing these changes through lifestyle interventions is of significant interest. Our study demonstrates that a 10-week dietary intervention with strawberries can beneficially modulate gut microbial composition and diversity in healthy elderly individuals. Notably, the group consuming the highest amount of strawberries (without capers in olive oil) initially had higher abundances of potentially pathogenic bacteria. Here, the intervention led to increased abundances of the beneficial genera Faecalibacterium and Prevotella, which are linked to health benefits including reduced inflammation and improved lipid metabolism. These findings suggest that strawberry consumption can positively influence gut microbial composition, thereby contributing to overall health and disease prevention in older adults.

Effect of soluble dietary fiber extracted from Lentinula edodes (Berk.) Pegler on lipid metabolism and liver protection in mice on high-fat diet

With the increasing annual production of Lentinula edodes, the residues of Lentinus edodes are mass produced and wasted every year. In order to further explore the added value and effective utilization of Lentinus edodes, we studied the lipid-lowering efficacy and liver protective effect of Lentinus edodes soluble dietary fiber in mice on high-fat diet. Project team from Lentinus edodes extracted soluble dietary fiber, and its physicochemical properties, selected 30 male mice, randomly divided into normal group (N), high fat diet group (F), add low dose dietary fiber high fat diet (FL), add medium dose dietary fiber high fat diet group (FM), add high dose dietary fiber high fat diet group (FH) five groups. After 4 weeks, we assessed general state, organ conditions, liver status, blood parameters, expression of hepatic lipid metabolism genes, mRNA levels of key hepatic lipid metabolism genes. The results showed that the molecular weight of soluble dietary fiber is about 17.029 kDa, and the monosaccharides such as galactose, glucose and mannitol are connected by β-glycosidic bond. The soluble dietary fiber of Lentinus edodes can effectively slow the weight growth due to high-fat diet, delay liver tissue lesions, reduce the levels of ALT, AST, ACP, LDL-C, TG, TV, FFA, SOD, GSH and MDA, and increase the levels of γ-GT, HDL-C and CAT in blood. Lentinus edodes soluble dietary fiber decreased the expression of AMPKα and SREBP-2 in the liver, and increased the expression of PPARα, ACS, CPT1a, CYP7A1. It is proved that the soluble dietary fiber of Lentinus edodes can alleviate the organ fat accumulation caused by high-fat diet to some extent, effectively combat the liver injury, oxidative stress pressure and lipid metabolism disorder caused by high-fat diet, and provide an experimental basis for the subsequent effective use of soluble dietary fiber of Lentinus edodes in fat reduction.

The Effect of β-Glucan on the Release and Antiradical Activity of Phenolic Compounds from Apples in Simulated Digestion

Beneficial activities of phenolic compounds in the gastrointestinal tract, such as antiradical activity, are affected by the food matrix. The aim of this study was to investigate the influence of one constituent of the food matrix (dietary fiber β-glucan) on the release and antiradical activity of phenolic compounds from apples in gastrointestinal digestion. Simulated digestion in vitro was conducted on whole apples without or with added β-glucan. Antiradical activity was determined with the DPPH method. The total amount of released phenolic compounds in the stomach (563 mg kg-1 fresh weight (fw), 85%) decreased in the intestine (314 mg kg-1 fw, 47%) (p < 0.05). The presence of β-glucan decreased the release of phenolic compounds to 80 and 74% in the stomach and to 44 and 40% in the small intestine when there were lower and higher β-glucan amounts, respectively. A statistical analysis showed differences between release in digestion without or with β-glucan. B-glucan adsorbed up to 24 (stomach) and 32 mg g-1 (small intestine) of the phenolics. Phenolic compounds scavenged more free radicals in the small intestine than in the stomach, and β-glucan decreased this activity, but not significantly. The interaction between β-glucan and phenolic compounds should be considered when explaining the beneficial effects in the stomach and small intestine.

Hybrid Modification of Wheat Bran Using Microbial Processing and Ultrasound: Enhancements in Bran Composition and Bread Quality

This study investigates the effects of microbial bioprocessing (MB), ultrasound treatment (UT), and their combined application (hybrid method, HM) on the functional and nutritional enhancement of wheat bran (WB) and its impact on bread quality. MB was performed by using Saccharomyces cerevisiae with Levilactobacillus brevis LABE 32 (MB32) and Lactiplantibacillus plantarum LABE 29 (MB29). MB32 significantly increased soluble dietary fiber (SDF) and reduced phytic acid content by up to 25.7% when compared to the control. UT further decreased phytic acid content by 52.2% and enhanced phenolic compound release, contributing to improved antioxidant activity. The hybrid method (HM) demonstrated the strongest effect, reducing phytic acid content by 95% and enhancing antioxidant properties, including a 2.4-fold increase in bound antioxidant activity (bound-AA). Bread produced from modified WB showed improvements in specific volume (SV), texture, and nutritional composition. The HM-treated WB yielded bread with the highest SV, approximately 10% greater than the control, while MB29 produced significantly harder bread than other samples (p < 0.05). The HM-treated bread had the highest crust L* value and softest texture (p < 0.05). Nutritionally, only UT and HM treatments significantly increased the total dietary fiber (TDF) content, with the most pronounced increase observed in the HM treatment. Phytic acid degradation in the WB modified with MB32 and UT was in accordance with their breads, notably lowering phytic acid content. Additionally, MB32 and HM increased total phenolic content (TPC) and antioxidant activity, enhancing the bread's overall nutritional quality. In conclusion, the hybrid application of MB and UT (HM) proved to be the most effective in improving the functional and nutritional properties of WB and the resulting bread, including increased dietary fiber content, reduced phytic acid levels, and enhanced antioxidant activity.

Effect of Daily Fiber Intake Among Cirrhotic Patients With and Without Portosystemic Shunts

Background

A diet rich in fiber, especially soluble fiber, causes cholestatic liver damage and fibrosis in animal models with intestinal dysbiosis, high serum bile acid concentrations, and congenital portosystemic shunts (PSs), but no data on patients with cirrhosis (CIRs) are available.

Objectives

To investigate whether dietary fiber consumption was associated with clinical outcomes of CIRs and whether their effect differed according to the presence of PSs.

Methods

Daily soluble and insoluble fiber intake was extrapolated from 3-d food diaries in 25 patients with chronic hepatitis (CH) and 80 CIRs outpatient liver transplant candidates abstinent from alcohol and nonviremic for ≥6 mo. In CIRs, the presence of PSs was verified by computed tomography, and the model for end-stage liver disease (MELD) score was calculated at enrollment and after 6 mo.

