The Association of Dietary Fiber Intake with Cardiometabolic Risk in Four Countries across the Epidemiologic Transition

Dietary fiber intake and all-cause and cause-specific mortality: An updated systematic review and meta-analysis of prospective cohort studies

BACKGROUND

Accumulating evidence supports the effects of dietary fiber on the risk of non-communicable diseases (NCDs). However, there is no updated systematic review and meta-analysis that compares and pools the effect of different types of fiber on mortality.

METHODS

In this systematic review and meta-analysis, all prospective cohort studies that evaluated the relationship between dietary fiber intake and all-cause or cause-specific mortality were included. The PubMed, SCOPUS, and Web of Science databases were searched up to October 2022. Data extraction and quality assessment were performed by two researchers independently. Heterogeneity between studies was assessed using Chi-square based test. Random/fixed effect meta-analysis was used to pool the hazard ratios (HR) or relative risks (RR) and 95 % confidence intervals (CI) for the association between different types of fiber and mortality.

RESULTS

This systematic review included 64 eligible studies, with a total sample size of 3512828 subjects, that investigated the association between dietary fiber intake and mortality from all-cause, cardiovascular disease (CVD), and cancer. Random-effect meta-analysis shows that higher consumption of total dietary fiber, significantly decreased the risk of all-cause mortality, CVD-related mortality, and cancer-related mortality by 23, 26 and 22 % (HR:0.77; 95%CI (0.73,0.82), HR:0.74; 95%CI (0.71,0.77) and HR:0.78; 95%CI (0.68,0.87)), respectively. The consumption of insoluble fiber tended to be more effective than soluble fiber intake in reducing the risk of total mortality and mortality due to CVD and cancer. Additionally, dietary fiber from whole grains, cereals, and vegetables was associated with a reduced risk of all-cause mortality, while dietary fiber from nuts and seeds reduced the risk of CVD-related death by 43 % (HR:0.57; 95 % CI (0.38,0.77)).

CONCLUSION

This comprehensive meta-analysis provides additional evidence supporting the protective association between fiber intake and all-cause and cause-specific mortality rates.

Longitudinal Associations of Dietary Fiber Intake with Glycated Hemoglobin and Estimated Insulin Sensitivity in Adults with and without Type 1 Diabetes

Dietary fiber, an essential bioactive compound in plant-based diets, is of public health concern based on habitual low intakes in the general population. Not much data are available on how habitual dietary fiber is associated with glycemic control in type 1 diabetes (T1D) as well as in prediabetes and normoglycemic adults. To address this gap, we conducted a six-year longitudinal analysis of an original cohort in adults with and without T1D (n = 1255; T1D: n = 563; non-diabetes mellitus (non-DM): n = 692). Dietary data were collected from a validated food frequency questionnaire, biochemical measures were obtained after an overnight fast, and anthropometric measurements were collected at baseline as well as after three and six years for the follow-up study. Glycated hemoglobin (HbA1c) and estimated insulin sensitivity (eIS) were the main outcomes examined. In adjusted analyses, dietary fiber intake was inversely associated with HbA1c in a minimally adjusted model, but it was positively associated with eIS in a model involving all relevant covariates in non-DM adults. These associations were not significant in the T1D group. Furthermore, when examined by HbA1c cut-offs for glycemic control, an inverse association with dietary fiber was only observed in adults with prediabetes (all p < 0.05). At a six-year mean (±SD) dietary fiber intake of 17.4 ± 8.8 g for non-DM and 17.0 ± 8.2 g for the T1D group, protective associations against poor glycemic control were observed in those without diabetes and in prediabetes.

Variation, during Shelf Life, of Functional Properties of Biscuits Enriched with Fibers Extracted from Artichoke (Cynara scolymus L.)

