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Abstract

Obesity is a prominent health problem in the developed world, and leads to other metabolic diseases. Besides exercise and physical activity, a dietary regimen of fiber-rich food could be a primary solution to overcome obesity. Over the past decades, scientists have been investigating the role of dietary fiber to prevent obesity through innumerable experimental or observational studies. Epidemiological evidences showed that dietary fiber in either soluble or insoluble form helps to reduce weight among overweight or obese adults. This review explores studies that used dietary fiber in different forms to provide a probable conclusion. The objective of this review is to demonstrate the relationship between intake of dietary fiber and its effect on obesity. A comprehensive search for published academic peer-reviewed articles up to August 2018 was carried out through a systematic electronic search of several databases. Any interventional, cross-sectional or prospective cohort study from 1980 to 2018 that examined the association between intake of dietary fiber and obesity was included. All the cross-sectional and cohort studies suggested a significant relationship between fiber intake and a reduction in obesity or a classification of being overweight. Within interventional studies, some treatment groups showed no association with fiber supplementation, whereas other studies with longer interventional periods showed a significant association with obesity. Though increased consumption of dietary fiber has an impact on health, it depends on the sources or functionality of the fiber, supplementation or consumption dosage of the fiber, and both the duration of the study and follow-up time points. This suggests that fiber in an edible form or from its mixing with other foods may contribute to prevent the prevalence of obesity.
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Dietary Fiber and its Effect on Obesity: A Review Article
Ruheea Taskin Ruhee , Katsuhiko Suzuki2*
1 Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan
2 Faculty of Sports Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan
Introduction
Obesity is dened as a condition of excessive fat
accumulation in the body that leads to impaired health
conditions. In recent years, the prevalence of central
obesity is increasing, whereas it is demonstrated that
other non-communicable diseases subsequently occur
from central obesity. According to past research, it was
revealed that low physical activity, excessive intake
of high energy foods, poor consumption of fruits and
vegetables, and smoking and drinking alcohol all
promote obesity [1-4]. From a prospective observational
study with children, it was evidenced that sedentary
lifestyles, especially watching television, is becoming
a risk factor of obesity [5]. Moreover, excessive fat
accumulation in the body leads to a failure to regulate
normal physiological processes, and increases the risk
of chronic diseases like diabetes [6], certain cancers
[7], cardiovascular diseases [63], hepatic diseases [8],
gallstones [9], and gastrointestinal disturbances [10].
In this way, the prevalence of obesity is becoming
major public health issue in the modern world.
The European Association for the Study of Obesity
declared that obesity was the fth leading cause of death,
whilst 41% of cancer cases were associated with being
overweight and obese. The World Health Organization
(WHO) set the cutoff point to measure obesity at a body
mass index (BMI) of more than or equal to 30 [22].
In 1978 it was inferred that dietary ber (DF) could
be a probable solution to prevent obesity [11]. Dietary
ber has been dened by researchers in a variety of
ways. The Codex Alimentarius Commission (CAC)
Abstract
Obesity is a prominent health problem in the developed world, and leads to other metabolic diseases. Besides exercise
and physical activity, a dietary regimen of ber-rich food could be a primary solution to overcome obesity. Over the past
decades, scientists have been investigating the role of dietary ber to prevent obesity through innumerable experimental
or observational studies. Epidemiological evidences showed that dietary ber in either soluble or insoluble form helps
to reduce weight among overweight or obese adults. This review explores studies that used dietary ber in different
forms to provide a probable conclusion. The objective of this review is to demonstrate the relationship between intake of
dietary ber and its effect on obesity. A comprehensive search for published academic peer-reviewed articles up to August
2018 was carried out through a systematic electronic search of several databases. Any interventional, cross-sectional or
prospective cohort study from 1980 to 2018 that examined the association between intake of dietary ber and obesity
was included. All the cross-sectional and cohort studies suggested a signicant relationship between ber intake and a
reduction in obesity or a classication of being overweight. Within interventional studies, some treatment groups showed
no association with ber supplementation, whereas other studies with longer interventional periods showed a signicant
association with obesity. Though increased consumption of dietary ber has an impact on health, it depends on the sources
or functionality of the ber, supplementation or consumption dosage of the ber, and both the duration of the study and
follow-up time points. This suggests that ber in an edible form or from its mixing with other foods may contribute to
prevent the prevalence of obesity.