Results

PSs were present in 48 (60%) CIRs. The MELD score after 6 mo, compared with enrollment, had improved in 19 and 10 CIRs with and without PSs, respectively. By adjusting for confounders in logistic regression models we found that improvement in MELD over time was inversely associated with insoluble fiber consumption expressed in milligrams per kilogram (mg/kg) body weight in CIRs without PSs [odds ratio (OR): 0.968; 95% confidence interval (CI): 0.939, 0.997; P = 0.005] but with soluble fiber consumption in CIRs with PSs [OR: 0.946; 95% CI: 0.912, 0.982; P = 0.001]. In CIRs with PSs, soluble fiber consumption was inversely associated with normal serum alkaline phosphatase values at enrollment [OR: 0.964; 95% CI: 0.963, 0.993; P = 0.010]. CHs with normal serum alanine transaminase consumed significantly more soluble fiber (p=0.015) than those with abnormal alanine transaminase.

Conclusions

The clinical impact of dietary fiber changes from beneficial to harmful as the stage of chronic liver disease progresses. In particular, in the advanced cirrhosis stage with PSs, soluble fiber intake appears to significantly influence disease progression and should be kept low.

Higher fiber higher carbohydrate diets better than lower carbohydrate lower fiber diets for diabetes management: Rapid review with meta-analyses

BACKGROUND

Some dietary recommendations continue to recommend carbohydrate restriction as a cornerstone of dietary advice for people with diabetes.

PURPOSE

We compared the cardiometabolic effects of diets higher in both fiber and carbohydrate with lower carbohydrate lower fiber diets in type 1 or type 2 diabetes.

DATA SOURCES

MEDLINE, Embase, and the Cochrane Database of Systematic Reviews up to June 24, 2024, with additional hand searching.

STUDY SELECTION

Randomized controlled trials in which both dietary fiber and carbohydrate amount had been modified were identified from source evidence syntheses on carbohydrate amount in people with diabetes.

DATA EXTRACTION

Two reviewers independently.

DATA SYNTHESIS

Ten eligible trials including 499 participants with diabetes (98% with T2) were identified from the potentially eligible 828 trials included in existing evidence syntheses. Pooled findings indicate that higher fiber higher carbohydrate diets reduced HbA1c (mean difference [MD] -0.50% [95% confidence interval -0.99 to -0.02]), fasting insulin (MD -0.99 μIU/mL [-1.83 to -0.15]), total cholesterol (MD -0.16 mmol/L [-0.27 to -0.05]) and low-density lipoprotein cholesterol (MD -0.16 mmol/L (-0.31 to -0.01) when compared with lower carbohydrate lower fiber diets. Trials with larger differences in fiber and carbohydrate intakes between interventions reported greater reductions. Certainty of evidence for these outcomes was moderate or high, with most outcomes downgraded due to heterogeneity unexplained by any single variable.

LIMITATIONS

Our predefined scope excluded trials with co-interventions such as energy restriction, which may have provided addition information.

CONCLUSIONS

Findings indicate the greater importance of promoting dietary fiber intakes, and the relative unimportance of carbohydrate amount in recommendations for people with diabetes.

The Management of Dietary Fiber Intake in Children With Chronic Kidney Disease - Clinical Practice Recommendations From the Pediatric Renal Nutrition Taskforce

The benefits of dietary fiber are widely accepted. Nevertheless, a substantial proportion of children fail to meet the recommended intake of dietary fiber. Achieving adequate fiber intake is especially challenging in children with chronic kidney disease (CKD). An international team of pediatric renal dietitians and pediatric nephrologists from the Pediatric Renal Nutrition Taskforce (PRNT) has developed clinical practice recommendations (CPRs) for the dietary intake of fiber in children and adolescents with CKD. In this CPR paper, we propose a definition of fiber, provide advice on the requirements and assessment of fiber intake, and offer practical guidance on optimizing dietary fiber intake in children with CKD. In addition, given the paucity of available evidence and to achieve consensus from international experts, a Delphi survey was performed in which all the clinical practice recommendations were reviewed.

Valorizing Agro‐Food Waste for Nutraceutical Development: Sustainable Approaches for Managing Metabolic Dysfunction‐Associated Steatotic Liver Disease and Related Co‐Morbidities

This comprehensive investigation delves into the interconnectedness of different features of cardiometabolic syndrome, such as metabolic dysfunction‐associated steatotic liver disease (MASLD), atherosclerotic cardiovascular disease (ASCVD), and gut dysbiosis, highlighting the crucial role of nutraceuticals in their management and prevention. Given the significant overlap in the pathophysiology of these conditions, the treatment with nutraceuticals, especially those derived from agro‐food waste, offers a promising, sustainable, and innovative approach to healthcare. The 2030 Agenda for Sustainable Development and the One Health concept are key frameworks for selecting the most interesting supply chain for the production of nutraceuticals from agro‐food waste, ensuring environmental sustainability, and innovative agricultural practices. In this review, the therapeutic potential of kiwifruit and apples has been explored, detailing how their bioactive compounds, like polyphenols, fiber, pectin, kaempferol, phloretin, and phlorizin, may contribute to the management of MASLD, ASCVD, and gut dysbiosis. Various extraction methods for active ingredients, including chemical, water, and enzyme extractions, are analyzed for their respective benefits and drawbacks. By integrating scientific research, sustainable agricultural practices, and innovative extraction methods, we can develop effective strategies to combat these pervasive health issues. This holistic approach not only enhances individual health outcomes but also supports broader environmental and societal goals, promoting a healthier future for all.

Broccoli, Artichoke, Carob and Apple By-Products as a Source of Soluble Fiber: How It Can Be Affected by Enzymatic Treatment with Pectinex® Ultra SP-L, Viscozyme® L and Celluclast® 1.5 L

Dietary fiber (DF), and especially soluble dietary fiber (SDF), is a nutrient of particular interest today because of its anti-inflammatory role and its ability to reduce cardiovascular risk. Therefore, the enhancement of SDF in foods using different techniques has become a promising field of research. In order to prove the possibility of increasing this SDF content, the effects of different commercial enzymes (Pectinex® Ultra SP-L, Viscozyme® L and Celluclast® 1.5 L) were tested on a variety of carob (CE), artichoke (ARE), apple (APE) and broccoli (BE) by-product extracts. Enzymatic treatment significantly affected SDF content in all by-products, showing the greatest increases for CE, ARE and APE using Celluclast® 1.5 L, while Viscozyme® L obtained the best results after application in BE. On the other hand, positive results were reported in the solubility, WHC and FAC of the by-products due to the enzymatic treatment, being increased in all extracts analyzed. Moreover, a general increase in antioxidant capacity (FRAP, ABTS and DPPH) was observed after enzymatic treatment. Finally, high yields were obtained after the application of the enzymatic processes, reaching values of 80-85% for each food by-product. These results evidenced a potential revalorization of carob, artichoke, apple and broccoli by-products after enzymatic treatment, improving its nutritional and physicochemical properties, revealing a possible application as a higher value-added ingredient.