To boost revaluation of industrial by-products of artichoke, this research tries to determine the stability throughout storage of phenolic compounds and their antioxidant activity in biscuits enriched with fiber-rich powders extracted from b y-products of artichokes (FRPA). To determine the most stable extraction method, biscuits were formulated with FRPA extracted by two different environmentally friendly extraction solvents: water (W) and a solution of 1% CaCl2∙5H2O (CA) and compared with biscuits made with pea fiber (P) and control biscuits (B) without fiber added. Initially and during storage, the biscuits enriched with FRPA (W, CA) showed a higher content of bioavailable polyphenols and antioxidant activity compared to the control biscuits (B) and the reference fiber (P, pea fiber). In conclusion, FRPA are an excellent source of bioavailable fiber with antioxidant activity, but especially the FRPA extracted with 1% CaCl2∙5H2O (CA), and they could present a good alternative to the use of pea fiber.

Diet, Gut Microbiome, and Their End Metabolites Associate With Acute Pancreatitis Risk

INTRODUCTION

Diet and decreased gut microbiome diversity has been associated with acute pancreatitis (AP) risk. However, differences in dietary intake, gut microbiome, and their impact on microbial end metabolites have not been studied in AP. We aimed to determine differences in (i) dietary intake (ii) gut microbiome diversity and sulfidogenic bacterial abundance, and (iii) serum short-chain fatty acid (SCFA) and hydrogen sulfide (H 2 S) concentrations in AP and control subjects.

METHODS

This case-control study recruited 54 AP and 46 control subjects during hospitalization. Clinical and diet data and stool and blood samples were collected. 16S rDNA sequencing was used to determine gut microbiome alpha diversity and composition. Serum SCFA and H 2 S levels were measured. Machine learning (ML) model was used to identify microbial targets associated with AP.

RESULTS

AP patients had a decreased intake of vitamin D 3 , whole grains, fish, and beneficial eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids. AP patients also had lower gut microbiome diversity ( P = 0.021) and a higher abundance of sulfidogenic bacteria including Veillonella sp. and Haemophilus sp., which were associated with AP risk. Serum acetate and H 2 S concentrations were significantly higher in the AP group ( P < 0.001 and P = 0.043, respectively). ML model had 96% predictive ability to distinguish AP patients from controls.

DISCUSSION

AP patients have decreased beneficial nutrient intake and gut microbiome diversity. An increased abundance of H 2 S-producing genera in the AP and SCFA-producing genera in the control group and predictive ability of ML model to distinguish AP patients indicates that diet, gut microbiota, and their end metabolites play a key role in AP.

Tracking of Dietary Patterns in the Secondary Prevention of Cardiovascular Disease after a Nutritional Intervention Program-A Randomized Clinical Trial

Individuals with a history of previous cardiovascular events have an increased risk of mortality and morbidity, so adherence to a healthy dietary pattern is essential. We aimed to evaluate and compare dietary patterns between the control and the experimental group from the BALANCE Program. A total of 2360 individuals aged 45 years or older with previous cardiovascular disease were included. The individuals were randomized into two groups: intervention (dietary prescription with nutritional recommendations, nutritional education program based on playful strategies, suggestions of typical and accessible Brazilian foods and intensive monitoring) and control (conventional nutritional counseling). The dietary patterns were identified using factor analysis with the principal component extraction method, and the t-Student tests and ANOVA test were performed to evaluate the associated factors. Four dietary patterns were identified for both groups: "Traditional", "Snack", "Western", "Cardioprotective". There was an increase in the variances of the "Cardioprotective" pattern in both groups. Regarding the "Western" pattern, there was a significant reduction in the variances of the experimental group (10.63% vs. 8.14%). Both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective pattern in the experimental group justifies the initiative of the BALANCE program.

Metabolomics Reveals Nutritional Diversity among Six Coarse Cereals and Antioxidant Activity Analysis of Grain Sorghum and Sweet Sorghum

