Prevalence of metabolic syndrome and diabetes mellitus type-2 and their association with intake of dairy and legume in Andean communities of Ecuador.

Metabolic syndrome (MetS) and type 2 diabetes (T2D) are metabolic alterations associated with high morbidity and mortality, particularly in low and middle-income countries. Diet has a significant impact on the risk to develop MetS and T2D; in this regard, consumption of fruits, vegetables, and protein rich foods (from plant and animals) are important to prevent and manage these pathologies. There are limited studies regarding the potential association between Andean foods rich in proteins and the presence of cardio-metabolic conditions in Ecuador. It is necessary to develop new low-cost, local-culturally acceptable strategies to reduce the burden of cardio-metabolic diseases. We describe the prevalence (baseline data) of MetS and T2D in the Ecuadorian cohort of the Prospective Urban and Rural Epidemiology (PURE) study and their potential association with the consumption of protein rich foods, including beef, white meat, dairy and legumes. In this cross-sectional study, we assessed 1,997 individuals aged 35-70 years (mean age 51 years, 72% women), included in the Ecuadorian cohort of the PURE study, from February to December 2018. The prevalence of MetS was 42% for male and 44% for female participants; the prevalence of T2D was 9% for male and 10% for female. Metabolic syndrome and T2D were more common in women older than 50 years of age with primary education or less, low economic income, and with obesity; MetS was more frequent in the rural area while T2D was more frequent in the urban area. Using logistic regression analysis, we observed a significant protective effect of higher consumption of dairy and legumes in the prevalence of MetS and T2D compared with low consumption. It will be important to develop policies for ample production and consumption of protein rich foods such as legumes and dairy, part of traditional diets, to reduce the burden of cardio-metabolic diseases.

Development of a Repertoire and a Food Frequency Questionnaire for Estimating Dietary Fiber Intake Considering Prebiotics: Input from the FiberTAG Project.

Most official food composition tables and food questionnaires do not provide enough data to assess fermentable dietary fibers (DF) that can exert a health effect through their interaction with the gut microbiota. The aim of this study was to develop a database and a food frequency questionnaire (FFQ) allowing detailed DF intake estimation including prebiotic (oligo)saccharides. A repertoire of DF detailing total, soluble DF, insoluble DF and prebiotic (oligo)saccharides (inulin-type fructans, fructo-oligosaccharides and galacto-oligosaccharides) in food products consumed in Europe has been established. A 12 month FFQ was developed and submitted to 15 healthy volunteers from the FiberTAG study. Our data report a total DF intake of 38 g/day in the tested population. Fructan and fructo-oligosaccharides intake, linked notably to condiments (garlic and onions) ingestion, reached 5 and 2 g/day, respectively, galacto-oligosaccharides intake level being lower (1 g/day). We conclude that the FiberTAG repertoire and FFQ are major tools for the evaluation of the total amount of DF including prebiotics. Their use can be helpful in intervention or observational studies devoted to analyze microbiota-nutrient interactions in different pathological contexts, as well as to revisit DF intake recommendations as part of healthy lifestyles considering specific DF.

PATTERNS OF FIBER INTAKE AMONG BRAZILIAN ADULTS: PERCEPTIONS FROM AN ONLINE NATIONWIDE SURVEY.

BACKGROUND: Adequate fiber intake is associated with digestive health and reduced risk of several noncommunicable diseases and is recognized as essential for human health (World Health Organization, 2003). The World Health Organization (WHO) recommends a daily fiber consumption of ≥25 g, but previous studies observed a fiber intake in Brazil lower than recommended. OBJECTIVE: We aimed to describe fiber intake among adults in Brazil and also respondents' knowledge and perceptions about their fiber intake. METHODS: National online survey with community-dwelling Brazilian individuals. The survey was conducted during September 2018, using an online platform with closed-ended questions. A representative sample of Brazilian internet users stratified by sex, age, socioeconomic status and geographic region was adopted. Sample size was calculated using a 2% error margin and 95% confidence interval (n=2,000). Data was descriptively analyzed using measures of frequency, central tendency and dispersion. RESULTS: Sample included 2,000 individuals who were well-balanced in terms of sex (51.2% female), with mean age of 35.9 years (most represented age group was 35-54 years, 39.6%) and from all country geographic regions (49.4% from Southeast). A total of 69.7% of them consider their usual diet as healthy and 78.4% reported consuming fibers regularly. Fibers from natural sources are consumed at least once a day by 69.5% of the sample, while daily fiber supplements were reported by 29.9%. Absence of regular fiber intake was reported by 21.7% of respondents and the most common reason was "lack of knowledge about fiber sources" (39.3%). When informed about the food sources of each type of fiber (soluble and insoluble) and asked about the regular intake, only 2.5% answered that they do not consume any of them regularly (as opposed to 21.7% before receiving information about specific fiber sources). CONCLUSION: Our findings indicate that fiber intake in Brazil is probably insufficient with a high proportion of individuals reporting irregular or absent ingestion of fiber sources in their daily lives. Lack of knowledge about fiber sources and fiber types seems to play a role in this inadequate intake, highlighting the need for nutritional education to achieve healthy dietary patterns in the country.