Keywords: Dietary ber, whole grain, obesity, weight loss
Citation: Ruhee RT, Suzuki K (2018) Dietary Fiber and its Effect on Obesity, Adv Med Res 1:1. doi:10.12715/amr.2018.1.2
Received date: August 27, 2018; Accepted date: September 12, 2018; Published date: September 20, 2018
Copyright: :© 2018 Ruhee RT. This is an open access article distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Competing Interests: The authors has declared that no competing interests exist.
*E-mail: katsu.suzu@waseda.jp
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in 2009, dened DF as carbohydrate (CHO) polymers
(including lignin and/or other compounds associated
with polysaccharide from plant cell walls) with ten or
more monomeric units, that have physiological health
benets demonstrated by generally accepted scientic
evidence. Furthermore, DF is not hydrolyzed by the
endogenous enzymes in the small intestine of humans,
and belongs to the following categories [12]:
Edible CHO polymers naturally occurring in the
food as consumed
CHO polymers from food, raw material by physical,
enzymatic or chemical means
Synthetic CHO polymers
Over the past decades it has been recognized that
there is a considerable positive effect of DF intake on
human health. According to the European Food Safety
Authority Panel on Dietetic Products, Nutrition and
Allergies, 25 g/day of DF intake is adequate for an adult
[13]. DF has some unique characteristics which help
to reduce mortality and morbidity caused by chronic
degenerative diseases [14]. Based on its digestibility in
the gastrointestinal tract, DF is classied into two basic
groups. The rst group is mostly of polysaccharides,
that are extracted from plant cell walls, are easily
hydrolyzed by enzymatic reactions and absorbed in
the small intestine. This group is also known as soluble
bers or soluble ber polysaccharides such as pectin,
obtained from fruits peel [15]. The second group is
composed of complex carbohydrates such as cellulose,
lignin and pectin which are resistant to digestion in the
small intestine, and undergo bacterial fermentation in
the colon; dened as insoluble bers [15]. There are
several mechanisms through which DF acts in human
body and reduces the risk of chronic diseases [15-16].
Soluble bers usually undergo fermentation to some
extent in the large intestine, and produce some short-
chain fatty acids which are absorbed and provide up to
2 kcal/g of energy [17-18]. On the other hand, insoluble
bers increase stool size and bowl movement [20].
Sources of such soluble bers include fruits, vegetables,
oats, dried beans and peas and whole grain; however,
wheat bran is considered as a source of insoluble bers
[19-20]. Moreover, DF has also been classied as a
CHO-based fat replacer, and is used in different dairy
products, frozen desserts, and baked goods for example
[17].
From 1987 to 2017, a wide range of trials had been
completed to investigate the interventional use of DF
from numerous soluble and insoluble sources, e.g.
cereal ber, fruit ber, vegetable ber, ber from beans,
soy ber, psyllium ber, cactus ber, glucomannan,
guar gum, and alginate for example; looking to examine
subsequent effects on a body weight. However, the
results of the past trials varied depending on the ber
sources.
It was mentioned by Burton-Freeman that DF has a role
in controlling level of satiety. In this way, it is possible to
regulate food intake and reduce the risk of obesity [26].
It has been hypothesized that ber-rich foods require
more chewing time than normal foods [27]. Moreover,
soluble bers absorb more water and create a viscous
gel which increases stomach distention [18]. Pereira
and Ludwig described how DF helps to maintain body
weight through three distinct physiological pathways;
intrinsic, hormonal, and colonic effects. Subsequently,
also assists to increase satiety levels and inuences on
fat oxidation, then decreases energy intake, along with
lowering body fat content [28]. Other review articles
support that DF provides low energy and has signicant
roles in slowing down gastric emptying, creating
a feeling of satisfaction, decreasing serum insulin
secretion, and reducing food intake. Furthermore,
fermentation of ber produces short-chain fatty acids
which modify eating patterns by releasing peptides and
gut hormones such as cholecystokinin and glucagon
like peptide 1; thus reducing hunger and promoting
satiety [21,29,42]. In an animal model experiment
using equal quantities (10% w/w) of both soluble and
insoluble bers, it was evident that insoluble ber has
a signicant role in controlling body weight compared
with soluble ber [30].