Coarse cereals are rich in dietary fiber, B vitamins, minerals, secondary metabolites, and other bioactive components, which exert numerous health benefits. To better understand the diversity of metabolites in different coarse cereals, we performed widely targeted metabolic profiling analyses of six popular coarse cereals, millet, coix, buckwheat, quinoa, oat, and grain sorghum, of which 768 metabolites are identified. Moreover, quinoa and buckwheat showed significantly different metabolomic profiles compared with other coarse cereals. Analysis of the accumulation patterns of common nutritional metabolites among six coarse cereals, we found that the accumulation of carbohydrates follows a conserved pattern in the six coarse cereals, while those of amino acids, vitamins, flavonoids, and lipids were complementary. Furthermore, the species-specific metabolites in each coarse cereal were identified, and the neighbor-joining tree for the six coarse cereals was constructed based on the metabolome data. Since sorghum contains more species-specific metabolites and occupies a unique position on the neighbor-joining tree, the metabolite differences between grain sorghum 654 and sweet sorghum LTR108 were finally compared specifically, revealing that LTR108 contained more flavonoids and had higher antioxidant activity than 654. Our work supports an overview understanding of nutrient value in different coarse cereals, which provides the metabolomic evidence for the healthy diet. Additionally, the superior antioxidant activity of sweet sorghum provides clues for its targeted uses.

Pretreatment with millet-derived selenylated soluble dietary fiber ameliorates dextran sulfate sodium-induced colitis in mice by regulating inflammation and maintaining gut microbiota balance

Inflammatory activation and intestinal flora imbalance play key roles in the development and progression of inflammatory bowel disease (IBD). Soluble dietary fiber (SDF) and selenium have been proven to be effective for preventing and relieving IBD. This study investigated and compared the therapeutic efficacy of millet-derived selenylated-soluble dietary fiber (Se-SDF) against dextran sulfate sodium (DSS)-induced colitis in mice alone or through the synergistic interaction between selenium and SDF. In female mice, Se-SDF markedly alleviated body weight loss, decreased colon length, reduced histological damage scores, and enhanced IL-10 expression to maintain the barrier function of intestinal mucosa compared to male mice. The 16S rRNA sequence analysis further indicated that pretreatment with Se-SDF restored the gut microbiota composition in female mice by increasing the relative abundance of Lactobacillus and the Firmicutes/Bacteroidetes ratio. In conclusion, these findings demonstrated that Se-SDF can protect against DSS-induced colitis in female mice by regulating inflammation and maintaining gut microbiota balance. This study, therefore, provides new insights into the development of Se-SDF as a supplement for the prevention and treatment of colitis.

Is Better Knowledge about Health Benefits of Dietary Fiber Related to Food Labels Reading Habits? A Croatian Overview

The aim of this cross-sectional study was to determine the associations between health dietary patterns, knowledge, and consumption of dietary fiber (DF) with frequency of food label reading on food products with special reference to DF. The study was conducted in 2536 Croatian adults using an original questionnaire. Multiple linear regression models were used to assess associations between food label reading habits and predictor variables. Our study confirms the association between habits regarding the reading of labels on food products, especially in relation to information about DF with the sociodemographic factors of respondents, dietary food patterns and DF consumption, as well as knowledge and sources of information about DF. Women, individuals with a university-level education, and those living in an urban environment had more frequent labels used. Food habits as well as eating outside of the home were positive predictors while eating fast food was a negative predictor of food label reading. Knowledge about DF, especially about its health benefits, was also associated with food label reading. The interpretation of associations could help with the design of effective public health programs. Targeted education campaigns to educate and sensitize the population about food labeling and monitoring may improve general knowledge about healthy food and its benefits, which include indirect effects on the prevention of non-communicable chronic diseases.

Effects of Oats, Tartary Buckwheat, and Foxtail Millet Supplementation on Lipid Metabolism, Oxido-Inflammatory Responses, Gut Microbiota, and Colonic SCFA Composition in High-Fat Diet Fed Rats

Coarse cereals rich in polyphenols, dietary fiber, and other functional components exert multiple health benefits. We investigated the effects of cooked oats, tartary buckwheat, and foxtail millet on lipid profile, oxido-inflammatory responses, gut microbiota, and colonic short-chain fatty acids composition in high-fat diet (HFD) fed rats. Rats were fed with a basal diet, HFD, oats diet (22% oat in HFD), tartary buckwheat diet (22% tartary buckwheat in HFD), and foxtail millet diet (22% foxtail millet in HFD) for 12 weeks. Results demonstrated that oats and tartary buckwheat attenuated oxidative stress and inflammatory responses in serum, and significantly increased the relative abundance of Lactobacillus and Romboutsia in colonic digesta. Spearman’s correlation analysis revealed that the changed bacteria were strongly correlated with oxidative stress and inflammation-related parameters. The concentration of the butyrate level was elevated by 2.16-fold after oats supplementation. In addition, oats and tartary buckwheat significantly downregulated the expression of sterol regulatory element-binding protein 2 and peroxisome proliferator-activated receptors γ in liver tissue. In summary, our results suggested that oats and tartary buckwheat could modulate gut microbiota composition, improve lipid metabolism, and decrease oxidative stress and inflammatory responses in HFD fed rats. The present work could provide scientific evidence for developing coarse cereals-based functional food for preventing hyperlipidemia.

