The glycemic index of bread and biscuits is markedly reduced by the addition of a proprietary fiber mixture to the ingredients

Role of Dietary Fibre in Managing Periodontal Diseases-A Systematic Review and Meta-Analysis of Human Intervention Studies

BACKGROUND

Periodontitis is a chronic multifactorial inflammatory disease, that leads to tooth loss and is associated with other systemic diseases. The role of dietary fibre in the prevention and management of periodontal diseases is not well understood. The objective of this systematic review and meta-analysis was to assess how an intake of dietary fibre affects periodontal diseases in humans and any concomitant effects on systemic inflammation.

METHODOLOGY

Human interventional studies investigating the effects of oral fibre intake on various clinical parameters of periodontal diseases were included. Search strategy with MeSH and free-text search terms was performed on the following database: CINAHL Complete, EMBASE, MEDLINE, SciVerse Scopus®, and Web of Science Core Collection on 21 October 2021 and updated on 19 February 2023 to identify relevant studies. Articles were filtered using the Covidence© web-based platform software. Data were pooled using random effects meta-analysis.

RESULTS

From all databases, a total of 19,971 studies were obtained. Upon title and abstract screening, 101 studies were included for full-text screening. Upon full-text screening, six studies were included for analysis. Of these, five were randomised controlled trials, and one was a sequential feeding trial involving fibre-rich daily diet for a 4-8 weeks period. Fibre-rich dietary intervention significantly reduced Clinical Attachment Loss/Level by 0.48 mm/tooth (95% CI, -0.63 to -0.33, p < 0.001), Bleeding On Probing by 27.57% sites/tooth (95% CI -50.40 to -4.74, p = 0.02), Periodontal Inflamed Surface Area by 173.88 mm2 (95% CI -288.06 to -59.69, p = 0.003), Plaque Index by 0.02 (95% CI -0.04 to -0.00, p = 0.04), and Gingival Index by 0.41 (95% -0.67 to -0.16, p= 0.002). A non-significant reduction was observed for Probing Depth (-0.17 mm/tooth; 95% CI, -0.37 to 0.02, p = 0.09).

CONCLUSIONS

Fibre-rich dietary interventions are associated with a reduction of clinical and particularly inflammatory markers of periodontal diseases. This shows a promising effect of dietary fibre as an intervention for inflammatory conditions like periodontal diseases.

Comparison of Glycemic Response to Carbohydrate Meals without or with a Plant-Based Formula of Kidney Bean Extract, White Mulberry Leaf Extract, and Green Coffee Extract in Individuals with Abdominal Obesity

Due to the rising prevalence of obesity and type 2 diabetes, a strategy that can positively influence diet quality in a simple way is being explored, since a low glycemic index (GI) diet is advised in the dietoprophylaxis and diet therapy of diabetes. Methods: Twenty-three women with abdominal obesity participated in the study. The postprandial glycemic response and glycemic index were determined after three carbohydrate meals (noodle soup, white rice, strawberry sorbet) without or with the addition of a plant-base supplement (extracts of kidney bean, white mulberry leaf, and green coffee) with a potentially hypoglycemic effect. For two products (instant noodle soup and white rice), the addition of the plant supplement resulted in a reduction in glicemic iAUC values (respectively, by: 17.1%, p = 0.005 and 5.3%; p = 0.03; 40.6%, p = 0.004 and 5.3%, p = 0.019). However, this effect was not observed for strawberry sorbet. The blood glucose concentrations 30 min after the consumption of instant noodle soup and white rice with the plant-based formula addition significantly affected the GI value of tested meals (p = 0.0086, r = 0.53; p = 0.0096, r = 0.53), which may indicate the effect of this plant supplement on enterohormone and/or insulin secretion. Conclusion: A formula containing kidney bean, white mulberry leaves, and green coffee extracts may therefore be a notable factor in lowering postprandial glycemia and the GI of carbohydrate foods. However, further research is needed to determine for which food groups and meals its use may be most effective.

Dietary fiber in bakery products: Source, processing, and function

Bakery products are prevalently consumed foods in the world, and they have been regarded as convenient dietary vehicles for delivering nutritive ingredients into people's diet, of which, dietary fiber (DF) is one of the most popular items. The food industry attempts to produce fiber-enriched bakery products with both increasing nutritional value and appealing palatability. As many new sources of DFs become available, and consumers are moving towards healthier diets, studies of using these DFs as functional ingredients in baked goods are becoming vast. Besides, the nutrition value of DF is commonly accepted, and many investigations have also revealed the health benefits of fiber-enriched bakery products. Thus, this chapter presents an overview of (1) trends in supplementation of DF from various sources, (2) impact of DF on dough processing, quality and physiological functionality of bakery products, and (3) technologies used to improve the compatibility of DF in bakery products.