The hormone leptin is primarily responsible for
regulating appetite and energy expenditure in humans
[64]. It has been evident from an experiment using
animals that, leptin resistance occurs with obesity, and
failed to maintain hunger balance [23].
Another review article suggested a probable
relationship between leptin and ghrelin, where
obese patients have leptin resistance, and increased
sensitivity to ghrelin [24]. Moreover, in a randomized
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crossover trial, subjects were exposed to liquid carob
ber (derived from Ceratonia silique, rich in insoluble
bers); reporting a signicantly lower level of ghrelin
compared to the control group (P<0.001) [33] However,
it was concluded that any effects of DF on the secretion
of leptin or ghrelin are yet to be fully understood [25].
This review included 20 interventional studies, 4 cross-
sectional studies and 9 cohort studies, each investigating
how different types of ber supplementation affect
body weight.
Methods
Search strategy
A systematic literature search was conducted using
PubMed and the Cochrane Central Register of
Controlled Trials (CENTRAL) databases, for related
randomized controlled trials up to August 2018.
Other journals like, Journal of European Food Safety
Authority, the American Journal of Clinical Nutrition,
International Journal of Obesity, and the Journal
of Nutrition were also searched directly to extract
relevant studies. To reveal information on specic
recommendations, international organizations were
cited including the World Health Organization and
European Association for the Study of Obesity. Specic
keywords used including dietary ber, obesity, weight
loss, cereal ber, whole grain, soy ber, glucomannan,
guar gum, alginate, fruit ber, and vegetable ber.
Inclusion Criteria
Any case-control, cohort or experimental study with an
intervention involving, or an objective to explore the
role of DF in governing weight loss was considered
for this review. Studies with healthy overweight or
obese subjects at any age were primary selection
criteria for cohort and cross-sectional studies, whilst
studies involving subjects with a BMI ≥20, or a body
weight ≥120% of ideal body weight were accepted for
experimental studies. Some of the studies measuring
physical activity levels, and providing consultation
about daily routine or diet, or exercises along with
supplementation were also included. Studies used food
diaries, dietary recall, food frequency questionnaires
and weighted food records as diet assessment tools. For
supplementation, ber could be consumed as soluble or
insoluble DF supplement in the form of tablets or pills,
or directly from dietary sources. As inclusion criteria,
studies that included body weight loss, BMI and
waist circumference selected as primary outcomes and
percent of body fat, fecal fat excretion were considered
as secondary outcome. In addition, nal outcomes
were compared with baseline data, and then expressed
as a signicance level of data using P values or 95%
condence intervals, reported with lower and upper
limits.
Exclusion criteria in the selection of studies included
pregnancy, diabetes, atherosclerosis, hypertension,
renal failure, dyslipidemia or other chronic disease
subjects. Also, studies were excluded if the dose of
the supplement and the outcomes were not mentioned.
Studies were also excluded when partial or multiple
interventions were used, and those not mentioning, or
missing a control group. Finally, studies published in
other languages to English were also excluded. This
study does not differentiate between races, gender,
socio-economic status, duration or follow up nature
of the study, or the method of supplementation. Some
additional literature was also studied to gather required
knowledge about the biochemical and physiological
relation between the study topics.
Results
Study inclusion
This review includes 71 records systematically searched
from databases as shown in Figure 1. A total of 2786
articles were searched from the electronic search, 2223
were from PubMed and 563 trials were from Cochrane
Central. Full text articles identied for the analysis
included 369 articles, with initial screening being done
by the title and abstract. On the other hand, 298 records
were excluded due to not meeting the dened inclusion
criteria. In particular, the 71 records selected for this
review included literature reviews, experimental
studies, and cohort and cross-sectional studies; with
38, 20, 9 and 4 records of each kind, respectively.
