Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: a randomised cross-over trial.

OBJECTIVE: To investigate whether a whole grain diet alters the gut microbiome and insulin sensitivity, as well as biomarkers of metabolic health and gut functionality. DESIGN: 60 Danish adults at risk of developing metabolic syndrome were included in a randomised cross-over trial with two 8-week dietary intervention periods comprising whole grain diet and refined grain diet, separated by a washout period of ≥6 weeks. The response to the interventions on the gut microbiome composition and insulin sensitivity as well on measures of glucose and lipid metabolism, gut functionality, inflammatory markers, anthropometry and urine metabolomics were assessed. RESULTS: 50 participants completed both periods with a whole grain intake of 179±50 g/day and 13±10 g/day in the whole grain and refined grain period, respectively. Compliance was confirmed by a difference in plasma alkylresorcinols (p<0.0001). Compared with refined grain, whole grain did not significantly alter glucose homeostasis and did not induce major changes in the faecal microbiome. Also, breath hydrogen levels, plasma short-chain fatty acids, intestinal integrity and intestinal transit time were not affected. The whole grain diet did, however, compared with the refined grain diet, decrease body weight (p<0.0001), serum inflammatory markers, interleukin (IL)-6 (p=0.009) and C-reactive protein (p=0.003). The reduction in body weight was consistent with a reduction in energy intake, and IL-6 reduction was associated with the amount of whole grain consumed, in particular with intake of rye. CONCLUSION: Compared with refined grain diet, whole grain diet did not alter insulin sensitivity and gut microbiome but reduced body weight and systemic low-grade inflammation. TRIAL REGISTRATION NUMBER: NCT01731366; Results.

A low-gluten diet induces changes in the intestinal microbiome of healthy Danish adults.

Adherence to a low-gluten diet has become increasingly common in parts of the general population. However, the effects of reducing gluten-rich food items including wheat, barley and rye cereals in healthy adults are unclear. Here, we undertook a randomised, controlled, cross-over trial involving 60 middle-aged Danish adults without known disorders with two 8-week interventions comparing a low-gluten diet (2 g gluten per day) and a high-gluten diet (18 g gluten per day), separated by a washout period of at least six weeks with habitual diet (12 g gluten per day). We find that, in comparison with a high-gluten diet, a low-gluten diet induces moderate changes in the intestinal microbiome, reduces fasting and postprandial hydrogen exhalation, and leads to improvements in self-reported bloating. These observations suggest that most of the effects of a low-gluten diet in non-coeliac adults may be driven by qualitative changes in dietary fibres.

In Vivo and Ex Vivo Inflammatory Markers of Common Metabolic Phenotypes in Humans.

BACKGROUND: Low-grade systemic inflammation (LGSI) is often characterized by elevated levels of interleukin (IL)6, tumor necrosis factor (TNF)α, and C-reactive protein (CRP). Other serum proteins, ex vivo-stimulated cytokine production, and leukocyte count have, however, also been suggested LGSI-markers, but their associations with the metabolic syndrome (MS) are less clear. We aimed to evaluate mutual relationships between in vivo and ex vivo inflammatory markers and their association with MS and its subcomponents. METHODS: A cross-sectional study of 118 overweight adults with one or several features of MS. Inflammatory markers included fasting serum levels of IL6, TNFα, CRP, and pentraxin-3 (PTX3), IL1-receptors, leukocytes, and whole-blood ex vivo-produced IL1ß, IL6, TNFα, and IL8 after lipopolysaccharide stimulation. RESULTS: All classical serum LGSI-markers correlated with each other, and IL6 and CRP were also correlated with leukocyte count. Ex vivo-produced cytokines were intercorrelated and correlated with leukocyte count, but did not correlate with the serum immune markers. MS score, body mass index, and glycated hemoglobin (HbA1c) were associated with 8%-16% higher inflammatory score per standard deviation increment (P = 0.030, 0.001, and 0.034, respectively), primarily driven by higher serum IL6. Serum PTX3 was only significantly associated with high-density lipoprotein cholesterol (1.19[1.04; 1.37], P = 0.013). HbA1c was inversely associated with surface expression of IL1R1 on monocytes and IL1R2 on granulocytes (P < 0.01) and with a 3%-9% lower ex vivo production of cytokines when adjusting for leukocyte count, as were plasma triacylglycerol (9%-10% lower IL1ß and IL6). Leukocyte count was most consistently associated with MS and its subcomponents, although not with HbA1. CONCLUSIONS: The classical fasting serum markers of LGSI and leukocyte counts associated best with measures of MS-associated LGSI, whereas ex vivo cytokine production was only associated with prevailing glycemia and dyslipidemia. Taken together, this indicates that the relationship between in vivo and ex vivo inflammatory markers is complex and may depend on the MS phenotype.

Effects on satiation, satiety and food intake of wholegrain and refined grain pasta.

Wholegrains have received much attention in recent years due to their role in prevention of obesity and its comorbidities. Many studies about energy regulation are focused on the effect between meals (satiety), but the effect within meal (satiation) for wholegrain foods has not been extensively studied. The objective was to investigate the effect of WG pasta (WGP) compared to refined grain pasta (RGP), on ad libitum energy intake (EI) within and at the subsequent meal as well as appetite. Two different ad libitum lunch meals (study A) and two different iso-caloric lunch meals (study B) were administered in sixteen overweight/obese subjects in a crossover design. The test meals consisted of RGP and WGP served with tomato sauce. Study A: the ad libitum lunch meal was consumed then EI registered. Study B: the iso-caloric lunch meal was served, then subjective appetite sensation and breath hydrogen excretion were assessed for 240 min followed by an ad libitum meal where EI was calculated. Overall, WGP did not significantly differ in the effect on ad libitum EI within meal (p = 0.23) in study A. In study B, WGP resulted in an increased sensation of satiety (p < 0.001) and lower ratings of hunger (p < 0.001) without increased in breath hydrogen excretion (p = 0.11). Again, no overall effect on EI at the subsequent meal was seen (p = 0.12). In conclusion, WGP increased satiety, diminished hunger without modifying energy intake at the subsequent meals.