Interactions between Vitamin D Genetic Risk and Dietary Factors on Metabolic Disease-Related Outcomes in Ghanaian Adults

The Ghanaian population is experiencing an upsurge in obesity and type 2 diabetes (T2D) due to rapid urbanization. Besides dietary factors, vitamin D-related genetic determinants have also been shown to contribute to the development of obesity and T2D. Hence, we aimed to examine the interactions between dietary factors and vitamin D-related genetic variants on obesity and T2D related outcomes in a Ghanaian population. Three hundred and two healthy Ghanaian adults (25-60 years old) from Oforikrom, Municipality in Kumasi, Ghana were randomly recruited and had genetic tests, dietary consumption analysis, and anthropometric and biochemical measurements of glucose, HbA1c, insulin, cholesterol, and triglycerides taken. A significant interaction was identified between vitamin D-GRS and fiber intake (g/day) on BMI (pinteraction = 0.020) where those who were consuming low fiber (≤16.19 g/d) and carrying more than two risk alleles for vitamin D deficiency (p = 0.01) had a significantly higher BMI. In addition, an interaction between vitamin D-GRS and fat intake (g/day) on HbA1c (total fat, pinteraction = 0.029) was found, where participants who had a lower total fat intake (≤36.5 g/d), despite carrying more than two risk alleles, had significantly lower HbA1c (p = 0.049). In summary, our study has identified novel gene-diet interactions of vitamin D-GRS with dietary fiber and fat intakes on metabolic traits in Ghanaian adults.

The Beneficial Effect of Coarse Cereals on Chronic Diseases through Regulating Gut Microbiota

In recent years, chronic diseases including obesity, diabetes, cancer, cardiovascular, and neurodegenerative disorders have been the leading causes of incapacity and death globally. Increasing evidence suggests that improvements of lifestyle habits and diet is the most commonly adopted strategy for the prevention of chronic disorders. Moreover, many dietary compounds have revealed health-promoting benefits beyond their nutritional effects. It is worth noting that diet plays an important role in shaping the intestinal microbiota. Coarse cereals constitute important sources of nutrients for the gut microbiota and contribute to a healthy gut microbiome. Furthermore, the gut microbiota converts coarse cereals into functional substances and mediates the interaction between the host and these components. In this study, we summarize the recent findings concerning functional components of cereal grains and their potential chemopreventive activity via modulating the gut microbiota.

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

Chronic inflammation plays a central role in the pathophysiology of various non-communicable diseases. Dietary interventions can reduce inflammation, in part due to their effect on the gut microbiome. This systematic review aims to determine the effect of dietary interventions, specifically fiber intake, on chronic inflammatory diseases and the microbiome. It aims to form hypotheses on the potential mediating effects of the microbiome on disease outcomes after dietary changes. Included were clinical trials which performed a dietary intervention with a whole diet change or fiber supplement (>5 g/day) and investigated the gut microbiome in patients diagnosed with chronic inflammatory diseases such as cardiovascular disease (CVD), type 2 diabetes (T2DM), and autoimmune diseases (e.g., rheumatoid arthritis (RA), inflammatory bowel disease (IBD)). The 30 articles which met the inclusion criteria had an overall moderate to high risk of bias and were too heterogeneous to perform a meta-analysis. Dietary interventions were stratified based on fiber intake: low fiber, high fiber, and supplemental fiber. Overall, but most pronounced in patients with T2DM, high-fiber plant-based dietary interventions were consistently more effective at reducing disease-specific outcomes and pathogenic bacteria, as well as increasing microbiome alpha diversity and short-chain fatty acid (SCFA)-producing bacteria, compared to other diets and fiber supplements.