Characteristics of the studies
In this review, 20 interventional studies, 4 cross-
sectional studies and 9 cohort studies were analyzed
to ascertain the association between intake of DF and
obesity. Table 1 presents the interventional studies,
where 19 were randomized placebo-controlled trials
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Author,
Year Study
Design
Study Size (M/F);
Age (year); BMI(kg/
m2); Duration
Diet
Assessment
Tool
Exposure Results
Uebelhack
et al., 2014
Double-blind,
randomized,
placebo-
controlled,crossover
single center study
20 healthy subject;
18 to 60; 20 to 30; 45
days
FD Cactus ber
tablet
Increase fecal fat excretion compared to
placebo 15.79% vs. 4.56% which takes into
account the wt loss effect (P <0.001).
Grube et
al., 2013
Double-blind,
randomized,
placebo-
controlled, clinical
investigation
123 (30/93); 18 to 60;
25 to 35; 12 weeks SD
Natural ber
complex
Litramine IQP
G-002AS
Body wt loss in the treatment group was more
in compare to placebo group (Difference 2.4
kg: 3.8 kg vs. 1.4 kg)
(P <0.001).
Melanson
et al., 2006
Randomized,
controlled, two-
phase clinical
trial
134 obese adults; 18
to 70; 27 to 35; 24
weeks
3-day food
records
Hypocaloric diet,
ber rich whole
grain cereal,
exercise
Both hypocaloric diet plus exercise with whole
grain consumption (5.7±0.7 kg) and diet and
exercise (6.2±0.7 kg) reduces more body wt
than exercise only (1.75±0.62 kg) group (P
<0.001).
Hypocaloric diet
and exercise
Exercise only
Turner et
al., 2013
Randomized,
controlled trial
20 (18/2); 18 to 70;
27 to 35; 6 weeks
3-day food
diaries
Beans (29.10
g/day) Both bean diet (1.62 ±1.26 kg) and SHF diet
(1.08±1.70 kg) has equal effects on changes in
wt reduction (P <0.001).
SHF diet (Fruits,
vegetables, WG )
(28.85 g/day)
Table 1: Results of Intervention studies
Figure 1: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) ow chart of search
strategy
Searched articles
identified from
PubMed (n = 2223)
Searched article
identified from Cochrane
central (n = 566)
Trials (n = 563)
Total searched article through database (n = 2786)
Removed Duplicate
articles (n = 719)
Excluded article
(n = 1698)
Result not specified
Irrelevant intervention
Full text unavailable
Screened full text articles for
analysis (n = 369)
Excluded article
(n = 298)
Animal studies
Did not meet inclusion
criteria
Data derived from
secondary analysis
Article included for review
(n = 71)
Literature review (n = 38)
Experimental study (n = 20)
Cohort study (n = 9)
Cross-sectional study (n = 4)
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Lambert et
al., 2017
Randomized,
double-blind,
placebo-controlled
study
50 (9/41) overweight
and obese; 18 to 70;
25 to 38; 12 weeks
3-day
weighted FR
Wafers
containing 15 g
of pea ber/day
Wt loss was -0.87 ± 0.37 kg (P = 0.022) and
fat mass was reduced by -0.74 ± 0.26 kg (P =
0.014). BMI also reduced slightly (P = 0.025)
Wafers with no
pea ber
Body wt and fat mass was gained by +0.4 0 ±
0.39 kg (P = 0.022) and +0.42 ± 0.38 kg (P =
0.014) respectively.
Hu et al.,
2013
Randomized
clinical trial
39 (17/22) overweight
and obese;
19 to 39; 23 to 35; 12
weeks
7-day food
diaries
Soy ber biscuit,
27.5 g/day
After 12 week BMI (-0.51±0.14) and body wt
(-1.39±0.36 kg) signicantly reduce (P <0.01).
Slight changes observed in WC (-1.75±0.48
cm) (P < 0.05).
Control biscuit
3.2 g/day
No signicant changes observed in body wt
(-0.68±0.32 kg; P = 0.157), BMI (-0.07±0.04; P
= 0.129) and WC (0.41±0.15cm; P = 0.937).
Keithley et
al., 2013
Randomized,
double-blind,
placebo-controlled
47 (7/40) subjects;
18 to 65; 25 to 35; 8
weeks
3-day FR
Glucomannan
3.99 g/day
No signicant difference found in body weight
between two groups (−.40 ± .06 and −.43 ± .07
respectively).