Nutritional, antioxidant, carbohydrate hydrolyzing enzyme inhibitory activities, and glyceamic index of wheat bread as influence by bambara groundnut substitution

The research was designed to ascertain the potential of bambara groundnut inclusion in wheat bread to improve antioxidant activity, modulate carbohydrate hydrolyzing enzyme activities, and lower glyceamic index/ load. Protein (g/100 g) (11.2—11.73) and energy value (kcal/100 g) (421.5—435.5) of the bread were significantly higher than commercial wheat flour bread (CWF—10.45; 388.7). However, developed experimental bread samples exhibited higher growth performance in rats, free radical scavenging potentials, inhibitory activities against carbohydrate hydrolyzing enzymes and low glycemic index than other bread samples. Nevertheless, experimental bread samples were rated lower compared with the controls samples as regards organoleptic properties. The study authenticates that WBO3—25% wheat, and 75% bamabara groundnut WBO3 exhibits higher potentials as regards nutritional composition, growth indices, free radical scavenging potentials, ability to modulate carbohydrate hydrolyzing enzyme and lower glycemic index/ load. Hence, WBO3 may be recommended as functional bread for hyperglycemia prevention/ management.

Perspective: Does Glycemic Index Matter for Weight Loss and Obesity Prevention? Examination of the Evidence on "Fast" Compared with "Slow" Carbs

High-glycemic index (high-GI) foods (so-called fast carbs) have been hypothesized to promote fat storage and increase risk of obesity. To clarify whether dietary GI impacts body weight, we searched PubMed and the Cochrane Database of Systematic Reviews for observational studies reporting associations between BMI and dietary GI, and for meta-analyses of randomized controlled trials (RCTs) comparing low-GI and high-GI diets for weight loss. Data on 43 cohorts from 34 publications, totaling 1,940,968 adults, revealed no consistent differences in BMI when comparing the highest with the lowest dietary GI groups. In the 27 cohort studies that reported results of statistical comparisons, 70% showed that BMI was either not different between the highest and lowest dietary GI groups (12 of 27 cohorts) or that BMI was lower in the highest dietary GI group (7 of 27 cohorts). Results of 30 meta-analyses of RCTs from 8 publications demonstrated that low-GI diets were generally no better than high-GI diets for reducing body weight or body fat. One notable exception is that low-GI diets with a dietary GI at least 20 units lower than the comparison diet resulted in greater weight loss in adults with normal glucose tolerance but not in adults with impaired glucose tolerance. While carbohydrate quality, including GI, impacts many health outcomes, GI as a measure of carbohydrate quality appears to be relatively unimportant as a determinant of BMI or diet-induced weight loss. Based on results from observational cohort studies and meta-analyses of RCTs, we conclude that there is scant scientific evidence that low-GI diets are superior to high-GI diets for weight loss and obesity prevention.

A bilingual dietary intervention early in treatment is feasible and prevents weight gain in childhood acute lymphoblastic leukemia

BACKGROUND

Childhood acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. The onset of obesity during childhood ALL has been well established and is associated with inferior survival rates and increased treatment-related toxicities. This pilot study sought to determine if a dietary intervention is feasible and minimizes weight gain during the initial phases of treatment for ALL.

METHODS

Participants were recruited from four institutions, fluent in English or Spanish, between 5 and 21 years old, and enrolled within 3 days of starting induction therapy. Participants were counseled for 6 months to follow a low glycemic diet. Dietary and anthropometric data were collected at diagnosis, end of induction, and end of month 6 (NCT03157323).

RESULTS

Twenty-three of 28 participants (82.1%) were evaluable and included in the analysis. Dietary changes targeted by the nutrition intervention were successful; sugar intake declined (P = .003), whereas vegetable intake increased (P = .033). The majority of participants were able to adhere to the dietary principles prescribed: ≥70.0% reduced glycemic load and ≥60.0% increased fiber intake and decreased sugar intake. Importantly, we did not observe an increase in body mass index z-score during induction or over the 6-month intervention period. Most families found the nutrition intervention easy to follow (60%) and affordable (95%) despite simultaneous initiation of treatment for ALL.

