[Sense and nonsense of diets]. / Sinn und Unsinn von Diäten.

Strict vegetarian diets and liquid formulations of "protein-sparing modified fast diets" can be harmful and represent potential "nonsense" in diets. "Sense" with respect to diets is demonstrated by a short summary of the physiological effects of dietary fibre. Fibre incorporates water, increases fecal bulk and reduces transit time of the bowel. Fermentation of fibres in the large bowel produces short-chain fatty acids, e.g. acetate, propionate and butyrate with desirable effects. Butyrate, for example, modifies colonic cell proliferation and may reduce the incidence of colorectal neoplasms. The beneficial effects of a diet, high in fibre, on blood lipids, overweight, colorectal disease and diabetes mellitus are briefly discussed.

Fibra e aparelho digestivo / Fiber and gastrointestinal human tract

Fibras alimentares sao polissacarideos de plantas e lignina que resistem a hidrolise pelas enzimas do aparelho digestivo humano. Retiradas da dieta no processo de industrializaçao dos alimentos, tornam o organismo privado de mecanismos protetores contra algumas doenças, de acordo com evidenciasepidemiologicas e clinicas. A açao das fibras alimentares sobre a fisiologia da digestao, seus efeitos colaterais e suas indicaçoes terapeuticas sao analisados com detalhes.

Effect of dietary fibre on the mutagenicity and distribution of 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ).

Female BALB/c mice were fed either a fibre-free diet or one supplemented with 30% wheat-bran for 5 weeks. The ability of these mice to convert MeIQ to a bacterial mutagen in vivo was determined using intrasanguinous host-mediated bacterial mutation assays. Less mutagenic activity was detected in the livers of mice fed the bran-supplemented diet compared with those fed the fibre-free diet. Subsequent experiments demonstrated that the effect of brain was not due to modifications in hepatic metabolism, but to changes in uptake of MeIQ from the gastrointestinal tract.

Dietary treatment of familial hypercholesterolemia.

The principal goal of dietary treatment of familial hypercholesterolemia (FH) is the reduction of the plasma low density lipoprotein (LDL) cholesterol. This is best accomplished by enhancing the number of LDL receptors and, at the same time, depressing liver synthesis of cholesterol. Both cholesterol and saturated fat down-regulate the LDL receptor and inhibit the removal of LDL from the plasma by the liver. Saturated fat down-regulates the LDL receptor, especially when cholesterol is concurrently present in the diet. The total amount of dietary fat is also important. The greater the flux of chylomicron remnants into the liver, the greater is the influx of cholesterol ester. In addition, factors that affect LDL synthesis could be important. These include excessive calories (obesity) that enhance very low density lipoprotein (VLDL) and, hence, LDL synthesis, and weight loss and omega-3 fatty acids, which depress synthesis of VLDL and LDL. The optimal diet for treatment of children and adults has the following characteristics: cholesterol (100 mg/day), total fat (20% of kcalories, 6% saturated with the balance from omega-3 and omega-6 polyunsaturated and monounsaturated fat), carbohydrate (65% kcalories, two thirds from starch), and protein (15% kcalories). This low-fat high-carbohydrate diet can lower the plasma cholesterol 18% to 21%. It is also an antithrombotic diet, thrombosis being another major consideration in preventing coronary heart disease. Dietary therapy is the mainstay of treatment of FH to which various drug therapies can be added.

Quantitation of phosphorus excretion in sheep by compartmental analysis.

The control of phosphorus excretion in sheep has been examined by constructing a kinetic model that contains a mechanistic set of connections between blood and gastrointestinal tract. The model was developed using experimental data from chaff-fed sheep and gives an accurate description of the absorption and excretion of phosphorus in feces and urine of the ruminating sheep. Simulation of the response to an intravenous phosphorus infusion by adding an inflow of 2 g/day of phosphorus into the compartment describing blood, predicted values for fecal output of phosphorus lower than found experimentally. However, by alteration of the parameters describing absorption or salivation, the predictions approached experimental values. Similarly simulation of the conditions existing when a liquid diet was infused directly into the abomasum, i.e., a decrease in salivation rate [L(4.1)] and dietary phosphorus entering compartment 5 (abomasum) instead of compartment 4 (rumen), gave incorrect predictions for plasma and urinary phosphorus, but when the parameter for urinary phosphorus was increased the predicted values approached experimental values. These results indicated the main control site for phosphorus excretion in the ruminating sheep was the gastrointestinal tract, whereas for the nonruminating sheep fed the liquid diet, control was exerted by the kidney. A critical factor in the induction of adaptation of phosphorus reabsorption by the kidney was the reduction in salivation, and since this response occurred independently of marked changes in the delivery of phosphorus to the kidney, a humoral factor may be involved in this communication between salivary gland and kidney.

