All Fibers Fit
Delineating Fiber’s Physiological Benefits
with Multiple Fibers
Julie Jones PhD
Nutrition Professor Emeritus
St. Catherine University
St. Paul, MN, USA
TM
Variety for maximum impact
 Dietary Fiber is beneficial to health
 How do consumers achieve recommended intakes?
 Meeting dietary fiber intakes within caloric recommendations.
 How do consumers receive all the benefits attributed to DF?
TM
ALL FIBERS FIT
DELINEATING FIBER’S PHYSIOLOGICAL
BENEFITS WITH MULTIPLE FIBERS
Julie Miller Jones
Professor Emerita
St. Catherine University
TM
Conflicts of Interest
Scientific Advisor, speaker and consultant to a variety of consumer package goods companies
and
suppliers
the food
industry
• ingredient
Advisor
to for
the
ILSI
North America Carbohydrate
Committee
• Scientific Advisor, speaker and consultant to a
variety of consumer package goods companies
and ingredient suppliers for the food industry
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PRESENTATION OVERVIEW
• Health benefits identified by participants in the 9th
Vahouny conference
• Additional data from observational and interventional
data (most of it 2011-14).
• Synergy of fibers
• Importance of innate and added fibers to address the
‘fiber gap’ while performing DF’s functions and
maintaining calories within allotted levels.
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Dietary Fibers Benefits: The ‘Vahouny 9’
DIETARY FIBER BENEFITS - VAHOUNY 2009
1.
2.
3.
4.
5.
6.
7.
8.
9.
Total and LDL cholesterol*
Post-prandial glucose & insulin*
Blood pressure
Increased fecal bulk and laxation*
Transit time (time it takes food to move through digestive
track)*
Colonic fermentation & SCFA production*
Modulation of colonic microflora
Weight loss, weight maintenance, and reduction in
adiposity
Increased satiety
* Have significant scientific agreement as indicated by health claims or in regulations
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Howlett et al 2009
Fiber and Lipid Reductions
US Health claim Diets low in saturated fat and
cholesterol that include [____ grams of
soluble fiber specified in paragraph
(c)(2)(i)(G) of this section] of soluble fiber per
day from [name of soluble fiber source from
paragraph (c)(2)(ii) of this section and, if
desired, the name of the food product] may
reduce the risk of heart disease. One serving
of [name of food] provides ____ grams of this
soluble fiber.-
3 g/d sol fiber - whole grain oats or oat bran,
oat derivatives, barley and 7 g psyllium
–  cholesterol 5-6 mg/dL
(FDA, 1996)
– Both intervention and observational
data
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Similar health
claims
approved by bodies
around the world
such as HC,
FDA,EFSA, FSANZ,
SE Asia, others
Fiber and Lipid Reduction
New Data on other Fibers
• Resistant Starch 4
– blood cholesterol if it replaced 30% of the flour
cross-over study n= 86 adults / Metabolic Syndrome – Two 12-wk periods
• Soy fiber replacing flour in biscuits
–  LDL cholesterol in overweight/ obese college
students
12-wk RCT
• Persimmon /tannin-rich fiber cookie with 3-5 g fiber
– LDL significantly n=40 - 12 weeks
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Nichenametla SN et al Mol Nutr Food Res. 2014
Jan 30. doi: 10.1002/mnfr.201300829;
Hu X et al. Mol Nutr Food Res. 2013;57:214754; Gato N et al. Ann Nutr Metab. 2013;62:1-6.
in a
Dietary Fibers Benefits: The ‘Vahouny 9’
DIETARY FIBER BENEFITS - VAHOUNY 2009
1.
2.
3.
4.
5.
6.
7.
8.
9.