CONCLUSIONS

A 6-month nutrition intervention initiated during the initial phase of treatment for childhood ALL is feasible and may prevent weight gain. Our preliminary findings need to be confirmed in a larger clinical trial.

Milling interventions for the production of atta for Indian flat bread with low carbohydrate digestibility

Study was aimed to produce atta for chapati, an Indian flat bread with low carbohydrate digestibility through different milling interventions; processing and formulating a functional ingredient mix (FM). Granulation, physico-chemical, rheological and chapati making characteristics of chakki atta, CA (control), roller mill atta (RA); RA replaced with 5, 10 and 15% FM (5, 10 and 15% RAFM) were evaluated. RA and RAFM samples showed lower water absorption, higher dough stability, pasting temperature and peak viscosity than CA. Evaluation of carbohydrate digestive profile showed differences in the pattern of carbohydrate digestibility and glucose release between the chapatis prepared from CA, RA and 10% RAFM. Rapidly available glucose (RAG), an indicator of glycemic response in vivo, was found to be lower in the 10% RAFM than CA. It can be concluded that milling interventions and compositional differences together determine the carbohydrate digestibility of the atta.

Bread making with sourdough and intact cereal and legume grains - effect on glycaemic index and glycaemic load

The concept of glycaemic index (GI) has led to efforts to develop low-GI foods. Bread contributes around one-quarter of carbohydrate intake in the Swedish diet. In this study, we sought to develop low-GI bread prototypes and examined the effects of bread making on content of total dietary fibre (TDF) and resistant starch (RS). Five bread prototypes were made in a commercial bakery, using sourdough fermentation and intact cereal and legume kernels. Predicted (p-GI) and in vivo GI values were determined, and TDF and RS were quantified. The p-GI value of the five prototypes was between 56 and 68. The confirmed in vivo GI value was 65 and 67 for two of the breads. The TDF content (≥17%) was not affected by bread making, but RS content was increased by three-fold. All breads were categorised as medium-GI, but with low glycaemic load (GL).

Relation between the Recipe of Yeast Dough Dishes and Their Glycaemic Indices and Loads

The aim of the study was to evaluate the glycaemic indices (GI) and glycaemic loads (GL) of four food dishes made from yeast dough (steamed dumplings served with yoghurt, apple pancakes sprinkled with sugar powder, rolls with cheese and waffles with sugar powder), based on their traditional and modified recipes. Modification of the yeast dough recipe consisted of replacing wheat flour (type 500) with whole-wheat flour (type 2000). Energy value and the composition of basic nutrients were assessed for every tested dish. The study was conducted on 50 people with an average age of 21.7 ± 1.1 years, and an average body mass index of 21.2 ± 2.0 kg/m2. The GI of the analysed food products depended on the total carbohydrate content, dietary fibre content, water content, and energy value. Modification of yeast food products by replacing wheat flour (type 500) with whole-wheat flour (type 2000) contributed to the reduction of their GI and GL values, respectively.

Studies on the Effect of Low Glycemic Index for Multi-Whole Grain Formulated Flour Samples in Type 2 Diabetic Patients

Different types of corns are used as staple food in Bangladesh, core source of nutrients from food stuffs for metabolic energy. Ready to eat or processed food stuffs that contains totally different macro and micronutrients such as Tocopherol , Thiamine , Riboflavin , Pyroxene, Mg and Zn etc. within the recipes for sample preparation, were incorporated different whole grains of wheat, wheat bran, rye, maize, soya, barley, chickpeas and plantain husk in numerous ratios. Developed flours were subjected to nutritionally active diet for diabetic patients, the extent of glucose when consumption of diets could be an essential issue. Protein, fat, crude fiber and energy values of developed multi grains combined and market flours were MFS- 1: (11.00%, 3.77%, 2.69%, 387.25); MFS- 2:(14.16%, 3.71%,3.21%, 385.73); MFS-3:(12.40%, 3.33%, 2.87%,385.24);MFS- 4: (11.31%, 2.16%, 2.45%, 382.83) and market flour samples CS-A: (12.04%, 2.05%,1.64%,358.37) and CS-B:(14.90%,2.06%,1.46%,350.82) respectively. Amongst, MFS- 3 sample resulted the preferences in hedonic sensory evaluation. Glycemic index (GI) resolved mistreatment normal methodology for MFS-3 and normal sugar. The GI worth of MFS- 3 sample (46.86) showed lowest postprandial aldohexose like compared to plain. once the analysis of all four mixed recipes compared to market samples, it showed that MFS- 3sample possessed the simplest preferences because the different useful diet for type- 2 diabetic patients. Aims of the analysis works were recipe preparation of samples, product acceptances and determination of Glycemic Index (GI) for four mixed multi-wholegrain flours compared with 2 market multi-grain flours within the market.