Placebo capsule
Jakše et
al., 2017
Non-randomized
interventional trial
325 (43/282) subjects;
mean age 41.2±12;
mean BMI 26.5; 10
week
DQ based on
food groups
Plant based diet
(TDF 40-45
g/day)
7.3 kg wt reduction found among obese subject
(P <0.001). Mean wt change was 1.1 ± 3.6
kg (P= 0.09) and −3.5 ± 5.5 kg (P < 0.001) in
control and treatment group.
Sartorelli
et al., 2008
Randomized
clinical trial
80 overweight
subject;
30 to 65; 24 to 35; 6
months
FFQ; 75
items
Fruits and
vegetable ber
For 100g of total vegetable and fruit intake
500g and 300g body wt reduces respectively
after follow up (P <0.5); and 1.5 kg reduce dark
colored vegetables (P <0.05; vegetables [95%
CI] = −0.00497 [−0.008, −0.002] and fruits
[95% CI] = −0.00290 [−0.005, −0.001]).
Solah et
al., 2017
Three-arm, parallel,
blind, randomized
control trial
120 (28/92)
overweight adult; 25
to 70;
25 to 35;
12 weeks
4-day mobile
food record
app
PolyGlycopleX
(PGX) soft gels
a commercial
functional ber
complex 7.6–
11.4 g/day.
Non-signicant reduction in WC (−0.17 ± 2.92
cm), body wt (0.22 ± 1.61) and BMI (0.07 ±
0.59).
PGX granules
12.2 g/day
Signicant reduction in WC (-2.5±0.60 cm; P
= 0.003), body wt (−1.4±0.10 kg, P < 0.01) and
BMI (−0.5 ± 0.10, P < 0.01).
RF 12 g/day
Non-signicant reduction in WC (−1.3 ± 1.0
cm), body wt (−0.03 ± 0.58) and BMI (0.01 ±
0.20).
Tonstad et
al., 2014
Prospective,
randomized clinical
trial
173 (45/128)subjects;
≥18; 30 to 44; 16
weeks
FD
High ber bean
rich diet Both diet reduces BMI and body wt in two
groups [difference, 1.1 kg, 95% condence
interval (CI) = ─2.6 to─0.5; P = 0.2].
Low
carbohydrate
diet
Birketvedt
et al., 2005
Randomized double
blind placebo-
controlled study
176 subject; 30 to
-60;
>25 to <30; 5 weeks
SQ
Glucomannan Signicant wt reduces after administration
in compare to placebo for three groups
approximately 0.8 kg/week, (3.8±0.9, 4.4±2.0,
4.1±0.6 respectively) but no individual changes
observed (P <0.001).
Glucomannan,
guar gum
Glucomannan,
guar gum and
alginate
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Rossner et
al., 1987
Randomized,
double-blind
parallel study
54 female subjects; 18
to 60; body wt ≥120%
of IBW; 2 months
24 hour DR
Fiber tablet
(grain and citrus
ber) Mean wt reduction in ber group was higher (7
kg) than placebo group (6 kg) (P <0.05).
Placebo tablet
(corn starch and
sucrose)
41 female subjects; 18
to 60; body wt ≥120%
of IBW; 3 months
Fiber tablet
(vegetable, grain
and citrus ber) Mean wt reduction in ber group was 6.2 kg,
that is higher than placebo group (4.1 kg) (P
<0.05).
Placebo tablet
(corn starch and
sucrose)
Salas-
Salvadó et
al., 2008
Parallel, double-
blind, randomized
placebo-controlled,
multi-centered
clinical trial
166 adults; 18 to 70;
27 to <35;
16 weeks
FD
Mixed ber dose
(3 g Plantago
ovata husk and 1
g glucomannan)
twice a day
Wt losses observed in both ber group
(-4·52±0·56 kg and -4·60±0·55 kg
respectively) and with the placebo group
(-3·79±0·58 kg) but there was no signicant
differences between the groups (P = 0.43).
Mixed ber dose
thrice a day
Placebo
sachets(3 g
microcrystalline
cellulose)
Pal et al.,
2016
Randomized,
double-blind,
parallel design
study
127 (54/73)
overweight adult;
mean age 49.2; 25 to
47; 52 weeks
3-day food
and drink
diary
PolyGlycopleX
(PGX, NSP
complex) 15
g/day
Weight reduction in the PGX group was −2.8%
and −1.5% for the PSY group compared to
control after 12 months
supplementation WC and body fat signicantly
lower in compare to control group (P <0.05).
