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Ravintokuitujen vaikutuksesta (jatkoa Els:in kommenttiin)

URL: http://velhottaret.net/alakarppi/forum/ ... d8df2d2753




Els

Sait minut hetkeksi "koukkuun" aiheesta. Tässä hieman jatkoa.

Oli tuossa hetki aikaa tehdä PubMedin haku "Effect of insoluble fiber" (muihin tietokantoihin tutustumiseen ei liennyt aikaa).

PuBMed
URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

Tulos näyttää olevan kohtalainen eli poislukien eläinkokeet (n. 50) ja muuten ei-relevantit tutkimukset jäi jäljelle 71 tutkimusta 188:sta löytyneestä. Linkkejä tässä haussa löytyi myös kokoteksteihin (saatavuus oikeuksista riippuen), mutta abstraktien perusteella (ks. alla) myös liukenemattomilla ravintokuiduilla näyttäisi kuitenkin olevan eri positiivisiakin vaikutuksia.

Ks. myös Harvardin linkki kuiduista kirjallisuusviitteineen.

Fiber Nutrition Source
URL: http://www.hsph.harvard.edu/nutritionsource/fiber.html


Nopeasti vilkaistuna etenkin kasvisten ja hedelmien kuidut ovat pääosassa, mutta myös viljojen kuituja (mukaanlukien leseet) on käsitelty (useimmiten samassa tutkimuksessa sekä liukoiset että liukenemattomat).

Tuloksia löytyy niin puolesta, neutraleja ja vastaankin. En ole kompetentti arvioimaan tutkimusten lääketieteellistä oikeellisutta, mutta hyväkarppaajan kannalta näyttää kuitenkin ihan riittävän hyvältä ravitsemukseltakin kannalta.

Omat kokemukseni hyvähiilihydraattisessa ruokavaliossani (kohta neljä vuotta) riittävät kyllä minulle vakuuttamaan kasvisten, hedelmien ja myös täysjyväviljojen terveellisistä vaikutuksista kuin myös yleisemmin vatsani toimintaan ilman sitovasti todettuja tieteellisiä tutkimuksia. Vatsani toiminta muuttui ja parani melkein välittömästi kesästä 2001 ja "paperin kulutus" myös sen myötä.

Toki referensseistä on aina hyötyä kun jotain pitäisi toiselle osoittaa, puhumattakaan tieteellisissä foruumeissa (symposiot ja julkaisut), joissa vertaiset pääsevät tutkimuksia kriittisesti (lue asiallisesti ja kiihkottomasti) tarkastelemaan.

Ohessa arvioitavaksi pikaisesti (ja sen kummemmin syventymättä) keräämäni referenssiluettelo PubMedistä abstrakteineen (helpottaa toivottavasti tutkimusten evaluointia ennen mahdollisia kokoteksteihin tutustumisia.

Pahoitteluni, jos kiireessä mukaan tuli ei-relevantteja viitteitä.



Referenssit:

Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome.

Bijkerk CJ, Muris JW, Knottnerus JA, Hoes AW, de Wit NJ.

Utrecht University Medical Center, Julius Center for Primary Care and Health Sciences, Utrecht, The Netherlands.

BACKGROUND: Both high-fibre dietary advice and the prescription of fibre as a bulking agent are very common in primary and secondary care management of irritable bowel syndrome. Irritable bowel syndrome patients with constipation may have delayed intestinal transit. Therefore, fibres that accelerate intestinal transit may be beneficial in these patients. The uncertain benefits reported in several clinical studies, however, have led us to reappraise the value of fibre in irritable bowel syndrome management. AIM: To quantify the effect of different types of fibre on global and symptom relief from irritable bowel syndrome. METHODS: Using a structured literature search in MEDLINE (1966-2002), we selected randomized controlled trials involving irritable bowel syndrome patients treated with fibre. Analyses were performed for the total group and for trials using soluble and insoluble fibre separately. RESULTS: Seventeen studies were included in the analysis. None investigated primary care irritable bowel syndrome patients. Fibre, in general, was effective in the relief of global irritable bowel syndrome symptoms [relative risk, 1.33; 95% confidence interval (CI), 1.19-1.50]. Irritable bowel syndrome patients with constipation may receive benefit from fibre treatment (relative risk, 1.56; 95% CI, 1.21-2.02), but there was no evidence that fibre was effective in the relief of abdominal pain in irritable bowel syndrome. Soluble and insoluble fibre, separately, had different effects on global irritable bowel syndrome symptoms. Soluble fibre (psyllium, ispaghula, calcium polycarbophil) showed significant improvement (relative risk, 1.55; 95% CI, 1.35-1.78), whereas insoluble fibre (corn, wheat bran), in some cases, worsened the clinical outcome, but there was no significant difference compared with placebo (relative risk, 0.89; 95% CI, 0.72-1.11). CONCLUSIONS: The benefits of fibre in the treatment of irritable bowel syndrome are marginal for global irritable bowel syndrome symptom improvement and irritable bowel syndrome-related constipation. Soluble and insoluble fibres have different effects on global irritable bowel syndrome symptoms. Indeed, in some cases, insoluble fibres may worsen the clinical outcome. Future clinical studies evaluating the effect and tolerability of fibre therapy are needed in primary care.

Publication Types:
· Review
· Review, Academic

PMID: 14984370 [PubMed - indexed for MEDLINE]



2: Nahrung. 2004 Feb;48(1):43-6. Related Articles, Links

Characterization and physicochemical properties of some potential fibres derived from Averrhoa carambola.

Chau CF, Chen CH, Lee MH.

Department of Food Science, National Chung Hsing University, 250 Kuokuang Road, Taichung 40227, Taiwan, Republic of China.

The pomace of Averrhoa carambola (carambola) was found to possess a high level of insoluble fibre-rich fractions (FRFs) including insoluble dietary fibre, alcohol-insoluble solid, and water-insoluble solid (46.0-58.2 g/100 g of pomace). These FRFs were mainly composed of pectic substances and hemicellulose. The physicochemical properties of these FRFs (e.g., water-holding capacities, swelling properties, and cation-exchange capacities) were significantly (P < 0.05) higher than those of cellulose. The apparent abilities of these FRFs to adsorb glucose and reduce amylase activity implied that they might help control postprandial serum glucose. These results recommended the consumption and application of the insoluble FRFs as low-calorie bulk ingredients in fibre enrichment. Further investigations on the in vivo hypoglycemic effect and other physiological effects of these FRFs using animal-feeding experiments are underway.

PMID: 15053350 [PubMed - indexed for MEDLINE]



3: Eur J Nutr. 2003 Oct;42(5):235-42. Related Articles, Links

Carob pulp preparation rich in insoluble fibre lowers total and LDL cholesterol in hypercholesterolemic patients.

Zunft HJ, Luder W, Harde A, Haber B, Graubaum HJ, Koebnick C, Grunwald J.

Institute for Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558, Bergholz-Rehbrucke, Germany.

BACKGROUND: Recently, insoluble fibre from carob pulp has been found to affect blood lipids in animals in a similar manner as soluble dietary fibre. AIM OF THE STUDY: To investigate whether a carob pulp preparation containing high amounts of insoluble fibre has a beneficial effect on serum cholesterol in humans. METHODS: Volunteers (n = 58) with hypercholesterolemia were recruited to participate in a randomised, double- blind, placebo-controlled and parallel arm clinical study with a 6 week intervention phase. All participants consumed daily both, bread (two servings) and a fruitbar (one serving) either with (n = 29) or without (n = 29) a total amount of 15 g/d of a carob pulp preparation (carob fibre). Serum concentrations of total, LDL and HDL cholesterol and triglycerides were assessed at baseline and after week 4 and 6. RESULTS: The consumption of carob fibre reduced LDL cholesterol by 10.5 +/- 2.2% (p = 0.010). The LDL:HDL cholesterol ratio was marginally decreased by 7.9 +/- 2.2 % in the carob fibre group compared to the placebo group (p = 0.058). Carob fibre consumption also lowered triglycerides in females by 11.3 +/- 4.5% (p = 0.030). Lipid lowering effects were more pronounced in females than in males. CONCLUSION: Daily consumption of food products enriched with carob fibre shows beneficial effects on human blood lipid profile and may be effective in prevention and treatment of hypercholesterolemia.

Publication Types:
· Clinical Trial
· Randomized Controlled Trial

PMID: 14569404 [PubMed - indexed for MEDLINE]



4: J Physiol Biochem. 2003 Sep;59(3):235-42. Related Articles, Links

Psyllium fibre and the metabolic control of obese children and adolescents.

Moreno LA, Tresaco B, Bueno G, Fleta J, Rodriguez G, Garagorri JM, Bueno M.

Departamento de Pediatria, Universidad de Zaragoza, C/ Domingo Miral S/N, 50009 Zaragoza, Spain.

In children and adolescents from developed countries, obesity prevalence has strongly increased in the last decades and insulin resistance and impaired glucose tolerance are frequently observed. Some dietary components such as low glycemic index foods and dietary fibre could be used in order to improve glucose homeostasis in these children. Psyllium or ispaghula husk (the husk of the seeds of Plantago ovata) is a mixture of neutral and acid polysaccharides containing galacturonic acid with a ratio of soluble/insoluble fibre of 70/30. Some foods could potentially be enriched with psyllium, like breads, breakfast cereals, pasta and snack foods. The aim of this review was to assess the usefulness of psyllium in the management of obese children and adolescents with abnormalities of carbohydrate and lipid metabolism. After psyllium supplementation, the percentage change in postprandial glucose in type 2 diabetes patients, ranged from -12.2 to -20.2%. In hypercholesterolemic children, the effect of psyllium in LDL-cholesterol serum concentrations ranged from 2.78 to -22.8%; the effect in HDL-cholesterol from -4.16 to 3.05%; and the effect on triglycerides from 8.49 to -19.54%. The reviewed evidence seems to show that psyllium improves glucose homeostasis and the lipid and lipoprotein profile; however, more well controlled trials and further studies are needed to clarify it's effects and the mechanisms involved.

Publication Types:
· Review
· Review, Tutorial

PMID: 15000455 [PubMed - indexed for MEDLINE]





7: Eur J Clin Nutr. 2003 Mar;57(3):464-70. Related Articles, Links

Fiber intake and risk of nonfatal acute myocardial infarction.

Negri E, La Vecchia C, Pelucchi C, Bertuzzi M, Tavani A.

Istituto di Richerche Farmacologiche Mario Negri, 20157 Milano, Italy.

OBJECTIVE: To investigate the association between fiber intake and risk of acute myocardial infarction (AMI), also according to type and source of fiber, in a Mediterranean country. DESIGN: Hospital-based case-control study. SETTING: Northern Italy. SUBJECTS: A total of 507 cases of first nonfatal AMI and 478 controls in hospital for acute conditions. INTERVENTIONS: Subjects were interviewed with a questionnaire that included a validated food frequency section. Odds ratios (OR) were obtained using multiple logistic regression, and adjusted for several recognized risk factors for AMI. Fiber was measured as non-starch polysaccharides. RESULTS: Compared with the lowest one, the OR in the highest tertile was 0.72 for total fiber, 0.64 for soluble fiber, 0.77 for total insoluble fiber, 0.71 for cellulose, 0.81 for insoluble non-cellulosic polysaccharides, 0.82 for vegetable fiber, 0.64 for fruit fiber and 1.11 for cereal fiber, and the estimates were statistically significant for soluble and fruit fiber. When further adjusted for beta-carotene, vitamin C and vitamin E intake, the fruit fiber still showed the strongest inverse relation, although the association was no longer significant. The protective effect of fiber was more marked in, or restricted to, subjects with other AMI risk factors, such as smokers, diabetics and hypertensives. CONCLUSIONS: Though an inverse association between fiber intake and AMI risk appears established, the causality of this association is still open to debate. In this population, cereal fiber derives chiefly from refined grains, and this may explain the lack of protection by this type of fiber.

PMID: 12627184 [PubMed - indexed for MEDLINE]


9: J Agric Food Chem. 2003 Jan 15;51(2):492-5. Related Articles, Links

Effects of xylanase treatments on gelling and water-uptaking properties of psyllium.

Yu LL, Perret J.

Department of Food Science and Human Nutrition, Colorado State University, 230 Gifford Building, Fort Collins, CO 80523-1571, USA.