Effects of differing purified cellulose, pectin, and hemicellulose fiber diets on fecal enzymes in 1,2-dimethylhydrazine-induced rat colon carcinogenesis.

The fecal microflora enzymes, beta-glucuronidase and beta-glucosidase, as well as fecal bacterial counts, were examined during colon carcinogenesis in rats administered parenteral 1,2-dimethylhydrazine and fed nutritionally equivalent diets free of fiber or containing one of three single sources of dietary fiber (cellulose, hemicellulose, and pectin). Whereas pectin-fed animals had increased fecal beta-glucuronidase activities, those fed cellulose and hemicellulose, two fibers protective in dimethylhydrazine colon neoplasia, had decreased activities. Although fecal bacterial counts were not significantly changed, similar differential changes in fecal beta-glucosidase activity were noted: cellulose but not pectin or hemicellulose feeding was associated with reduced activity. Although cellulose fiber may cause differing physiological effects resulting in a reduction in colonic neoplasia development in this experimental animal model, decreased bacterial metabolic enzyme activation of carcinogens or cocarcinogens may lead to diminished exposure of colonic cells to exogenous or endogenous mutagens.

Diet, nutrition, and cancer. The role of fiber.

The mechanisms by which dietary fiber could inhibit development of colon cancer include effects on fecal weight and transit time, adsorption of bile acids, dilution of colonic contents, production of short chain fatty acids (products of fiber fermentation), inhibition of dehydroxylation of bile acids, and regulation of energy intake. Review of the literature suggests that effects on fecal weight and transit time and adsorption of bile acids are not likely mechanisms. Since concentration of bile acids is lower in feces of less susceptible populations, dilution of colonic contents may contribute to fiber effects. High colonic pH is associated with promotion of cancer and production of short chain fatty acids would counteract this effect. Animals maintained on calorie-restricted diets exhibit fewer spontaneous or experimentally induced tumors. Regulation of energy intake by fiber may contribute towards reduction of colon cancer incidence in man especially when caloric content is low from infancy.

Markers for estimating digesta flow in pigs and the effects of dietary fiber.

Effects of diluting the energy content of a corn-soybean meal diet with either alfalfa meal or corn cobs on nutrient digestibility and rate of passage of feed residues and particle markers were measured in crossbred (Yorkshire X Landrace X Chester White X Large White) barrows with a mean body weight of about 80 kg. The excretion pattern in the feces of Cr-mordanted diet and of rare earths initially bound individually to the mixed diet or to the corn or soybean meal suggested a model having a single age-dependent compartment with time delay. The compartmental turnover rate parameter (lambda 1) estimated by this model did not differ for the rare earths individually used to mark the corn-soybean meal diet (Yb), the corn (La) or the soybean meal (Sm). In contrast, lambda 1 for Cr was smaller (P less than .001) than that of the mean for the three rare earths. The residence time due to displacement flow (tau) did not differ among markers. These results were interpreted to indicate that the high specific gravity of Cr-mordanted feed slowed flow due to mixing but not due to displacement. Correlations between lambda 1 and tau were less than .71. These results suggested that the flow of rare earths initially bound to feed ingredients provides a reasonable estimate of the flow of their undigested residues through the gastrointestinal tracts of nonruminant animals. Inclusion of the fibrous feeds reduced digestibility of dry matter, cell contents, crude protein and acid detergent lignin and increased digestibility of cell walls, cellulose and acid detergent fiber. Digestibilities of cellulose and acid detergent fiber were greater with alfalfa than with corn cobs as the fiber source. Differences in digestibility of crude protein and acid detergent fiber existed due to litter in one replicate of the experiment. Variation in digestibility was not significantly related to variation in lambda 1 or tau within or among treatments and litters. This suggests that variations in lambda 1 and tau were not important causes of the observed variation in digestibility.

Nutritional aspects of colon cancer.