Psyllium ber
(PSY) 15 g/day
RF 15 g/day
(Placebo)
Allison et
al., 2003
Randomized
controlled clinical
trial
100 (20/80)obese
subject;
35 to 65; 28 to ≤41;
12 weeks
SSI
Soy based
meal diet (Scan
Diet meal-
replacement
formula)
Mean wt loss was 7.1 kg (95% CI 5.4, 8.8; P =
0.001).
1200 kcal
exchange system
diet
Mean wt loss 2.9 kg (95% CI 1.8, 4.0; P
<0.0001).
Georg
Jensen, et
al., 2012
Randomized,
double-blind,
parallel design
study
80 (26/54) obese
subject;
20 to 55; 30 to 45; 12
weeks
FD
Sodium alginate
ber 15 g/day Signicant wt loss was observed in alginate
group than control group (-1.7±0.5 kg, P
=0.031).
Placebo
(maltodextrin
and sucrose)
Fatahi et
al., 2018
Randomized
parallel controlled
feeding trial
75 female adults; 18
to 50; ≥25;
10 weeks
3-day FR
WG
WG group signicantly reduces more wt (P
=0.03) and WC (P=0.001) in compare to other
two groups.
Fruits and
vegetables
WG, fruits and
vegetables
Venn et al.,
2010
Randomized
controlled study
108 overweight
subject; ≥40;
≥28; 18 months
3-day
weighted FR
WG & pulse No different observed between treatment and
control group wt loss (P >0.05); but signicant
reduction in WC observed in exposure group
(-2.8 cm; 95% CI: -0.4, -5.1).
Control diet of
NFHNZ
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and 1 study was non-randomized trial using low fat
plant-based diet along with some dietary guidelines
[47]. Almost all the experimental studies used different
forms of DF, with most results were positively
associated, albeit with a few exceptions. Fatahi et al.
proposed that whole grain ber reduced more weight
than fruits and vegetables ber (P = 0.03). However,
whole grain with a pulsed intervention program
showed no effect on weight loss, but was inversely
associated with waist circumference [61]. In 1987, one
study compared two groups separately with the effect
of grain, citrus ber and vegetable, and grain and citrus
ber. Although both groups reduced signicant amount
of weight, the citrus ber group reduced weight by
more (7.0 kg) than the vegetable ber group (6.2 kg)
[55]. Dietary ber in the form of soy ber or a soy-
based diet also showed an inverse association in two
randomized controlled trials [45,58]. Two studies
evidenced that DF along with calorie restriction (low
CHO) diet adjunct to exercise-induced signicant
weight reduction among the treatment group [35,53].
In 2008, Sartorelli et al. implemented a randomized
clinical trial with 80 overweight subjects and provided
a prescribed diet in the treatment group, reporting
that dark colored fruits and vegetables might play a
signicant role in reducing obesity. A few interventions
were performed with functional ber such as Litramine
IQP G-002AS (derived from Opuntia cus-indica), and
PolyGlycoplex and psyllium ber. PolyGlycoplex in
granule form supplemented in a 12 g/day dose showed a
reduction in BMI and body weight (P<0.01) compared
with a soft gel form [51]. Furthermore, sodium alginate
ber at a 15 g/day dose in conjunction to an energy
Babiker et
al., 2012
Two-arm
randomized,
placebo controlled,
double-blind study
120 female subject;
≥17;
mean BMI 26.5±4.6;
6 weeks
NA
Gum Arabic 30
g/day
Slight reduction of BMI (95% CI: 0.17 to 0.47;
P <0.0001) and body fat percentage (95% CI:
1.54 to 283; P <0.0001).
Placebo (pectin)
5 g/day
Slight increase in BMI (95% CI: -0.16 to 0.02;
p = 0.132) and percentage of body fat (95% CI:
-1.44 to −0.20; P = 0.010).