The effects of a commercial food-grade xylanase on the physicochemical properties of psyllium were evaluated. The enzymatic reactions were conducted in solid state at ambient temperature. The enzyme-treated psyllium preparations were analyzed and compared with the starting psyllium for their water-uptake properties, gelling capacities, soluble and insoluble fiber contents, and surface structures. The solid-state xylanase treatment significantly reduced both water-uptake and gelling capacities of psyllium (p < 0.01), with a slight decrease of soluble fiber content, whereas no effect on insoluble fiber content was observed. The xylanase treatment also resulted in a smoother surface structure of psyllium particles. In addition, no special equipment and operation were required to conduct the enzymatic reaction, which generated no waste. These data indicated a potential to improve the physicochemical properties of psyllium by use of the solid-state xylanase reactions to promote the utilization of psyllium fiber in functional foods for promoting human health.

PMID: 12517115 [PubMed - indexed for MEDLINE]



10: Am J Med. 2002 Dec 30;113 Suppl 9B:30S-37S. Related Articles, Links

High-complex carbohydrate or lente carbohydrate foods?

Jenkins DJ, Kendall CW, Augustin LS, Vuksan V.

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Current dietary guidelines of the American Diabetes Association emphasize the importance of minimizing risk factors for cardiovascular disease while maximizing diabetes control. Potential advantages are seen for increased monounsaturated fat intake, but only the quantity rather than the quality of the carbohydrate is considered important. However, review of the carbohydrate issue suggests that many cultures now at high risk of diabetes originally consumed starchy staples higher in fiber and with a lower glycemic index than eaten currently. Furthermore, diets high in cereal fiber have been associated with improved glycemic control, and low glycemic index diets resulted in reduction in glycosylated proteins in type 1 and 2 diabetes. Finally, large cohort studies have demonstrated beneficial effects of cereal fiber and low glycemic index carbohydrate foods in reducing the risk both for diabetes and cardiovascular disease. The effect of insoluble cereal fiber is not readily explained, but a low glycemic index may result from a slower rate of carbohydrate absorption. Increased meal frequency as a model for reducing the rate of carbohydrate absorption has been shown to reduce day-long glucose and insulin levels in type 2 diabetes and reduce serum lipids in nondiabetic subjects. Therefore, there appears to be a potential role for low glycemic index, high-cereal fiber foods for prevention and treatment of diabetes. Both the nature of the dietary fat and the carbohydrate should be considered as potentially modifiable factors that together with weight control and exercise may play a role in diabetes and cardiovascular disease prevention and treatment.

Publication Types:
· Review
· Review, Tutorial

PMID: 12566136 [PubMed - indexed for MEDLINE]



11: Eur J Clin Nutr. 2002 Oct;56(10):952-7. Related Articles, Links

Phloem fortification in rye bread elevates serum enterolactone level.

Vanharanta M, Mursu J, Nurmi T, Voutilainen S, Rissanen TH, Salonen R, Adlercreutz H, Salonen JT.

The Research Institute of Public Health, University of Kuopio, Kuopio, Finland.

OBJECTIVE: To analyse the lignan content of phloem powder enriched rye bread and to study the dose-response relationship of the effect of dietary plant lignans derived from phloem on intestinal production of enterolactone by measuring enterolactone concentration in serum. DESIGN: A randomized double-blind supplementation trial. SUBJECTS: Seventy-five non-smoking men recruited by newspaper advertisements. INTERVENTION: Subjects were randomized to three study groups receiving either rye bread high in phloem (HP, 14% of rye flour substituted with phloem powder), rye bread low in phloem (LP, 7% of rye flour substituted with phloem powder) or placebo rye bread. Participants consumed 70 g of study bread daily for 4 weeks and provided serum samples for enterolactone analysis at baseline and at the end of the intervention. RESULTS: There was a significant increase in serum enterolactone concentration in the LP and HP groups compared with the placebo group (P=0.009 and P=0.003, respectively). Considerable interindividual differences were observed in the response to dietary lignans within the study groups. CONCLUSIONS: Our results indicate that plant lignans attached to insoluble fibre layer in phloem can be further metabolized and converted to enterolactone presumably by the bacteria present in the colon. Phloem powder is useful source of lignans for functional foods aimed to elevate serum enterolactone levels. SPONSORSHIP: Phloem powder and the study breads were provided by Finnpettu Oy and Linkosuo Oy, respectively. The clinical study work was sponsored in part by Oy Jurilab Ltd.

Publication Types:
· Clinical Trial
· Randomized Controlled Trial

PMID: 12373614 [PubMed - indexed for MEDLINE]



12: Dig Liver Dis. 2002 Sep;34 Suppl 2:S129-33. Related Articles, Links

Effects of guar gum, ispaghula and microcrystalline cellulose on abdominal symptoms, gastric emptying, orocaecal transit time and gas production in healthy volunteers.

Bianchi M, Capurso L.

Department of Gastroenterology and Internal Medicine, A.C.O. San Filippo Neri, Rome, Italy.

BACKGROUND: Dietary fibres are carbohydrates that resist hydrolysis by human intestinal enzymes but are fermented by colonic microflora. Soluble dietary fibres are fermented by anaerobic bacteria with production of gases, short chain fatty acids and other metabolic products believed to cause symptoms such as bloating, abdominal distension, flatulence. Insoluble fibres are only partially fermented, serving almost exclusively as bulking agents that result in shorter transit time and increased faecal mass. AIMS: To evaluate effect of a supplementation of a single 5 g dose of dietary fibre to a solid meal on gastric emptying, orocaecal transit time, gas production and symptom genesis, in healthy volunteers. Three different dietary fibres were tested, two soluble (guar gum and ispaghula] and one insoluble (microcrystalline cellulose). PATIENTS AND METHODS: After a 24-hour low fibre diet, 10 healthy subjects had a standard meal consisting of white bread and one 70 g egg the yolk of which was mixed with 100 mg of 13C octanoic acid and fried. Breath samples were collected for 13CO2 measurements with a mass spectrophotometer and excretion curve (Tlag, T1/2) evaluation. Further breath samples were collected and analysed with a gas chromatograph for the evaluation of H2 and CH4 production and orocaecal transit time. Each evaluation was repeated adding to standard meal, diluted in 300 ml tap water, respectively: a single 5 g dose of microcrystalline cellulose, guar gum or ispaghula. Subjects were asked to report all symptoms experienced from time of meal ingestion over 24 hours, evaluating the intensity. RESULTS: Dietary fibres did not significantly change gastric emptying (Tlag, T1/2) and orocaecal transit time of standard meal. Subjects experienced more symptoms when meals were supplemented with guar gum (p=0.009 vs standard meal) and ispaghula (p=0.048 vs standard meal). There was a poor, but significant, correlation between gas production and symptoms (r=0. 38, p=0. 01). CONCLUSIONS: Addition of different dietary fibres to a solid meal did not influence gastric emptying and orocaecal transit time. Microcrystalline cellulose caused fewer symptoms than guar gum and ispaghula probably due to the insoluble nature and the dimensions of the particles of this micronised cellulose.

PMID: 12408456 [PubMed - indexed for MEDLINE]



13: Int J Mol Med. 2002 Jan;9(1):65-70. Related Articles, Links

Prebiotic treatment of experimental colitis with germinated barley foodstuff: a comparison with probiotic or antibiotic treatment.

Fukuda M, Kanauchi O, Araki Y, Andoh A, Mitsuyama K, Takagi K, Toyonaga A, Sata M, Fujiyama Y, Fukuoka M, Matsumoto Y, Bamba T.

Pharmaceutical Division, Kirin Brewery Co. Ltd., Shibuya-ku, Tokyo 150-8011, Japan.

There is increasing evidence that intestinal microflora play an important role in the pathogenesis of ulcerative colitis. Therefore, modification of the microflora by prebiotics, probiotics, and antibiotics may be a rational approach for controlling intestinal inflammation. Germinated barley food-stuff (GBF) is an insoluble mixture of glutamine-rich protein and hemicellulose-rich dietary fiber. GBF is utilized efficiently by Bifidobacterium, Lactobacillus, and Eubacterium and converted by them into lactate, acetate, and butyrate. These bacterial organic acids preserve a favorable intestinal condition. We have previously shown that GBF has attenuated intestinal inflammation in patients with ulcerative colitis and experimental colitis models through prebiotic actions. The aim of this study was to compare the effect of GBF with that of probiotics and antibiotics in an experimental colitis model. Colitis was induced by feeding male SD rats with a diet containing 3.0-3.5% dextran sodium sulfate (DSS). The therapeutic effect of oral administration of a prebiotic (GBF), probiotics (mixture of Lactobacillus and Clostridium butyricum), antibiotics (vancomycin, metronidazole), and the vehicle was determined by assessing clinical and pathological scores on day 6 after initiation of colitis. Butyrate concentrations in the cecal content were also determined. GBF treatment significantly reduced colonic inflammation as assessed by clinical scores with an increase in cecal butyrate levels. Probiotic treatment with a mixture of Lactobacillus and Clostridium butyricum did not show such an effect. Both antibiotic treatments significantly attenuated clinical and pathological scores. However, in contrast to GBF, this treatment led to a significant decrease in cecal butyrate levels. These data suggest that modification of the intestinal microflora by prebiotics, including GBF, may serve as a useful adjunct in the treatment of ulcerative colitis as well as antibiotic treatment.

PMID: 11744999 [PubMed - indexed for MEDLINE]



14: Eur J Cancer. 2001 Nov;37(17):2235-9. Related Articles, Links

Dietary fibres and ovarian cancer risk.

Pelucchi C, La Vecchia C, Chatenoud L, Negri E, Conti E, Montella M, Calza S, Dal Maso L, Franceschi S.

Istituto di Ricerche Farmacologiche Mario Negri, 20157 Milan, Italy. pelucchi@marionegri.it

Data from an Italian multicentre case-control study on ovarian cancer were used to analyse the relationship between various types of fibres and ovarian cancer risk. The study, conducted between 1992 and 1999, included 1031 cases of incident, histologically-confirmed epithelial ovarian cancer. Controls were 2411 women admitted to the same network of hospitals for acute, non-malignant, non-hormonal-related diseases. Cases and controls were interviewed using a validated food frequency questionnaire (FFQ). Odds ratios (ORs), and the corresponding 95% confidence intervals (CI), were estimated using unconditional multiple logistic regression models. For total (Englyst) fibre, the OR for the highest versus the lowest quintile of intake was 0.68, and the continuous OR for the difference between the 80th and the 20th percentile of intake was 0.87. For most types of fibre, the continuous OR was significantly below 1. The OR was 0.83 for cellulose, 0.89 for soluble non-cellulose polysaccharides (NCPs), 0.86 for total insoluble fibre, 0.92 for insoluble NCP, and 0.95 (non-significant) for lignin. The inverse association was consistent across strata of age, family history and menopausal status, even if the association was apparently stronger in postmenopausal women. When fibre was classified according to the source, vegetable (but not grain) fibres, showed a significant protective effect, with an OR of 0.78.

Publication Types:
· Multicenter Study

PMID: 11677113 [PubMed - indexed for MEDLINE]



15: Adv Ther. 2001 Sep-Oct;18(5):230-6. Related Articles, Links

Carob pulp preparation for treatment of hypercholesterolemia.

Zunft HJ, Luder W, Harde A, Haber B, Graubaum HJ, Gruenwald J.

Institute for Nutritional Science University of Potsdam, Germany.

The lipid-lowering effect of a carob pulp preparation rich in insoluble dietary fiber and polyphenols was investigated in a noncomparative, open-label pilot study. Over 8 weeks, 47 volunteers with moderate hypercholesterolemia (total cholesterol 232-302 mg/dL) consumed 15 g of carob per day in three products (breakfast cereal, fruit muesli bar, powdered drink) as a supplement to their regular diet. After 4 weeks, reductions of 7.1% in mean total cholesterol and 10.6% in LDL cholesterol were noted; respective decreases after 6 weeks were 7.8% and 12.2% (all P<.001). HDL cholesterol and triglyceride levels remained unchanged. Overall compliance was good. Only 3 volunteers (6%) reported a sensation of fullness, which led to 2 of the 3 dropouts. The carob preparation may have value in the dietary treatment of hypercholesterolemia.

PMID: 11783460 [PubMed - indexed for MEDLINE]



16: Diabetes Care. 2001 May;24(5):811-6. Related Articles, Links

The effect of Indian or Anglo dietary preference on the incidence of diabetes in Pima Indians.