O padrão de consumo de fibras entre adultos brasileiros: percepções de um inquérito nacional online / Patterns of fiber intake among brazilian adults: perceptions from an online nationwide survey

ABSTRACT BACKGROUND: Adequate fiber intake is associated with digestive health and reduced risk of several noncommunicable diseases and is recognized as essential for human health (World Health Organization, 2003). The World Health Organization (WHO) recommends a daily fiber consumption of ≥25 g, but previous studies observed a fiber intake in Brazil lower than recommended. OBJECTIVE: We aimed to describe fiber intake among adults in Brazil and also respondents' knowledge and perceptions about their fiber intake. METHODS: National online survey with community-dwelling Brazilian individuals. The survey was conducted during September 2018, using an online platform with closed-ended questions. A representative sample of Brazilian internet users stratified by sex, age, socioeconomic status and geographic region was adopted. Sample size was calculated using a 2% error margin and 95% confidence interval (n=2,000). Data was descriptively analyzed using measures of frequency, central tendency and dispersion. RESULTS: Sample included 2,000 individuals who were well-balanced in terms of sex (51.2% female), with mean age of 35.9 years (most represented age group was 35-54 years, 39.6%) and from all country geographic regions (49.4% from Southeast). A total of 69.7% of them consider their usual diet as healthy and 78.4% reported consuming fibers regularly. Fibers from natural sources are consumed at least once a day by 69.5% of the sample, while daily fiber supplements were reported by 29.9%. Absence of regular fiber intake was reported by 21.7% of respondents and the most common reason was "lack of knowledge about fiber sources" (39.3%). When informed about the food sources of each type of fiber (soluble and insoluble) and asked about the regular intake, only 2.5% answered that they do not consume any of them regularly (as opposed to 21.7% before receiving information about specific fiber sources). CONCLUSION: Our findings indicate that fiber intake in Brazil is probably insufficient with a high proportion of individuals reporting irregular or absent ingestion of fiber sources in their daily lives. Lack of knowledge about fiber sources and fiber types seems to play a role in this inadequate intake, highlighting the need for nutritional education to achieve healthy dietary patterns in the country.

RESUMO CONTEXTO: A adequada ingestão de fibras está diretamente associada à saúde digestiva e é reconhecida como essencial à saúde humana (World Health Organization, 2003). A Organização Mundial da Saúde (OMS) recomenda consumo diário de fibras de ≥25 g, mas estudos prévios observaram uma ingesta de fibras no Brasil abaixo do recomendado. OBJETIVO: Descrever a ingestão, o conhecimento e as percepções sobre o consumo de fibras entre adultos brasileiros. MÉTODOS: Inquérito nacional online com indivíduos brasileiros na comunidade. O inquérito foi conduzido em setembro de 2018, usando uma plataforma online com questões fechadas. Uma amostra representativa dos usuários de internet no Brasil estratificada por sexo, idade, status socioeconômico e região geográfica foi utilizada. O tamanho da amostra foi calculado usando uma margem de erro de 2,0% em um intervalo de confiança de 95% (n=2.000). Os dados foram analisados descritivamente usando medidas de frequência, tendência central e dispersão. RESULTADOS: A amostra incluiu 2.000 indivíduos equilibrados em termos de sexo (51,2% mulheres), com idade média de 35,9 anos (faixa etária mais representada foi 35-54 anos, 39,6%) e de todas as regiões geográficas do país (49,4% do Sudeste). Dos respondentes, 69,7% consideram sua dieta usual como saudável e 78,4% relataram consumir fibras regularmente. Fibras de fontes naturais são consumidas pelo menos uma vez ao dia por 69,5% da amostra, enquanto que suplementos de fibras, por 29,9%. O não consumo regular de fibras foi relatado por 21,7% dos respondentes e a causa mais comum para tal foi "falta de conhecimento sobre fontes de fibras" (39,3%). Quando informados sobre fontes de fibra de cada tipo (solúvel e insolúvel) e interrogados sobre a ingestão regular, apenas 2,5% responderam não consumir nenhuma delas regularmente (por oposição a 21,7% antes de receberem informação sobre fontes específicas de fibras). CONCLUSÃO: Nossos achados indicam que a ingestão de fibras no Brasil é provavelmente insuficiente com uma alta proporção de indivíduos relatando consumo ausente ou irregular de fontes de fibras no cotidiano. Falta de conhecimento sobre fontes e tipos de fibras parece desempenhar um papel relevante nesta ingestão inadequada, reforçando a necessidade de educação nutricional para alcançar padrões alimentares saudáveis no país.