FFQ; Food Frequency Questionnaire, FD; Food Diary, SD; Subject diary, wt; weight, DQ; Dietary Questionnaire, SHF; Standard High
Fiber, TDF; Total Dietary Fiber, RF; Rice Flour, SQ; Standardized Questionnaire, DR; Dietary Recall, IBW; Ideal Body Weight, NSP; Non-
Starch Polysaccharide, SSI; Standardized Structured Interview, FR; Food Record, NHFNZ; National Heart Foundation of New Zealand,
WG; Whole Grain, WC; Waist Circumference, NA; Not Applicable.
Author, year Study design Study size
(M/F); Age
Diet assessment
tool Exposure Results
Newby et al.,
2007
Baltimore
Longitudinal Study on
Aging
1516 subject;
27 to 88 year
7-day dietary
records
WG, CF,
RG
WG and CF intake was inversely associated with
BMI (P <0.0001), weight, (P =0.0004), WC (P
<0.0001). For WG consumption a signicant
difference observed with subjects in the lowest
quintal (Q1) to the highest quintal (Q2) for BMI
(Q1, 25.5; Q5, 24.8; P < 0.0001), wt (Q1, 75.0 kg;
Q5, 72.6 kg; P= 0.004) and smaller WC (Q1, 87.4
cm, Q5, 85.0 cm; P =0.002).
Lutsey et al.,
2007
Multi-Ethnic Study of
Atherosclerosis
5496 subjects;
45 to 84 year
FFQ, 127 food
items WG
WG intake was inversely associated with BMI
(mean differences between highest and lowest
quintal was 0·6 kg/m2, P <0.0001).
McKeown et
al., 2010
Framingham Heart
Study
2834
(1434/1400)
subjects; 32 to
83 year
Semi quantitative
FFQ, 126 food
items
WG
Inverse association between WG intake with
WC (97.0 compared with 93.7 cm in the lowest
compared with the highest quintile category, P
<0.001).
RG Positive association between RG intake with WC
(95.9 compared with 97.3 cm, P = 0.06).
O'Neil et al.,
2010
National Health and
Nutrition Examination
Survey1999 to 2004
7039 for 19
to 50 year and
6237 subjects
for ≥51 year
24 hour dietary
recall
WG
WG intake was inversely associated with BMI
and WC (P =0.04) among 19 to 50 year; for age
≥51 year BMI (P =0.03) and WC (P =0.01).
Total CF No association observed with obesity.
FFQ; Food Frequency Questionnaire, WG; Whole Grain, CF; Cereal Fiber, RG; Rened Grain, WC; Waist Circumference.
Table 2: Results of Cross-sectional study
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restricted diet or gum arabic supplementation at 30 g/
day also reduced body weight and fat in the treatment
group compared to a placebo [59-62].
Four cross-sectional studies with more than 20,000
subjects examined the role of whole grain compared
with rened grain to reduce obesity (Table 2). The
National Health and Nutrition Examination Survey
(NHANES) 1999 to 2004 was cross-sectioned between
the consumption of whole grain and cereal ber;
Author;
Year Study name
Study size (M/F);
Age;
Follow up period
Diet Assessment tool Exposure Results
Koh-Banerjee
et al., 2004
The Health
Professionals
Follow-up Study
27082 subjects;
40 to75;
8 years
Semi quantitative
FFQ,
250 food items
WG, FF,
VF
20 g/day increase in DF wt gain
reduced by 1.18 kg (whole grain, P
<0.0001) & 2.51 kg (fruit ber, P
<0.001).
Ludwig et al.,
1999
The Coronary
Artery Risk
Development in
Young Adults Study
2909 healthy adults,
18 to 30;
10 years
Interviewer
administered
quantitative FFQ; 700
foods
TDF Fiber consumption inversely
associated with wt gain (P <0.001).
Liu et al., 2003 Nurses’ Health
Study
740191 female subjects;
38 to 63; 12 years
Validated FFQ; 61
item
RG Wt gain inversely associated with
WG consumption rather than RG ( P
<0.0001).
WG
Van et al., 2009 Netherlands Cohort
Study
4237 (2078/2159)
subjects;
55 to 69; 5 years
Semi-quantitative
FFQ; 150 food items
BB No signicant association found
between intake and obesity.
WG Inverse association found with intake
and wt gain (P <0.01).