Total protein, not amino acid composition, differs in plant-based versus omnivorous dietary patterns and determines metabolic health effects in mice

Plant-based dietary patterns are associated with improved cardiometabolic health, but causal dietary components are unclear. Protein has been proposed to play a role, but the importance of protein quantity versus quality remains unknown. We investigated the contributions of total protein amount, amino acid (AA) composition, and plant versus animal source. Analysis of total protein and AA composition of food items and dietary patterns revealed differences between individual food items, but few differences between AA profiles of vegan versus omnivorous dietary patterns. Effects of protein quantity, but not quality, on cardiometabolic health markers were observed in mice using semi-purified diets with crystalline AAs in plant versus animal-based ratios and naturally sourced diets with whole-food ingredients. Our data show relatively little difference in protein quality between plant-based and omnivorous dietary patterns and that reduced total protein intake in plant-based dietary patterns may be a contributor to the benefits of plant-based diets.

The role of microbiota-gut-brain axis in neuropsychiatric and neurological disorders

Emerging evidence indicates that the gut microbiota play a crucial role in the bidirectional communication between the gut and the brain suggesting that the gut microbes may shape neural development, modulate neurotransmission and affect behavior, and thereby contribute to the pathogenesis and/or progression of many neurodevelopmental, neuropsychiatric, and neurological conditions. This review summarizes recent data on the role of microbiota-gut-brain axis in the pathophysiology of neuropsychiatric and neurological disorders including depression, anxiety, schizophrenia, autism spectrum disorders, Parkinson's disease, migraine, and epilepsy. Also, the involvement of microbiota in gut disorders co-existing with neuropsychiatric conditions is highlighted. We discuss data from both in vivo preclinical experiments and clinical reports including: (1) studies in germ-free animals, (2) studies exploring the gut microbiota composition in animal models of diseases or in humans, (3) studies evaluating the effects of probiotic, prebiotic or antibiotic treatment as well as (4) the effects of fecal microbiota transplantation.

Dietary intake of mixture coarse cereals prevents obesity by altering the gut microbiota in high-fat diet fed mice

Functional components including β-glucan, dietary fiber, resistant starch and polyphenols extracted from various coarse cereals have been reported to prevent high-fat diet (HFD) induced obesity via modulating gut microbiota. In this study, millet, maize, oat, soybean, and purple potato were ultrafine comminuted, mixed, and then extruded for the preparation of puffed mixture coarse cereals. HFD was used to investigate the effects of mixture coarse cereals on obesity and gut microbiota in mice. The results showed that dietary intake of mixture coarse cereals could decrease body weight gain and fat accumulation, improve the blood glucose tolerance and serum lipids levels, reduce the systemic inflammation, and down-regulate the expression of hepatic lipogenic genes. In addition, the levels of SCFAs and the composition of gut microbiota were investigated. The results indicated that mixture coarse cereals could promote the release of SCFAs, enhance the diversity of gut microbiota, and increase the relative abundance of Lactobacillus and Bifidobacterium, which might contribute to the anti-obesity activity. Present work suggested that the mixture coarse cereals could be developed as a nutraceutical for the prevention of HFD-induced obesity.

Dietary fiber and its associations with depression and inflammation

Dietary fiber is a crucial component of a healthy diet, with benefits that can be attributed to processes in the gut microbiota and the resulting by-products. Observational studies support associations between dietary fiber intake and depression and inflammation, but the potential mechanisms are poorly understood. This review examines evidence of the effects of dietary fiber on depression and inflammation and considers plausible mechanisms linking dietary fiber and depression, including microbiota-driven modification of gene expression and increased production of neurotransmitters. Additionally, inflammation may mediate the relationship between dietary fiber intake and depression. A high-fiber diet potentially lowers inflammation by modifying both the pH and the permeability of the gut. The resultant reduction in inflammatory compounds may alter neurotransmitter concentrations to reduce symptoms of depression. Further research into the link between dietary fiber intake and inflammation and depression is essential, as findings could potentially provide guidance for improvement in or prevention of inflammatory and depressive disorders.