Total and LDL cholesterol*
Post-prandial glucose & insulin*
Blood pressure
Increased fecal bulk and laxation*
Transit time (time it takes food to move through digestive
track)*
Colonic fermentation & SCFA production*
Modulation of colonic microflora
Weight loss, weight maintenance, and reduction in
adiposity
Increased satiety
* Have significant scientific agreement as indicated by health claims or in regulations
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Howlett et al 2009
Fiber & Type II Diabetes Control
4,399 Japanese patients with diabetes
• Inverse association of dietary fiber with: ( after adjustment for
many other factors)
– Fasting plasma glucose
– HbA1c
– Triglyceride
– C-reactive protein
– BMI
• Increased dietary fiber intake was associated with better glycemic
control and better cardiovascular disease risk factors
Fujii H et al Nutr J. 2013;12:159
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Blood Glucose and Insulin / Health Claims for
Dietary Fiber
EFSA - Inulin FOS can lower blood sugar spikes from foods and beverages
when FOS replaces sugar - considered beneficial for humans, especially
diabetics, and will be approved as the following health claim language:
•
Consumption of foods/drinks containing non-digestible carbohydrates
instead of sugars induces a lower blood glucose rise after meals
compared to sugar-containing foods/drinks.
•
Consumption of arabinoxylan contributes to a reduction of the glucose
rise after a meal.
•
”Replacement of 14 g of available starch with 14 g of resistant starch can
help minimize blood glucose rise.”
US Psyllium structure-function claim
• Psyllium helps maintain healthy blood sugar levels as ... Trapped
sugars are slowly released and ... in postprandial and fasting blood
glucose levels...
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Partially Hydrolyzed Guar Gum Improves
Diabetes Markers
• 45 Type 2 Diabetics
– mean age 62 yrs 10 g d partially hydrolyzed guar, 6 wk RCT
•  HbA1c 6.88 to 6.57
•  waist circumference
Dall'Alba V et al Br J Nutr. 2013 ;110:1601-10.
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β -Glucan and Reduced Blood Glucose
• 76 human studies identified, 34 met criteria
–  glycemic response ave. 48 ± 33 mmol
• 0.3-12.1 g oat or barley β-glucan
– Intact grains more effective than in some processed
foods
– 4 g β-glucan in processed foods
• predicted glycemic response of 27 ± 3 mmol ·
min/l
–  added fiber is effective if adequate amount is
added
Tosh S. Eur J Clin Nutr. 2013;67:310-7
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β-Glucan Linked to Appetite Control,
Glucose Attenuation, & Blood Pressure in
Metabolic SYNDROME
• Recent review β-glucan intake
• blood-pressure in hypertensive subjects
• Improves glycemic index of meals
– beneficially influences glucose metabolism
• appetite
• Changed gut hormone responses
• VAS / other subjective appetite scales
Cloetens L et al Nutr Rev. 2012;70:444-58
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Dietary Fibers Benefits: The ‘Vahouny 9’
DIETARY FIBER BENEFITS - VAHOUNY 2009
1.
2.
3.
4.
5.
6.
7.
8.
9.
Total and LDL cholesterol*
Post-prandial glucose & insulin*
Blood pressure
Increased fecal bulk and laxation*
Transit time (time it takes food to move through digestive
track)*
Colonic fermentation & SCFA production*
Modulation of colonic microflora
Weight loss, weight maintenance, and reduction in
adiposity
Increased satiety
* Have significant scientific agreement as indicated by health claims or in regulations
TM
Howlett et al 2009
Fiber and Hypertension – New Epi Studies
French Nutrition and Health Survey n=1968, 18-74-year-olds (Etude
Nationale Nutrition Santé)
• Fruit and vegetables, fiber and whole-grain food consumption were
inversely and linearly associated with systolic blood pressure
Korean NHANES(2008-2010)
• Dairy and carbohydrate pattern was inversely related with BMI and
blood pressures
– Intakes of fiber (P for trend < 0.0001), calcium (P for trend < 0.0001),
retinol (P for trend = 0.0164), vitamin B1 (P for trend = 0.001), vitamin
B2 (P for trend < 0.0001), niacin (P for trend = 0.0025), and vitamin C (P
for trend < 0.0001) were significantly increased across quartiles for the
dairy and carbohydrate pattern.