Williams DE, Knowler WC, Smith CJ, Hanson RL, Roumain J, Saremi A, Kriska AM, Bennett PH, Nelson RG.

Phoenix Epidemiology and Clinical Research Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, Arizona 85014, USA. demw@mail.nih.gov

OBJECTIVE: In short-term studies, adoption of a traditional diet is associated with reduction in metabolic abnormalities often found in populations experiencing rapid lifestyle changes. We examined the long-term effects of a self-assessed traditional or nontraditional dietary pattern on the development of type 2 diabetes in 165 nondiabetic Pima Indians. RESEARCH DESIGN AND METHODS: Dietary intake was assessed in 1988 by a quantitative food frequency method, and subjects were asked to classify their diet as "Indian," "Anglo," or "mixed." The Indian diet reflects a preference for Sonoran-style and traditional desert foods. The Anglo diet reflects a preference for non-Sonoran-style foods typical of the remaining regions of the U.S. RESULTS: In women, the intake of complex carbohydrates, dietary fiber, insoluble fiber, vegetable proteins, and the proportion of total calories from complex carbohydrate and vegetable proteins were significantly higher (P < 0.05) in the Indian than in the Anglo diet. The mixed diet was intermediate in of all these constituents. In men, the intake for these nutrients was also higher in the Indian than in the Anglo group, but not significantly. Diabetes developed in 36 subjects (8 men and 28 women) during 6.2 years of follow-up (range 0.9-10.9). The crude incidence rates of diabetes were 23. 35, and 63 cases per 1,000 person-years in the Indian. mixed, and Anglo groups, respectively. After adjustment for age, sex, BMI, and total energy intake in a proportional hazards model, the risk of developing diabetes in the Anglo-diet group was 2.5 times as high (95%) CI 0.9-7.2) and the rate in the mixed-diet group was 1.3 times as high (0.6-3.3) as in the Indian-diet group. CONCLUSIONS: This study suggests that the adoption of an Anglo diet may increase the risk of developing diabetes in Pima Indians, but it does not provide unequivocal evidence for or against this hypothesis.

PMID: 11347735 [PubMed - indexed for MEDLINE]



17: J Gastroenterol Hepatol. 2001 Feb;16(2):160-8. Related Articles, Links

Dietary fiber fraction of germinated barley foodstuff attenuated mucosal damage and diarrhea, and accelerated the repair of the colonic mucosa in an experimental colitis.

Kanauchi O, Iwanaga T, Andoh A, Araki Y, Nakamura T, Mitsuyama K, Suzuki A, Hibi T, Bamba T.

Applied Bioresearch Center, Corporate Research and Development Division, Kirin Brewery Co. Ltd, Takasaki, Gunma, Japan.

BACKGROUND AND AIMS: Germinated barley foodstuff (GBF) contains protein and insoluble dietary fiber. We have previously shown in ulcerative colitis patients and a colitis model that GBF feeding attenuates mucosal damage by increasing luminal butyrate levels. However, the detailed mechanism remains unclear because of its heterogeneous nature. The present study was carried out to: (i) evaluate the active ingredient in GBF; and (ii) examine its effect on the repair process in colonic inflammation by using a dextran sulfate sodium (DSS) colitis model. METHODS: Colitis was induced by feeding a diet containing 0.5-3.5% DSS to male Sprague-Dawley rats. (i) Active ingredient: GBF was fractionated enzymatically into fiber- and protein-rich fractions. Each fraction was administered to DSS-colitis rats. Clinical signs, cecal short chain fatty acid concentrations and serum alpha1-acid glycoprotein (AAG) levels were determined. (ii) Effect on mucosal repair: GBF with or without salazosulfapyridine (SASP), or SASP alone was administered to rats after the onset of colitis. Seven days after initial treatment, the number of epithelial cells in HE sections was evaluated morphologically in a blind fashion and serum AAG was determined. RESULTS: (i) Germinate barley foodstuff and GBF-fiber significantly attenuated the clinical signs of colitis and decreased serum AAG levels, with a significant increase in cecal butyrate production, while GBF-protein did not. (ii) Treatment with GBF alone and GBF plus SASP significantly accelerated colonic epithelial repair and improved clinical signs. CONCLUSIONS: These findings suggest that the fiber fraction of GBF may effectively enhance luminal butyrate production, and thereby accelerate colonic epithelial repair in colitis.

PMID: 11207896 [PubMed - indexed for MEDLINE]



18: N Engl J Med. 2000 May 11;342(19):1392-8. Related Articles, Links

Comment in:
· N Engl J Med. 2000 May 11;342(19):1440-1.

Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus.

Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ.

Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75390, USA.

BACKGROUND: The effect of increasing the intake of dietary fiber on glycemic control in patients with type 2 diabetes mellitus is controversial. METHODS: In a randomized, crossover study, we assigned 13 patients with type 2 diabetes mellitus to follow two diets, each for six weeks: a diet containing moderate amounts of fiber (total, 24 g; 8 g of soluble fiber and 16 g of insoluble fiber), as recommended by the American Diabetes Association (ADA), and a high-fiber diet (total, 50 g; 25 g of soluble fiber and 25 g of insoluble fiber), containing foods not fortified with fiber (unfortified foods). Both diets, prepared in a research kitchen, had the same macronutrient and energy content. We compared the effects of the two diets on glycemic control and plasma lipid concentrations. RESULTS: Compliance with the diets was excellent. During the sixth week, the high-fiber diet, as compared with the the sixth week of the ADA diet, mean daily preprandial plasma glucose concentrations were 13 mg per deciliter [0.7 mmol per liter] lower (95 percent confidence interval, 1 to 24 mg per deciliter [0.1 to 1.3 mmol per liter]; P=0.04) and mean median difference, daily urinary glucose excretion 1.3 g (0.23; 95 percent confidence interval, 0.03 to 1.83 g; P= 0.008). The high-fiber diet also lowered the area under the curve for 24-hour plasma glucose and insulin concentrations, which were measured every two hours, by 10 percent (P=0.02) and 12 percent (P=0.05), respectively. The high-fiber diet reduced plasma total cholesterol concentrations by 6.7 percent (P=0.02), triglyceride concentrations by 10.2 percent (P=0.02), and very-low-density lipoprotein cholesterol concentrations by 12.5 percent (P=0.01). CONCLUSIONS: A high intake of dietary fiber, particularly of the soluble type, above the level recommended by the ADA, improves glycemic control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients with type 2 diabetes.

Publication Types:
· Clinical Trial
· Randomized Controlled Trial

PMID: 10805824 [PubMed - indexed for MEDLINE]



19: Br J Nutr. 2000 Mar;83 Suppl 1:S157-63. Related Articles, Links

Dietary fibre, lente carbohydrates and the insulin-resistant diseases.

Jenkins DJ, Axelsen M, Kendall CW, Augustin LS, Vuksan V, Smith U.

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada.

Several epidemiological studies link consumption of fibre-rich foods to a reduced risk of type 2 diabetes and CHD. The 'fibre hypothesis' suggested that this was a direct effect of fibre. However, fibre-rich foods contain different types of fibre as well as other potentially beneficial compounds, and many foods naturally high in fibre have low glycaemic and insulinaemic indices, possibly due to food form. The question therefore emerges as to the effect of isolated fibre per se on insulin sensitivity, lipids and other risk factors associated with the metabolic syndrome. Many beneficial effects are seen with pharmacological doses of isolated viscous soluble fibre, including improved insulin sensitivity, decreased LDL-cholesterol levels and decreased clotting factors. Similar effects are seen with low glycaemic-index foods. In contrast, insoluble non-viscous cereal fibre is not seen to act directly on risk factors when taken in refined foods such as in milled flour. Since cereal fibre, the major type of fibre in western diets, does not directly act on the risk factors for the metabolic syndrome, the question remains as to possible mechanisms. Until now, fibre and the nature and processing of the starch and particle size have been seen as the main determinants of the metabolic response to starchy foods. However, fibre-rich foods also have an increased protein-to-carbohydrate ratio. Hence we suggest that the protective effect of fibre may also be due to increased vegetable protein content, which may act directly to reduce clotting factors and oxidized LDL-cholesterol levels.

Publication Types:
· Review
· Review, Tutorial

PMID: 10889807 [PubMed - indexed for MEDLINE]



20: Curr Opin Lipidol. 2000 Feb;11(1):49-56. Related Articles, Links

Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease.

Jenkins DJ, Kendall CW, Axelsen M, Augustin LS, Vuksan V.

Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, and Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada. cyril.kendall@utoronto.ca

Viscous fibres such as guar, glucomannans, pectins, oat betaglucan and psyllium continue to be seen as hypocholesterolaemic. Nevertheless, in large cohort studies, ironically it is the insoluble cereal fibre that has been demonstrated to relate negatively to cardiovascular disease and diabetes, despite an absence of effect on fasting lipids or postprandial glycaemia. In general, resistant or nonabsorbable starch is lipid neutral, whereas some nonabsorbable sugars or oligosaccharides may raise serum cholesterol, possibly through providing more acetate after colonic fermentation by colonic microflora. On the other hand, fructo-oligosaccharides appear to reduce serum triglycerides for reasons that are not entirely clear. Of possibly greater recent interest have been the carbohydrates that are not so much resistant to absorption, but rather are slowly absorbed. They possess some of the features of dietary fibre in providing a substrate for colonic bacterial fermentation. In the small intestine, however, they form lente or sustained release carbohydrate. In the form of low glycaemic index foods, lente carbohydrate consumption has been shown to relate to improved blood lipid profiles in hyperlipidaemic individuals and improved glycaemic control in diabetes. In larger cohort studies, low glycaemic index foods or low glycaemic load diets have been associated with higher HDL-cholesterol levels and reduced incidence of diabetes and cardiovascular disease.

Publication Types:
· Review
· Review, Tutorial

PMID: 10750694 [PubMed - indexed for MEDLINE]



21: Arch Latinoam Nutr. 1999 Dec;49(4):309-17. Related Articles, Links

[Wheat bran and breast cancer: revisiting the estrogen hypothesis]

[Article in Spanish]

Pena-Rosas JP, Rickard S, Cho S.

University of Toronto, Canada.

Breast cancer is the most relevant form of cancer among women in Latin America. Many studies have evaluated the hormonal mechanisms involved in mammary carcinogenesis, although new focus is aimed towards factors that can potentially be used individually to reduce risk. Wheat bran seems to show a consistent protective effect in mammary carcinogenesis. Wheat bran, besides high level of insoluble fiber, also contains phytic acid and lignins, phytochemicals that have shown to inhibit in vitro and in vivo growth of mammary cancer. The protective effect of wheat bran in breast carcinogenesis is greatest at the promotional phase and when supplemented to a high fat diet. Doses of wheat bran in the 9-12% range have been consistently protective and the inconsistencies observed at higher doses may be dependent on the animal model used. This review examines the protective role of wheat bran in the development of breast cancer and the possible mechanisms involved.

Publication Types:
· Review
· Review, Tutorial

PMID: 10883293 [PubMed - indexed for MEDLINE]



22: Nutr Hosp. 1999 May;14 Suppl 2:22S-31S. Related Articles, Links

[Dietary fiber: concept, classification and current indications]

[Article in Spanish]

Garcia Peris P, Camblor Alvarez M.

Seccion de Nutricion Clinica y Dietetica, Hospital General Universitario Gregorio Maranon, Madrid, Espana.

Fiber is a concept that refers to or encompasses several carbohydrates and lignine that resist hydrolysis by human digestive enzymes and that are fermented by the microflora of the colon. From a practical point of view, fibers can be divided into soluble and insoluble. There is general acceptance of the concepts soluble fiber, fermentable, viscous and insoluble fiber, and non-viscous and barely fermentable fiber. The physiological effects and therefore the clinical applications of both fibers are different. In general, the insoluble fiber is barely fermentable and has a marked laxative and intestinal regulatory effect. Soluble fiber is fermented to a high degree, showing a powerful trophic effect at the colon level. Soluble fiber is also attributed a positive role in the carbohydrate and lipid metabolism due to the effects that this has at the intestinal and the systemic level on the glucose and the cholesterol metabolism. The goal of this article is to review the current concept of fiber based on the existing bibliography (it is thought that perhaps the current classification should be changed and that fiber should be talked about depending on its degree of polymerization), its physiologic effects and the possible indications that this may have from a clinical point of view, be this at the level of oral or enteral nutrition.