On computing critical factors based healthy behavior index for behavior assessment

OBJECTIVE

Ubiquitous computing has supported personalized health through a vast variety of wellness and healthcare self-quantification applications over the last decade. These applications provide insights for daily life activities but unable to portray the comprehensive impact of personal habits on human health. Therefore, in order to facilitate the individuals, we have correlated the lifestyle habits in an appropriate proportion to determine the overall impact of influenced behavior on the well-being of humans.

MATERIALS AND METHODS

To study the combined impact of personal behaviors, we have proposed a methodology to derive the comprehensive Healthy Behavior Index (HBI) consisting of two major processes: (1) Behaviors' Weight-age Identification (BWI), and (2) Healthy Behavior Quantification and Index (HBQI) modeling. The BWI process identifies the high ranked contributing behaviors through life-expectancy based weight-age, whereas HBQI derives a mathematical model based on quantification and indexing of behavior using wellness guidelines.

RESULTS

The contributing behaviors are identified through text mining technique and verified by seven experts with a Kappa agreement level of 0.379. A real-world user-centric statistical evaluation is applied through User Experience Questionnaire (UEQ) method to evaluate the impact of HBI service. This HBI service is developed for the Mining Minds, a wellness management application. This study involves 103 registered participants (curious about the chronic disease) for a Korean wellness management organization. They used the HBI service over 12 weeks, the results for which were evaluated through UEQ and user feedback. The service reliability for the Cronbach's alpha coefficient greater than 0.7 was achieved using HBI service whereas the stimulation coefficient of the value 0.86 revealed significant effect. We observed an overall novelty of the value 0.88 showing the potential interest of participants.

CONCLUSIONS

The comprehensive HBI has demonstrated positive user experience concerning the stimulation for adapting the healthy behaviors. The HBI service is designed independently to work as a service, so any other wellness management service-enabled platform can consume it to evaluate the healthy behavior index of the person for recommendation generation, behavior indication, and behavior adaptation.

Awareness and Knowledge Regarding the Consumption of Dietary Fiber and Its Relation to Self-Reported Health Status in an Adult Arab Population: A Cross-Sectional Study

The objective of this study was to examine the awareness, knowledge, and habits regarding dietary fiber intake and to analyze its relationship with self-reported health status among Saudi adults. A survey-based study using face-to-face interview was designed, and 1363 apparently healthy adult Saudi males and females participated. Most participants were females (81.2%), aged 25 and above (87.2%), and were educated at least up to the secondary level of education (80.8%). The majority of the participants were aware of the role of fiber-rich foods in health conditions such as obesity (70.5%), cardiovascular diseases (68.9%), and regulation of blood sugar (68.9%), with females significantly having higher nutrition knowledge than males. A disconnect in translating this nutrition knowledge was observed particularly in food choices when eating out, where preferences for white bread (84.4%), fried potatoes (69.9%) and peeled fruits (60.6%) were significantly higher than preferences for cooked vegetables (29.6%) and brown bread (18.1%). The most common reason for this disconnect was due to perception that foods rich in dietary fibers were expensive (72.1%), have less health benefits (56.5%), were not readily available (51.6%), and participants’ disliking of the taste (52.8%). Participants in the highest quartile (Q4) for dietary fiber consumption reported a lower prevalence of constipation (odds ratio, 95% confidence interval of 0.40, 0.28–0.57, p < 0.01), high cholesterol (0.43, 0.27–0.68, p < 0.01) and obesity (0.67, 0.44–0.98, p = 0.03) than participants in the lowest quartile (Q1). Dietary fiber intake appears to be protective against constipation, high cholesterol and obesity in Saudi adults. However, a disparity observed between knowledge and attitude towards intake of dietary fibers could limit its health benefits. Further studies including adolescents should be conducted to impart knowledge on the emotional, cognitive and sensory factors related to food choices in order to minimize the gap between nutrition knowledge and the consumption of healthy high-fiber diets.