Comparison Between Two Divergent Diets, Mediterranean and Western, on Gut Microbiota and Cognitive Function in Young Sprague Dawley Rats

Clinical studies strongly suggest the importance of diet quality on cognition in youth populations (15-24 years). The Mediterranean diet (MeDi) has been shown to improve cognition in contrast to the commonly consumed Western diet (WD). The gut microbiota may serve as a mechanism for diet-induced changes in cognition. Ten-week-old male Sprague Dawley rats were assigned a MeDi or WD (n=10/group) for 14 weeks. Prior to neurobehavior assessments, microbiota community composition was assessed. At the genus level, the relative abundance of four bacteria increased with the MeDi and five decreased compared to the WD. Rats in the MeDi group demonstrated cognitive flexibility and improvement in reference and working memory relative to the WD group. At the end of the study, serum cytokines were increased, and low-density lipoproteins were decreased in the MeDi group. Markers for neuroinflammation, blood-brain barrier, glial cells, and synaptic plasticity in brain regions did not differ between groups. Overall, the MeDi modulated gut microbiota, cognitive function, and serum lipid and cytokines but not gene expression in the brain compared to the WD. Further studies are needed to determine causality between diet-modulated gut microbiota, cognitive function, and immune function.

Fructooligosaccharides for Relieving Functional Constipation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Fructooligosaccharides (FOS) are prebiotics with great potential to improve constipation. This study set out to investigate the usefulness of consuming FOS as a dietary supplement on bowel movement frequency, stool consistency, abundance of Bifidobacteria, gastrointestinal transit time, and gastrointestinal symptoms through a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched the Cochrane Library, PubMed, EMBASE, and Web of Science databases up to 2 March 2024. Randomized controlled trials reporting the use of FOS as a supplement by participants were included. Bias risk was assessed using the Cochrane Risk of Bias assessment tool. Results were synthesized using a random-effects model or fixed-effects model, combining outcomes using odds ratios (OR), weighted mean differences (MD), or standardized mean differences (SMD) with 95% confidence intervals (CI). The meta-analysis encompassed 17 randomized controlled trials, involving a total of 713 study participants. Overall, the intake of FOS significantly increased bowel movement frequency (95% CI: 0.80, 1.50, p < 0.00001) and positively affected stool consistency, softening the stool (SMD: 0.36, 95% CI: 0.12, 0.60, p = 0.76). It also reduced the effort and pain during defecation (SMD: -0.60, 95% CI: -0.85, -0.34, p = 0.12). At the same time, mild bloating was noted as an adverse event associated with FOS ingestion (OR: 10.36, 95% CI: 3.32, 33.23, p = 0.24). No reports of serious adverse events were documented. Overall, FOS may enhance bowel movement frequency, stool consistency, and overall constipation symptoms, suggesting cautious optimism regarding their use as a dietary treatment alternative. Nevertheless, further robust and definitive randomized controlled trials are required to more accurately determine the most effective dosage and duration of use. Additional research and evidence are necessary before the efficacy of FOS as a therapeutic method for treating functional constipation can be firmly established.

An exploration of fibre intake and bowel function in a sample of adults at an Irish university campus

BACKGROUND

Bowel dysfunction can significantly impair quality of life. Adequate fibre intake is associated with good bowel health but intakes have been reported to be low in Ireland.

AIM

This study aimed to gather data on fibre intake and bowel habits in a cohort of adults at a university campus in Dublin, Ireland.

METHODS

An online questionnaire was developed by adapting validated tools to assess habitual fibre intake and bowel function. The questionnaire was circulated through mailing lists and advertised via QR codes on campus in February/March 2023. Data was analysed using SPSS, p < 0.05 was considered statistically significant.

RESULTS

In total, 275 valid responses were received. Low fibre intakes (< 19 g/day) were found in 50.5% of participants. A significantly higher proportion of males had low fibre intake compared to females (62.2% vs 44.8%, p = 0.039). Nearly a third (30.2%) of respondents experienced mild symptoms of bowel dysfunction, and 13.1% experienced moderate to severe symptoms. An inverse relationship was observed between fibre intake (g/day) and bowel dysfunction (p = 0.033).

CONCLUSIONS

In this cohort, low fibre intakes and some degree of bowel dysfunction were prevalent. Public health campaigns to increase fibre intake could prove to be a cost-effective way to improve bowel function and health amongst adults in Ireland.

Evaluation of the Phenolic Components, Fiber Content, Antioxidant Activity, and Prebiotic Capacity of a Shortbread Cookie Fortified with Hazelnut Skin Waste

Food reformulation is a strategy to make healthier foods by using food waste matrices that are still nutritionally valid. A shortbread cookie was reformulated replacing hazelnut skin (HS) of the Tonda Gentile Romana variety (5% and 10%) to refined flour and proportionally decreasing the butter amount. This resulted in significant, two- and five-fold, increases in the antioxidant capacity compared with the control, in the 5% and 10% fortified recipes, respectively. Among the most important antioxidants, gallic acid, catechin, phloridzin, and protocatechuic acid were found. Moreover, here we found, for the first time, that HS from the Romana variety had a high total fiber content (44.13 g/100 g), most of which was insoluble fiber. Therefore, HS 10% addition to the shortbread cookie recipe caused a significant increase in fiber content, making the experimental cookie earn the nutritional claim of "high fiber content". Finally, preliminary evidence demonstrated that 10% HS, in comparison to 5%, following in vitro upper gastrointestinal digestion, conferred significant prebiotic activity in an in vitro culture of L. rhamnosus. Therefore, from the perspective of the circular economy, HS could be a valuable ingredient to increase the antioxidant and prebiotic activities of conventional foods.