Publication Types:
· Review
· Review, Tutorial

PMID: 10548024 [PubMed - indexed for MEDLINE]



23: Diabetes Care. 1999 Mar;22 Suppl 2:B21-8. Related Articles, Links

Fiber intake, serum cholesterol levels, and cardiovascular disease in European individuals with type 1 diabetes. EURODIAB IDDM Complications Study Group.

Toeller M, Buyken AE, Heitkamp G, de Pergola G, Giorgino F, Fuller JH.

Clinical Department, Heinrich-Heine-University, Dusseldorf, Germany.

OBJECTIVE: A cross-sectional analysis of dietary fiber intake was performed in European type 1 diabetic patients enrolled in the EURODIAB IDDM Complications Study to explore its potential relationship to serum cholesterol levels and the prevalence of cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS: Dietary intake was assessed by a standardized 3-day dietary record. For analysis of fiber intake (total, soluble, and insoluble) and its associations with CVD (past history or electrocardiogram abnormalities), complete data were available from 1,050 male and 1,012 female individuals. Relationships of fiber intakes to serum cholesterol levels (total, HDL, and LDL cholesterol) were examined in 926 men and 881 women with type 1 diabetes. RESULTS: Higher intakes of total fiber (g/day) were independently associated with significantly higher levels of HDL cholesterol in male (P = 0.01) and female individuals (P = 0.03). Fiber intakes of men with type 1 diabetes were also inversely related to ratios of total cholesterol to HDL cholesterol (P = 0.0001) and levels of LDL cholesterol (P = 0.0002). A protective effect of total fiber intake against CVD was observed for female subjects, where a significant trend was maintained after adjustment for potential confounders, including energy and saturated fat (P = 0.03 vs. P = 0.2 in men). Results were similar in separate analyses of soluble and insoluble fiber. CONCLUSIONS: The present study demonstrates that higher fiber intakes are independently related to beneficial alterations of the serum cholesterol pattern in men and to a lower risk for CVD in European insulin-dependent women. Beneficial effects can already be observed for fiber amounts within the range commonly consumed by outpatients with type 1 diabetes.

PMID: 10097895 [PubMed - indexed for MEDLINE]



24: Am J Clin Nutr. 1998 Sep;68(3):711-9. Related Articles, Links

Mechanisms by which wheat bran and oat bran increase stool weight in humans.

Chen HL, Haack VS, Janecky CW, Vollendorf NW, Marlett JA.

Department of Nutritional Sciences, University of Wisconsin-Madison, 53706, USA.

Generally, stool weight is significantly increased by adding sources of insoluble fiber to the diet. Comparable amounts of fiber provided by wheat and oat brans have the same effect on daily stool output, even though > 90% of wheat bran fiber but only 50-60% of oat bran fiber is insoluble. To determine the bases for these increases in stool weight, stool samples collected from 5 men in 2 constant diet studies that determined the effects of wheat and oat brans on large-bowel physiology were fractionated by using a physicochemical procedure into plant, bacterial, and soluble fractions, which were weighed and analyzed for sugar content and composition. Nitrogen, crude fat, and ash outputs were also determined. Wheat bran increased the fecal concentration of sugars and mass of plant material more than did oat bran, whereas oat bran increased fecal bacterial mass more. Each fiber source increased nitrogen, ash, and fat excretion, but excretion of fat was greater with oat bran. The apparent digestibility of plant-derived neutral sugars decreased significantly when wheat but not oat bran was consumed. The apparent digestibility of neutral sugars provided by wheat bran was 56%; the apparent digestibility of those provided by oat bran was 96%. We conclude that bacteria and lipids are major contributors to the increase in stool weight with oat bran consumption, whereas undigested plant fiber is responsible for much of the increase in stool weight with wheat bran consumption. Results are consistent with the hypothesis that oat bran increases stool weight by providing rapidly fermented soluble fiber in the proximal colon for bacterial growth, which is sustained until excretion by fermentation of the insoluble fiber.

Publication Types:
· Clinical Trial
· Controlled Clinical Trial

PMID: 9734752 [PubMed - indexed for MEDLINE]



25: Dig Dis Sci. 1998 Sep;43(9):2099-110. Related Articles, Links

Intestinal absorption of nutrients is not influenced by soy fiber and does not differ between oligomeric and polymeric enteral diets.

Ehrlein H, Stockmann A.

Institute of Physiology, University of Hohenheim, Stuttgart, Germany.

Enteric feeding is often associated with diarrhea. To avoid this side effect, isoosmotic and fiber-supplemented enteral diets are recommended. The aims of this study were to determine whether supplementing enteral diets with soy fiber influences nutrient absorption and whether in enteric feeding absorption of nutrients and water fluxes differ between hyperosmotic oligomeric and isoosmotic polymeric diets. In mini pigs intestinal absorption and water fluxes were measured by perfusing a 150-cm length of jejunum. Six noncommercial iso- and hyperosmotic oligomeric and polymeric diets and six commercial polymeric diets, either fiber-free or supplemented with soy fiber, were used. Pancreatic enzymes were infused concomitantly with the polymeric diets. The absorption of nutrients and energy did not differ between oligomeric and polymeric diets. Oligomeric diets of high energy density produced a pronounced secretion of water. Despite lower initial osmolality, polymeric diets produced a similar secretion of water due to rapid pancreatic hydrolysis. Supplementing diets with largely insoluble soy fiber increased viscosity only between 4.6 and 14.5 mPa x sec. Soy fiber did not influence absorption of nutrients and energy and had also no effects on luminal transit and flow rate. The lack of effects was not due to dilution of chyme by intestinal secretion of water because no differences existed between isoosmotic and hyperosmotic oligomeric diets. In conclusion, supplementing enteral diets with soy fiber does not impair the absorption of nutrients. Enteric feeding with isoosmotic polymeric diets provides no advantage compared with hyperosmotic oligomeric diets with respect to absorption of nutrients and secretion of water.

PMID: 9753279 [PubMed - indexed for MEDLINE]



26: Cancer Epidemiol Biomarkers Prev. 1998 Aug;7(8):667-71. Related Articles, Links

Fiber intake and risk of colorectal cancer.

Negri E, Franceschi S, Parpinel M, La Vecchia C.

Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.

The relationship between various types of fiber and colorectal cancer risk was investigated using data from a case-control study conducted between January 1992 and June 1996 in Italy. The study included 1953 cases of incident, histologically confirmed colorectal cancers (1225 colon cancers and 728 rectal cancers) admitted to the major teaching and general hospitals in the study areas and 4154 controls with no history of cancer admitted to hospitals in the same catchment areas for acute nonneoplastic diseases. Dietary habits were investigated using a validated food frequency questionnaire. Odds ratios (ORs) were computed after allowance for age, sex, and other potential confounding factors, including physical activity and protein, fat, and carbohydrate intake. Fiber was analyzed both as a continuous variable and in quintiles. For most types of fiber, the OR of colon and rectal cancers was significantly below 1, and no appreciable differences emerged between the two. When the unit was set at the difference between the upper cutpoints of the fourth and first quintile, i.e., the 80th and 20th percentiles, the ORs for colorectal cancer were 0.68 for total fiber (determined by the Englyst method as nonstarch polysaccharides), 0.67 for soluble noncellulose polysaccharides (NCPs), 0.71 for total insoluble fiber, 0.67 for cellulose, 0.82 for insoluble NCPs, and 0.88 for lignin. When fiber was classified according to the source, the OR was 0.75 for vegetable fiber, 0.85 for fruit fiber, and 1.09 for cereal fiber. The ORs were similar for the two sexes and the strata of age, education, physical activity, family history of colorectal cancer, and energy intake. Likewise, no appreciable differences emerged when subsites of the colon and rectum were investigated separately. This study provides additional support for a protective and independent effect of fiber on colorectal cancer, particularly for cellulose and soluble NCPs, and of fiber of vegetable or fruit origin.

PMID: 9718218 [PubMed - indexed for MEDLINE]



27: Diabetologia. 1998 Aug;41(8):882-90. Related Articles, Links

Relation of fibre intake to HbA1c and the prevalence of severe ketoacidosis and severe hypoglycaemia. EURODIAB IDDM Complications Study Group.

Buyken AE, Toeller M, Heitkamp G, Vitelli F, Stehle P, Scherbaum WA, Fuller JH.

Clinical Department, Diabetes Research Institute at the Heinrich-Heine-University, Dusseldorf, Germany.

The effect of dietary fibre intake on glycaemic control is still controversial. This study analysed the intake of natural dietary fibre in patients with Type I diabetes mellitus enrolled in the EURODIAB IDDM Complications Study to determine any associations with HbA1c levels and with the prevalence of severe ketoacidosis or severe hypoglycaemia. Dietary intake was assessed by a 3-day dietary record. The relation between intake of fibre (total, soluble and insoluble) and HbA1c was examined in 2065 people with Type I diabetes. Associations with severe ketoacidosis (requiring admission to hospital) and severe hypoglycaemia (requiring the help of another person) were analysed in 2687 people with Type I diabetes. Total fibre intake (g/day) was inversely related to HbA1c (p = 0.02), independently of carbohydrate intake, total energy intake and other factors regarding lifestyle and diabetes management. Severe ketoacidosis risk fell significantly with higher fibre intake (p = 0.002), with an adjusted odds ratio of 0.48 (95 % confidence interval 0.27 to 0.84) in the highest quartile ( > or = 23.0 g fibre/day) compared with the lowest quartile ( < or = 13.7 g fibre/day). The occurrence of severe hypoglycaemia was not related to fibre intake. Beneficial effects of fibre on HbA1c and the risk of severe ketoacidosis were particularly pronounced in patients from southern European centres. This study shows that higher fibre intake is independently related to a reduction in HbA1c levels in European people with Type I diabetes. Furthermore, increased fibre intake may reduce the risk of severe ketoacidosis. These beneficial effects were already observed for fibre intake within the range commonly consumed by people with Type I diabetes.

PMID: 9726589 [PubMed - indexed for MEDLINE]



28: West Afr J Med. 1998 Jul-Sep;17(3):153-6. Related Articles, Links

Effect of acute dietary fibre supplementation on colonic pH in healthy volunteers.

Naaeder SB, Evans DF, Archampong EQ.

Department of Surgery, University of Ghana Medical School, Accra, Ghana.

Dietary fibre and undigested starch are fermented to short chain fatty acids by colonic bacteria with acidification of the colon. It has been suggested that acidification of the colon by these fatty acids inhibits bacterial metabolism, but this concept has been disputed. The aim of this study was to investigate the short term effect of a dietary fibre load on colonic metabolism. Colonic pH and breath hydrogen was measured in healthy omnivorous British male volunteers following ingestion, in turn and at weekly intervals, of 15g lactulose, wheat bran biscuits, oat bran biscuits and ispaghula husk. All the test meals caused a reduction in caecal pH and an increase in breath hydrogen production. The changes were greatest with lactulose. Lactulose and wheat bran caused acidification of the right and left colon whereas oat bran and ispaghula husk caused acidification of mainly the right colon. An inverse correlation between right colonic pH and breath hydrogen was observed in only the oat bran study. This study has demonstrated the ability of dietary fibre to lower right colonic pH and to increase breath hydrogen excretion. The changes were greater with soluble fibre than with insoluble fibre but the change in luminal pH was persistent all round the colon with insoluble fibre.

Publication Types:
· Clinical Trial

PMID: 9814083 [PubMed - indexed for MEDLINE]



29: Nutr Cancer. 1998;31(2):138-42. Related Articles, Links

Estrogen profiles in postmenopausal African-American women in a wheat bran fiber intervention study.

Stark AH, Switzer BR, Atwood JR, Travis RG, Smith JL, Ullrich F, Ritenbaugh C, Hatch J, Wu X.

Lineberger Comprehensive Cancer Center, USA.