Intake of Dietary Fiber, Fruits, and Vegetables and Risk of Diverticulitis.

OBJECTIVES: Although low fiber intake has been considered a risk factor for diverticulitis, prospective evidence is limited in women despite having a disproportionate burden of disease, with little known about variation in the protective effects according to food sources. We assessed the associations of intakes of fiber and major food sources of fiber including fruits and vegetables with risk of diverticulitis in a large cohort of women. METHODS: We followed 50,019 women in the Nurses' Health Study (1990-2014) who were aged 43-70 years and free of diverticulitis, cancer, and inflammatory bowel disease at baseline. Incident diverticulitis was identified through self-report with validity confirmed by review of medical records. RESULTS: We documented 4,343 incident cases of diverticulitis, encompassing 1,106,402 person-years of follow-up. Compared with participants in the lowest quintile, the multivariable hazard ratio of diverticulitis in the highest quintile of total fiber intake was 0.86 (95% confidence interval: 0.78-0.95; P-trend = 0.002). Fiber from fruits and cereals, but not vegetables, was associated with a decreased risk of diverticulitis. Furthermore, intake of total whole fruit intake and specific fruits such as apples/pears and prunes were associated with reduced risk of diverticulitis with a multivariable hazard ratio for diverticulitis of 0.95 (0.92-0.98; P-trend < 0.001) for every serving increase of total whole fruit intake per day. DISCUSSION: Higher intake of dietary fiber and fiber from different food sources, except for vegetable fiber, are associated with a lower risk of diverticulitis in women. A greater intake of whole fruit is also associated with reduced risk.

Correlation between habitual dietary fibre intake and postprandial plasma glucose levels in early adulthood.

Background: Increasing dietary fibre (DF) intake through a habitual diet is recommended for preventing diabetes. Aim: To investigate a stepwise approach to nutrition education on DF intake among young adults in Japan with the largest deficit in habitual DF intake from the recommended value. Subjects and methods: Plasma glucose levels were measured in 54 adults in their 20s and 30s (29 men, 25 women) during fasting and at 30, 60, 90, and 120 minutes. Habitual DF intake and postprandial plasma glucose level were analysed. Results: DF intake was low (men = 5.7 ± 1.5 g/1000 kcal; women = 6.3 ± 1.2 g/1000 kcal) with no sex difference. Comparison between low- and high-DF groups based on the cut-off point (7.0 g/1000 kcal) showed that the pattern of changes in postprandial plasma glucose levels was significant, and a significant increase was observed at 30 minutes in the low-DF group. Comparison by food group demonstrated that habitual intake of potatoes, green/yellow vegetables, other vegetables, seaweed, peas and beans, and fruits was significantly higher in the high-DF group. Conclusion: This study provides valuable information regarding food selection for preventing diabetes and suggests that 7.0 g/1000 kcal of DF is an effective target value for a stepwise approach to nutrition education in Japan.

Dietary advice to cardiovascular patients. A brief update for physicians.

It is important, in our opinion, to provide physicians with a brief update of scientifically-sound evidence in preventive nutrition, to be employed in their everyday practice, since the latest scientific and clinical advances in this area are generally not well known. Here, we review the most recent evidence in support of an optimal cardio-protective diet, and we identify the need to focus mainly on protective food which should be part of such diet, rather than on nutrients with negative effects to be limited (salt, saturated fats, simple sugars). We conclude that, to favor patient compliance, it is also necessary to underscore indications on the topics for which there is convincing and coherent literature, leaving other less-explored aspects to individual preferences.

