Whole wheat and triticale flours with differing viscosities stimulate cecal fermentations and lower plasma and hepatic lipids in rats.

Whole flours from oat, rye or barley effectively modify digestive fermentation and lipid metabolism, whereas the effectiveness of whole wheat flour has not been established. To address this question, cecal digestion, short-chain fatty acid (SCFA) metabolism and cholesterol metabolism were investigated in four groups of rats fed the following semipurified diets differing in their carbohydrate source: a control diet (purified wheat starch) and three whole cereal flour diets [Valoris wheat (Wv), Soissons wheat (Ws), or Carnac triticale (Tc)]. Wv is particularly viscous and rich in arabinoxylans, and Tc is richer in hemicellulose than wheat. Compared with controls, rats fed the whole-flour diets had enlarged ceca and a moderate acidification of the bulk pH ( approximately 6.4). In these rats, the cecal SCFA pool size was enhanced (P < 0.05), and the SCFA molar ratio reflected propionic/butyric acid-rich fermentations, especially in those fed TC: The portal SCFA concentrations reflected the rise of the acetic and propionic acid pools in the cecum, whereas portal butyric acid remained relatively low, probably reflecting extensive metabolism by the cecal wall. The fecal excretion of total steroids (bile acids + sterols) was markedly enhanced by all of the whole-flour diets, with Wv (+78%) > Tc (+64%) > Ws (+47%). In parallel, there was a significant plasma cholesterol-lowering effect for rats fed Wv (-27%) and Tc (-32%) and a plasma triglyceride-lowering effect (approximately -40%) in all rats fed whole-flour diets (P < 0.05). This effect was observed mainly for triglyceride-rich lipoprotein-cholesterol, whereas HDL cholesterol was unaffected. These results indicate that whole wheat flours can strikingly affect cecal SCFA, especially butyrate, and are effective plasma cholesterol-lowering agents.

Inverse association between intake of cereal fiber and risk of gastric cardia cancer.

BACKGROUND & AIMS: Recent data show that salivary nitrites form carcinogenic nitrosamines, especially at the gastric cardia. Wheat fiber has been shown to neutralize such mutagen formation. Our aim was to evaluate the association between dietary fiber and cancers of the esophageal and gastric cardia. METHODS: We examined data from a large-scale population-based case-control study of risk factors for adenocarcinoma of the gastric cardia and esophagus and squamous cell carcinoma of the esophagus. RESULTS: We found a strong dose-dependent inverse association between total dietary fiber intake and risk of gastric cardia adenocarcinoma, which was driven mainly by intake of cereal fiber. The odds ratio among individuals in the highest quartile of cereal fiber intake compared with the lowest was 0.3 (95% confidence interval, 0.2-0.5; P trend < 0.0001). High intake of cereal fiber was also associated with a moderately decreased risk of esophageal adenocarcinoma, but no linear dose-risk trend was observed. There was no association between dietary fiber and esophageal squamous cell carcinoma. CONCLUSIONS: High intake of cereal fiber may significantly lower the risk of gastric cardia cancer.

Grain processing and nutrition.

Whole grains provide a wide range of nutrients and phytochemicals that optimize health. Epidemiologic studies support the protectiveness of whole grain consumption for cardiovascular disease and cancer. Dietary guidance endorses increased whole grains in our diet. A crucial question remaining is the effect of processing of whole grains on their content of nutrients and phytochemicals. Although processing is often considered to be a negative attribute in nutrition, and some forms of processing reduce nutritional value, many factors support the importance of processing of grains to enhance grain consumption. First, whole grains as harvested are generally not consumed directly by humans but require some processing prior to consumption. While refining, that is, removal of the bran and the germ, reduces the nutrient content of grain, milling of grains otherwise concentrates desirable grain components and removes poorly digested compounds and contaminants. Cooking of grains generally increases digestibility of nutrients and phytochemicals. Studies in both animal models and humans support the notion that processed grains are often nutritionally superior to unprocessed grains, probably because of enhanced nutrient bioavailability in processed grains. Processing of grains also provides shelf-stable products that are convenient and good tasting for consumers.

Plausible mechanisms for the protectiveness of whole grains.

Dietary guidelines recommend the consumption of whole grains to prevent chronic diseases. Epidemiologic studies support the theory that whole grains are protective against cancer, especially gastrointestinal cancers such as gastric and colon can-cer, and cardiovascular disease. Components in whole grains that may be protective include compounds that affect the gut environment, such as dietary fiber, resistant starch, and oligosaccharides. Whole grains are also rich in compounds that function as antioxidants, such as trace minerals and phenolic compounds, and phytoestrogens, with potential hormonal effects. Other potential mechanisms whereby whole grains may protect against disease include binding of carcinogens and modulation of the glycemic response. Clearly, the range of protective substances in whole grains is impressive and advice to consume additional whole grains is justified. Further study is needed regarding the mechanisms behind this protection so that the most potent protective components of whole grains will be maintained when developing whole grains into acceptable food products for the public.