Effects of exercise and dietary interventions on asprosin, leptin, and lipid metabolism in males with abdominal obesity, a randomized controlled trial

Addressing abdominal obesity requires multifaceted strategies, with physical activity and diet playing a pivotal role. The objective of this study was to assess alterations in body composition, adipokine concentrations, insulin resistance parameters, and lipid metabolism in males with abdominal obesity following two distinct interventions: exercise alone and exercise combined with a specific diet. The study involved 44 males with abdominal obesity (average age 34.7 ± 5.5 years, waist circumference [WC] 110.3 ± 8.5), randomly assigned to three groups: an experimental group with aerobic-resistance exercise (EG, n = 16), an experimental group with aerobic-resistance exercise combined with a high-protein, low-glycemic index carbohydrate diet (EDG, n = 16), both interventions lasting 6 weeks, and a control group without interventions (CG, n = 12). Body composition (body mass [BM], body fat percentage [BF%], fat-free mass [FFM], android body fat percentage [ANDR]), as well as biochemical blood analyses (asprosin [ASP], leptin [LEP], quantitative insulin sensitivity check index [QUICKI], and total cholesterol [TC]), were conducted at baseline and after 6 weeks of intervention. The impact of interventions on the analyzed variables among groups was assessed using mixed ANOVA tests with post-hoc comparisons. Effect size (ES) was also evaluated using 𝜂p2. Significant reductions in ASP concentration after intervention were observed in both EG (p = 0.04) and EDG (p = 0.01). However, post-hoc tests revealed a decrease in LEP only in the EDG group (p < 0.01). In EDG substantial decreases after 6 weeks of intervention were noted in BM (p < 0.01), BF% (p < 0.01), ANDR (p < 0.01) and TC (p < 0.01). The most notable increase in FFM was observed in the EDG group (p < 0.01). More favourable metabolic outcomes were confirmed in the group combining diet with exercise, where there was a notable reduction in ASP levels by 16% and LEP by 48% after 6 weeks of intervention, compared to the group undergoing exercise alone.

Nutrition among nursing home residents: results from the NutriCare study

Background

Older adults living in nursing homes (NHs) are considered a vulnerable population in terms of nutrition. The aim of the present study was to explore the usual intake of energy, macronutrients, and specific food groups, along with offers in the NH menus on a nationally representative sample of Slovenian NH residents and compare dietary patterns with the established recommendations.

Methods

The study was conducted as part of a cross-sectional NutriCare study on 317 residents (65-101 years) from 20 Slovenian NHs in 9 health regions. Relatively independent residents were selected using quota sampling by sex and age. Data collection involved interviews and anthropometric measurements. Usual dietary intake was assessed by a multiple-source method from two 24-h dietary recalls and food frequency questionnaires. Adherence of dietary intake to the recommendations and dietary composition of NH menus were assessed. The Mini Nutritional Assessment (MNA) was used to explore nutritional status.

Results

Notable variability in energy and macronutrient intakes was observed with some participants showing intakes below and others above the recommended values. A high prevalence of BMI > 30 kg/m2 was observed in 39% of participants, indicating potential discrepancies between total energy intake and expenditure. The usual intake of fat was 36% of total energy intake (TEI). The intake of foods of animal origin exceeded dietary guidelines. Intake of carbohydrates (46% TEI in men and 47% TEI in women) as well as dietary fibre (20 g/day for both sexes) was below recommendations. A scarce intake of fruits, vegetables, and cereals was observed. In total, 40% of men and 35% of women had usual daily protein intakes lower than 1 g/kg of body weight. The protein content of breakfast and dinner could be improved. NH residents consumed little food from outside NH. The usual nutrient and food group intakes of residents reflected the NH menu offers.

Conclusion

The study results on the usual intake of energy, macronutrients, specific food groups, and offers in the NH menus indicate the potential for optimisation. According to the World Health Organisation, the prevalence of BMI > 30 kg/m2 is notable and warrants attention. Careful meal planning and regular monitoring of the nutritional status of NH residents should be considered.

Rethinking the classification of non-digestible carbohydrates: Perspectives from the gut microbiome

Clarification is required when the term "carbohydrate" is used interchangeably with "saccharide" and "glycan." Carbohydrate classification based on human digestive enzyme activities brings clarity to the energy supply function of digestible sugars and starch. However, categorizing structurally diverse non-digestible carbohydrates (NDCs) to make dietary intake recommendations for health promotion remains elusive. In this review, we present a summary of the strengths and weaknesses of the traditional dichotomic classifications of carbohydrates, which were introduced by food chemists, nutritionists, and microbiologists. In parallel, we discuss the current consensus on commonly used terms for NDCs such as "dietary fiber," "prebiotics," and "fermentable glycans" and highlight their inherent differences from the perspectives of gut microbiome. Moreover, we provide a historical perspective on the development of novel concepts such as microbiota-accessible carbohydrates, microbiota-directed fiber, targeted prebiotics, and glycobiome. Crucially, these novel concepts proposed by multidisciplinary scholars help to distinguish the interactions between diverse NDCs and the gut microbiome. In summary, the term NDCs created based on the inability of human digestive enzymes fails to denote their interactions with gut microbiome. Considering that the gut microbiome possesses sophisticated enzyme systems to harvest diverse NDCs, the subclassification of NDCs should be realigned to their metabolism by various gut microbes, particularly health-promoting microbes. Such rigorous categorizations facilitate the development of microbiome-targeted therapeutic strategies by incorporating specific types of NDCs.

Fibre & fermented foods: differential effects on the microbiota-gut-brain axis

The ability to manipulate brain function through the communication between the microorganisms in the gastrointestinal tract and the brain along the gut-brain axis has emerged as a potential option to improve cognitive and emotional health. Dietary composition and patterns have demonstrated a robust capacity to modulate the microbiota-gut-brain axis. With their potential to possess pre-, pro-, post-, and synbiotic properties, dietary fibre and fermented foods stand out as potent shapers of the gut microbiota and subsequent signalling to the brain. Despite this potential, few studies have directly examined the mechanisms that might explain the beneficial action of dietary fibre and fermented foods on the microbiota-gut-brain axis, thus limiting insight and treatments for brain dysfunction. Herein, we evaluate the differential effects of dietary fibre and fermented foods from whole food sources on cognitive and emotional functioning. Potential mediating effects of dietary fibre and fermented foods on brain health via the microbiota-gut-brain axis are described. Although more multimodal research that combines psychological assessments and biological sampling to compare each food type is needed, the evidence accumulated to date suggests that dietary fibre, fermented foods, and/or their combination within a psychobiotic diet can be a cost-effective and convenient approach to improve cognitive and emotional functioning across the lifespan.