Differences in Fecal Gut Microbiota, Short-Chain Fatty Acids and Bile Acids Link Colorectal Cancer Risk to Dietary Changes Associated with Urbanization Among Zimbabweans.

The incidence of colorectal cancer (CRC) is gradually rising in sub-Saharan Africa. This may be due to dietary changes associated with urbanization, which may induce tumor-promoting gut microbiota composition and function. We compared fecal microbiota composition and activity in 10 rural and 10 urban Zimbabweans for evidence of a differential CRC risk. Dietary intake was assessed by a food frequency questionnaire. Fecal microbiota composition, metabolomic profile, functional microbial genes were analyzed, and bile acids and short chain fatty acids quantified. Animal protein intake was higher among urban volunteers, but carbohydrate and fiber intake were similar. Bacteria related to Blautia obeum, Streptococcus bovis, and Subdoligranulum variabile were higher in urban residents, whereas bacteria related to Oscillospira guillermondii and Sporobacter termitidis were higher in rural volunteers. Fecal levels of primary bile acids, cholic acid, and chenodeoxycholic acid (P < 0.05), and secondary bile acids, deoxycholic acid (P < 0.05) and ursodeoxycholic acid (P < 0.001) were higher in urban residents. Fecal levels of acetate and propionate, but not butyrate, were higher in urban residents. The gut microbiota composition and activity among rural and urban Zimbabweans retain significant homogeneity (possibly due to retention of dietary fiber), but urban residents have subtle changes, which may indicate a higher CRC risk.

Physical frailty in older men: prospective associations with diet quality and patterns.

BACKGROUND: increasing numbers of older adults are living with frailty and its adverse consequences. We investigated relationships between diet quality or patterns and incident physical frailty in older British men and whether any associations were influenced by inflammation. METHODS: prospective study of 945 men from the British Regional Heart Study aged 70-92 years with no prevalent frailty. Incident frailty was assessed by questionnaire after 3 years of follow-up. Frailty was defined as having at least three of: low grip strength, low physical activity, slow walking speed, unintentional weight loss and feeling of low energy, all based on self-report. The Healthy Diet Indicator (HDI) based on WHO dietary guidelines and the Elderly Dietary Index (EDI) based on a Mediterranean-style dietary intake were computed from questionnaire data and three dietary patterns were identified using principal components analysis: prudent, high fat/low fibre and high sugar. RESULTS: men in the highest EDI category and those who followed a prudent diet were less likely to become frail [top vs bottom category odds ratio (OR) (95% CI) 0.49 (0.30, 0.82) and 0.53 (0.30, 0.92) respectively] after adjustment for potential confounders including BMI and prevalent cardiovascular disease. No significant association was seen for the HDI. By contrast those who had a high fat low fibre diet pattern were more likely to become frail [OR (95% CI) 2.54 (1.46, 4.40)]. These associations were not mediated by C-reactive protein (marker of inflammation). CONCLUSIONS: the findings suggest adherence to a Mediterranean-style diet is associated with reduced risk of developing frailty in older people.

Association between dietary fiber intake and risk of ovarian cancer: a meta-analysis of observational studies.

Objective To evaluate the associations between dietary fiber intake and ovarian cancer risk. Methods A literature survey was conducted by searching the PubMed, Web of Science, and Wanfang Med Online databases up to March 1st, 2018. The effect of dietary fiber intake on ovarian cancer risk was evaluated by calculating relative risks with 95% confidence intervals (95%CI) using Stata 12.0 software. Results A total of 17 articles with 149,177 participants including 7609 ovarian cancer patients were included in this analysis. The summarized relative risk for ovarian cancer in participants with the highest compared with the lowest fiber intake was 0.760 (95%CI=0.702-0.823), with no significant between-study heterogeneity ( I2=12.4%). Subgroup analysis according to study design demonstrated positive associations in both cohort studies and case-control studies. Moreover, the results were consistent among populations from America, Europe, and Asia. No publication bias was found by Egger's test or funnel plots. Conclusion This meta-analysis concluded that a high intake of dietary fiber could significantly reduce the risk of ovarian cancer compared with a low fiber intake.

Dietary Fiber Intake in Children With Inflammatory Bowel Disease.

