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CVD > Dietary fibre > Flashcards

Dietary fibre Flashcards

1
Q

What did CODEX Alimentarius define dietary fibre as in 2009?

A

Carbohydrate polymers (also includes lignin and other compounds if quantified by AOAC) with 10 or more monomeric units (decision on whether to include carbohydrates with a degree of polymerisation from DP 3 to 9 up to national authorities), which are not hydrolysed by the endogenous enzymes in the small intestine of humans and belong to the following categories….

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2
Q

What are the three categories?

A
  • Edible carbohydrate polymers naturally occurring in the food consumed
  • Carbohydrate polymers, which have been obtained from food raw material by physical, enzymatic or chemical means and which have been shown to have physiological benefit to health, as demonstrated by generally accepted scientific evidence to competent authorities.
  • Synthetic carbohydrate polymers that have been shown to have a physiological benefit to health, as demonstrated by generally accepted scientific evidence to competent authorities
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3
Q

Which method of defining fibre do we use in UK now?

A

AOAC

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4
Q

What three categories can dietary fibre be split into?

A

High molecular weight, resistant starch, low molecular weight

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5
Q

What is high molecular weight?

A
  • Insoluble: cellulose, lignin, insoluble pectin

- Soluble: hydrocolloids (e.g. gums) , soluble pectin, cereal beta-glucan

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6
Q

What is resistant starch?

A

Physical inaccessible starch, resistant starch granules, chemically modified starch

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7
Q

What is low molecular weight?

A

Inulin, fructose oligosaccharide, polydextrose, resistant maltodextrin

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8
Q

Give the definition and food source of: Cellulose

A

Polysaccharides of glucose

Main component of cell walls of most plants

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9
Q

Give the definition and food source of: Hemi-cellulose

A

Polysaccharides of other sugars

Cereal grains are main source

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10
Q

Give the definition and food source of: Lignin

A

Woody fibre

In outer layers of cell grains

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11
Q

Give the definition and food source of: Gums, mucilages

A

Hydrocolloids

In endosperm of grain, legumes, nuts and seeds

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12
Q

Give the definition and food source of: Pectins

A

Polysaccharides containing galacturonic acid

In cell walls and intracellular tissue of fruits, veg and legumes

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13
Q

Give the definition and food source of: B-glucans

A

Branched structure of glucose polymers

Cell walls in oats and barley

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14
Q

Give the definition and food source of: Resistant starch

A

Starch not digested in small intestine

Legumes, unripe bananas, potatoes (stored)

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15
Q

What are different dietary sources of fibre?

A

o Grains: cellulose, hemicellulose, Arabinoxylans,
o Fruit & veg: cellulose, hemicellulose, pectin
o Legumes: hemicellulose, pectin, resistant starch 1
o Potatoes: resistant starch

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16
Q

What do we need dietary fibre to be?

A

Varied, not all from one type

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17
Q

Where does fibre come from?

A
  • Cereal and cereal products 48%
  • Vegetables 20%
  • Fruits and nuts 13%
  • Potatoes and savoury snacks
    15%
  • Misc 4%
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18
Q

What is the recommendation for fibre?

A

30g/day AOAC

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19
Q

What are examples of fibre content in food?

A

White bread has 2g/100g, wholemeal bread has 7.4g/100g
Small tin of beans: 7g
Bowl of porridge: 3-6g

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20
Q

What is the historical perspective of fibre?

A
  • There was high meat & high vegetable/fruit fibre (>100g/day) in hunter gatherer times
  • There was then a change in fibre source from F&V to cereal – shift from soluble to insoluble.
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21
Q

What is happening with fibre consumption from different food groups now?

A
  • Total vegetable, bread, potato consumption is decreasing

- Total fruit and total cereal excluding bread is increasing

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22
Q

How does fibre interact with the body?

A

Different types of fibre interact with the body in different ways, e.g. in mouth, stomach, colon, small intestine

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23
Q

What effect does fibre have one stool bulk have?

A

Increases it
Decreased transit time
Dilutes carcinogens

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24
Q

What effect does fibre binding with bile acids have?

A

Excretes potential carcinogens

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25
Q

What effect does the fibre have on cholesterol?

A

Reduces it
Reduced absorption
There is fermentation by fecal flora to SCFA

26
Q

What effect does fibre have on glucose absorption?

A

Slows absorption which improves insulin sensitivity
Forms a diffusion barrier due to increased viscosity
Inhibits amylase and absorption of sugars

27
Q

What effect does fibre have on satiety?

A

Increases satiety (soluble types)

28
Q

What effect does fibre have on oestrogen?

A

Affects its metabolism

  • inhibits reabsorption
  • inhibits synthesis
29
Q

What additional effects does fibre have on the body?

A
  • Lower blood pressure
  • Promotes weight loss
  • Anti-inflammatory
30
Q

What might fibre do to gut microbiota composition?

A

Diet, particularly fibre intake, may modify gut microbiota composition, which may affect cancer risk

31
Q

What did Lin et al (2018) find?

A

Fibre intake was associated with gut microbiota composition but not diversity in generally healthy adults. Fibre from specific food sources may yield differential effects on gut microbiota. In our analysis, greater fibre intake, particularly from beans, was associated with greater abundance of beneficial bacteria (e.g. F. prausnitzii, which has demonstrated anti-inflammatory activity).