Importance of dietary fiber in children

Dietary fibers (DFs) are essential components of human nutrition and are principally defined as non-digestible carbohydrates (oligosaccharides and polysaccharides) usually classified by their physicochemical and physiological characteristics (water solubility, viscosity, fermentability, and bulking effect). Unfortunately, there is limited information on dietary fiber recommendations for children, and the evidence on their effect on health and symptom control is mainly available for the adult population. Therefore, this review aims to give a comprehensive overview of the characteristics and dietary sources of dietary fiber and their potential health benefits in healthy children but also their potential use in the treatment of sick children.

Plant protein, fibre and physical activity solutions to address poor appetite and prevent undernutrition in older adults: study protocol for the APPETITE randomised controlled trial

Reduced appetite with ageing is a key factor that may increase risk of undernutrition. The objective of this study is to determine the impact of innovative plant protein fibre (PPF) products within a personalised optimised diet (PD), a physical activity (PA) programme, and their combination on appetite, and other nutritional, functional and clinical outcomes in community-dwelling older adults in a multi-country randomised controlled intervention trial. One hundred and eighty community-dwelling adults (approximately sixty per trial centre in Germany, Ireland and Italy) aged 65 years and over will be recruited to participate in a 12-week, parallel-group, controlled trial. Participants will be randomised into one of four groups: 1, PD (incorporating two PPF products): 2, PA; 3, PD + PA; and 4, no intervention (control). The primary outcome is appetite measured by visual analogue scales and energy intake from an ad libitum test meal. Secondary outcomes include fasting and postprandial appetite-related gut hormones, Simplified Nutritional Appetite Questionnaire score, body composition, cardiorespiratory fitness, muscle strength, physical function and PA. In addition, self-efficacy, cognitive status, dietary restraint, depressive symptoms and compliance and acceptability of the intervention will be assessed. Metabolomic profiles, RMR, muscle motor unit properties and gut microbiome will also be assessed to explore potential underlying mechanisms. This multi-centre randomised controlled trial will advance knowledge on how PD (incorporating PPF products), PA and their combination influence appetite, nutritional status and related health outcomes in community-dwelling older adults and contribute to the prevention of undernutrition. Trial registration: Clinical Trials.gov Registry NCT05608707 (registered on 2 November 2022). Protocol Version: NCT05608707 Version 4 (registered on 29 September 2023).

The gut microbiota of healthy individuals remains resilient in response to the consumption of various dietary fibers

This study focuses on the resilience of gut microbiota during a five-month multi-interventional nutrition trial. The modulatory effects of beta-glucan, rye bran and two dietary fiber mixtures on the fecal pH and compositional changes of the microbiome of healthy subjects were studied. To analyze the stability of intestinal microbiota, we collected an extensive dataset of sequential fecal samples (23-29 from each participant) during a week of the base, beta-glucan consumption and wash-out periods accompanied by the collection of daily food diary data. Microbiota analyses were also conducted after the end of each fiber intake and wash-out period, along with measurements of fecal organic acids and pH. Based on the dominant bacterial taxa, two prevalent microbiota types were identified. The Prevotella-type microbiota responded more to the tested dietary fibers, while the Bacteroides-type microbiota was the least affected. Three microbiota types could not be clustered and behaved differently. Although we noted individual effects of definite fibers on participants' gut microbiota and metabolic profile, relative abundances of bacteria remained stable in the base period (z-scores - 2.2 to 2.3). In most cases, the bacterial abundances of the final samples remained within the normal fluctuation range stressing out the resilience of healthy microbiota. The pH of all fecal samples varied between 6.1 and 8.3 and was associated with the concentration of organic acids and microbial composition. The effect of dietary fibers on the metabolism of fecal microbiota clearly depended on the individual microbiota type. Combining the analysis of gut microbiota with knowledge of the properties of dietary fibers would provide a powerful strategy for nutrition guidance and disease prevention.

A global analysis of the burden of ischemic heart disease attributable to diet low in fiber between 1990 and 2019

AIM

Ischemic heart disease (IHD) represents a major cardiovascular condition heavily influenced by dietary factors. This study endeavors to assess the global, regional, and temporal impact of low-fiber diets on the burden of IHD.

METHOD

Leveraging data from the Global Burden of Disease (GBD) 2019 study, we analyzed the worldwide burden of IHD resulting from diet low in fiber using indices including death and disability-adjusted life years (DALY). This burden was further segmented based on variables including regions and countries. To track the evolution from 1990 to 2019, we utilized the Joinpoint regression model to estimate the temporal trend of IHD burden stemming from low-fiber diets.

RESULTS

In 2019, a total of 348.85 thousand (95%UI: 147.57, 568.31) deaths and 7942.96 thousand (95%UI: 3373.58,12978.29) DALY (95% UI: 707.88, 1818) of IHD were attributed to diet low in fiber globally. These figures correspond to 3.82% of all IHD deaths and 4.36% of total IHD DALYs. The age-standardized death and DALY rates per 100,000 individuals were 4.48 (95% UI: 1.90,7.27) and 97.4(95%UI: 41.44, 158.88) respectively. However, significant regional disparities emerged in these age-standardized rates, with South Asia and Central Asia experiencing the highest rates. Between 1990 and 2019, we observed that most regions displayed a downward trend of the age-standardized DALY and death rate of IHD resulting from low-fiber diets, except for Central Sub-Saharan Africa and Southern Sub-Saharan Africa.

CONCLUSION

Our analysis underscores the substantial toll of IHD associated with low-fiber diets, particularly considering the significant regional variations. Therefore, it is imperative to sustain efforts to implement effective measures aimed at enhancing fiber intake worldwide, particularly in countries with lower socio-demographic indices.

Assessing the impact of dietary choices on fiber deficiency: insights from the 2017-2020 Polish national adult nutrition survey

Introduction

Dietary fiber is a key component of a healthy diet, associated with a reduced risk of cardiovascular disease, obesity, type 2 diabetes, certain cancers, chronic inflammation, or depression. The aim of the study was to perform an in-depth analysis of dietary fiber intake in the Polish population, taking account of the consumption of groups of products that are fiber sources and identify any age-related differences in the dietary fiber intake of the subjects.