OBJECTIVES: The aim of the study was to estimate intake of total dietary fiber, and its soluble and insoluble fractions, by children with inflammatory bowel disease (IBD) in comparison with healthy controls. METHODS: This was a prospective controlled study on children with IBD. Food consumption data were collected by using the 3-day diet record. For intake of soluble and insoluble fibers author's questionnaire was used. RESULTS: The study included 50 children with IBD (80% in clinical remission) and 50 healthy controls. There were no statistically significant differences in age, weight, height, and BMI percentiles between both groups. The mean disease duration was 3.5 ±â€Š2.5 years. The daily median dietary fiber intake in patients was 15.3 ±â€Š4.2 g, whereas controls consumed about 14.1 ±â€Š3.6 g/day; differences were not statistically significant. The median intake of soluble fiber in the study group was 5.0 g/day and in controls 4.7 g/day, whereas the intake of insoluble fractions was 10.2 versus 9.7 g/day, respectively. The total fiber intake significantly increased with age and it was higher among boys in each age group. The boys better achieved adequate intake recommendations (P = 0.003). Both, children with IBD and healthy controls, did not meet the adequate intake recommendations. CONCLUSIONS: Intake of fiber in patients with IBD and healthy controls was comparable; however, in both groups, it was lower than recommended.

Dietary intake of fibre and risk of knee osteoarthritis in two US prospective cohorts.

OBJECTIVES: Dietary fibre reduces body weight and inflammation both of which are linked with knee osteoarthritis (OA). We examined the association between fibre intake and risk of knee OA. METHODS: We used data from the Osteoarthritis Initiative (OAI) of 4796 participants and Framingham Offspring Osteoarthritis Study (Framingham) of 1268 persons. Dietary intake of fibre was estimated at baseline, and incident radiographic OA (ROA) and symptomatic OA (SxOA) were followed annually until 48 months in OAI and assessed 9 years later in Framingham. Knee pain worsening was also examined in OAI. Generalised estimating equations were applied in multivariable regression models. RESULTS: In OAI, we identified 869 knees with SxOA, 152 knees with ROA and 1964 knees with pain worsening among 4051 subjects with valid dietary intake (baseline mean age: 61.2 years; mean body mass index (BMI): 28.6). In Framingham, 143 knees with SxOA and 176 knees with ROA among 971 such subjects (baseline mean age: 53.9 years; mean BMI: 27.0) were identified. In both cohorts, dietary total fibre was inversely associated with risk of SxOA (p trend <0.03) with significantly lower risk at the highest versus lowest quartile (OR (95% CI): 0.70 (0.52, 0.94) for OAI and 0.39 (0.17, 0.88) for Framingham). Furthermore, dietary total and cereal fibre were significantly inversely associated with knee pain worsening in OAI (p trend <0.02). No apparent association was found with ROA. CONCLUSIONS: Findings from two longitudinal studies consistently showed that higher total fibre intake was related to a lower risk of SxOA, while the relation to ROA was unclear.

Desempenho, frequência de diarreia, produção de fezes e custos de dietas com teores crescentes de farelo de abacaxi para leitões desmamados / Performance, diarrhea frequency, feces production and costs of diets with increasing levels of pineapple byproducts in weaned piglets

Esta pesquisa objetivou avaliar dietas com teores crescentes de farelo de abacaxi na alimentação de leitões desmamados. Foram utilizados 56 leitões, no intervalo de 21 a 63 dias de idade, que receberam dietas compostas principalmente por milho, farelo de soja e produtos lácteos, com adição de farelo de abacaxi em 0%, 3,4%, 6,8% e 10,2%. Foram avaliados o desempenho zootécnico; a incidência de diarreia; as excreções nas fezes, totais e por unidade de peso vivo ganho, de matérias seca (MS), mineral (MM) e orgânica (MO), nitrogênio (N) e fósforo (P); os custos relativos ao ganho de peso dos animais e os índices de eficiência econômica e de custo. As avaliações foram efetuadas dos 21 aos 35 dias; dos 21 aos 49 dias; e dos 21 aos 63 dias de idade dos leitões. Adotou-se delineamento em blocos ao acaso, de acordo com os pesos dos animais no início do experimento, com quatro tratamentos e sete repetições. Dos 21 aos 49 dias os animais submetidos às dietas com 3,4 e 6,8% de farelo de abacaxi consumiram mais ração (P<0.05) do que os alimentados com a dieta controle, e dos 21 aos 63 dias verificou-se maior ganho de peso (P<0.05) somente dos animais que receberam a dieta com 3,4% de farelo de abacaxi em relação aos leitões controle. Dos 21 aos 63 dias os animais que receberam as dietas com farelo de abacaxi apresentaram excreções de MS, MM, MO e N superiores (P<0.05) às dos animais controle. Contudo, ao se verificarem as excreções destes componentes nas fezes por unidade de peso vivo ganho neste mesmo período, foi constatado que não houve diferença (P>0.05) entre os leitões que receberam as dietas sem farelo de abacaxi e os que consumiram a dieta com 3,4% do produto. Portanto, a inclusão do farelo de abacaxi em dietas para leitões desmamados em 3,4% é viável, por não interferir negativamente nas excreções por unidade de peso vivo ganho e nos índices de custos das dietas e por proporcionar melhor ganho de peso aos leitões em relação àqueles que não consumiram farelo de abacaxi.(AU)