32
Q

What UK (NHS) advice is there regarding fibre?

A

Does not include anything about fibre, other than the recommendation for 5 a day which is connected

33
Q

What is associated with a higher risk of CVD?

A
  • High blood sugar/type 2 diabetes mellitus
  • High blood pressure
  • High LDL cholesterol
34
Q

What might fibre also be beneficial for?

A

o Breast cancer, most common cancer in women

o Colorectal cancer

35
Q

What is best to worst epidemiological evidence?

A

Meta-analysis, RCT, controlled trials, cohort studies, case control studies, ecological studies, cross sectional surveys, case series and case reports

36
Q

What did Threapleton et al (2013) do?

A

Looked at individual cohort studies that gave the risk reduction of CVD with each additional 7g fibre/day

37
Q

What did all cohort studies find and example?

A

Increased fibre has reduction in CVD risk e.g. Liu 2002 had 10% reduction with with 7g fibre/day

38
Q

What was pooled estimate for the study by Threapleton et al (2013)?

A

0.91 risk ratio so 9% reduction in risk of CVD with each 7g/day increase in fibre

39
Q

What happens with more fibre over 30g?

A

The protective effect continues

40
Q

What else did Threapleton et al (2013) look at?

A

Effects of different types of fibre, e.g. insoluble and soluble

41
Q

What was the problem Threapleton et al (2013) found?

A

Number of studies is very small, all tend to show reducing risk but can’t be sure which type of fibre

42
Q

What do the studies seem to suggest?

A

Insoluble fibre has high protective effect

43
Q

What else can fibre help with?

A

Blood pressure
- Evans et al (2015) found beta glucans seem to help to reduce blood pressure, but no relationship seen for overall fibre intake

44
Q

What other cholesterol benefits are there with beta-glucans?

A

Can reduce LDL cholesterol, confusing as beta-glucans driving the CVD protection

45
Q

What do diets high in WG do?

A

Reduce type 2 diabetes
Dagfinn et al, (2013) found per 3 servings per day there is a reduced risk - 32% reduction of risk found. If we assume a linear result it is 10% reduction per 1 serving

46
Q

What did Threapleton find regarding total fibre and type 2 diabetes?

A

6% reduction in risk per 7g of fibre (stronger with wholegrain)

47
Q

What is the effect of fibre on risk of cancer?

A

Aune et al 2011 found 10% reduction of risk of colorectal per 10g fibre
Aune et al 2012 found 5% reduction of risk of breast per 10g fibre (mainly soluble fibre)

48
Q

What was the old UK fibre recommendation?

A

25g AOAC

49
Q

What is the current UK consumption?

A 
Men 21g AOAC
Women 17g AOAC
13% men meeting
4% women meeting
20% adults don't consume any wholegrain
(NDNS rolling programme years 7-8)
50
Q

What is the recommendation from Germany Nutrition Society?

A

High dietary fibre intake, mainly from whole-grain products, reduces the risk of obesity, type 2 diabetes mellitus, & cardiovascular disease .

51
Q

What is the USA recommendation?

A

High fibre intakes recommended are double the average intake. Wholegrain foods are encouraged.

52
Q

What are EFSA recommendations?

A

Have not updated their recommendations recently (45-60% of energy as carbohydrate, 25g of fibre). Insufficient evidence to set an upper limit on added sugar intake

53
Q

What are Australia and New Zealand recommendations?

A

Recommendations (for adequate intake) are 25g of fibre for women and 30g fibre for men. Dietary recommendation for sugar is to limit intake.

54
Q

What can be said about fibre in Europe?

A

The sources vary country to country
In Netherlands, Germany, Sweden, Denmark, cereals are main source
In France, UK, vegetables are important

55
Q

What can be said about the UK recommendations?

A

It is a hard diet to follow, following 30g fibre and 5% free sugar

56
Q

How to make a wholegrain claim in UK?

A

At least 51% whole grain content in products (Richardson, 2003)
Provides 16g whole grain/reference amount customarily consumed (Seal, 2006)

57
Q

What is the recent definition?

A

8 g whole grains/30 g serving (around 27%) (Ferruzzi et al., 2014)

58
Q

What WG recommendation is there in UK?

A

No official UK recommendations: UK adults are recommended to eat a variety of wholegrain foods whenever possible

59
Q

What is the UK accepted recommendation currently?

A 
3 servings per day    (HEALTHGRAIN EU, 2005-2010)
1 serving: 
1 slice of wholemeal bread
I tbsp. oats
3tbsp. Wholegrain cereal
60
Q

Why are the WG claims important?

A

Because it might be easier message than promoting fibre consumption in general

61
Q

What is one suggestion to increase fibre?

A

Use fibre in labelling in traffic lights
In 2000 FSA issued notice that AOAC method should now be used for labelling
Source of fibre: 3g/100g
High fibre: 6g/100g

62
Q

What is an example of a good that looks bad but high fibre?

A

Flapjacks
Potential benefits of 3g of fibre (B-glucan type):
- 4% reduction in risk of cardiovascular disease
- 2 mmHg reduction in blood pressure
- 0.1 mmol/L reduction in LDL
- 3% reduction in risk of colorectal cancer
- 1.5% reduction in breast cancer for women

CVD (12 decks)

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