Dietary Fibre Consensus from the International Carbohydrate Quality Consortium (ICQC).

Dietary fibre is a generic term describing non-absorbed plant carbohydrates and small amounts of associated non-carbohydrate components. The main contributors of fibre to the diet are the cell walls of plant tissues, which are supramolecular polymer networks containing variable proportions of cellulose, hemicelluloses, pectic substances, and non-carbohydrate components, such as lignin. Other contributors of fibre are the intracellular storage oligosaccharides, such as fructans. A distinction needs to be made between intrinsic sources of dietary fibre and purified forms of fibre, given that the three-dimensional matrix of the plant cell wall confers benefits beyond fibre isolates. Movement through the digestive tract modifies the cell wall structure and may affect the interactions with the colonic microbes (e.g., small intestinally non-absorbed carbohydrates are broken down by bacteria to short-chain fatty acids, absorbed by colonocytes). These aspects, combined with the fibre associated components (e.g., micronutrients, polyphenols, phytosterols, and phytoestrogens), may contribute to the health outcomes seen with the consumption of dietary fibre. Therefore, where possible, processing should minimise the degradation of the plant cell wall structures to preserve some of its benefits. Food labelling should include dietary fibre values and distinguish between intrinsic and added fibre. Labelling may also help achieve the recommended intake of 14 g/1000 kcal/day.

The Effect of Nonoperative Management of Chronic Anal Fissure and Hemorrhoid Disease on Bowel Function Patient-Reported Outcomes.

BACKGROUND: Nonoperative management has been reported to decrease symptoms from common anorectal conditions such as chronic anal fissures and hemorrhoids. The effects of these interventions on bowel function are unknown. OBJECTIVE: This study aims to perform a prospective evaluation of patient-reported outcomes of bowel function on nonoperative management for chronic anal fissures and hemorrhoid disease. DESIGN: This is a prospective, observational study. SETTINGS: Patient-reported outcome measures were collected from the clinical practice of the division of colon and rectal surgery at a tertiary colon and rectal surgery referral center. INTERVENTION: All patients received standardized dietary counseling including fiber supplementation as well as toileting strategies. Those with chronic anal fissures were also prescribed topical calcium channel blockers. The Colorectal Functional Outcome questionnaire was administered at baseline and at first follow-up visit. MAIN OUTCOME MEASURES: The primary outcomes measured were the mean change in patient-reported bowel function scores after nonoperative management for each disease and in aggregate. RESULTS: A cohort of 64 patients was included, 37 patients (58%) with chronic anal fissure and 27 patients with hemorrhoid disease. Incontinence, social impact, stool-related aspects, and the global score were observed to have statistically significant improvement in the aggregate group. When analyzed by diagnosis, hemorrhoid disease demonstrated a statistically significant improvement in incontinence and stool-related aspects, whereas chronic anal fissure was associated with a statistically significant change in social impact, stool-related aspects, and the global score. LIMITATIONS: This study was limited by the small cohort size and unclear patient adherence to medical management. CONCLUSIONS: Nonoperative management of chronic anal fissures and hemorrhoid disease is associated with significant improvement in patient-reported outcome scores in several domains, suggesting that dietary counseling and medical therapy should be the first-line outpatient therapy for these diseases. See Video Abstract at http://links.lww.com/DCR/A726.

Review of fiber methods and applicability to fortified foods and supplements: choosing the correct method and interpreting results.

Fiber is known to be an important part of our nutrition and has many positive health benefits, including weight management and maintaining heart health. In recent years, a number of new ingredients have been manufactured or isolated that are being used to increase the health benefits of a product. Some are used as prebiotics that stimulate the growth of the beneficial bacteria in the gut, or are used as replacements for sugars, starch, or fat in manufactured foods. Fiber supplements have also been produced that can be taken to provide additional fiber to the diet. The term "fiber" does not relate to a single analyte or entity, but instead relates to a multitude of components. This adds to the complexity of analytical testing as there are a number of AOAC International and AACC International official methods which have been validated and can be used. Although methods have been developed for specific fiber ingredients, a number of methods have also been developed to capture just "fiber". These "fiber" methods will capture differing degrees of the different fiber ingredients, so knowledge of the fiber sources is critical. The net result is that a variety of testing approaches may be used, but caution must be exercised in order to ensure that the total fiber result is accurately determined. A critical review of available fiber methodology and possible testing approaches is presented, along with how to accurately interpret and understand results.