Methods

We analyzed data obtained from two representative cross-sectional studies on the diet and nutritional status of adult Polish residents including the total of 4,000 individuals aged 19 years and more. Two 24-h recalls were used per individual to assess the diet using the computer-assisted personal interview (CAPI) technique. Total fiber content and fiber contained in cereal products, vegetables, fruits, legumes, nuts and seeds were calculated. Fiber intake was compared to the recommendations: 25 g/d for adults up to 65 years of age and 20 g/d for those aged 66 years and older. All statistical analyses, including the Pearson's chi-squared test, the Student's t-test, and the Analysis of Variance (ANOVA), were conducted using STATISTICA™ version 13.3, with the results being adjusted for demographic distribution biases to enhance the representativeness.

Results

The average daily fiber intake was 17.83 ± 0.14 g/day (78% of the recommended intake), with 20.5% of respondents meeting the requirement. More men than women (27.05% vs. 14.3%;) met the requirement and men were characterized by a higher average intake (19.34 ± 0.20 g/day) than women (16.43 ± 0.19 g/day). The main fiber sources were cereals (44.1%), vegetables (23.6%), and fruits (16.0%). As regards men, the sources included refined bread (25.8%), vegetables (23.1%), and fruits (10.2%) and for women, they were vegetables (24.0%), fruits (17.2%), and refined bread (16.3%). Although refined bread is not recommended as a primary fiber source due to its lower fiber content compared to whole grain bread, its high consumption significantly contributed to the total fiber intake.

Conclusion

The prevalence of widespread dietary fiber deficiency calls for the intensification of educational efforts that address the health advantages and sources of dietary fiber, as well as methods for its inclusion in daily meals.

Role of the intestinal microbiota in contributing to weight disorders and associated comorbidities

SUMMARYThe gut microbiota is a major factor contributing to the regulation of energy homeostasis and has been linked to both excessive body weight and accumulation of fat mass (i.e., overweight, obesity) or body weight loss, weakness, muscle atrophy, and fat depletion (i.e., cachexia). These syndromes are characterized by multiple metabolic dysfunctions including abnormal regulation of food reward and intake, energy storage, and low-grade inflammation. Given the increasing worldwide prevalence of obesity, cachexia, and associated metabolic disorders, novel therapeutic strategies are needed. Among the different mechanisms explaining how the gut microbiota is capable of influencing host metabolism and energy balance, numerous studies have investigated the complex interactions existing between nutrition, gut microbes, and their metabolites. In this review, we discuss how gut microbes and different microbiota-derived metabolites regulate host metabolism. We describe the role of the gut barrier function in the onset of inflammation in this context. We explore the importance of the gut-to-brain axis in the regulation of energy homeostasis and glucose metabolism but also the key role played by the liver. Finally, we present specific key examples of how using targeted approaches such as prebiotics and probiotics might affect specific metabolites, their signaling pathways, and their interactions with the host and reflect on the challenges to move from bench to bedside.

Short-chain fatty acids play a positive role in colorectal cancer

Short-chain fatty acids (SCFAs) are produced by bacterial fermentation in the colon and are thought to be protective against gastrointestinal disease. SCFAs such as acetate, propionate and butyrate are important metabolites in the maintenance of intestinal homeostasis and have been shown to be beneficial in colorectal cancer (CRC). SCFAs are responsible for maintaining a normal intestinal barrier and exhibit numerous immunomodulatory functions. In this review article, we will discuss the metabolism and mechanism of action of SCFAs and their effects on the CRC, with particular emphasis on dietary fiber treatment and the clinical research progress.

AJ, Kurian C, Chakraborty P, Paari KA. Food additives and contaminants in infant foods: a critical review of their health risk, trends and recent developments

The infant food market has expanded rapidly over the past two decades. However, the industry faces significant challenges, including concerns over the health effects of infant food additives and issues with food safety. However, new evidences suggest that certain food additives, such as those used to preserve and transport infant formula to keep it fresh for longer, should be avoided. Science into the effects of additives on human behavior makes up a sizable sector of the additives market. Problems such as hypernatremic dehydration, malnutrition, and obesity in infants are directly linked to faulty formula production. The Food and Drug Administration (FDA) has established the toxicity types and chemical tests necessary for evaluating the safety of food additives and GRAS (Generally Recognized as Safe) compounds. These tests are crucial in understanding the food safety aspects of food additives. The health effects of different types of food additives on infants are discussed in this context. The article gives an outline of various national and global agencies that provides recommendations and standards to gauge the quality of baby food. The immunological responses, allergic reaction pathways and other related health hazards among the infants and young children caused by the food additive are discussed in this article.

Graphical Abstract

Roles of citrus fruits on energy expenditure, body weight management, and metabolic biomarkers: a comprehensive review

Citrus fruits are widely consumed for their nutritional and health benefits. They belong to the Rutaceae and have many varieties, such as sweet orange (Citrus sinensis), which is the most popular. Citrus fruits are rich in water (>80%), dietary fiber, and vitamins. They also contain bioactive components, which may modulate energy metabolism and lipid oxidation through various mechanisms. These mechanisms include stimulating β3-adrenergic receptors, increasing mitochondrial biogenesis and thermogenesis, activating AMP kinase and peroxisome proliferator-activated receptor-gamma coactivator-1α pathways, inhibiting lipogenesis and lipid accumulation, and inducing browning of white adipose tissue. This review summarizes the mechanisms and outcomes of citrus fruits and their metabolites on energy metabolism and body weight in different experimental models. The literature was searched for in vitro and in vivo animal and human studies that investigated the effects of citrus consumption on energy expenditure, thermogenesis, adipogenesis, and lipid accumulation. Citrus fruits and their metabolites have shown promising effects on energy metabolism and lipid oxidation in in vitro and in vivo animal studies. However, the evidence from human studies is limited and inconsistent. Possible reasons for the discrepancy are briefly discussed, and knowledge gaps and research needs are identified for future studies. Citrus fruits may have beneficial effects on energy metabolism and body weight, but more rigorous and well-designed human trials are needed to confirm their efficacy and safety.

"Wait, Do I Need More Fiber?" Exploring UK Consumers' Dietary Fiber-Related Awareness and White Bread as a Viable Solution to Promote Subsequent Intake

Background

Sufficient dietary fiber consumption is associated with well-established health benefits, yet such intake is currently suboptimal globally. Thus, there is interest in developing strategies to improve dietary fiber intake. One such approach is to increase the dietary fiber content of staple foods, but this needs relevant investigation.

Methods

Forty-two United Kingdom (UK) based consumers (18-76 y) were recruited to take part in seven focus group sessions investigating: (i) key factors in food choice; (ii) dietary fiber-related knowledge, awareness, consumption habits, and engagement levels; (iii) willingness to consume dietary fiber-rich staple foods; and (iv) gain initial feedback on dietary fiber-rich breads.