Cereals, legumes, and chronic disease risk reduction: evidence from epidemiologic studies.

There is growing evidence that cereals and legumes play important roles in the prevention of chronic diseases. Early epidemiologic studies of these associations focused on intake of dietary fiber rather than intake of grains or legumes. Generally, these studies indicated an inverse association between dietary fiber intake and risk of coronary artery disease; this observation has been replicated in recent cohort studies. Studies that focused on grain or cereal intake are fewer in number; these tend to support an inverse association between intake of whole grains and coronary artery disease. Studies on the association of dietary fiber with colon and other cancers have generally shown inverse relations, but whether these relations are attributable to cereals, other fiber sources, or other factors is less clear. Although legumes have been shown to lower blood cholesterol concentrations, epidemiologic studies are few and inconclusive regarding the association of legumes with risk of coronary artery disease. It has been hypothesized that legumes, in particular soybeans, reduce the risk of some cancers, but epidemiologic studies are equivocal in this regard. Overall, there is substantial epidemiologic evidence that dietary fiber and whole grains are associated with decreased risk of coronary artery disease and some cancers, whereas the role of legumes in these diseases appears promising but as yet inconclusive.

Reflujo gastroesofágico: un intento de clarificar conceptos / Gastroesophageal reflux: an attempt to clarify concepts

EL reflujo gastroesofágico (RGE) es uno de los temas de gastroenterología pediátrica que tal vez suscite mayor controversia.pese a las numerosas publicaciones aparecidas en los últimos años, persiste aún bastante confusión respecto a sus aspecto conceptuales y prácticos, lo que se traduce con frecuencia en un manejo inadecuado de los pacientes que lo presentan. La mayor confusión conceptual deriva de la dificultad de discriminar entre lo que constituye un reflujo fisiológico de uno patológico. La existencia de numerosas técnicas de estudios que se han desarrollado en los últimos años indica que ninguna de ellas es completamente satisfactoria; por otra parte la utilización de dicha técnicas no siempre es más adecuada. En el presente artículo se hace una discusión crítica del tema en relación a los aspectos conceptuales, patogénicos, diagnósticos y terapéuticos, en base a las publicaciones más recientes aparecidas en la literatura médica

[The use of dietary fiber as natural enterosorbents in diseases of the hepatobiliary system]. / Zastosuvannia kharchovykh volokon iak pryrodnykh enterosorbentiv pry zakhvoriuvanniakh hepatobiliarnoï systemy.

Intensity was studied of sorption of cholesterol, bile acids, and phospholipids by cereals food fibre in samples of vesicular and hepatic bile. Intensive absorption has been shown of these fractions by food fibres. Clinical observation over 92 patients with chronic noncalculous cholecystitis confirmed the beneficial effect of cereals food fibre.

A 3-hour quantitative comparison of glucose-based versus rice-based oral rehydration solution intake by children with diarrhoea in Port Moresby General Hospital.

Measurements were made of the intake of a WHO/UNICEF glucose-based and a rice cereal-based oral rehydration solution (ORS) by children with diarrhoea. Twenty children who presented to the Children's Outpatient Department at Port Moresby General Hospital with acute diarrhoea and mild dehydration were randomly assigned to an ORS and measurements were taken over the following 3 hours. For data analysis, the patients were paired by weight. Testing the means of the paired samples by t test showed that there was no significant difference between the amount of rice ORS and the amount of glucose ORS taken over 3 hours.

PIP: The discovery of oral rehydration solution (ORS) for the treatment of diarrheal disease has been heralded as the most important medical discovery of the century. Cereal-based ORS is able to decrease stool output and the duration of diarrheal illness more than the standard glucose-based ORS, through the increased absorption provided by oligosaccharides without the imposition of a greater osmotic penalty. Moreover, the peptides in cereals enhance amino acid and water absorption, while providing nutritional benefits. UNICEF's glucose-based ORS is becoming more widely used in Papua New Guinea (PNG). 20 children aged 6-37 months (mean age, 15 months) who presented to the Children's Outpatient Department at Port Moresby General Hospital during September-October 1993 with acute diarrhea and mild dehydration were randomly assigned to receive either a rice-based ORS or standard glucose ORS, and measurements were taken over the following 3 hours. The patients were paired by weight for analysis. No statistically significant difference was found between the amount of rice ORS and the amount of glucose ORS taken over 3 hours.