Dietary guidelines for chronic disease prevention.

In developed nations, diet is related directly or indirectly to the most prevalent chronic diseases. Research has helped clarify diet-disease relationships and enabled the promulgation of dietary recommendations for chronic disease prevention. We reviewed epidemiologic study results, clinical trial data, and general dietary recommendations from various agencies to develop a set of overall dietary guidelines for the prevention of the most common chronic diseases in the United States, including coronary heart disease, hypertension, cancer, and osteoporosis. Intake of monounsaturated fats, fiber, calcium, vegetables and fruits, and whole grains should be promoted. Consumption of saturated and trans fats, sodium, and refined grains should be minimized. Moderation in alcohol and caloric intake should be encouraged. Although research into associations between diet and disease is constantly in flux, our guidelines are based on replicated findings and provide a starting point for assisting patients in improving their diets.

A diet supplement for captive wild ruminants.

Nutritional husbandry of captive wild ruminants often requires feeding these animals a supplemental diet to enhance their health, reproductive performance, and productivity. Although supplemental diets for wild ruminants are commercially available, few have been evaluated in controlled intake and digestion trials. Voluntary intake, digestive efficiency, nitrogen retention, and gross energy utilization of pronghorn (Antilocapra americana), mule deer (Odocoileus hemionus), mountain sheep (Ovis canadensis), mountain goats (Oreamnos americanus), and wapiti (Cervus elaphus) consuming a high-energy, high-protein pelleted supplement were compared. Voluntary intake of dry matter, energy, and nitrogen were similar (P > 0.34) between mountain goats and mountain sheep and consistently lower (P < 0.03) for these species than for pronghorn, mule deer, and wapiti. Differences in digestive efficiency among species were inversely related to dry matter intake rates. Apparent digestibility of dry matter, organic matter, and neutral-detergent fiber was 10-20% higher for mountain goats and mountain sheep than for the other species (P < 0.04). Although these findings suggest a superior digestive efficiency for mountain goats and mountain sheep, species comparisons are inconclusive because of the confounding effects of season and ambient temperature on voluntary intake and digestion. Under the conditions of this experiment, the diet tested was safe, nutritious, and highly palatable. Protein and energy concentrations appear to be sufficient to meet or exceed known nutritional requirements of captive wild ruminants.

Protein and energy value of pearl millet grain for mature goats.

We conducted two studies to assess the protein and energy value of pearl millet grain (Pennisetum glaucum [L.] R. Br.) for mature goats. In Exp. 1, 15 2-yr-old male castrated goats were gradually introduced over a 4-mo period to three all-grain diets consisting of 100% corn (Zea mays L.), 50:50 corn:pearl millet, and 100% pearl millet. After the adjustment to all-grain feeds, the goats were fed the diets in metabolism crates for 2-d adjustment and 7-d total collection periods. For Exp. 2, complete diets containing the three grain treatments (corn, 50:50 corn:pearl millet, and pearl millet) as 40% of the total DM as fed (the remainder was mainly alfalfa meal and mineral supplement) were balanced to contain 16% crude protein (CP) and 2.24 Mcal digestible energy (DE)/kg on an air-dry basis. Twelve mature (4- to 6-yr-old) buck goats were randomly assigned to diets and fed in pens for 14 d and then moved to metabolism crates for 10-d adjustment and 10-d total collection periods. In Exp. 1, DM intake was unaffected by dietary treatment, but digestibility of DM and organic matter was lowest (P < .10) in goats fed 100% pearl millet. Digestibility of complete diets also decreased (P < .10) as corn was replaced by 50 or 100% pearl millet, but DM intake increased (P < .10) on the 100% millet diet. In both experiments, substituting pearl millet for corn had no effect on nitrogen retained by the goats. Metabolizable energy of pearl millet was only 92% that of corn, but ME intake was similar when the grains were fed as 40% of the dietary DM. Pearl millet has potential as a major energy feed for goats in areas where it can be economically produced.

Interaction of dietary flaxseed with coccidia infections in chickens.