This research aimed to evaluate diets with growing levels of pineapple meal in weaned piglets feeding. Fifty-six piglets, from 21 to 63 days old, were fed diets composed mainly of corn, soybean meal, and dairy products, with the addition of pineapple byproduct in 0%, 3.4%, 6.8% and 10.2%. The parameters evaluated were: growth performance; diarrhea incidence; excretion in feces, total and per unit of weight gain, of dry (DM), mineral (MM) and organic (OM) matters, nitrogen (N) and phosphorous (P); diet costs related to weight gain, index of economic efficiency and of costs. The evaluations were performed from 21 to 35 days; from 21 to 49 days; and from 21 to 63 days of age. A complete randomized block design was adopted, according to the animal's weight in the beginning of the trial, with four treatments and seven repetitions. From day 21 to 49 the animals fed diets with 3.4 and 6.8% of pineapple meal consumed more feed (P<0.05) than those fed the control diet, and from day 21 to 63 only the animals that received the diet with 3.4% of pineapple presented a higher weight gain (P<0.05) than control piglets. From day 21 to 63 animals fed diets with pineapple meal presented higher (P<0.05) excretions of DM, MM, OM, and N than the control animals. However, checking the excretions of these components in the feces per unit of live weight gain in the same period, it was found that there was no difference (P>0.05) among the piglets fed diets without pineapple meal and those who consumed the diet with 3.4% of the product. Thus, the inclusion of pineapple meal in weaned piglet's diets at 3.4% is feasible, because it did not interfere negatively on excretions per unit of live weight gain and in diet cost indices, and provided better weight gain to the animals, as compared with pigs who did not consume pineapple meal.(AU)

Development of a Publicly Available, Comprehensive Database of Fiber and Health Outcomes: Rationale and Methods.

BACKGROUND: Dietary fiber is a broad category of compounds historically defined as partially or completely indigestible plant-based carbohydrates and lignin with, more recently, the additional criteria that fibers incorporated into foods as additives should demonstrate functional human health outcomes to receive a fiber classification. Thousands of research studies have been published examining fibers and health outcomes. OBJECTIVES: (1) Develop a database listing studies testing fiber and physiological health outcomes identified by experts at the Ninth Vahouny Conference; (2) Use evidence mapping methodology to summarize this body of literature. This paper summarizes the rationale, methodology, and resulting database. The database will help both scientists and policy-makers to evaluate evidence linking specific fibers with physiological health outcomes, and identify missing information. METHODS: To build this database, we conducted a systematic literature search for human intervention studies published in English from 1946 to May 2015. Our search strategy included a broad definition of fiber search terms, as well as search terms for nine physiological health outcomes identified at the Ninth Vahouny Fiber Symposium. Abstracts were screened using a priori defined eligibility criteria and a low threshold for inclusion to minimize the likelihood of rejecting articles of interest. Publications then were reviewed in full text, applying additional a priori defined exclusion criteria. The database was built and published on the Systematic Review Data Repository (SRDR™), a web-based, publicly available application. CONCLUSIONS: A fiber database was created. This resource will reduce the unnecessary replication of effort in conducting systematic reviews by serving as both a central database archiving PICO (population, intervention, comparator, outcome) data on published studies and as a searchable tool through which this data can be extracted and updated.