Vernay M et al J Hypertens. 2012;30:1920-7;
Shin J Yet al.Nutr Res Pract. 2013;7:224-32.
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Dietary Fibers Benefits: The ‘Vahouny 9’
DIETARY FIBER BENEFITS - VAHOUNY 2009
1.
2.
3.
4.
5.
6.
7.
8.
9.
Total and LDL cholesterol*
Post-prandial glucose & insulin*
Blood pressure
Increased fecal bulk and laxation*
Transit time (time it takes food to move through
digestive track)*
Colonic fermentation & SCFA production*
Modulation of colonic microflora
Weight loss, weight maintenance, and reduction in
adiposity
Increased satiety
* Have significant scientific agreement as indicated by health claims or in regulations
TM
Howlett et al 2009
Fiber: Transit time
"1/4 cup of Product X
contains 7 grams of
coarse wheat bran,
which promotes
regularity.”
Structure-function claim
Health Canada
Delayed nutrient absorption,
blunted glucose and insulin
response
Change in gut hormones
(GLP-1, PYY, ghrelin)
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Increased gastric
distention and
delayed emptying
Impacts stool
consistency
Fiber and Fecal Bulking
g feces/g fiber fed
Wheat bran
5.4
Psyllium*
4.0
Oats
3.4
Corn
3.3
Legumes
2.2
Pectin*
1.2
Resistant starch (RS2)*
1.1
Inulin*
1.0
* isolated fibres
the average weight of stools of 115 individuals is 123.6 Gm.
Cummings JH. 1993. CRC Handbook of Dietary Fiber in Human Nutrition
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Dietary Fibers Benefits: The ‘Vahouny 9’
DIETARY FIBER BENEFITS - VAHOUNY 2009
1.
2.
3.
4.
5.
6.
7.
8.
9.
Total and LDL cholesterol*
Post-prandial glucose & insulin*
Blood pressure
Increased fecal bulk and laxation*
Transit time (time it takes food to move through digestive
track)*
Colonic fermentation & SCFA production*
Modulation of colonic microflora
Weight loss, weight maintenance, and reduction in
adiposity
Increased satiety
* Have significant scientific agreement as indicated by health claims or in regulations
TM
Howlett et al 2009
Fiber, Fermentation & Prebiotic Effects
• Impacts on the speed of
digestion
• Effects pH of the colon
• Produces by-products with
important physiological
functions
• Impacts the immune system
• Diet does have an impact on
species and fermentation
7
6.5
6
pH
Control
Control
Polydextrose Sol. Corn
Fiber
PDX
SCF
Hardy H et al. Nutrients. 2013;5:1869-912;Bernaud FS, Rodrigues TC. Arq Bras Endocrinol Metabol.
2013;57:397-405.
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Fermentation-generated metabolites
promote metabolic benefits
Metabolites from fermentation of soluble dietary fibers
promote
– Intestinal gluconeogenesis affected by short-chain fatty
acids (SCFAs)
• Thought to have beneficial effects on glucose and
energy homeostasis
• In mice - propionate and butyrate activate IGN
through impacts on cAMP
– Metabolic benefits on body weight and glucose control
De Vadder F et al. Cell. 2014;156:84-96
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Individual Fiber and Blends & Microbial Fermentation
In vitro fermentation model of individual fibers and blends differs from that of
50:50 blends
– Medium- and long-chain fructooligosaccharides (FOS)
– Oligofructose-enriched inulin
– Galactooligosaccharide (GOS)
– Polydextrose (POL)
• 50:50 substrate blends
– Mixing of the various oligosaccharides with oligofructose-enriched inulin
produced less gas and at a slower rate
• POL with any other fibers produced less total SCFA and butyrate after 12
hours of in vitro fermentation, compared to individual carbohydrates.
• Bifidogenic bacteria growth rate was less with medium-chain FOS and
oligofructose-enriched inulin when mixed with POL.