Two experiments were conducted to determine effects of diets containing n-3 fatty acids (n-3FA) from whole as well as ground flaxseed on the performance of broilers during coccidia infections. Diets were fed from 1 d of age through 3 wk of age. Chickens were infected with coccidia at 2 wk of age and the effects of infection assessed at 6 d postinfection. The first experiment contrasted effects of several high n-3FA-containing diets, including one supplemented with whole flaxseed, on infections with Eimeria tenella or Eimeria maxima. Infected chickens that consumed the flaxseed-supplemented diet had the lowest weight gains, but they were not significantly different from gains of infected chickens on the control diet. Diets supplemented with 5% menhaden oil or 15% flaxseed significantly reduced lesions caused by E. tenella, but had no effect on lesions caused by E. maxima. In a second experiment, diets supplemented with 5 or 10% ground flaxseed were assessed for effects on the performance of broilers infected with three dose levels (500, 5,000, or 50,000 oocysts) of E. maxima. Neither flaxseed diet protected weight gain during infection with 50,000 oocysts. However, a 5% flax diet protected weight gains in chickens infected with 500 or 5,000 oocysts. Diets supplemented with 5 or 10% ground flaxseed exacerbated lesions in chickens infected with 5,000 or 50,000 E. maxima oocysts compared to the control diet. Thus, diets containing high amounts of n-3 fatty acids do not affect the development of all Eimeria sp. in the same manner. The oxidative stress produced by these diets may more adversely affect development of E. tenella, which infects the relatively oxygen-poor ceca, whereas it does not affect development of E. maxima which parasitizes the middle portion of the small intestine.

Replacement of alfalfa neutral detergent fiber with a combination of nonforage fiber sources.

Sixteen Holstein cows in midlactation were used in a 4 x 4 Latin square design to determine the effect of replacing alfalfa neutral detergent fiber (NDF), with NDF from a combination of whole linted cottonseed, dried distillers grains, and wheat middlings. The four diets were a basal control diet that was low in forage and fiber [(5.9 g of corn silage NDF and 6.1 g of alfalfa NDF/100 g of dry matter (DM)], a normal forage diet (low forage plus 10 g of additional alfalfa NDF/100 g of DM), and two low forage diets with either 5 or 10 g of NDF from the nonforage fiber sources added per 100 g of DM. Milk yield, milk protein yield, and milk protein percentage were higher, and milk fat percentage and fat yield were lower, for cows fed the low forage diets than for those fed the alfalfa control diet that was higher in fiber. Among the low forage diets, dry matter intake, milk fat percentage, and fat yield all increased linearly as NDF content increased. The ratio of acetate to propionate in the rumen and rumination times were greater for the normal forage control diet than for the high nonforage fiber diet. Added NDF from these nonforage fiber sources increased milk fat percentage and yield, but this increase was less than the NDF from alfalfa and less than predicted. In agreement with results of similar previous trials, milk protein yield and percentage were increased when alfalfa NDF was replaced with fiber from nonforage fiber sources.

Whole-grain consumption and chronic disease: protective mechanisms.

Dietary guidance recommends consumption of whole grains to reduce the risk of chronic diseases including cancer and cardiovascular disease. Epidemiologic studies support the belief that whole grains are protective against cancers, especially gastrointestinal cancers such as gastric and colonic, and cardiovascular disease. Components in whole grains that may be protective are diverse and include compounds that affect the gut environment, i.e., dietary fiber, resistant starch, and other undigestible compounds in whole grains, compounds that function as antioxidants such as trace minerals and phenolic compounds, and compounds that are phytoestrogens with potential hormonal effects. Many of the protective compounds in whole grains are also in fruits and vegetables, but some plant compounds are more concentrated in whole grains, such as phenolic compounds including ferulic and caffeic acid. Other potential mechanistic effects of whole grains include binding of carcinogens and modulation of glycemic index. Clearly, the range of protective substances in whole grains is impressive, and advice to consume additional whole grains is justifiable.

The combined influence of dietary flaxseed variety, level, form, and storage conditions on egg production and composition among vitamin E-supplemented hens.