Glycaemic index, glycaemic load and dietary fibre characteristics of two commercially available fruit smoothies

In light of the updated Eatwell Guide and the corresponding change in the consumption of fruit smoothies, the aim of this study was to measure the glycaemic index and load of two commercial fruit smoothies and to investigate the retention of dietary fibre following production. In vitro analysis was performed to identify fibre material (cellulose and pectins) using calcofluor staining and immunocytochemical labelling. A repeated measures cross-over study was conducted (n 10) to determine the glycaemic index (GI) and glycaemic load (GL) of the smoothies. Results showed that dietary fibre was still present in the smoothies after processing (16.9-17.5% cellular material by dry weight). The GI was low for both smoothies (39 and 36), whereas the GL was medium and borderline-low, respectively (11.4 and 9.7). The retention of fibre in these smoothies may have a potential positive effect on glycaemic response and may contribute to daily fibre requirements.

Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations

Background: The potential impact of prior meal composition on the postprandial glycemic response and glycemic index (GI) and glycemic load (GL) value determinations remains unclear.Objective: We determined the effect of meals that varied in macronutrient composition on the glycemic response and determination of GI and GL values of a subsequent standard test food.Design: Twenty healthy participants underwent 6 test sessions within 12 wk. The subjects received each of 3 isocaloric breakfast meals (i.e., high carbohydrate, high fat, or high protein) on separate days in a random order, which was followed by a standard set of challenges (i.e., white bread and a glucose drink) that were tested on separate days in a random order 4 h thereafter. Each challenge provided 50 g available carbohydrate. Arterialized venous blood was sampled throughout the 2-h postchallenge period. GI, GL, and insulin index (II) values were calculated with the use of the incremental area under the curve (AUC_i) method, and serum lipids were determined with the use of standard assays.Results: The consumption of the high-protein breakfast before the white-bread challenge attenuated the rise in the postprandial serum glucose response (P < 0.0001) and resulted in lower glucose AUC_i (P < 0.0001), GI (P = 0.0096), and GL (P = 0.0101) values than did the high-carbohydrate and high-fat breakfasts. The high-protein breakfast resulted in a lower insulin AUC_i (P = 0.0146) for white bread than did the high-fat breakfast and a lower II value (P = 0.0285) than did the high-carbohydrate breakfast. The 3 breakfasts resulted in similar serum lipid responses to the white-bread challenge.Conclusions: These data indicate that the macronutrient composition of the prior meal influences the glycemic response and the determination of GI and GL values for white bread. Future studies are needed to determine whether the background food macronutrient composition influences mean dietary GI and GL values that are calculated for eating patterns, which may alter the interpretation of the associations between these values and chronic disease risk. This trial was registered at clinicaltrials.gov as NCT01023646.

Biscuits with No Added Sugar Containing Stevia, Coffee Fibre and Fructooligosaccharides Modifies α-Glucosidase Activity and the Release of GLP-1 from HuTu-80 Cells and Serotonin from Caco-2 Cells after In Vitro Digestion

This study assessed the in vitro effects of the bioaccessible food components released during the simulated human digestion of a coffee fibre-containing biscuit (CFB) on α-glucosidase activity, antioxidant capacity and satiety hormones. Digest of CFB presented a significantly (p < 0.05) lower amount of sugar (68.6 mg/g) and a higher antioxidant capacity (15.1 mg chlorogenic acid eq./g) than that of a sucrose-containing biscuit (SCB). The CFB significantly reduced (p < 0.05) α-glucosidase activity (IC50 = 3.3 mg/mL) compared to the SCB (IC50 = 6.2 mg/mL). Serotonin and glucagon-like peptide-1 (GLP-1) release by differentiated Caco-2 and HuTu-80 cells, respectively, was stimulated by the CFB (355% at a concentration of 0.5 mg/mL and 278% at a concentration of 0.05 mg/mL) to the same order of magnitude as those of the SCB. To summarize, the CFB was demonstrated to reduce monosaccharide bioaccessibility, to inhibit a diabetes-related digestive enzyme, and to improve the release of satiety hormones.

Fiber-rich diet with brown rice improves endothelial function in type 2 diabetes mellitus: A randomized controlled trial

Background & Aims

A fiber-rich diet has a cardioprotective effect, but the mechanism for this remains unclear. We hypothesized that a fiber-rich diet with brown rice improves endothelial function in patients with type 2 diabetes mellitus.