High dietary fiber intake has been hypothesized to lower blood estrogen concentrations, an effect thought to be beneficial for decreasing breast cancer risk. This study investigated the association between dietary supplementation of wheat bran and circulating estrogen levels in postmenopausal African-American women participating in a community intervention trial. Seventeen postmenopausal women (aged 63 +/- 1.6 yr) participated in the study. Nutritional status was assessed and blood and 24-hour urine samples were collected before and after five to six weeks of daily supplementation of the diet with 35 g of wheat bran cereal (11.6 g insoluble dietary fiber) marked with 28 mg of riboflavin. Riboflavin confirmed that all postmenopausal participants adhered to the intervention protocol. Nine of the 17 postmenopausal women were taking some form of estrogen replacement therapy (PM-ERT). Baseline hormone levels in the PM-ERT group did not significantly change after the dietary intervention. Estradiol (96.8 +/- 20.3 vs. 113.8 +/- 23.3 pg/ml), androstenedione (0.47 +/- 0.06 vs. 0.45 +/- 0.06 ng/ml), and sex hormone-binding globulin (SHBG, 107 +/- 13.5 vs. 106.6 +/- 13.3 nmol/l) levels remained constant. In the eight postmenopausal women who were not receiving exogenous hormones (PM), wheat bran consumption was not associated with predicted decreased levels of estradiol (25.7 +/- 2.7 vs. 31.0 +/- 1.9 pg/ml), estrone (38.3 +/- 10.1 vs. 39.3 +/- 10.6 pg/ml), and androstenedione (0.78 +/- 0.08 vs. 0.68 +/- 0.11 ng/ml) or with increased concentrations of SHBG (35.2 +/- 6.4 vs. 34.8 +/- 6.5 nmol/l). Participants receiving ERT had baseline and postintervention levels of estradiol and SHBG significantly higher and androstenedione significantly lower than those not receiving ERT. No association between wheat bran supplementation and hormone levels was found in PM or PM-ERT African-American participants. These results in postmenopausal women are in contrast to findings of earlier studies in premenopausal women indicating that wheat bran fiber decreases serum sex hormones. Estrogen levels in postmenopausal women are only 5-10% of those in premenopausal women; therefore, a high wheat bran fiber diet alone may not be sufficient to depress these low levels even further.

PMID: 9770726 [PubMed - indexed for MEDLINE]



30: Epidemiology. 1997 Nov;8(6):658-65. Related Articles, Links

Dietary fiber and colorectal cancer risk.

Le Marchand L, Hankin JH, Wilkens LR, Kolonel LN, Englyst HN, Lyu LC.

Etiology Program, University of Hawaii Cancer Research Center, Honolulu, USA.

We conducted a population-based case-control study among different ethnic groups in Hawaii to evaluate the role of various types and components of fiber, as well as micronutrients and foods of plant origin, on the risk of colorectal cancer. We administered personal interviews to 698 male and 494 female Japanese, Caucasian, Filipino, Hawaiian, and Chinese cases diagnosed during 1987-1991 with adenocarcinoma of the colon or rectum and to 1,192 population controls matched to cases by age, sex, and ethnicity. We used conditional logistic regression to estimate odds ratios, adjusted for caloric intake and other covariates. We found a strong, dose-dependent, inverse association in both sexes with fiber intake measured as crude fiber, dietary fiber, or nonstarch polysaccharides. We found inverse associations of similar magnitude for the soluble and insoluble fiber fractions and for cellulose and noncellulosic polysaccharides. This protective effect of fiber was limited to fiber from vegetable sources, with an odds ratio of 0.6 (95% confidence interval = 0.4-0.9) and 0.5 (95% confidence interval = 0.3-0.7) for the highest compared with the lowest quartile of intake for men and women, respectively. We found associations of the same magnitude for soluble and insoluble vegetable fiber, but no clear association with fiber from fruits or cereals. This pattern was consistent between sexes, across segments of the large bowel (right colon, left colon, and rectum), and among most ethnic groups. The effect of vegetable fiber may be independent of the effects of other phytochemicals, since the effect estimates remained unchanged after further adjustment for other nutrients. Intakes of carotenoids, light green vegetables, yellow-orange vegetables, broccoli, corn, carrots, bananas, garlic, and legumes (including soy products) were inversely associated with risk, even after adjustment for vegetable fiber. The data support a protective role of fiber from vegetables against colorectal cancer, which appears independent of its water solubility property and of the effects of other phytochemicals. The data also indicate that certain vegetables and fruits may be protective against this disease through mechanisms other than their fiber content.

PMID: 9345666 [PubMed - indexed for MEDLINE]



31: Eur J Clin Invest. 1997 Oct;27(10):857-62. Related Articles, Links

Intestinal fatty acid-binding protein variation associated with variation in the response of plasma lipoproteins to dietary fibre.

Hegele RA, Wolever TM, Story JA, Connelly PW, Jenkins DJ.

Department of Medicine, Faculty of Medicine, University of Toronto, Canada.

Increased dietary fibre intake is a component of prudent dietary advice, although the mechanism of its beneficial effect is unclear. Furthermore, plasma lipoprotein response to dietary fibre seems to vary both between individuals and according to the type of fibre consumed. Two common genetic variants, A54 and T54, of the intestinal fatty acid-binding protein gene (FABP2) have different in vitro binding affinities for long-chain fatty acids. We have hypothesized that variation in FABP2 would be associated with interindividual variation in the response of plasma lipoproteins to either dietary soluble or insoluble fibre. We studied 43 subjects who participated in a year-long cross-over study of the effect of insoluble and soluble fibre on plasma lipoproteins. We tested for associations between FABP2 genotypes and the response of plasma lipoproteins to dietary fibre. When compared with subjects homozygous for FABP2 A54, we found that subjects with FABP2 T54 had significantly greater decreases in plasma total and low-density lipoprotein (LDL)-cholesterol and apoB during the period when the diet was high in soluble fibre than during the period when the diet was high in insoluble fibre. Furthermore, compared with subjects with the FABP2 A54 allele, subjects with the FABP2 T54 allele had significantly lower secretion of total fecal bile acids, but this did not increase with dietary soluble fibre. Genetic variation in FABP2 may thus contribute to interindividual variation in the response of plasma lipoproteins to different dietary fibres, but the mechanism does not appear to be related to increases in fecal bile acid secretion.

Publication Types:
· Clinical Trial
· Randomized Controlled Trial

PMID: 9373766 [PubMed - indexed for MEDLINE]



32: Int J Food Sci Nutr. 1997 Jan;48(1):67-77. Related Articles, Links

Effects of amount and type of dietary fibre (soluble and insoluble) on short-term control of appetite.

Delargy HJ, O'Sullivan KR, Fletcher RJ, Blundell JE.

Department of Psychology, University of Leeds, UK.

Fibres which are soluble or insoluble in water have different physiochemical properties and may therefore be expected to exert different effects on post-ingestive satiety signals. This study compared the effects on short-term (24 h) appetite of two equienergetic high (22 g) fibre breakfasts, an equienergetic low fibre breakfast and a low energy, 'light' breakfast. Psyllium gum (the soluble fibre) and wheat bran (the insoluble fibre) were incorporated into breakfast cereals and consumed at breakfast by sixteen healthy, normal weight males after an overnight fast using a repeated measures, counterbalanced design. Ad libitum energy intake was assessed at a test snack 1.5 h after breakfast, later in the day using food boxes and the following day using food diaries. Motivation to eat and gastrointestinal sensations were tracked for the next 24 h. Hunger ratings showed a trend towards the subjects being less hungry and they consumed significantly less energy at snack time after the high insoluble than after the high soluble fibre breakfast cereal. The soluble fibre breakfast produced a greater suppression of snack intake than the light breakfast, but smaller suppression than the other breakfasts. Interestingly there was a trend toward reduced hunger and voluntary energy consumption following the soluble fibre compared with the insoluble fibre much later in the day (9.5-13.5 h after breakfast) although this was not significant. There was no significant effect of breakfast type on total day energy intake. The results suggest that different types of fibre modulate the timecourse of appetite control and may produce alterations in the experience of motivation and patterns of eating without necessarily effecting total energy intake.

Publication Types:
· Clinical Trial

PMID: 9093551 [PubMed - indexed for MEDLINE]



33: Nutr Cancer. 1997;28(1):14-9. Related Articles, Links

Dietary fiber and risk of breast cancer: a case-control study in Uruguay.

De Stefani E, Correa P, Ronco A, Mendilaharsu M, Guidobono M, Deneo-Pellegrini H.

Registro Nacional de Cancer, Montevideo, Uruguay.

To examine whether dietary fiber modifies breast cancer risk, a case-control study involving 351 newly diagnosed patients with breast cancer and 356 hospitalized controls was conducted in Uruguay. Dietary patterns were assessed in detail by use of a food frequency questionnaire on 64 items, which allowed the calculation of total energy intake. Nutrient residuals were calculated through regression analysis. After adjustment for potential confounders (which included age, residence, family history of breast cancer, prior history of benign breast disease, parity, total energy, red meat, lutein/zeaxanthin and quercetin intake, and menopausal status), dietary fiber and total nonstarch polysaccharides were associated with a strong reduction in risk of breast cancer (odds ratio for uppermost quartile of total dietary fiber = 0.51, 95% confidence limit = 0.31-0.82). Also the dose-response pattern was highly significant (p < 0.001). The inverse association was observed in pre- and post-menopausal women and was similar for soluble and insoluble fiber. Furthermore, dietary fiber displayed a strong joint effect with fat, quercetin, and lutein/zeaxanthin.

PMID: 9200145 [PubMed - indexed for MEDLINE]



34: Plant Foods Hum Nutr. 1997;50(3):249-57. Related Articles, Links

Effect of processing on dietary fiber content of cereals and pulses.

Ramulu P, Rao PU.

National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India.

Total dietary fiber (TDF), insoluble dietary fiber (IDF) and soluble dietary fiber (SDF) content of rice, wheat, sorghum, maize, ragi, bajra, whole grains of pigeonpea, chickpea, green gram and lentil as well as their dehusked split dhals were analyzed. Cereals except rice flours were made into chapati (unleavened bread), while rice and dhals were cooked in a pressure cooker. After the processing, IDF and SDF contents of these foods were also analyzed. Among the cereals, rice had the lowest TDF (4.1%) and wheat had the highest (12.5%). TDF content of whole pulses ranged from 15.8% in lentil to 28.3% in chickpea. IDF as % of TDF constituted 85 to 89% in whole pulses. Dehusking of pulses into dhals decreased TDF and IDF contents significantly. Among the dhals, green gram dhal had the lowest (8.2

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Montignac'illa onnistunut (vuodesta 2001)

Kiitos!
Lueskelen ja kommentoin. Täytyy samalla hiukan kaivella arkistoja, jotta löytäisin listan viljan ja diabeteksen korrelaatioista. Mutta onhan tässä vielä viikonloppua jäljellä...
terv els

_________________
Erkki terveys- eko- ja eettisistä syistä. Tyyli täällä, kliks
Ei eläinkään pysy terveenä jatkuvasti vaihtelevalla sapuskalla.
We are 90% microbes and 10% human.
Why invent a cure when you can profit from thousands of remedies? (DrWho)

Viitteesi, vajaa vuosi sitten saamani viitteet aiheesta vilja vs. diabetes ja jo kuuden suomalaisen tutkijan vaikeneminen viljan liukenemattomien kuitujen terveyseduista kertovista tutkimuksista ovat vahvistamssa kantaani: Viljakuiduilla (siinä muodossa kun nykyisin niitä nautimme) ei ole vahvistettua terveysetuja. Enig sivuillaan ehdotta, että vanhanaikaisilla ruoanvalmistustavoilla (mm. idätys, hapatus) viljastakin voisi saada käypää tai suorastaan hyvää ruokaa. Olen tällä hetkellä taipuvainen uskomaan häntä enemmän kuin virallisterveellisiä gurujamme.

Tuo ylläoleva ei sitten ole kritiikkiä vaikka montia vastaan. Montissa, niinkuin näissä muissakin hiilihydraatteja valikoivissa ja rajoittavissa ruokavalioissa syödään huomattavan paljon huomattavan terveellisiä ruoka-aineita. Se, toimivatko hedelmät paremmin ilman valkuaista (sinä & monti) tai nimenomaan valkuaisilla tasapainotettuna (minä & zone) saattaa olla yksilöstä riippuva juttu.