Trial 1 tested the effects of ground vs whole flaxseed at dietary levels of 5, 10, or 15% compared to a corn-soybean or fish oil control on egg production of Leghorn hens over a period of 8 wk. Dietary flaxseed decreased feed consumption, weight gain, and egg weights compared to the control diets; however, flaxseed and fish oil significantly improved egg production (88.9 and 93.0%, respectively) compared to the control (83.1%). Incorporation of linolenic acid (C18:3n-3) into the egg increased linearly as the level of dietary flaxseed increased (2.31, 4.18, or 6.83% of the yolk fatty acids for 5, 10, and 15% flaxseed diets, respectively). In Trial 1, flaxseed and fish oil significantly increased percentage white and decreased percentage yolk compared to the control treatment but had no effects on egg cholesterol. Trial 2 was a factorial design of varieties of flaxseed (brown vs golden), types (ground vs whole), levels of dietary vitamin E (27 vs 50 IU/kg), and feed storage temperatures (4 vs 21 C) fed to hens for 6 wk. Brown flaxseed significantly increased egg weight and egg production compared to the golden variety. There was no difference in whole vs ground flaxseed for measured production variables. Vitamin E (50 IU) significantly improved egg production (96.1 vs 94.3%) compared to 27 IU. Storage temperature of flaxseed did not significantly affect any production variables. In conclusion, dietary flaxseed can be safely added whole to layer diets up to 15% without any detrimental effects on hen-day egg production. Levels of 10 to 15% flaxseed yield eggs with 4 to 7% yolk n-3 fatty acids, respectively, making these eggs rich sources of n-3 fatty acids.

Nutrient composition and biological evaluation of mesta (Hibiscus sabdariffa) seeds.

Two varieties of mesta (Hibiscus sabdariffa) seeds were analysed for their proximal composition. Their protein (18.8-22.3%), fat (19.1-22.8%) and dietary fiber (39.5-42.6%) content were found to be high. The seeds were found to be a good source of minerals like phosphorus, magnesium and calcium. Their lysine and tryptophan contents were also high. Sulphur containing amino acids were limiting in this seed protein and the chemical score of mesta seed protein was 40 and 57 for AMV-2 and Bhimili-1 varieties respectively. Mesta seed oil is rich in unsaturate fatty acids (70%), of which linoleic acid constituted 44%. Weanling rats were fed with 10% mesta seed protein before and after cooking for 4 weeks. Food intake of animals receiving raw mesta seed diets was significantly lower than those receiving cooked mesta seed diets as well as the casein control diet. Protein and dry matter digestibilities of raw and cooked mesta seed diets were lower than that of casein control diet. Cooking improved the food intake, gain in body weight, dry matte and protein digestibility of mesta seed diets. PER and NPU of cooked mesta seed diets were significantly higher than the corresponding raw diets. These results indicate that cooked mesta seed protein is of relatively good quality.

Effect of green lentils on colonic function, nitrogen balance, and serum lipids in healthy human subjects.

Green lentils are an increasingly popular food, but their effects on human colonic function and serum lipids have been studied little. Nine healthy males aged 19-38 y consumed for 3-wk periods a controlled Western diet and the same diet supplemented with 130 g dry lentils/d [which contained 11.8 g non-starch polysaccharide (NSP)] incorporated into loaves, cakes, and soups. Protein was equilibrated with soy protein isolate and carbohydrate with soft drinks. Radioopaque markers were used to calculate mean transit time (MTT) and to correct fecal weight for infrequency of bowel movements. Feces were collected throughout the study and blood was taken on 2 d at the end of each period. Lentils increased fecal weight from 131 +/- 12 g/d (means +/- SEM) to 189 +/- 17.4 g/d (44.9%) (P < 0.005). MTT was unchanged: 46 +/- 6 h for the control diet and 43 +/- 4 h for the lentils (NS). Fecal nitrogen was increased to 2.49 +/- 0.08 g/d for lentils compared with 1.74 +/- 0.09 g/d for the control diet (P < 0.001) and urine nitrogen decreased to 15.31 +/- 0.52 g/d with the lentils compared with 15.90 +/- 0.51 g/d for the control diet (P < 0.05); nitrogen balance was unaffected. Serum lipids were unchanged by addition of lentils to the diet. Green lentils were effective in increasing fecal weight and can therefore make a valuable contribution to a healthy diet.