Methods

Twenty-eight patients with type 2 diabetes mellitus at a single general hospital in Japan were randomly assigned to a brown rice (n = 14) or white rice (n = 14) diet and were followed for 8 weeks. The primary outcome was changes in endothelial function determined from flow debt repayment by reactive hyperemia using strain-gauge plethysmography in the fasting state. Secondary outcomes were changes in HbA_1c, postprandial glucose excursions, and markers of oxidative stress and inflammation. The area under the curve for glucose after ingesting 250 kcal of assigned rice was compared between baseline (T0) and at the end of the intervention (T1) to estimate glucose excursions in each group.

Results

Improvement in endothelial function, assessed by fasting flow debt repayment (20.4% vs. −5.8%, p = 0.004), was significantly greater in the brown rice diet group than the white rice diet group, although the between-group difference in change of fiber intake was small (5.6 g/day vs. −1.2 g/day, p<0.0001). Changes in total, HDL-, and LDL-cholesterol, and urine 8-isoprostane levels did not differ between the two groups. The high-sensitivity C-reactive protein level tended to improve in the brown rice diet group compared with the white rice diet group (0.01 μg/L vs. −0.04 μg/L, p = 0.063). The area under the curve for glucose was subtly but consistently lower in the brown rice diet group (T0: 21.4 mmol/L*h vs. 24.0 mmol/L*h, p = 0.043, T1: 20.4 mmol/L*h vs. 23.3 mmol/L*h, p = 0.046) without changes in HbA_1c.

Conclusions

Intervention with a fiber-rich diet with brown rice effectively improved endothelial function, without changes in HbA1c levels, possibly through reducing glucose excursions.

Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations

Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed.Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values.Design: Four studies were conducted during which participants [n = 20-22; women: 50%; age: 50-80 y; body mass index (in kg/m²): 25-30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUC_i) method.Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUC_i (P < 0.0001), measured meal GI (P = 0.0066), and mean GL (P < 0.0001). Adding protein (50 g only) decreased glucose AUC_i (P = 0.0026), measured meal GI (P = 0.0139), and meal GL (P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUC_i or II; fiber had no effect.Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at clinicaltrials.gov as NCT01023646.

Glycemic index and microstructure analysis of a newly developed fiber enriched cookie

A diet with a high glycemic index (GI) is associated with an elevated risk for obesity or type 2 diabetes.

Non-cereal ingredients for the attenuation of glycaemic response to bread: a review of the clinical evidence

Enrichment of bread with non-cereal ingredients could favourably influence postprandial glucose response to bread.

Effect of an isocaloric diet containing fiber-enriched flour on anthropometric and biochemical parameters in healthy non-obese non-diabetic subjects

We studied the effect of soluble fiber-enriched products on anthropometric and biochemical variables in 30 healthy non-obese, non-diabetic subjects. This was a randomized, controlled crossover, single-blind, dietary intervention study performed for 8 weeks. Subjects received an isocaloric diet with fiber-enriched products for the first 4 weeks and with regular flour products for the following 4 weeks, or vice versa. Weight, height, measures of fat distribution (waist, hip circumference), glucose, insulin and triglycerides were measured at baseline, after 4 and 8 weeks of intervention. BMI and insulin sensitivity indices were calculated. Weight and BMI decreased in the first period of isocaloric diet in both groups, regardless of the type of flour consumed (weight p<0.01, p<0.001 respectively; BMI p = 0.01, p<0.001 respectively). At the end of the 8 weeks, weight and BMI further decreased in the group consuming the fiber-enriched diet (p<0.01). Insulin resistance, estimated with the Homeostasis Model Assessment index and the Lipid Accumulation Product index, improved in all subjects after the fiber-enriched flour diet (p = 0.03, p = 0.02, respectively). In conclusion, an isocaloric diet supplemented with fiber-enriched products may improve measures of fatness and insulin sensitivity in healthy non-obese non-diabetic subjects. We might hypothesize a similar effect also in subjects with metabolic abnormalities.

Long-term effect of dietary fibre intake on glycosylated haemoglobin A1c level and glycaemic control status among Chinese patients with type 2 diabetes mellitus

OBJECTIVE

Dietary fibre has been linked to lower levels of glycosylated haemoglobin A1c (HbA1c) among diabetes patients. The present study aimed to evaluate the long-term effect of dietary fibre on HbA1c levels among Chinese patients with type 2 diabetes mellitus.