• GOS with other fiber (except with medium-chain FOS) increased
bifidobacteria
Vester Boler BM et al Nutr Res. 2009; 29:631-9
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IN Vitro Fermentation of Soluble fibers varies
•
•
•
•
Wheat dextrin (WD)
Psyllium (PS)
Inulin – produced significantly more H2/ total gas
All fibers produced similar total SCFA concentrations
at 24 hours; however, the rate of production was
different.
– fast-fermenting substrates may not provide as
much SCFAs to the distal colon as slowfermenting substrates.
Timm DA et al J Med Food. 2010;13:961-6.
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Dietary Fibers Benefits: The ‘Vahouny 9’
DIETARY FIBER BENEFITS - VAHOUNY 2009
1.
2.
3.
4.
5.
6.
7.
8.
9.
Total and LDL cholesterol*
Post-prandial glucose & insulin*
Blood pressure
Increased fecal bulk and laxation*
Transit time (time it takes food to move through digestive
track)*
Colonic fermentation & SCFA production*
Modulation of colonic microflora
Weight loss, weight maintenance, and reduction in
adiposity
Increased satiety
* Have significant scientific agreement as indicated by health claims or in regulations
TM
Howlett et al 2009
Animal Models Show effects of SCFA on
Weight and Glucose
Lin HV et al PLoS One 2012;7(4):a35240
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Dietary Fiber and Change in Body Weight and
Waist Circumference
•
•
•
EPIC subset 89,432 European ages 20 –
78 yrs
Total DF and cereal fiber inversely
associated with weight and waist
circumference change.
Fruit and vegetable fiber inversely
associated with waist circumference
change.
Epidemiologic studies show that fiber intake is associated
with a lower body weight.
It must be too little fiber
Du, et al. Am J Clin Nutr. 2010;91:329-136.
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Soy Fiber and Weight
• 39 overweight and obese college adults (19-39 years of age);
RCT with biscuits or biscuits supplemented with SF for their
breakfast for 12 wk (approximately 100 g/day).
• Soy Fiber added to biscuits
– BMI and body weight
–  waist circumference
–  body & trunk fat
–  diastolic blood pressure,
–  serum levels of total cholesterol,
That reminds me, Walt, “Did you
– LDL-C, and glucose
remember to buy the tofu?”
Hu X et al Mol Nutr Food Res. 2013;57:2147-54.
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High Fiber Decreases Total Energy Intake
EFSA’s claim about fiber
and weight loss
Recommend that you need
at least 1g of glucomannan
3 times a day (with a glass
of water), in order to lose
weight as part of a caloriecontrolled diet.
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Howarth. Nutr Rev. 2001;59(5):129-39.
Fiber and Satiety – Evidence-Based Review
•
44 studies measuring appetite, food and/or energy intake; ≤24 hours, specified fiber type
and amount, a low- or no-fiber control; 38 fiber types/ treatments compared to control
• 39% significantly  subjective appetite scores
• 22% significantly  food or energy intake
•
Neither fiber type nor dose were related to satiety response or food intake
•
Satiety-enhancing effects supported in more than one publication
– β-glucan
•Lupin kernel fiber
– Rye bran
•Whole grain rye
Clark MJ1, Slavin JL. J Am Coll Nutr. 2013;32:200-11
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Benefits beyond ‘The Vahouny 9’
DIETARY FIBER BENEFITS - VAHOUNY 2009
1.
2.
3.
4.
5.
Total and LDL cholesterol*
Post-prandial glucose & insulin*
Blood pressure
Increased fecal bulk and laxation*
Transit time (time it takes food to move through digestive
track)*
6. Colonic fermentation & SCFA production*
7. Modulation of colonic microflora
8. Weight loss, weight maintenance, and reduction in
adiposity
9. Increased satiety
10. Mineral Absorption
* Have significant scientific agreement as indicated by health claims or in regulations
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Howlett et al 2009
Fermentation, Fibers and Calcium Absorption
• Fermentation of fiber  SCFA + lower pH  increased
mineral absorption (Ca, Mg, Fe)
• Animal and human studies – adolescents and middle-aged women
with various soluble fibers - inulin, soluble corn fiber
•  bone mass density
• calcium absorption
Whole Body Bone-Mass
Density
• types of organisms that may help
with calcium absorption
Legette LL et al J Food Sci. 2012;77:H88-94.