Zinc intake and plasma zinc level are maintained in men consuming cholesterol-lowering diets.

OBJECTIVE: Reduced zinc intake has been reported when cholesterol-lowering diets are adopted. This study examined whether such diets compromise the zinc status of men with hypercholesterolemia. DESIGN: Zinc intake on baseline 4-day food records and baseline plasma zinc levels were compared with intake and levels 12 and 24 months after subjects adopted a low-fat, increased-fiber diet. Dietary fiber intake, supplement use, alcohol intake, and exercise were evaluated as possible confounding variables. SUBJECTS: Subjects were free-living men (n = 365) with baseline cholesterol level above the 75th percentile who were participants in a randomized trial comparing cholesterol-lowering diets with goals of 30%, 26%, 22%, and 18% of energy from fat and 300, 200, 100, and 100 mg cholesterol, respectively. STATISTICAL ANALYSES: Data were analyzed using two sample t tests, multiple linear regression, and analysis of variance. RESULTS: For all subjects combined, mean fat and cholesterol intakes approached or met the guidelines of the National Cholesterol Education Program step 2 diet, with approximately 30 g fiber per day. Density (mg/1,000 kcal) of zinc intake was unchanged from the baseline value. We found a slightly positive relationship between fiber and zinc intakes; no relationship between fiber intake and plasma zinc level; no effect of supplement use (category included all types of supplements), alcohol use, or level of exercise on plasma zinc levels; and no difference by dietary assignment in zinc intake or plasma zinc levels. APPLICATION: Zinc status does not appear to be at risk in adult men who adopt cholesterol-lowering diets. These results may not be generalized to higher-risk population groups or situations in which dietary counseling is less comprehensive.

Polyunsaturated fatty acids result in greater cholesterol lowering and less triacylglycerol elevation than do monounsaturated fatty acids in a dose-response comparison in a multiracial study group.

Cholesterol-lowering effects of polyunsaturated and monounsaturated fatty acids were compared as they were varied in a reciprocal dose-dependent fashion in the context of a National Cholesterol Education Program (NCEP) Step 1 diet. The study population comprised 63 moderately hypercholesterolemic African American and white men and women. After a 6-wk baseline diet containing 37% of energy from total fat and 15% from saturated fat, participants consumed four diets for 6 wk each, in random order, containing 10% of energy as saturated fatty acids; 3%, 6%, 10%, and 14% of energy as polyunsaturated fatty acids; and 17%, 14%, 10%, and 6% of energy as monounsaturated fatty acids. Dietary cholesterol, fiber, plant sterol, and squalene contents were constant with all four diets. There was a progressive decrease in total (P = 0.028) and low-density-lipoprotein cholesterol (P = 0.184) across the four diets, with the greatest decrease observed in the diet with the highest content of polyunsaturated fatty acids; a small but significant decrease in high-density-lipoprotein (HDL) cholesterol that did not show a trend between the polyunsaturated and monounsaturated diets; and a trend between the four diets in triacylglycerol elevations (P = 0.029), with the smallest increment occurring in the diets highest in polyunsaturates. The magnitude of the cholesterol-lowering response was greater in those with higher baseline cholesterol and less in those who were more obese. The dietary response was similar in both ethnic groups and in both sexes. In conclusion, in an NCEP Step 1 diet containing 30% total fat, with all other known cholesterol-influencing dietary factors held constant, the substitution of polyunsaturated fatty acid for monounsaturated fatty acid from 3% to 14% resulted in a progressive decline in total cholesterol and less triacylglycerol elevations, without effect on HDL cholesterol.

Dietary fiber for cats: in vitro fermentation of selected fiber sources by cat fecal inoculum and in vivo utilization of diets containing selected fiber sources and their blends.