Second meal effect on appetite and fermentation of wholegrain rye foods.

BACKGROUND: Wholegrain rye has been associated with decreased hunger sensations. This may be partly mediated by colonic fermentation. Sustained consumption of fermentable components is known to change the gut microflora and may increase numbers of saccharolytic bacteria. OBJECTIVE: To investigate the effect of wholegrain rye consumption on appetite and colonic fermentation after a subsequent meal. METHODS: In a randomized, controlled, three-arm cross-over study, twelve healthy male subjects consumed three iso-caloric evening test meals. The test meals were based on white wheat bread (WBB), wholegrain rye kernel bread (RKB), or boiled rye kernels (RK). Breath hydrogen excretion and subjective appetite sensation were measured before and at 30 min intervals for 3 h after a standardized breakfast in the subsequent morning. After the 3 h, an ad libitum lunch meal was served to assess energy intake. In an in vitro study, RKB and RK were subjected to digestion and 24 h-fermentation in order to study SCFA production and growth of selected saccharolytic bacteria. RESULTS: The test meals did not differ in their effect on parameters of subjective appetite sensation the following day. Ad libitum energy intake at lunch was, however, reduced by 11% (P < 0.01) after RKB and 7% (P < 0.05) after RK compared with after WWB evening meal. Breath hydrogen excretion was significantly increased following RKB and RK evening meals compared with WWB (P < 0.01 and P < 0.05, respectively). Overall, RKB and RK were readily fermented in vitro and exhibited similar fermentation profiles, although total SCFA production was higher for RK compared with RKB (P < 0.001). In vitro fermentation of RKB and RK both increased the relative quantities of Bifidobacterium and decreased Bacteroides compared with inoculum (P < 0.001). The C. coccoides group was reduced after RKB (P < 0.001). CONCLUSION: Consumption of wholegrain rye products reduced subsequent ad libitum energy intake in young healthy men, possibly mediated by mechanisms related to colonic fermentation.

Extracted oat and barley ß-glucans do not affect cholesterol metabolism in young healthy adults.

ß-Glucans are known to exhibit hypocholesterolemic effects. Increased intestinal viscosity is thought to be crucial for cholesterol lowering. It is suggested that concentration, molecular mass, and structure, including the ratio of (1→3) to (1→4) glucan bonds in the molecule, are of importance for ß-glucan functionality. This study investigated the effects of 3 different ß-glucan sources, incorporated into a beverage and yogurt, on blood lipids and fecal endpoints. Fourteen participants completed this randomized, crossover, single-blinded study with four 3-wk periods: control and 3.3 g/d oat, barley, and barley mutant ß-glucans of similar molecular mass. Before and after each period, fasting and postprandial blood samples were drawn and 3-d fecal samples were collected. Treatment did not affect changes in total, LDL, and HDL cholesterol compared with control; however, consumption of 3.3 g/d of oat ß-glucans for 3 wk resulted in greater decreases in total (-0.29 ± 0.09 mmol/L, P < 0.01), LDL (-0.23 ± 0.07 mmol/L, P < 0.01), and HDL (-0.05 ± 0.03 mmol/L, P < 0.05) cholesterol compared with baseline. Changes in LDL in the ß-glucan treatments were not related to ß-glucan structure (cellotriosyl:cellotetraosyl). Decreases in fasting triacylglycerol were substantially greater after oat ß-glucan treatment compared with control (P = 0.03). Fecal dry and wet weight, stool frequency, fecal pH, and energy excretion were unaffected. The results do not fully support the hypocholesterolemic effects by differently structured oat and barley ß-glucans. However, substantial differences compared with baseline suggest a potential for oat ß-glucan, presumably due to its higher solubility and viscosity. This underlines the importance of elusive structural ß-glucan features for beneficial physiologic effects.

Flaxseed dietary fiber supplements for suppression of appetite and food intake.

UNLABELLED: We conducted two single-blinded randomized crossover acute studies with 24 and 20 subjects, respectively, to compare (I) CONTROL vs. Flax drink; and (II) Flax drink vs. Flax tablets. The subjects were exposed to one of the treatments after an overnight fast, and rated appetite sensation for 120 min using visual analog scales (VAS). Hereafter they consumed an ad libitum early lunch to assess energy intake. The treatments were iso-caloric and iso-volumeric: CONTROL: 300 mL drink; Flax drink: CONTROL drink with addition flax fiber extract (2.5 g of soluble fibers); and Flax tablet: CONTROL drink with flax fiber tablets (2.5 g of soluble fibers). Flax drink increased sensation of satiety and fullness compared to CONTROL and a significant decrease in subsequent energy intake was observed after the Flax drink compared to CONTROL (2937 vs. 3214 kJ). Appetite ratings were similar for Flax tablets and Flax drink as they did not differ by more than 1-4%. Subsequent energy intake was similar after the two treatments (3370 vs. 3379 kJ). A small dose of flaxseed fiber significantly suppresses appetite and energy intake. Furthermore, flaxseed fibers administered as drinks or tablets produce similar responses.