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Control
Using the Fiber Database
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Intakes everywhere are below recommendations
Recommended Range
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Gray J. ILSI Europe Dietary Fibre Concise Monograph Series. 2006.
Cho SS and Samuel P. Fiber Ingredients: Food Applications and Health Benefits. 2009.
Clemens R et al. J Nutr. 2012;142:1390S-401S.
Murphy N et al. PLoS One. 2012;7:e39361.
Consumers are Confused
Consumers are afraid of the names of isolated
fibers and are worried they are ‘fake’ fiber.
Consumers overestimate the fiber content of many
foods including whole-grain foods and think they
are getting enough fiber.
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November 2010 by Caravan® Survey for Kellogg
US Goals & Actual Intakes Affect Fiber Intake
• Healthy People 2010 Goals
• 75% of the population would consume 2 sv of fruit and 3 sv of veg
BUT
• 32% meet fruit goal of 2 sv
• 26% meet veg goal of 3 sv
• < 10% meet the whole grain goal
• Per capita intake of legumes 8 g/d (0.3 oz)
• Only 3-8% meet Dietary Guidelines
•
Only 4% US NHANES gender / age categories meet the fiber
requirement
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Addressing the “Dietary Fiber Gap”
Dietary Fiber in the Typical US Diet:
• Commonly consumed sources of dietary fiber contain ~ 1-3 g per serving.
• Greatest dietary fiber contributors to US population are potatoes and
refined grains due to their ubiquitous consumption.
In order to increase dietary fiber
intake and not increase calories…
Individuals should:
1. Limit options low in fiber.
2. Choose more nutrient dense, dietary fiber rich
choices including a variety of selections from the
family of fibers to meet their intake goals.
3. Consider all sources of dietary fiber -- look for
fiber-fortified foods and foods high in fiber.
TM
Typical U.S. Adult Male Diet
Meal Pattern #2
Breakfast
1 White toasted bagel
1 Fried egg
1 Slice American cheese
2 Bacon strips
8 oz Orange juice (no pulp)
16 oz Coffee-w/ 2 tsp sugar
Lunch
Turkey sandwich
3 oz Luncheon meat
1 Leaf lettuce
2 Slices tomato
1 Tbsp mayo
2 Slices white bread
1 Med apple
Dinner
8 oz Grilled steak
6 oz Potato wedges w/ skin
1/2 Cup mixed veggies (corn, peas, carrots)
2 Dinner rolls
2 Tbsp butter
1 Cup watermelon
Snacks/Other
1/4 Cup peanuts
1 oz Wheat crackers
1 Cup vanilla ice-cream
Calories
Grams Fiber
260
92
68
92
108
33
2
2
384
1.9
95
4.4
6.3
427
200
68
168
204
4
2.7
1.7
46
0.6
9.5
211
140
237
2.9
1
0.9
Meal Pattern #2 w/ Fiber Changes
Breakfast
1 Whole wheat double fiber bagel
1 Fried egg
1 Slice American cheese
2 Bacon strips
8 oz Orange Juice (no pulp)
16 oz Coffee w/ 2 packets sweetener +fiber
Calories Grams Fiber
220
92
68
92
108
0
Lunch
Turkey sandwich
3 oz Luncheon meat
1 Leaf lettuce
2 Slices tomato
1 Tbsp light mayo
2 Slices whole wheat added fiber bread
1 Med apple
Dinner
8 oz Grilled steak
6 oz Potato wedges w/ skin
1/2 Cup mixed veggies (corn, peas, carrots)
2 Whole wheat double fiber dinner roll
2 Tbsp Butter
Snacks/Other
1/4 Cup almonds
1 oz Bran crackers
1 Cup vanilla ice-cream
6.5
95
4.4
10.9
Should be consum ing at least:
39.9 g fiber based on AI (14g/ 1000 kcal)
22.1
2833
3
15.7
207
130
237
4
5
0.9
Total Fiber
Total Calories
Saved 116 calories and
I ncreased fiber by 22.4 g (201% )
4
2.7
6
50
4.8
Total Fiber
Total Calories
2
8
339
427
200
68
180
204
1 Cup strawberries
6
9.9
44.5
2717
Fiber Synergy with foods
• 46 overweight women, aged 50-72 yrs; 4 wks, diets matched for
nutrients ; RCT feeding
• Whole grain wheat / barley / legumes vs
whole grain wheat products
– 46.9 vs 43.5 g fiber
– Both  Total and LDL cholesterol but
combination >> than single source
» Combination also  BP and
fermentation
Tovar J et al. Br J Nutr. 2014;111:706-14
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Synergy of Isolated & Intrinsic Fiber
Control diet 20g dietary fiber (DF)
12 week
Healthy pattern (HP)
DF suppl.