Two experiments were conducted to evaluate the addition of single sources and blends of dietary fibers to cat diets. In Exp. 1, fermentability of selected fibrous substrates by cat fecal microflora was evaluated. After 24 h of fermentation, OM disappearance (OMD) and total short-chain fatty acid (SCFA) production were greatest (P < .05) for citrus pectin, guar gum, and locust bean gum, whereas Solka Floc resulted in the least (P < .05) OMD and total SCFA production. In Exp. 2, six diets were formulated based on results of Exp. 1. The highest (P < .05) digestibilities of DM and OM occurred when cats consumed the diet with no supplemental fiber, and the lowest (P < .05) digestibilities occurred when cats consumed the SCFA blend (SC) diet. Nitrogen and lipid digestibilities also were lowest (P < .05) for cats consuming the SC diet, whereas total dietary fiber (TDF) digestibility (P < .05) was greatest for cats consuming the beet pulp, SC, and combination blend diets. Fecal consistency scores were highest (P < .05) for cats consuming the SC diet, indicating liquid, unformed stools. In conclusion, the in vitro fermentation technique was reasonably accurate in predicting in vivo digestion of fiber. The SC diet, which contained the most fermentable fibers, severely decreased nutrient digestibility and resulted in poor stool characteristics. Diets that contain moderately fermentable fiber provide fermentation end products that may be important in maintaining the health of the gastrointestinal tract of the cat.

Intake and digestion of low-, medium-, and high-quality grass hays by lambs receiving increasing levels of corn supplementation.

Thirty wether lambs (52.5 +/- 1.5 kg) were used in a replicated 3 x 5 factorial treatment arrangement and four periods to determine dietary intake and digestibility of three ground forages with increasing levels of supplemental ground corn. Forages were a mature, low-protein grass hay (LQH; 5.2% CP), an immature, medium-protein grass hay (MQH; 10.2% CP), and an immature, high-protein grass hay (HQH; 14.2% CP). Supplementation treatments were no supplement (NS), a protein supplement (PS), protein plus .25% BW of corn (LC), protein plus .5% BW of corn (MC), and protein plus .75% BW of corn (HC). Crude protein intake (1.4 g/kg BW) from supplements was equalized with soybean meal and corn gluten meal. Lambs were housed in metabolism crates. Supplements were fed at 0700 each morning after orts from the previous day's feeding were removed. Hay was subsequently offered at approximately the previous day's consumption plus 25%. Each of the four periods lasted 21 d. Sixteen days were allowed for diet adaptation. Feces were collected with fecal bags during d 17 to 21. Lambs receiving LQH and PS had higher forage (P < .04) and total DMI (P < .001) than lambs fed LQH and NS. Corn supplementation decreased forage intake (quadratic effect; P = .08), total intake (quadratic effect; P = .08), and increased apparent DM digestibility (linear effect; P < .04) with lambs receiving LQH. Protein supplementation did not affect forage or total DMI (P > .11), and corn supplementation did not affect total DMI (P > .20) with either MQH or HQH.(ABSTRACT TRUNCATED AT 250 WORDS)

Soluble fiber enhances the hypocholesterolemic effect of the step I diet in childhood.

BACKGROUND: Psyllium, a water-soluble fiber, has been shown to have a cholesterol-lowering effect in studies of adults. A small number of studies in children have produced variable results. METHODS: A 12-week, randomized, single-blind, placebo-controlled, parallel clinical trial was conducted to test the effectiveness of psyllium in lowering total (TC) and low-density lipoprotein cholesterol (LDL-C) in 50 healthy 2 to 11 year old children. Children with two baseline LDL-C levels > or = 110 mg/dL were invited to participate in the trial, and were randomly assigned to follow a usual Step I (Control) diet of low dietary fat, saturated fat and cholesterol, or a Step I diet enriched with psyllium. Children consumed two 1-oz boxes of cereal per day, with each box of psyllium-enriched cereal containing 3.2 g of soluble fiber, and each box of placebo cereal containing less than 0.5 g of soluble fiber. RESULTS: Greater reduction of total and LDL-cholesterol, and increase in HDL-cholesterol were noted after 12 weeks of the psyllium-enriched Step I diet compared to the Step I control diet. Total cholesterol decreased 21 mg/dL for the high fiber group compared with 11.5 mg/dL for the control group. LDL-C decreased 23 mg/dL for the high fiber group compared with 8.5 mg/dL for the control group. HDL-C increased 4 mg/dL for the high fiber group compared with 1 mg/dL for the controls. TC/HDL and LDL/HDL ratios decreased significantly more so for the high fiber group as well. CONCLUSIONS: In this 12-week study, soluble fiber (psyllium) provided added benefit to the Step I diet in the treatment of hypercholesterolemia.