Mutta löytämäni tutkimuskirjallisuuden mukaan nykymuodossa nautittu viljakuitu (joka on lähes kokonaan liukenematonta) ei auta diabetekseen, lipidiarvoihin eikä edes siihen aikoinaan mainostettuu paksusuolen syöpään. Joissakin tutkimuksissa sen on todettu näitä jopa pahentaneen. Vihanneksilla kuituineen voi olla ehkäisevää merkitystä. Se johtuuko tuo kuiduista vai siitä kaikesta muusta hyvästä, jota vihanneksissa on, ei nytkytutkimus kerro. Mutta ei kai se ole niin oleellistakaan?

terv els

_________________
Erkki terveys- eko- ja eettisistä syistä. Tyyli täällä, kliks
Ei eläinkään pysy terveenä jatkuvasti vaihtelevalla sapuskalla.
We are 90% microbes and 10% human.
Why invent a cure when you can profit from thousands of remedies? (DrWho)

Els, muistelen, että keho.netin Anssi joskus tämän vuoden aikana, kun asiasta kyselin, löysi jonkun tutkimusabstraktin, jonka mukaan viljan kuiduista oli hyötyä sitä enemmän mitä hiilihydraattipitoisempi ravinto. Kerro jos törmäät. Jos näin, niin silloin olisi melko turhaa tulle meille jauhamaan viljakuitujen puuttumisesta. Jäljelle jää tällöin kysmys, kannattaako viljansyöjien harrastaa kuitupitoista vai kuorittua, kuten Cordain muistaakseni on jossain vilauttanut.

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Karppaus kannattaa: Kymmenen vuotta virkeyttä ja painonhallintaa, ilman tarpeettomia ruokarajoitteita.

blogi: http://mirkankysymyksia.blogspot.com/

Mitä tarkoitat "Viljakuiduilla (siinä muodossa kun nykyisin niitä nautimme)". Täysviljojako myös?




"Meille" käsite lienee tässä foorunissa melko laaja (Atkins, Heikkilä, SBD, Montignac, Zone ym.). Mikäli tarkoitat "meillä"
hyvähiilihydraattisia ruokavalioita noudattaville niin kuiduthan eri muodoissaan (kasvikset, marjat ja täysjyväviljat) ovat meille olennainen osa terveellistä ruokavaliota.



Lämmöllä teille molemmille -Els ja Mirka- asiantuntevista ja mainioista keskusteluketjuista,

_________________
Montignac'illa onnistunut (vuodesta 2001)

Onnistuneelle: Ennekuin saan kokeellista vahvistua, en näe syytä edes täysjyväviljan hyväksymiseen nykymuodossa. Oletko lukenut Cordainin perusteita (viitten pitäisi löytyä näiltä sivuilta nimihaulla)? En sano että ongelma liittyy juuri kuituihin, mutta johonkin jyvissä olevaan. Enig'in (ja Cordaininkin) mukaan osan ongelmista saa ratkaistua sopivalla esikäsittelyllä. Mutta mikään nykyisen teollisen tuotannon tapa ei hyödynnä niitä - ainakaan vielä.

Tuossa listassasi vain osassa jutuista oli kuidut oli eroteltu, ja vain parissa raaka-aineen mukaan. Listan mukaan vihannesten kuitu näyttää edelleen hyvältä, viljakuidut eivät. Ne näyttäisivät olevan joissain tapauksissa jopa haitallisia.

Ja jostain syystä yksikään suomalainen tutkija ei ole onnistunut kaivamaan esiin tutkimusta, jossa vilja olisi auttanut vaikapa diabetekseen. Tämä jos mikä häiritsee minua nyt todella paljon. Suomi johtaa 1-diabetes-tiliastoja, on kovasti vahvoilla myös 2-diabeteksessa ja täällä pääosa saaduista kuidusta on viljaperäisiä. Jos viljakuidut ennaltaehkäisevät diabeteksessa (kuten väitetään) niin SIITÄ PITÄISI OLLA TARJOLLA VAIKKA KUINKA PALJON KUNNON TILASTODATAA. Miksei ole?????

terv els
Alla otteita listastasi ja alimpana yksi uusi viite.


No 1: CONCLUSIONS: The benefits of fibre in the treatment of irritable bowel syndrome are marginal for global irritable bowel syndrome symptom improvement and irritable bowel syndrome-related constipation. Soluble and insoluble fibres have different effects on global irritable bowel syndrome symptoms. Indeed, in some cases, insoluble fibres may worsen the clinical outcome. Future clinical studies evaluating the effect and tolerability of fibre therapy are needed in primary care.

No 14 ... When fibre was classified according to the source, vegetable (but not grain) fibres, showed a significant protective effect, with an OR of 0.78. ...

No. 19: Since cereal fibre, the major type of fibre in western diets, does not directly act on the risk factors for the metabolic syndrome, the question remains as to possible mechanisms.

No 26. the ORs for colorectal cancer were 0.68 for total fiber (determined by the Englyst method as nonstarch polysaccharides), 0.67 for soluble noncellulose polysaccharides (NCPs), 0.71 for total insoluble fiber, 0.67 for cellulose, 0.82 for insoluble NCPs, and 0.88 for lignin. When fiber was classified according to the source, the OR was 0.75 for vegetable fiber, 0.85 for fruit fiber, and 1.09 for cereal fiber.

No 30. We found associations of the same magnitude for soluble and insoluble vegetable fiber, but no clear association with fiber from fruits or cereals. This pattern was consistent between sexes,

JA tässä vielä yksi muualta saatu: eli 1-diabeteksen ja viljan välisestä linkistä.

JAMA. 2003 Oct 1;290(13):1713-20.
Timing of initial cereal exposure in infancy and risk of islet autoimmunity.
Norris JM, Barriga K, Klingensmith G, Hoffman M, Eisenbarth GS, Erlich HA, Rewers M.
Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver 80262, USA. jill.norris@uchsc.edu

CONTEXT: Dietary exposures in infancy have been implicated, albeit inconsistently, in the etiology of type 1 diabetes mellitus (DM). OBJECTIVE: To examine the association between cereal exposures in the infant diet and appearance of islet autoimmunity (IA). DESIGN: Birth cohort study conducted from 1994 to 2002 with a mean follow-up of 4 years. SETTING: Newborn screening for HLA was done at St Joseph's Hospital in Denver, Colo. First-degree relatives of type 1 DM individuals were recruited from the Denver metropolitan area. PARTICIPANTS: We enrolled 1183 children at increased type 1 DM risk, defined as either HLA genotype or having a first-degree relative with type 1 DM, at birth and followed them prospectively. We obtained exposure and outcome measures for 76% of enrolled children. Participants had variable lengths of follow-up (9 months to 9 years). MAIN OUTCOME MEASURES: Blood draws for the detection of insulin autoantibody, glutamic acid decarboxylase autoantibody, or IA-2 autoantibody were performed at 9, 15, and 24 months and annually thereafter. Children with IA (n = 34) were defined as those testing positive for at least 1 of the autoantibodies on 2 or more consecutive visits and who tested positive or had diabetes on their most recent visit. RESULTS: Children initially exposed to cereals between ages 0 and 3 months (hazard ratio [HR], 4.32; 95% confidence interval [CI], 2.0-9.35) and those who were exposed at 7 months or older (HR, 5.36; 95% CI, 2.08-13. had increased hazard of IA compared with those who were exposed during the fourth through sixth month, after adjustment for HLA genotype, family history of type 1 DM, ethnicity, and maternal age. In children who were positive for the HLA-DRB1*03/04,DQB8 genotype, adjusted HRs were 5.55 (95% CI, 1.92-16.03) and 12.53 (95% CI, 3.19-49.23) for initial cereal exposure between ages 0 to 3 months and at 7 months or older, respectively. CONCLUSION: There may be a window of exposure to cereals in infancy outside which initial exposure increases IA risk in susceptible children.

_________________
Erkki terveys- eko- ja eettisistä syistä. Tyyli täällä, kliks
Ei eläinkään pysy terveenä jatkuvasti vaihtelevalla sapuskalla.
We are 90% microbes and 10% human.
Why invent a cure when you can profit from thousands of remedies? (DrWho)

Tarkoitin "meillä" sitä, että tätähän on karppaamisessa moitittu. Mutta jos tuo viittaamani tulos pätisi, niin hyväkarpithan saavat viljan kuitua, eli ei voi moittia, ja viljaa käyttämättömät kuten minä, syövät niin vähän hiilihydraatteja, että hyöty olisi kyseenalainen.

Tuosta viimeisestä tutkimuksesta en ymmärtänyt mitään, voisiko joku selventää?

_________________
Karppaus kannattaa: Kymmenen vuotta virkeyttä ja painonhallintaa, ilman tarpeettomia ruokarajoitteita.

blogi: http://mirkankysymyksia.blogspot.com/

Osaisiko joku viisaampi suomentaa minulle nuo hazard ratiot (4.32, 5.36, 5.55, 12.53). Ymmärsinkö oikein että niillä jotka ovat altistuneet viljoille 0-3kk ikäisinä on matalampi riski sairastua tyypin 1 diabetekseen kuin niillä jotka ovat altistuneet vasta 7kk tai vanhempina? Niin ja mitä nuo CI:n perässä tulevat luvut kertovat, esim 2.0-9.35?

Vaimollani on tyypin 1 diabetes, tyttärelläni kohonnut riski sairastua

Jos ymmärsin oikein, niin siinä on ikkuna 4-6kk jonka ulkopuolella viljalle totuttelu lisää enemmän diabeteksen riskiä. Mutta tässä kyseessä olivat geneettisesti diabetekselle riskialttiit pienoikaiset.

Nyt en löydä sitä toista juttua, jossa vilja korreloi nimenomaan kasvavaan diabetesriskiin, eikä juuri niinkuin täällä väitetään. Jatkan tänne kun löydän.

terv els

Minä olen nähnyt semmoisia vauvanruokintasuosituksia, että alle 6 kk ei mitään muuta kuin rintamaitoa/vastiketta, sitten vähitellen hedelmää, vihannesta, lihaa, kalaa, munaa, ja viljat vasta viimeiseksi. Itse olen ajatellut noin, koska suvussamme ei tiedetä diabetesta, mutta keliakiaa sen sijaan kyllä.

-Saan muuten kutinaa jo hapankorpun käsittelemisestä CD-levyn tyyliin, vain reunoihin koskien.

_________________
Karppaus kannattaa: Kymmenen vuotta virkeyttä ja painonhallintaa, ilman tarpeettomia ruokarajoitteita.

blogi: http://mirkankysymyksia.blogspot.com/

(Mirka: oheinen ei sitten ole keliaatikoille... )

Onnistunut: Tuttavalta löytyi muutama hyvä viite kokojyvien ehkäisevästä vaikutuksesta 2-diabetekseen. Niissä kaikissa oli tosin verrattu runsastärkkelyksistä vähäkuituista kokojyvitettyyn. Eikä kuitulisä sinänsä ei auttanut, vaan se että homma tarjottiin kokojyvinä, siis oikeassa paketissa. Se ainokinen tutkimus (suomalaisten) jossa kaikki vilja oli todettu hyväksi sai myöhemmin kritiikkiä varsin arvostetun kuitutukijan editoriaalissa, muiden laajempien tutkimusten tuloksien valossa, ihan asiallisesti esiteltynä.

Joten: Monti ja hyväkarppi kokojyvineen sopii niille joille sopii. Hyvää jyvässä näyttää kuidun sijaan olevan se koko paketin kokonaisuus. Mekanismi voi liittyä antioksidantteihin - tai jopa vaan siihen että vaihdetaan nopeasti sokeristuvat hitaampiin, mikä jo alentaa glykeemirasitetta (ja huom, jotkut kokonaiset jyvät ovat hitaita, vaikkei juuri mikään nykyleipä sitä olekaan). Mikä taas tukee hyvin Ludwig'in GI-kokeita ja Enig'in teorioita.

Tutkimusta, jossa verrataan hyvä- tai alakarppia runsasjyväiseen, en ole nähnyt. Eivätkä viljat sovi kaikille (esimerkkinä me joiden verensokeri vaatii kovempia vakiointisysteemejä, joko geenien tai nälänhallinan takia). Mutta verrattuna kuorittuun viljaan ja sokeriin, se on kohtuumäärissä säällistä kamaa varmaan monelle.

terv els

_________________
Erkki terveys- eko- ja eettisistä syistä. Tyyli täällä, kliks
Ei eläinkään pysy terveenä jatkuvasti vaihtelevalla sapuskalla.
We are 90% microbes and 10% human.
Why invent a cure when you can profit from thousands of remedies? (DrWho)

Viljansietäjille esim. keitetty ohra on hyvä lisuke, GI vain 35-36.

_________________
Karppaus kannattaa: Kymmenen vuotta virkeyttä ja painonhallintaa, ilman tarpeettomia ruokarajoitteita.

blogi: http://mirkankysymyksia.blogspot.com/

Kiitos Els palautteesta.