HP + DF suppl.
 wt, BMI, TAG, insulin, LDL
 wt, BMI, % fat, LDL
 wt, BMI, % fat, TAG,
insulin, LDL
31 g DF
55 g DF
59 g DF
Overweight and diabetic subjects
Pal S, et al. Br J Nutr. 2011;105:90-100
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Science Supported Benefits of Added Fibers
Isolated Fiber (Added/Functional Fiber)
Beneficial Role
Primary Source
Beta-glucan (β-glucan) and oat bran
Blood lipid lowering
Attenuates blood glucose response
Oats and Barley
Cellulose
Laxation
Plant foods
Guar Gum
Blood lipid lowering
Attenuates blood glucose response
Guar bean (legume)
Inulin/Oligofructose/
Fructooligosaccharide (FOS)
Prebiotic
Calcium absorption
Chicory root
Jerusalem artichoke
Synthesized from simple CHO
Pectin
Blood lipid lowering
Attenuates blood glucose response
Plant foods
Polydextrose
Laxation
Prebiotic
Dental health
Synthesized from corn
Psyllium
Laxation
Blood lipid lowering
Psyllium husk (plant)
Resistant Dextrins
Blood lipid lowering
Attenuates blood glucose response
Corn and wheat
Resistant Starch
Laxation/fermentation
Plant foods
Soluble Corn Fiber
Laxation
Prebiotic
Calcium absorption
Corn
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IOM, Food and Nutrition Board. DRIs:Energy, Carbohydrates, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. Washington, DC:
National Academies Press; 2005.
Timm DA, et al. J Nutr. 2013;143:473-478.
Weaver CM, et al. J Agric Food Chem. 2010;58:8952-8957.
Whisner CM, et al. FASEB J. 2012. EFSA Journal 2011;9(4):2076
Slide of Dr. JS Slavin.
We have to convince people that illness is
due to something they didn’t eat.
42
All Fibers Fit
TM
‘All Fibers Fit’
To Address the Fiber Gap
• A growing body of research continues to support the
“Vahouny 9” benefits of dietary fiber as well as new ones
•
Added, as well as innate, fibers have documented physiological benefits, but not all
fibers are promote all health outcomes.
– Demonstrated effects of one fiber may not apply to others.
– Fiber effects may increase or decrease when removed from intact plant
structure or in mixtures.
– Data is being compiled for new fiber benefits.
•
Fiber is a nutrient of concern – few consume recommended levels.
– Meeting the recommended intakes for fiber will require continued
encouragement of foods naturally rich in fiber and consumption of fiber-fortified
foods in the context of a healthy diet..
– Adding fibers to foods is a realistic and simple way to address this global public
health concern.
TM
Variety for maximum impact
 Dietary Fiber is beneficial to health
 How do consumers achieve recommended intakes?
 Meeting dietary fiber intakes within caloric recommendations.
 How do consumers receive all the benefits attributed to DF?
TM