Dietary fibre intake and its association with inflammatory markers in adolescents

A high dietary fibre intake has been associated with improvements in inflammatory conditions in adults. However, little is known on whether associations between dietary fibre and inflammation are evident during adolescence. We examined the relationship between dietary fibre intake measured by FFQ and the inflammatory marker high-sensitivity C-reactive protein (hs-CRP) and the adipokines leptin and adiponectin cross-sectionally in 17-year-olds participating in the Raine Study (n 621). In weighted analysis using tobit and linear regression, and after excluding participants with hs-CRP > 10 mg/l, higher total dietary fibre intake (per 5 g/d) was significantly associated with lower leptin (β = -0·13, 95 % CI -0·17, -0·09) and adiponectin (β = -0·28, 95 % CI -0·49, -0·07), but not hs-CRP, in unadjusted analyses. These associations were no longer significant after adjustment for sex, anthropometry and a number of lifestyle factors. However, higher cereal and grain fibre intake was significantly associated with lower leptin (β = -0·06, 95 % CI -0·10, -0·01) in fully adjusted analysis. Our findings suggest that a higher intake of cereal and grain fibre may contribute to lower leptin in adolescents. This may contribute to reductions in low-grade chronic inflammation and improved health outcomes.

Concise review: Coarse cereals exert multiple beneficial effects on human health

Coarse cereals (CC) refer to cereal grains except for rice and wheat which are highly-valued as functional foods with nutritional and pharmacological properties. Owing to their diverse positive effect on chronic diseases, coarse cereals exert a vital role in food industry. CC and the main contents prevent tumor pathogenesis through promoting apoptosis, inducing cell cycle arrest as well as modulating metastasis initiation. Meanwhile, CC ameliorates cardiovascular diseases through affecting multiple pathways, such as CaMKII/p-BFAF-3, NF-κB, MAPK, PI3K/Akt, etc. Besides, CC and the main contents have potential as prebiotics which facilitating the activities and growth of probiotics such as Bifidobacteria and Lactobacillus. However, there's a lack of report on CC' beneficial properties and the underlying mechanisms are not fully understood. Here this article explains in detail, the effect and mechanism of CC on chronic diseases like tumor, inflammation and cardiovascular diseases.

Applying Nutrient Profiling Systems to Packaged Foods and Drinks Sold in Jamaica

The Pan American Health Organization (PAHO) and Chile stage III nutrient profiling systems (NPSs) were applied to packaged beverages/foods sold in Jamaica to: (a) identify products with excess nutrients of concern (NOC) under each NPS; (b) assess differences between these NPS, and (c) discuss the advantages and disadvantages of each NPS when applied to Jamaica’s food supply. Data on 6261 branded multi-ingredient packaged products were collected from the city of Kingston in 2018; of these, 4739 products, comprised of 3423 foods (from 15 food groups) and 1316 beverages (from four beverage groups), provided sufficient information. Products containing excessive NOC under each NPS were identified and the proportions of categories with excess NOC were compared using correlation coefficients. Also assessed were the mean nutrient values among the subset of products exceeding versus not exceeding both NPSs using tests of significance. A larger proportion of packaged beverages and foods exceeds thresholds under PAHO versus Chile Stage III. Additionally, a larger percentage of foods, like fruits, vegetables, legumes, fish and seafood, would be considered as having excess sugar or sodium under PAHO versus Chile. This is the first study in the Caribbean that applies two existing NPSs to packaged products. The results can help to determine an appropriate NPS for use in Jamaica as the basis for food and nutrition policies, to help consumers make improved food choices.

Dietary fiber intake and glycemic control: coronary artery calcification in type 1 diabetes (CACTI) study

Background

Dietary fiber has been recommended for glucose control, and typically low intakes are observed in the general population. The role of fiber in glycemic control in reported literature is inconsistent and few reports are available in populations with type 1 diabetes (T1D).

Methods

Using data from the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study [n = 1257; T1D: n = 568; non-diabetic controls: n = 689] collected between March 2000 and April 2002, we examined cross-sectional (baseline) and longitudinal (six-year follow-up in 2006–2008) associations of dietary fiber and HbA1c. Participants completed a validated food frequency questionnaire, and a physical examination and fasting biochemical analyses (12 h fast) at baseline visit and at the year 6 visit. We used a linear regression model stratified by diabetes status, and adjusted for age, sex and total calories, and diabetes duration in the T1D group. We also examined correlations of dietary fiber with HbA1c.