During the last decade, a substantial amount of progress has been made in the understanding of the relationship between the dietary constituents and the development of colon cancer in man. The information base is sufficiently convincing with respect to an enhancing effect as a function of total fat intake and a protective effect of certain dietary fibers in colon cancer. The populations with high incidence of colon cancer are characterized by consumption of high-dietary fat which may be a risk factor in the absence of factors that are protective, such as use of whole-grain cereals, high fibrous foods and vegetables mainly of cruciferous type. Application of the findings made thus far in colon cancer research for the general public is, therefore, to have a far-reaching impact on the major premature, killing diseases in the western world.

Diet, nutrition, and cancer.

Evidence pertaining to the role of dietary factors in carcinogenesis comes from both epidemiological studies and laboratory experiments. In 1982, the Committee on Diet, Nutrition, and Cancer of the National Research Council conducted a comprehensive evaluation of this evidence. That assessment as well as recent epidemiological and laboratory investigations suggest that a high fat diet is associated with increased susceptibility to cancer of different sites, particularly the breast and colon, and to a lesser extent, the prostate. Current data permit no definitive conclusions about other dietary macroconstituents including cholesterol, total caloric intake, protein, carbohydrates and total dietary fiber. Specific components of fiber, however, may have a protective effect against colon cancer. In epidemiological studies, frequent consumption of certain fruits and vegetables, especially citrus fruits and carotene-rich and cruciferous vegetables, is associated with a lower incidence of cancers at various sites. The specific components responsible for these effects are not clearly identified, although the epidemiological evidence appears to be most consistent for a protective effect of carotene on lung cancer and less so for vitamins A and C and various cancer sites. The laboratory evidence is most consistent for vitamin A deficiency and enhanced tumorigenesis, and for the ability of various nonnutritive components in cruciferous vegetables to block in-vivo carcinogenesis. The data for minerals and carcinogenesis are extremely limited, although preliminary evidence from both epidemiological and laboratory studies suggests that selenium may protect against overall cancer risk. Frequent consumption of cured, pickled, or smoked foods, possibly because they may contain nitrosamines or polycyclic aromatic hydrocarbons, appears to increase the risk of esophageal or stomach cancer, however, the specific causative agents in these foods are not clearly identified. Excessive alcohol consumption among smokers appears to be associated with an elevated risk of cancers of the oral cavity, esophagus, larynx, and respiratory tract. The mechanisms of action of dietary factors on carcinogenesis are poorly understood. The NRC committee, and more recently, the National Cancer Institute and the American Cancer Society have proposed interim dietary guidelines to lower the risk of cancer. These guidelines are consistent with general dietary recommendations proposed by U.S. government agencies for maintenance of good health.(ABSTRACT TRUNCATED AT 400 WORDS)

Dietary fibre: consensus and controversy.

Technological advances have reduced and refined man's plant food intake and consequently brought about an unprecedented decline in his consumption of dietary fibre (DF). The emergence of certain diseases selectively in regions which have been affected the most by this dietary change has led to an enhanced awareness of the functions of DF. DF is a heterogeneous group of substances which resist digestion by the endogenous enzymes of the human gut, although they are fermented to a substantial extent by the bacterial flora of the large intestine. Chemically, DF essentially consists of nonstarch polysaccharides and lignin, and its major constituents are cellulose, hemicelluose, lignin and pectin. The physiological effects of DF are attributable largely to its physicochemical properties. DF primarily affects gastrointestinal (GI) function; its effects are observable at all stages from ingestion through defaecation. It restricts caloric intake, shows gastric and small intestinal transit, and affects the activity of digestive enzymes and release of GI hormones. Its overall impact is to reduce apparent digestibility of nutrients marginally but consistently. In the large intestine, DF accelerates transit, supports bacterial growth and serves to hold water. As a result, the faecal weight and water content increase, and the transit time generally becomes shorter. Secondary to its GI effects, DF attenuates postprandial glycaemia and has long term effects on glucose tolerance and lipoprotein metabolism. These effects have important implications in the aetiopathogenesis of constipation and its sequelae including diverticulosis, cholesterol gallstones, colorectal cancer, obesity, diabetes mellitus and atherosclerosis. DF has traditionally been used therapeutically for constipation; now its use in diabetes is also well established. Our appreciation of the role of DF in human nutrition has undergone a major change in the last two decades. From a redundant constituent of plant foods, it has now moved to the position of an essential nutrient, the deficiency of which seems to have serious consequences.