Assessment of the food patterns of immigrant Ecuadorian population in Southern Spain based on a 24-h food recall survey / Evaluación del patrón alimentario de la población ecuatoriana inmigrante en el sur de España basado en un estudio de recordatorio de alimentos de 24 horas

Introduction: Ecuador is a country with limited nutritional information, with exception of some general studies supported by Food Agriculture Organization (FAO) Aims: to carry out a nutritional assessment of the diet of Ecuadorian immigrant population in Southern Spain to determine differences in food patterns and possible nutritional deficiencies. Methods: the nutritional assessment was based on a 24-h food recall survey applied to the Ecuadorian population residing in Seville and Córdoba (Spain) in combination with the application of national and international food composition data bases. Nutrient intake levels and fulfillment of Dietary Reference Intakes (DRIs) were estimated and statistically tested for social, sex, age and geographical factors. Results: macronutrient distributions and nutrient intake levels in relation with DRIs were adequate in most cases. Importantly, Ecuadorian food habits were still present in immigrant population, with rice being the main energy source. Intakes levels were significantly different for several nutrients depending on age group, sex, place of residence and professional occupation. Comparison with previous nutritional data from Ecuador revealed a better nutritional status of immigrant population in Spain, though deficiencies in fiber, vitamin E, I and Se were detected in the diet of both populations. Nevertheless, data for these deficiencies were insufficient to be conclusive given both limitations in the food composition data bases (e.g. Se) and the lack of more adequate information tools for its assessment (e.g. long-term studies for vitamin E). Conclusions: the results in the present study evidenced that Ecuadorian immigrants in Spain showed more adequate food patterns that those reported for Ecuador. These data can be helpful to get further insight into the nutritional value of Ecuadorian diet and develop suitable nutrition intervention (AU)

Introducción: ecuador es un país con limitada información nutricional con la excepción de algunos estudios de carácter general realizados por FAO (Food Agriculture Organization). Objetivos: realizar una evaluación nutricional de la dieta de la población inmigrante ecuatoriana en el sur de España para determinar diferencias en los patrones alimentarios y posibles deficiencias nutricionales. Métodos: la evaluación nutricional se basa en un estudio de recordatorio de alimentos de 24 horas llevado acabo sobre la población ecuatoriana residente en Sevilla y Córdoba (España) en combinación con la aplicación de bases de datos nacionales e internacionales de composición de alimentos. Se estimaron los niveles de ingesta de nutrientes y el cumplimiento de las ingestas dietéticas de referencia (IDR) que se analizaron estadísticamente para los factores, genero, edad, profesión y ciudad. Resultados: según las IDR utilizadas, la distribución de macronutrientes y los niveles de ingesta de nutrientes fueron, en la mayoría de los casos, adecuadas. De manera destacada, se constató que los hábitos alimentarios ecuatorianos permanecieron en la población inmigrante, con el arroz como fuente principal de energía. Los niveles de ingesta fueron significativamente diferentes para diferentes nutrientes dependiendo del grupo de edad, sexo, lugar de residencia y ocupación profesional. Comparando estos datos con un estudio previo en Ecuador reveló que la población inmigrante en España presenta un mejor estado nutricional, si bien en ambas poblaciones se detectaron deficiencias en fibra, vitamina E, I y Se. En cuanto a estas deficiencias, los resultados no pueden considerarse concluyentes debido a limitaciones propias de las bases de datos (por ej. Se) y a la carencia de estudios adecuados que permitan una evaluación más precisa (por ej. estudios de larga duración para vitamina E). Conclusiones: estos resultados evidencian que la población inmigrante ecuatoriana presenta un patrón alimentario más adecuado que el documentado para la población Ecuador. Estos resultados pueden ser útiles para determinar el valor nutricional de la dieta ecuatoriana y desarrollar estrategias adecuadas de intervención nutricional (AU)

Fat, fibre and cancer risk in African Americans and rural Africans.

Rates of colon cancer are much higher in African Americans (65:100,000) than in rural South Africans (<5:100,000). The higher rates are associated with higher animal protein and fat, and lower fibre consumption, higher colonic secondary bile acids, lower colonic short-chain fatty acid quantities and higher mucosal proliferative biomarkers of cancer risk in otherwise healthy middle-aged volunteers. Here we investigate further the role of fat and fibre in this association. We performed 2-week food exchanges in subjects from the same populations, where African Americans were fed a high-fibre, low-fat African-style diet and rural Africans a high-fat, low-fibre western-style diet, under close supervision. In comparison with their usual diets, the food changes resulted in remarkable reciprocal changes in mucosal biomarkers of cancer risk and in aspects of the microbiota and metabolome known to affect cancer risk, best illustrated by increased saccharolytic fermentation and butyrogenesis, and suppressed secondary bile acid synthesis in the African Americans.