Results

Overall, key dietary fiber themes emerged such as knowledge (benefits, foods, recommendations and labeling), consumption (not measuring intake), barriers (convenience and knowledge), resources (education and public appeal), and topics (food examples and cooking). Consumers were positive per se to the idea of dietary fiber-rich staple foods but with various caveats (no changes in appearance, taste, and cost). White bread trends were centered around context (sandwich and toast), habit (comfort food), preferences (soft and fresh), and consumption is variable (daily to less often). In addition, consumers' preferred labeling strategy for dietary fiber-rich breads was predominately focused on transparency and visibility. Overall, the newly developed breads were well received demonstrating the potential of our prototypes to fit into the white bread market; however, additional consumer insights are needed.

Conclusion

Our findings recommend combining education with a personalized element of advice, coupled with a collective effort from the government and food industry, as essential to help encourage a step-change in dietary fiber consumption in the UK population.

Association between preconception dietary fiber intake and hypertensive disorders of pregnancy: The Japan Environment and Children's Study

OBJECTIVES

Hypertensive disorders of pregnancy (HDP) are a significant cause of morbidity and mortality. This study aimed to investigate whether preconception dietary fiber intake is associated with new-onset HDP.

STUDY DESIGN

We identified 84,873 (primipara, 33,712; multipara, 51,161) normotensive participants from the Japan Environmental Children's Study database who delivered between 2011 and 2014. The participants were subsequently categorized into five groups based on their preconception dietary fiber intake quintiles (Q1-Q5).

MAIN OUTCOME MEASURES

The main obstetric outcome was HDP, and the secondary obstetric outcomes included early-onset (Eo, <34 weeks)-HDP, late-onset (Lo, ≥34 weeks)-HDP, small for gestational age (SGA) births, and HDP with/without SGA.

RESULTS

Multiple logistic regression analysis showed that in primiparas, the risks of HDP, Lo-HDP, and HDP without SGA were lower in the Q5 group compared with the Q3 group (HDP: adjusted odds ratio [aOR] = 0.73, 95 % confidence intervals [95 % CI] = 0.58-0.93; Lo-HDP: aOR = 0.72, 95 % CI = 0.55-0.94; and HDP without SGA: aOR = 0.68, 95 % CI = 0.53-0.88). However, the risks of Eo-HDP and HDP with SGA were higher in the Q1 group compared with the Q3 group (Eo-HDP: aOR = 1.66, 95 % CI = 1.02-2.70; and HDP with SGA: aOR = 1.81, 95 % CI = 1.04-3.17). In multiparas, the risks of Lo-HDP and SGA were higher in the Q1 group compared with the Q3 group (Lo-HDP: aOR = 1.47, 95 % CI = 1.10-1.97; SGA: aOR = 1.17, 95 % CI = 1.02-1.35).

CONCLUSIONS

Preconception dietary fiber intake is beneficial in preventing HDP onset. Therefore, new recommendations should be considered to encourage higher dietary fiber intake as part of preconception care.

Manipulation of Post-Prandial Hyperglycaemia in Type 2 Diabetes: An Update for Practitioners

This review paper explores post-prandial glycemia in type 2 diabetes. Post-prandial glycemia is defined as the period of blood glucose excursion from immediately after the ingestion of food or drink to 4 to 6 hours after the end of the meal. Post-prandial hyperglycemia is an independent risk factor for cardiovascular disease with glucose "excursions" being more strongly associated with markers of oxidative stress than the fasting or pre-prandial glucose level. High blood glucose is a major promoter of enhanced free radical production and is associated with the onset and progression of type 2 diabetes. Oxidative stress impairs insulin action creating a vicious cycle where repeated post-prandial glucose spikes are key drivers in the pathogenesis of the vascular complications of type 2 diabetes, both microvascular and macrovascular. Some authors suggest post-prandial hyperglycemia is the major cause of death in type 2 diabetes. Proper management of post-prandial hyperglycemia could yield up to a 35% cut in overall cardiovascular events, and a 64% cut in myocardial infarction. The benefits of managing post-prandial hyperglycemia are similar in magnitude to those seen in type 2 diabetes patients receiving secondary prevention with statins - prevention which today is regarded as fundamental by all practitioners. Given all the evidence surrounding the impact of post-prandial glycemia on overall outcome, it is imperative that any considered strategy for the management of type 2 diabetes should include optimum dietary, pharma, and lifestyle interventions that address glucose excursion. Achieving a low post-prandial glucose response is key to prevention and progression of type 2 diabetes and cardiometabolic diseases. Further, such therapeutic interventions should be sustainable and must benefit patients in the short and long term with the minimum of intrusion and side effects. This paper reviews the current literature around dietary manipulation of post-prandial hyperglycemia, including novel approaches. A great deal of further work is required to optimize and standardize the dietary management of post-prandial glycemia in type 2 diabetes, including consideration of novel approaches that show great promise.

Effect of Low vs. High Carbohydrate Intake after Glycogen-Depleting Workout on Subsequent 1500 m Run Performance in High-Level Runners

Carbohydrate (CHO) metabolism is crucial for short-duration, high-intensity exercise performance, but the effects of variations in glycogen availability have not been investigated in field trials of trained athletes. This study was designed to test how 1500 m time trial (TT) performance is affected by the manipulation of pre-race glycogen reserves. Competitive middle-distance runners (n = 11 (4 females)) completed a 1500 m individually paced indoor TT after abundant (high, >5 g/kg/d) or restricted (low, <1.5 g/kg/d) dietary CHO intake for 2 days after a glycogen-depleting session. Stride pattern, heart rate (HR), capillary blood lactate, and glucose and plasma malondialdehyde (MDA) response were determined. The TT was slower in low vs. high condition by 4.5 (4.5) s (~2%; p < 0.01), with a tendency toward shorter stride length. Blood lactate and glucose were lower before the TT in low vs. high condition (1.8 (0.5) vs. 2.2 (0.7) mmol/L and 5.4 (0.7) vs. 5.9 (0.8) mmol/L, p = 0.022 and 0.007, respectively), and peak lactate was higher in high vs. low condition (16.8 (3.1) vs. 14.5 (4.2) mmol/L, p = 0.039). Plasma MDA was the same before the TT, and 15 min after the TT, it increased similarly by 15% in low (p = 0.032) and high (p = 0.005) conditions. The restriction of pre-test CHO intake impaired 1500 m TT performance and reduced baseline and peak blood lactate concentrations but not blood glucose or MDA response.