Jatkoa kuiduista (kesti hieman)

Pahoittelen, että sattuneesta syystä joudun kirjoittamaan "yksikätisenä". Onneksi on hiiri ja "Edit-Copy-Paste" -tekniikka.
Tosin kommentit jäävät sentähden lyhyiksi ja "tönköiksi"


Lähetetty: Maa Nov 01, 2004 11:32 am



Ks. lopussa oleva kommenttini myös Cordainin artikkeliin.




Ongelmana tutkimuksissa onkin usein tuo eri kuitumuotojen vaikutuksen erottaminen. Onneksi myös yhteisvaikutuksella on merkitystä.



Allaolevissa julkaisuissa on viittauksia tähän (osassa tilastollisia merkitsevyyksiä)



Tässä viittaus negatiiviseen vaikutukseen eräissä tapauksissa mutteivät yleistä ja odottavat jatkotutkimuksia..




Onneksi terveellisessä ruokavaliossa ei kuitujen saanti rajoitu vain viljatuotteiden varaan (ei ainakaan Montignac'issa).




Suoria vaikutuksia epäillän mutta eivät myöskään anna selitystä epäsuoran mekanismiin. Ja kysehän on "western diets", ei Montignac'in tai esim. Zonen mukaiset ruokavaliot.




Jälleen: Onneksi terveellisessä ruokavaliossa ei kuitujen saanti rajoitu vain viljatuotteiden varaan (ei ainakaan Montignac'issa).




Ei selvää assosiaatiota (mutta ehkä jonkinlaista). Ei anna vielä perusteita "tuomita" hedelmiä ja täysviljoja.




Pitänee tuossa tutkimuksessa paikkansa ja koskenee juuri noita tiettyjä diabetes 1:lle alttiita vauvoja. Onneksi olen aikuinen ja mies.




Seuraavassa lisäkommentteja aikaisempaan PubMedin luetteloon:





Tässä siis nimenomaan halutaan viitata viljojen liukenemattomien kuitujen potentiaalista vaikutusta hiilihydrattien (sokerin/glukoosin) hidastuneeseen imeytymiseen eli alentuneeseen glykemiaindeksivaikutukseen ja tätä kautta vaikutuksiin diabetes 1/ 2:ssa, alentaneeseen riskiin diabetekseen ja sydäntauteihin, vaikka se ei olekaan helposti selitettävissä.




Viittaa siis (tässä erityisesti liukuisten) kuitujen positiiviseen vaikutukseen diabetes 2 potilaissa.




Tässä jälleen viitataan liukenemattomien kuitujen epäsuoraan vaikutukseen yhdessä muiden tekijöiden kanssa. Täysjyvätuotteissa kuitujen eri muodot ja proteiinit ovat yleensä paketissa ja niiden yhteisvaikutus lienee tärkeämpi kuin yksittäinen vaikutus.




Vehnäleseellä voi siis olla kuitujen ohella muitakin positiivisia ominaisuuksia (kokonaispaketin merkitys). Abstraktissa ei mekanismeja mainita.





Kuvaa kuitujen luokittelun tärkeyttä, niiden eri vaikutuksia ja huomioonottamista tutkimuksissa. Usein ei kuitenkaan kuituja erotella koejärjestelyissä tai tarkastella tuloksia näistä lähtökohdista.




Kuitujen (tosin totaali) tilastollista vaikutusta HDL-kolesteroliin ja sydänsairauksiin diabetes 1:ssä




Eri viljakuitujen (leseiden) vaikutuksista ulosteen laatuun ja painoon.




Vaikutukset mahdollisia diabetes 1:ssä




Vaikutukset ilmeisiä PM:ssä




Tässä liukenemattomat kuidut antavat nopeammin suuremman kylläisyyden tunteen kuin liukenemattomat, joiden vaikutus näkyi vasta myöhemmin (yhteisvaikutuksen voitaisiin katsoa olevan jopa hyvä) .


[quote]
33: Nutr Cancer. 1997;28(1):14-9. Related Articles, Links
Dietary fiber and risk of breast cancer: a case-control study in Uruguay.
De Stefani E, Correa P, Ronco A, Mendilaharsu M, Guidobono M, Deneo-Pellegrini H.

After adjustment for potential confounders (which included age, residence, family history of breast cancer, prior history of benign breast disease, parity, total energy, red meat, lutein/zeaxanthin and quercetin intake, and menopausal status), dietary fiber and total nonstarch polysaccharides were associated with a strong reduction in risk of breast cancer (odds ratio for uppermost quartile of total dietary fiber = 0.51, 95% confidence limit = 0.31-0.82). Also the dose-response pattern was highly significant (p < 0.001). The inverse association was observed in pre- and post-menopausal women and was similar for soluble and insoluble fiber.


Muita uusia viitteitä lisää (ei välttämättä eroteltu kuitujen eri muotoja):



E. M. Ostman, H. G. M. Liljeberg Elmstahl, and I. M. E. Bjorck
Barley Bread Containing Lactic Acid Improves Glucose Tolerance at a Subsequent Meal in Healthy Men and Women
J. Nutr., June 1, 2002; 132(6): 1173 - 1175.

URL: http://www.nutrition.org/cgi/content/full/132/6/1173
URL: http://www.nutrition.org/cgi/reprint/132/6/1173

Abstract:
In the present study, we evaluated whether a low glycemic index (GI) breakfast with lactic acid bread had an effect on glucose tolerance and insulinemia at a subsequent high GI lunch meal. A barley bread containing lactic acid and a reference barley bread were consumed in the morning after an overnight fast in random order by 10 healthy men and women. Four hours after the breakfasts, the subjects ate a standardized high GI lunch, and the blood glucose and insulin responses were measured for the next 3 h. Significant lowerings of the incremental glycemic area (-23%, P = 0.033) and of the glucose response at 95 min were found after the lunch meal when the barley bread with lactic acid was given as a breakfast. At 45 min after the lunch meal, the insulin level was significantly lower (-21%, P = 0.045) after the lactic acid bread breakfast, compared with the barley bread breakfast without lactic acid. We concluded that barley bread containing lactic acid eaten at breakfast has the potential to improve second-meal glucose tolerance at a high GI lunch meal 4 h later.



American Journal of Clinical Nutrition, Vol. 76, No. 3, 535-540, September 2002
Original Research Communication
Whole-grain intake and the risk of type 2 diabetes: a prospective study in men1,2,3
Teresa T Fung, Frank B Hu, Mark A Pereira, Simin Liu, Meir J Stampfer, Graham A Colditz and Walter C Willett

URL: http://www.ajcn.org/cgi/content/full/76/3/535
URL: http://www.ajcn.org/cgi/reprint/76/3/535

ABSTRACT:
Background: Certain dietary components may play a role in the prevention of type 2 diabetes.

Objective: We examined prospectively the associations between whole- and refined-grain intake and the risk of type 2 diabetes in a large cohort of men.

Design: Men from the Health Professionals Follow-up Study without a history of diabetes or cardiovascular disease in 1986 (n = 42898) were followed for <=12 y. Intakes of whole and refined grains, measured every 4 y by use of food-frequency questionnaires, were used to predict subsequent type 2 diabetes risk through multivariate analysis.

Results: We ascertained 1197 cases of incident type 2 diabetes. After adjustment for age; physical activity; cigarette smoking; alcohol consumption; family history of diabetes; and fruit, vegetable, and energy intakes, the relative risk of type 2 diabetes was 0.58 (95% CI: 0.47, 0.70; P for trend < 0.0001) comparing the highest with the lowest quintile of whole-grain intake. The association was moderately attenuated when additionally adjusted for body mass index (relative risk: 0.70; 95% CI: 0.57, 0.85; P for trend = 0.0006). Intake of refined grains was not significantly associated with risk of type 2 diabetes. After further adjustment for magnesium intake, cereal fiber intake, and glycemic load, the association between whole grains and type 2 diabetes was attenuated and the trend no longer significant.

Conclusions: In men, a diet high in whole grains is associated with a reduced risk of type 2 diabetes in men that may be mediated by cereal fiber. Efforts should be made to replace refined-grain with whole-grain foods.

Key Words: Type 2 diabetes • whole grains • refined grains • men



Journal of the American College of Nutrition, Vol. 21, No. 4, 298-306 (2002)
Published by the American College of Nutrition
REVIEW
Intake of Refined Carbohydrates and Whole Grain Foods in Relation to Risk of Type 2 Diabetes Mellitus and Coronary Heart Disease
Simin Liu, MD, ScD, FACN

URL: http://www.jacn.org/cgi/content/full/21/4/298
URL: http://www.jacn.org/cgi/reprint/21/4/298

Abstract:
Recent survey data indicate that more than 50% of all adult Americans are overweight or obese. In parallel with this epidemic of weight gain in the general population, the incidence rate of type 2 diabetes mellitus (DM) is rapidly rising. Although their precise contributions are unclear, dietary factors are thought to affect body weight and the development of insulin resistance. Recent epidemiological data indicate that diets rich in high-fiber whole grains are associated with lower risk of coronary heart disease (CHD) and type 2 DM. These data are consistent with results from recent metabolic experiments, suggesting favorable lipid profiles and glycemic control associated with higher intake of whole grains, but not with refined grains. It seems prudent, therefore, to distinguish whole-grain rather than refined-grain cereal products for the prevention of chronic diseases.

Key words: obesity, type 2 diabetes mellitus, coronary heart disease, whole grains, dietary carbohydrate, dietary fat, fiber, dietary glycemic index


American Journal of Clinical Nutrition, Vol. 76, No. 2, 390-398, August 2002
Original Research Communication
Whole-grain intake is favorably associated with metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study

URL: http://www.ajcn.org/cgi/reprint/76/2/390
URL: http://www.ajcn.org/cgi/content/full/76/2/390

Abstract:
Background: The influence of whole grains on cardiovascular disease risk may be mediated through multiple pathways, eg, a reduction in blood lipids and blood pressure, an enhancement of insulin sensitivity, and an improvement in blood glucose control.

Objective: The objective was to examine the association between diets rich in whole- or refined-grain foods and several metabolic markers of disease risk in the Framingham Offspring Study cohort.

Design: Whole-grain intake and metabolic risk markers were assessed in a cross-sectional study of 2941 subjects.

Results: After adjustment for potential confounding factors, whole-grain intake was inversely associated with body mass index (: 26.9 in the lowest and 26.4 in the highest quintile of intake; P for trend = 0.06), waist-to-hip ratio (0.92 and 0.91, respectively; P for trend = 0.005), total cholesterol (5.20 and 5.09 mmol/L, respectively; P for trend = 0.06), LDL cholesterol (3.16 and 3.04 mmol/L, respectively; P for trend = 0.02), and fasting insulin (205 and 199 pmol/L, respectively; P for trend = 0.03). There were no significant trends in metabolic risk factor concentrations across quintile categories of refined-grain intake. The inverse association between whole-grain intake and fasting insulin was most striking among overweight participants. The association between whole-grain intake and fasting insulin was attenuated after adjustment for dietary fiber and magnesium.

Conclusion: Increased intakes of whole grains may reduce disease risk by means of favorable effects on metabolic risk factors.

Key Words: Whole grains • refined grains • risk factors • survey • Framingham Offspring Study • food-frequency questionnaire • type 2 diabetes • cardiovascular disease



The American Society for Nutritional Sciences J. Nutr. 133:3658-3663, November 2003

Nutritional Epidemiology
Dietary Fiber Reduces Peripheral Arterial Disease Risk in Men
Anwar T. Merchant*,{dagger},2, Frank B. Hu*,**, Donna Spiegelman**,{ddagger}, Walter C. Willett*,**,{dagger}{dagger}, Eric B. Rimm*,**,{dagger}{dagger} and Alberto Ascherio

URL: http://www.nutrition.org/cgi/reprint/133/11/3658
URL: http://www.nutrition.org/cgi/content/full/133/11/3658

Abstract:
We prospectively evaluated the relationship between dietary fiber and peripheral arterial disease risk (PAD) among 46,032 men, aged 40 to 75 y, in 1986. Subjects answered a vascular disease questionnaire and completed a validated 131-item food frequency questionnaire, and were free of PAD, cardiovascular disease and diabetes. During 12 y of follow-up 308 incident PAD cases were documented. After adjusting for age, smoking, hypertension, hypercholesterolemia, family history of early coronary heart disease, alcohol consumption, BMI, physical activity and energy intake, PAD risk in each quintile of cereal fiber intake compared with the lowest quintile was 0.69, 95% CI 0.49–0.97 for quintile 2; 0.65, 95% CI 0.45–0.94 for quintile 3; 0.68, 95% CI 0.47–0.98 for quintile 4; and 0.67, 95% CI 0.47–0.97 for quintile 5. In a nonlinear model the overall inverse association (P = 0.02) and nonlinear components (P = 0.03) were significant. Fruit, vegetable and total fiber intakes were not associated with PAD risk. These results suggest an inverse association between cereal fiber intake and PAD risk in men. Increasing cereal fiber intake may prevent PAD.