Association between dietary fiber and lower risk of all-cause mortality: a meta-analysis of cohort studies.

Although in vitro and in vivo experiments have suggested that dietary fiber might have beneficial effects on health, results on the association between fiber intake and all-cause mortality in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of prospective cohort studies to quantitatively assess this association. Pertinent studies were identified by searching articles in PubMed and Web of Knowledge through May 2014 and reviewing the reference lists of the retrieved articles. Study-specific risk estimates were combined using random-effects models. Seventeen prospective studies (1997-2014) that had a total of 67,260 deaths and 982,411 cohort members were included. When comparing persons with dietary fiber intakes in the top tertile with persons whose intakes were in the bottom tertile, we found a statistically significant inverse association between fiber intake and all-cause mortality, with an overall relative risk of 0.84 (95% confidence interval: 0.80, 0.87; I(2) = 41.2%). There was a 10% reduction in risk for per each 10-g/day increase in fiber intake (relative risk = 0.90; 95% confidence interval: 0.86, 0.94; I(2) = 77.2%). The combined estimate was robust across subgroup and sensitivity analyses. No publication bias was detected. A higher dietary fiber intake was associated with a reduced risk of death. These findings suggest that fiber intake may offer a potential public health benefit in reducing all-cause mortality.

Food groups and the risk of colorectal cancer: results from a Jordanian case-control study.

The role of diet in colorectal cancer (CRC) in Jordan has not been studied previously. This study aimed at examining the association between food groups (including grains, fruits, vegetables, milk, and meat and legumes) and CRC risk in Jordan. We compared intakes of the different food groups among CRC patients (n=167) and matched controls (n=240) by age, sex, occupation, and marital status. A validated food frequency questionnaire was used to collect dietary data. Logistic regression was used to evaluate the association of quartiles of intakes of the different food groups with CRC risk. In addition, the association of selected food items with CRC risk was examined. Odds ratios (ORs) for the fourth versus the first quartile of intake were 2.92 [95% confidence interval (CI): 1.40-6.08] for grains, 1.66 (95% CI: 0.81-3.40) for vegetables, 0.55 (95% CI: 0.26-1.16) for fruits, 0.96 (95% CI: 0.46-1.97) for milk, and 1.43 (95% CI: 0.68-2.98) for meat and legumes. In a comparison of the highest with the lowest weekly frequency of consumption, there was a direct association between the risk of CRC and the frequency of consumption of chicken (OR=2.52, 95% CI: 1.33-4.77). An increase in risk was observed with increased consumption of white bread (OR=3.13, 95% CI: 1.18-9.25), whereas consumption of whole bread was associated with a decreased risk for CRC (OR=0.32, 95% CI: 0.12-0.84). Our results support a role of diet in CRC. Direct associations were found for grains, white bread, and chicken, whereas an inverse relation was reported for whole bread.

Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies.

Greater intake of dietary fiber has been associated with lower risk of several chronic diseases. Some observational studies have examined the association between dietary fiber intake and total mortality, but the results were inconclusive. We conducted a meta-analysis of data from prospective cohort studies to quantitatively assess the association. Eligible studies were identified by searching the PubMed and Embase databases for all articles published through November 30, 2013, and by reviewing the reference lists of retrieved articles. Study-specific estimates adjusting for potential confounders were combined to calculate a pooled relative risk and 95% confidence interval using a random-effects model. Seven prospective cohort studies of dietary fiber intake and total mortality, including 62,314 deaths among 908,135 participants, were identified. The pooled adjusted relative risk of total mortality for the highest category of dietary fiber intake versus the lowest was 0.77 (95% confidence interval: 0.74, 0.80). In a dose-response meta-analysis, the pooled adjusted relative risk for a 10-g/day increment of dietary fiber intake was 0.89 (95% confidence interval: 0.85, 0 92). By source of fiber, cereal and, to a lesser extent, vegetable fiber were significantly associated with lower total mortality, while fruit fiber showed no association. In conclusion, high dietary fiber intake may reduce the risk of total mortality.