Production of prebiotic enriched maple syrup through enzymatic conversion of sucrose into fructo-oligosaccharides

Maple syrup, a popular natural sweetener has a high content of sucrose, whose consumption is linked to different health issues such as obesity and diabetes. Hence, within this paper, the conversion of sucrose to prebiotics (fructo-oligosaccharides, FOS) was proposed as a promising approach to obtaining a healthier, value-added product. Enzymatic conversion was optimized with respect to key experimental factors, and thereafter derived immobilized preparation of fructosyltransferase (FTase) from Pectinex® Ultra SP-L (FTase-epoxy Purolite, 255 IU/g support) was successfully utilized to produce novel functional product in ten consecutive reaction cycles. The product, obtained under optimal conditions (60 °C, 7.65 IU/mL, 12 h), resulted in 56.0% FOS, 16.7% sucrose, and 27.3% monosaccharides of total carbohydrates, leading to a 1.6-fold reduction in caloric content. The obtained products` prebiotic potential toward the probiotic strain Lactobacillus plantarum 299v was demonstrated. The changes in physico-chemical and sensorial characteristics were esteemed as negligible.

Dietary and Lifestyle Strategies for Obesity

The prevalence of obesity globally has tripled over the last half century, and currently affects around 650 million adults and 340 million children and adolescents (ages 5-19 years). Obesity contributes towards >50 co-morbidities and premature mortality. Obesity is a highly stigmatised condition that is associated with much mental and emotional distress and dysfunction. Thus, obesity is a major contributor to healthcare expenditure globally. Traditionally, the management of obesity stratifies into three major groups that include metabolic (bariatric) surgery, pharmacotherapies, and lifestyle (primarily dietary) strategies. Although listed as a separate category, dietary strategies for obesity remain a central component of any management plan, and often complement other surgical and pharmacotherapeutic options. Indeed, the effectiveness of any management approach for obesity relies upon successful behavioural changes, particularly relating to eating behaviours. In this concise review, we explore the foundational pillars of dietary strategies for obesity: sleep, listening, routine, de-stressing and optimisation of social conditions. We then discuss the importance of balancing dietary macronutrients (including dietary fibre, carbohydrates, protein and ultra-processed foods [UPFs]) as a key dietary strategy for obesity. Although we focus on general principles, we should provide bespoke dietary strategies for our patients, tailored to their individual needs. Rather than judging the utility of a diet based simply on its associated magnitude of weight loss, we should adopt a more holistic perspective in which a dietary strategy is valued for its overall health benefits, including the nurturing of our gut microbiota, to enable them to nurture and protect us.

Dietary fiber alleviates alcoholic liver injury via Bacteroides acidifaciens and subsequent ammonia detoxification

The gut microbiota and diet-induced changes in microbiome composition have been linked to various liver diseases, although the specific microbes and mechanisms remain understudied. Alcohol-related liver disease (ALD) is one such disease with limited therapeutic options due to its complex pathogenesis. We demonstrate that a diet rich in soluble dietary fiber increases the abundance of Bacteroides acidifaciens (B. acidifaciens) and alleviates alcohol-induced liver injury in mice. B. acidifaciens treatment alone ameliorates liver injury through a bile salt hydrolase that generates unconjugated bile acids to activate intestinal farnesoid X receptor (FXR) and its downstream target, fibroblast growth factor-15 (FGF15). FGF15 promotes hepatocyte expression of ornithine aminotransferase (OAT), which facilitates the metabolism of accumulated ornithine in the liver into glutamate, thereby providing sufficient glutamate for ammonia detoxification via the glutamine synthesis pathway. Collectively, these findings uncover a potential therapeutic strategy for ALD involving dietary fiber supplementation and B. acidifaciens.

Fructan content in most commonly consumed Slovenian foods and estimation of daily fructan consumption

Fructans can be considered as part of the group of fermentable oligo-, di- and monosaccharides and polyols (FODMAPs). Short-chain fructans have a rapid fermentation rate and can thus worsen symptoms in patients with irritable bowel syndrome. In this study, the fructan content in 40 of the most commonly consumed foods in Slovenia was measured. Overall, the fructan content was relatively low: 0.1-1.97 g/100 g fresh weight. The highest fructan content was found in onion (1.97 g/100 g), followed by wheat flour (0.75 g/100 g). A simple model for calculating fructan intake was developed based on the results of the SI. Menu 2017/2018 national survey, which collected data on the frequency of intake of different foods and food groups (expressed in g/day). After calculating the daily intake of the surveyed foods, we used our results on fructan content to estimate daily fructan consumption. Mean daily fructan intake reaches 1.6-1.7 g/day, with no differences between men and women. Our assessment of fructan intake at the national level represents the first step toward the creation of a database on FODMAP intake.

Current practice in the care of children with functional constipation: What is the hold up?

OBJECTIVES

For children with intractable functional constipation (FC), there are no evidence-based guidelines for subsequent evaluation and treatment. Our objective was to assess the practice patterns of a large, international cohort of pediatric gastroenterologists.

METHODS

We administered a survey to physicians who attended the 2nd World Congress of Pediatric Neurogastroenterology and Motility held in Columbus, Ohio (USA) in September 2023. The survey included 29 questions on diagnostic testing, nonpharmacological and pharmacological treatment, and surgical options for children with intractable FC.

RESULTS

Ninety physicians from 18 countries completed the survey. For children with intractable FC, anorectal manometry was the most commonly used diagnostic test. North American responders were more likely than Europeans to use stimulant laxatives (97% vs. 77%, p = 0.032), prosecretory medications (69% vs. 8%, p < 0.001), and antegrade continence enemas (ACE; 83% vs. 46%, p = 0.009) for management. Europeans were more likely than North Americans to require colonic transit testing before surgery (85% vs. 30%, p < 0.001). We found major differences in management practices between Americans and the rest of the world, including use of prosecretory drugs (73% vs. 7%, p < 0.001), anal botulinum toxin injections (81% vs. 58%, p = 0.018), ACE (81% vs. 58% p = 0.018), diverting ileostomies (56% vs. 26%, p = 0.006), and colonic resections (42% vs. 16%, p = 0.012). No differences were found when respondents were compared by years of experience.

CONCLUSIONS

Practice patterns in the evaluation and treatment of children with intractable FC differ widely among pediatric gastroenterologists from around the world. A clinical guideline regarding diagnostic testing and surgical decision-making is needed.