KEY WORDS: • dietary fiber • peripheral arterial disease • cereal fiber • prospective study



Diabetes Care 26:1979-1985, 2003
The American Diabetes Association, Inc.
Clinical Care/Education/Nutrition
Original Articles
Associations of Dietary Fiber With Glucose Metabolism in Nondiabetic Relatives of Subjects With Type 2 Diabetes
The Botnia Dietary Study

URL: http://care.diabetesjournals.org/cgi/reprint/26/7/1979
URL: http://care.diabetesjournals.org/cgi/co ... /26/7/1979

Abstract:
OBJECTIVE—To study cross-sectional associations of dietary fiber intake with insulin resistance, insulin secretion, and glucose tolerance in a population at high risk for type 2 diabetes.

RESEARCH DESIGN AND METHODS—The subjects consisted of 248 male and 304 female adult nondiabetic relatives of patients with type 2 diabetes. Dietary intake was measured by means of two 3-day food records. Associations of total, water-insoluble, and water-soluble fiber with measures of glucose metabolism based on an oral glucose tolerance test, were analyzed by multiple linear regression analysis adjusting for sex, age, length of education, physical activity, BMI, waist-to-hip ratio, systolic blood pressure, and serum triglyceride and HDL cholesterol concentrations. The homeostasis model assessment insulin resistance index, the incremental 30-min serum insulin concentration divided by the incremental 30-min glucose concentration, and fasting and 2-h glucose concentrations were the outcome variables.

RESULTS—The dietary intake of total as well as water-insoluble and water-soluble fiber was inversely associated with insulin resistance: -0.17 (0.07), P = 0.012; -0.15 (0.07), P = 0.024; and -0.14 (0.07), P = 0.049 [regression coefficients (SE)]. Fiber variables were unrelated to insulin secretion and plasma glucose concentrations.

CONCLUSIONS—The results support evidence that a high intake of dietary fiber is associated with enhanced insulin sensitivity and therefore may have a role in the prevention of type 2 diabetes.

Abbreviations: HOMA, homeostasis model assessment • IAUC, incremental area under the curve • MET, metabolic unit value • NEFA, nonesterified fatty acid



Fat versus carbohydrate in insulin resistance, obesity, diabetes and cardiovascular disease
Tony Hunga, John L. Sievenpiper

Current Opinion in Clinical Nutrition and Metabolic Care 2003, 6:165–176

URL: http://www.uoguelph.ca/hb+ns/NUTR4350/N ... 04Hung.pdf

Summary
Diets that are higher in monounsaturated fatty acids, fiber and low glycemic index foods appear to have advantages in insulin resistance, glycemic control and blood lipids in a number of studies. The division of nutrients into total fat (regardless of fatty acids) versus carbohydrate
(type and quantity not specified) appears to be less helpful in predicting outcomes.

Keywords
fat, carbohydrate, insulin resistance, obesity, diabetes, glycemic index, cardiovascular disease,
monounsaturated fat, polyunsaturated fat




Kiitos Loren Cordainiin viittauksesta. Ohessa joitakin kommentteja aiheeseen "Cereal grains: humanity’s double-edged sword"

Mitä "kaksiteräisyyteen" tulee niin on sekä hyviä että huonoja puolia. On siis arvotettava (täysjyvä)vilat suhteessa käytettyyn ruokavalioon.


Cordain näyttää luennoineen aiheesta muutamia kertoja:

Dr. Loren Cordain: Public Speaking and Presentations
URL: http://www.thepaleodiet.com/speak.htm

23 Mar 02 Cereals vs. fruits and vegetables: nutrition and health implications American Nutraceutical Association Spring Symposium, Tucson, AZ

28 Jun 01 Cereal grains: humanity’s double-edged sword
Design for Health Institute BoulderFest, 2001, Boulder, CO

18 Apr 00 Cereal grains: an evolutionary perspective


Suomessa aihetta näkyy käsitellyn "Kivikauden ruoka / The Paleolithic Diet" yhteydessä:

Kivikauden ruokaa avaruusaikana
URL: http://www.hypnopaleolaihdutus.com/optimaalinen.html


Kivikauden hiilihydraatit, proteiinit ja rasvat

Kaikki hiilihydraatit eivät toimi samoin aineenvaihdunnan kannalta. Vihreiden kasvisten, marjojen ja hedelmien sekä maidon sokeri nostavat vähemmän verensokeria kuin viljojen, perunoiden eli tärkkelyksen sokerit. Kasviksia ja marjoja suositetaan syötäviksi puolesta kilosta kiloon päivässä.

Kasvisten liukenevat kuidut ovat tutkimusten mukaan suositeltavampia kuin viljojen liukenemattomat kuidut. Viljojen runsas hiilihydraattimäärä lihottaa tehokkaasti ja niiden kuoriosien sisältämät vahingolliset antiravinteet (lektiinit, glykoproteiinit) puolestaan pieninäkin määrinä saattavat aiheuttaa ihmisen aineenvaihdunnalle häiriöitä, jotka ilmenevät lihomisen lisäksi ruoansulatusongelmina, mielialan vaihteluina ja muina fyysisinä ja/tai psyykkisinä oireina.

Onneksi olen itse laihtunut täysjyvätuotteiden avulla ja ruoansulatukseni vain on parantunut. Olo niin mielialoineen ja fyysisen ja psyykkisen kunnon puolesta on edelleen mitä mainioin.

Marjat, yrtit, kasvikset ja hedelmät sisältävät runsaasti terveyttä ja hyvinvointia edistäviä fytokemikaaleja ja flavonoideja, joita ei ole viljoissa.

Pitää hyvin paikkansa ja Montignac'in ruokavalioon nuohan kuuluvat luonnostaan.

Joissakin vähähiilihydraattisten ruokavalioiden tutkimuksissa hiilihydraattien määrää on rajoitettu 22 – 40 prosenttiin kokonaisenergiasta tai vähempään kuin 70 grammaan päivässä.


Pätee hyvinkin Montignac'iin kuin Zoneen (40% niitä hyviä hiilihydraatteja)


Cordainin ajatuksista vielä (kaksi lähtdettä):

1.
The Felix Letters
Issue 112, 2000
CEREAL GRAINS: HUMANITY'S DOUBLE-EDGED SWORD
URL: http://www.smartlifeforum.org/felixletter/issue112.htm

Cordain writes. "Cereal grains obviously can be included in moderate amounts in the diets of most people without any noticeable, deleterious health effects, and herein lies their strength."

But we didn't know, until nutrition science's great strides in the early part of the century, that people who subsisted largely on grain products could suffer grim vitamin and mineral deficiencies.


Cordain siis ei tuomitse täysin (täysjyvä)viljoja, koska ne sopivat monille kohtuullisesti käytettynä (Montignac ja Zone) huolimatta että niistä voi olla ongelma toisille.

Toinen Cordainia koskeva lähde:

2.
The Paleolithic Diet and Its Modern Implications
An Interview with Loren Cordain, PhD
URL: http://www.mercola.com/fcgi/pf/article/ ... c_diet.htm

Robert Crayhon: How much cereal grain is too much?
Loren Cordain: That varies by the person. Some people can handle more cereal grains than others. For a celiac patient a single teaspoonful of gluten containing grains is too much.

Generally, health begins to noticeably be disrupted when cereal grains provide 70% or more of the daily caloric intake.

Tämähän ei toteudu Montignac'issa eikä Zonessa.


The high phytate content of whole grain cereals can impair mineral metabolism i.e. iron, calcium, and other anti-nutrients have the potential to interact with the gastrointestinal tract and perhaps the immune system as well. The high lectin content of whole grain cereals can bind enterocytes in the small intestine and cause villous atrophy in addition to changing tight junction characteristics thereby allowing intestinal antigens (both dietary and pathogenic) access to the peripheral circulation.

Toisaalta esim. lektiinejä on esitetty olevan myös jopa kananmunassa! Tekee mieli kysyä mitä oikein voisi oikeastaan syödä?

Ks. THE LECTIN REPORT
Krispin Sullivan, CN 2/28/2000
URL: http://www.krispin.com/lectin.html

WHERE CAN I GET HELP IN DETERMINING MY INTOLERANCE OR HELP WITH DIET TO TEST OR MAINTAIN?

Throughout our history our ancestors had limited exposure to many lectin families depending on location. In our modern world it is common to believe that we can eat any food we like. We can but the food we eat may not like us. Some persons (a minority) can tolerate all foods. For the rest of us most will find one or more lectin groups they do not tolerate. Of those who experience antigen responses most will not need to eliminate more than one or two major lectin groups. You have to experiment and see 'who' you are and 'what' your ideal foods are. It is a process.

Consider the group most likely to be causing a problem:

- Deadly nightshades including tomato, potato and eggplant.
- Glutens found in wheat, rye, barley, malt, and oats.
- Legumes, all beans including soy and peanut.
- Dairy including all milk products, milk, cheese, cottage cheese, yogurt, kefir.
- Eggs

These are the most common lectin families that cause problems.




Ja taas Cordainia:

Robert Crayhon: Are there particular grains that are more of a problem than others?
Loren Cordain: Wheat, rye, barley, and perhaps oats are problematical for individuals with celiac disease. Wheat seems to be associated with many auto-immune diseases.

Onneksi kaikki eivät ole keliaakikkoja.



Although high grain cereals intrinsically contain higher nutrient levels than do refined cereal grains, the biological availability of nutrients in whole grain cereals remains paradoxically low because of their high anti-nutrient content. On the plus side, whole grain cereals, because of their high fiber content tend to have superior glycemic indices than do their refined counterparts.

Jälleen tuota kaksiteräisyyttä ja hyvänä puolena glykeeminen indeksi (täysjyväviljatuotteet yleensä keskinkertaisia eli
GI alle 50 tai tätä luokkaa).

Obviously, low to moderate amounts of cereal grains in the diet presents little or no health problems to most people. The majority of the grain products consumed in this country are refined, and consequently many of the anti-nutrients are milled out.

Robert Crayhon: Such as the bran?
Loren Cordain: Yes, exactly. There's a tradeoff. Milling takes out the anti-nutrients, but it also lowers the levels of vitamins and minerals.

Molemmissa jälleen tuota kaksiteräisyyttä. Kumpi on parempi?


Summa summarum.

Mikään ylläesitetyistä (julkaisut ym.) ei mielestäni aseta Montignac'ia (tai Zonea) mitenkään huonoon valoon, päinvastoin. Montignac'in ruokavalio monipuolisine vaihtoehtoineen pitää huolen siitä ettei se koostu pelkästään täysjyvätuotteiden tai leseiden syönnistä.

Itselläni esim. täysjyvätuotteet kuuluvat aamiaisiini ja silloin tällöin päivällisiini (luonnon- tumma- tai basmatiriisi tai durumvehnäpasta tai pavut) mutta vain lisukkeena. Lounailla ja päivällisillä puolet lautasesta on aina kasviksia ja vihanneksia sellaisenaan tai höyrytettynä. Näistä saan siis nuo erittäin alhaisen GI:n hiilihydrattini kaikkiene hyvine ominaisuuksineen.

Aamiaisiini kuuluvat täysjyväleipien kanssa useimiten rahkan kanssa myös raejuusto (nykyisin useimmiten rasvattoman sijasta 2%:n). Rasvani saan hyvistä rasvoista (kylmäpuristetut oliivi- ja rypsiöljyt, Möllerin omega-3 öljykapselit ja lihojen, kalan ja "lihamakkaroiden rasvoista, Montignac'in periaatteita noudattaen.

Korostan vielä, että sovellan Montignac'in ruokavaliota nimenomaan alhaisen glykemiaindeksin ruokavaliona. Montignac'in ruokavalion periaatteethan antavat tähän mainion mahdollisuuden.


Toivottavasti ei ollut kovin sekava jatkokommentti.

Terveisin,

_________________
Montignac'illa onnistunut (vuodesta 2001)