DESIGN

Two cross-sectional surveys were conducted in 2006 and 2011, with the second one being a repeat survey on a sub-sample from the initial one. In both surveys, an in-person interview was conducted to collect information on demographic characteristics and lifestyles following a similar protocol. Dietary intake was assessed with a validated FFQ. Anthropometric measures and biochemical assays were performed at the interview.

SETTING

Communities in Pudong New Area of Shanghai, China.

SUBJECTS

Chinese patients (n 934) with type 2 diabetes mellitus.

RESULTS

An inverse association was observed between dietary fibre and glycaemic status indicated by HbA1c level in both surveys, although it was significant only in the first survey. Among 497 patients participating in both surveys, dietary fibre intake at the first survey was inversely associated with uncontrolled glycaemic status at the second survey, with adjusted odds ratios across the tertiles of intake being 1·00, 0·72 (95 % CI 0·43, 1·21) and 0·58 (95 % CI 0·34, 0·99; P trend = 0·048). The change in fibre intake was slightly associated with glycaemic status, with each increase in tertile scores of intake linked to a 0·138 % (β = -0·138; 95 % CI -0·002, 0·278) decrease in HbA1c value and a 19 % (OR = 0·81; 95 % CI 0·65, 1·02) reduced risk of uncontrolled glycaemic status at the second survey.

CONCLUSIONS

Dietary fibre may have a long-term beneficial effect on HbA1c level among Chinese diabetes patients.

A high-fiber, low-fat diet improves periodontal disease markers in high-risk subjects: a pilot study

Periodontal disease is related to aging, smoking habits, diabetes mellitus, and systemic inflammation. However, there remains limited evidence about causality from intervention studies. An effective diet for prevention of periodontal disease has not been well established. The current study was an intervention study examining the effects of a high-fiber, low-fat diet on periodontal disease markers in high-risk subjects. Forty-seven volunteers were interviewed for recruitment into the study. Twenty-one volunteers with a body mass index of at least 25.0 kg/m(2) or with impaired glucose tolerance were enrolled in the study. After a 2- to 3-week run-in period, subjects were provided with a test meal consisting of high fiber and low fat (30 kcal/kg of ideal body weight) 3 times a day for 8 weeks and followed by a regular diet for 24 weeks. Four hundred twenty-five teeth from 17 subjects were analyzed. Periodontal disease markers assessed as probing depth (2.28 vs 2.21 vs 2.13 mm; P < .0001), clinical attachment loss (6.11 vs 6.06 vs 5.98 mm; P < .0001), and bleeding on probing (16.2 vs 13.2 vs 14.6 %; P = .005) showed significant reductions after the test-meal period, and these improvements persisted until the follow-up period. Body weight (P < .0001), HbA1c (P < .0001), and high-sensitivity C-reactive protein (P = .038) levels showed improvement after the test-meal period; they returned to baseline levels after the follow-up period. In conclusion, treatment with a high-fiber, low-fat diet for 8 weeks effectively improved periodontal disease markers as well as metabolic profiles, at least in part, by effects other than the reduction of total energy intake.

Wholegrain cereals and bread: a duet of the Mediterranean diet for the prevention of chronic diseases

OBJECTIVE

The promotion of healthy lifestyles is one of the major goals of governments and international agencies all over the world. Wholegrain cereals are rich in nutrients and many phytochemical compounds, with recognised benefits for health, including dietary fibre, a number of phenolic compounds, lignans, vitamins and minerals and other bioactive components. The aim of the present work is to review the fundamental studies that support the consumption of wholegrain cereals and bread to prevent chronic diseases.

DESIGN

Descriptive review considering human studies.

SETTING AND SUBJECTS

Subjects included in randomised intervention trials and cohort studies from different countries published up to 2010.

RESULTS

Several studies show consistently that subjects who ingest three or more portions of foods per day based on wholegrain cereals have a 20-30 % lower risk of CVD than subjects who ingest low quantities of cereals. This level of protection is not observed with the ingestion of refined cereals, these being even higher than with the intake of fruit and vegetables. Likewise, high intake of wholegrain cereals and their products, such as whole-wheat bread, is associated with a 20-30 % reduction in the risk of type 2 diabetes. Finally, protection against the risk of colorectal cancer and polyps, other cancers of the digestive tract, cancers related to hormones and pancreatic cancer has been associated with the regular consumption of wholegrain cereals and derived products.

CONCLUSIONS

The regular intake of wholegrain cereals can contribute to reduction of risk factors related to non-communicable chronic diseases.