Results

Baseline dietary fiber intake and serum HbA1c in the T1D group were 16 g [median (IQ): 11–22 g) and 7.9 ± 1.3% mean (SD), respectively, and in the non-diabetic controls were 15 g [median (IQ): 11–21 g) and 5.4 ± 0.4%, respectively. Pearson partial correlation coefficients revealed a significant but weak inverse association of total dietary fiber with HbA1c when adjusted for age, sex, diabetes status and total calories (r = − 0.07, p = 0.01). In the adjusted linear regression model at baseline, total dietary fiber revealed a significant inverse association with HbA1c in the T1D group [β ± SE = − 0.32 ± 0.15, p = 0.034], as well as in the non-diabetic controls [− 0.10 ± 0.04, p = 0.009]. However, these results were attenuated after adjustment for dietary carbohydrates, fats and proteins, or for cholesterol and triglycerides. No such significance was observed at the year 6 follow-up, and with the HbA1c changes over 6 years.

Conclusion

Thus, at observed levels of intake, total dietary fiber reveals modest inverse associations with poor glycemic control. Future studies must further investigate the role of overall dietary quality adjusting for fiber-rich foods in T1D management.

Insights on Medical Nutrition Therapy for Type 2 Diabetes Mellitus: An Indian Perspective

It is critical to integrate medical nutrition therapy (MNT) provided by a registered dietician (RD) into primary care of type 2 diabetes mellitus (T2DM). This is necessary to achieve the goals of improving overall metabolic measures beyond calorie restriction and weight loss. Misconceptions about nutrition in T2DM add to the challenges of executing MNT in a culturally sensitive population. The current review provides insights into MNT for the prevention and management of T2DM in India, based on both evidence and experience. It revisits historical Indian studies and provides information on appropriate dietary intake of carbohydrates (60-70%), proteins (~ 20%) and fats (10%) that will be acceptable and beneficial in an Indian T2DM population. It discusses nuances of types of carbohydrates and fats and explains associations of increased dietary fiber intake, balanced intake of low and high glycemic index foods and substitution of saturated fats with plant-based polyunsaturated fats in improving outcomes of T2DM and attenuating risk factors. The article also deliberates upon special patient populations with comorbid conditions and diseases and the necessary adjustments needed in their nutritional care. It outlines a step-wise approach to MNT involving a careful interplay of nutrition assessment, diagnosis, individualization and patient counseling. Overall, the success of MNT relies on providing accurate, acceptable and appropriate dietary choices for continued patient adherence. Collaborative efforts from diabetologists, endocrinologists, internists and RDs are required to prioritize and implement MNT in diabetes practice in India.Funding: Signutra Inc.

Whole Fruits and Fruit Fiber Emerging Health Effects

Less than 10% of most Western populations consume adequate levels of whole fruits and dietary fiber with typical intake being about half of the recommended levels. Evidence of the beneficial health effects of consuming adequate levels of whole fruits has been steadily growing, especially regarding their bioactive fiber prebiotic effects and role in improved weight control, wellness and healthy aging. The primary aim of this narrative review article is to examine the increasing number of health benefits which are associated with the adequate intake of whole fruits, especially fruit fiber, throughout the human lifecycle. These potential health benefits include: protecting colonic gastrointestinal health (e.g., constipation, irritable bowel syndrome, inflammatory bowel diseases, and diverticular disease); promoting long-term weight management; reducing risk of cardiovascular disease, type 2 diabetes and metabolic syndrome; defending against colorectal and lung cancers; improving odds of successful aging; reducing the severity of asthma and chronic obstructive pulmonary disease; enhancing psychological well-being and lowering the risk of depression; contributing to higher bone mineral density in children and adults; reducing risk of seborrheic dermatitis; and helping to attenuate autism spectrum disorder severity. Low whole fruit intake represents a potentially more serious global population health threat than previously recognized, especially in light of the emerging research on whole fruit and fruit fiber health benefits.