RESUMEN
Background: Fiber is an integral part of a healthy diet. Studies have shown that the fiber intake in children is below adequate amounts, leading to adverse health outcomes. Objectives: This study aimed to perform a scoping review to assess the available evidence for the impact of isolated and synthetic dietary fiber on children's health outcomes. Methods: A systematic literature search was conducted in Ovid Medline, Ovid Global Health, Embase, and Cochrane Library via Wiley to identify randomized controlled trials (RCTs) in healthy children aged 1-18 y at baseline who consumed added, isolated, or synthetic dietary fiber. The outcomes of interest were categorized based on the Food and Drug Administration's guidance for industry on nondigestible carbohydrates and the Vahouny Fiber Symposium criteria, which included reduced fasting blood, glucose, total and/or LDL cholesterol concentrations, attenuation of postprandial glycemia/insulinemia, increased fecal bulk/laxation, reduced transit time, weight loss/reduction in adiposity, reduced energy intake from food consumption, increased satiety, bone health/enhanced mineral absorption, and blood pressure. We also cataloged additional reported outcomes. Results: Of 3837 randomized controlled parallel or crossover trials screened at the abstract level, 160 were eligible for full-text review, and 32 included for data extraction. This scoping review presents analysis of data from 32 RCTs in children who were healthy, overweight/obese or had mild hypercholesterolemia. Inulin-type fructans (41%) and psyllium (22%) were the most frequently administered fiber types, with weight/adiposity, markers of lipid metabolism (41%), and bone-related markers (38%) being the most frequently reported health outcomes. Only a few RCTs have investigated the effects of laxation (9%), and none specifically studied the impact of fiber on reducing postprandial glycemia/insulinemia. Conclusions: This scoping review demonstrates sufficient evidence for conducting systematic reviews and meta-analyses for several outcomes. Evidence gaps remain on the impact of isolated fibers on outcomes such as laxation, colonic transit time, and postprandial glycemia/insulinemia in children.
RESUMEN
OBJECTIVE: To identify barriers that prevent healthy eating practices in Puerto Rican early adolescents (EAs). DESIGN: Qualitative data collected via focus groups. A total of 7 focus groups were conducted: 5 with EAs and 2 with parents and caregivers (PCs). SETTING: Urban and rural Puerto Rico. PARTICIPANTS: Early adolescents aged 12-14years (nâ¯=â¯52) and PCs (nâ¯=â¯17). PHENOMENON OF INTEREST: Factors that prevent healthy eating behavior in EAs in Puerto Rico. ANALYSIS: Verbatim transcripts from focus group interviews were coded for concept frequency, extension, and content analysis. RESULTS: The 3 main factors that influenced participants' eating habits, according to EAs' and PCs' answers, were stores that sold less healthful foods on or near school and the community, parental influence in the development of unhealthy eating habits, and the low cost of unhealthy foods. CONCLUSIONS AND IMPLICATIONS: When EAs chose what to eat, primary food choices were based on taste preferences, physical access, economic cost, and influence of PCs, whereas health effects had little consideration. Nutrition education programs have to meet taste preferences and provide eating options that are affordable, accessible, and easy to prepare to achieve healthy food practices among EAs.