Steffen et al.,
2003
Minneapolis Public
School Students
Study
285 (155/130) healthy
adolescents; mean age
13; 2 years
Two FFQ, 127 food
items WG, RG WG intake was inversely associated
with BMI (P = 0.01) than RG.
Lindstrom et
al., 2006
Finnish Diabetes
Prevention Study
522 (172/350)
overweight middle
aged adults;
40 to 64;
3years
3 day food record
High ber,
Low fat
3.1 kg wt reduces (95% CI 2.3–3.9)
(P = 0.001).
Low ber,
high fat 0.7 kg wt loss (95% CI−1.7 to +0.1).
Tucker &
Thomas: 2009
NS (covering two
metropolitan areas
in Mountain West
region)
252 women; mean age
40.1; 20 months
7day weighted food
records TDF
Weight decreased by 0.25 kg (P
=0.0061) and fat decreased by 0.25
percentage point (P =0.0052) for 1 g
increase in total ber consumption.
Du et al., 2009
DiOGenes (Diet,
Obesity, and Genes)
project
89432 (37125/52307)
European subjects; 20
to 78;
6.5years
Country specic FFQ
Cereal ber Inversely associated with weight
change (P = 0.01)
Fruits and
vegetables
ber
No strong association (P = 0.05)
Rautiainen et
al., 2015
Women's Health
Study
18,146 women; age
≥45;
17 years
FFQ, 131 food items FF
Strong inverse association found
between fruit intake and BMI (HR:
0.82; 95% CI: 0.71, 0.94).
VF Associated with wt gain (P = 0.02)
FFQ; Food Frequency Questionnaire, wt; weight, WG; Whole Grain, FF; Fruit Fiber, VF; Vegetable Fiber, RG; Rened Grain, TDF;
Total Dietary Fiber, FR; Food Record, BB; Brown Bread
Table 3: Results of Prospective cohort study
reporting that intake of whole grain was inversely
associated with obesity.
Nine prospective cohort studies (Table 3) including
855,974 participants showed a signicant relationship
between DF intake and a change in body weight.
Ludwig et al. conducted a population-based
prospective cohort study for 10 years, concluding that
DF is independently and inversely related to weight
reduction [36]. A considerable number of studies had
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conducted examining the role of whole grain intake
and weight reduction. However, Rautiainen et al. in
2015 postulated that fruit ber intake is more strongly
inversely associated with weight loss compared with
vegetable ber [48].
Discussion
In total, 33 studies were examined, using different
types and sources of DF and several functional bers.
During the trial period, subjects were guided with
dietary advice to drink a minimum level of water or
skim milk before taking the supplements [45, 46, 51,
54, 59]. To minimize potential discomforts, ber doses
in interventional studies were increased gradually
throughout the supplementary period; whilst results were
subsequently compared with baseline characteristics. It
was evident from the reviewed trial that, pea ber was
a good source of DF, comprising of 8% soluble ber
from 92% total ber; where moderate doses of yellow
pea ber (15 g/day) signicantly helped reduce body
fat among overweight or obese subjects [44]. It was
hypothesized that glucomannan, a fermentable water
soluble DF (known as konjac) helped to reduce body
weight by inducing bulking properties. However, an
8-week trial of glucomannan ingestion alone showed
no signicant changes in weight compared with a
placebo [46]. Also, a 5-week trial of glucomannan in
combination with guar gum and alginate resulted in a
reduction in weight in the treatment group compared
with a placebo [54].
In terms of palatability and appetite, ber-rich foods
are less palatable and create a feeling of fullness after
having a low amount, whilst foods and hunger ratings are
inversely related with time [55,69] There is substantial
evidence that whole grains are associated with lowering
the percentage of abdominal adiposity compared with
rened grain [70]. This can be further elaborated from
a recent cross-sectional study with middle-aged and
elderly Japanese people; the WASEDA'S Health Study.
The results revealed that a healthy dietary pattern was
inversely related to waist circumference and visceral
fat [4]. Kehlet et al. compared hunger, fullness,
satiety and palatability levels between four test meals,
demonstrating that the addition of ber to meals leads
to less palatability, as well as increased satiety and
fullness perceptions, and mitigated hunger. Overall, DF
could be a probable solution to alleviate overweight or
obesity [18,71].
Mattes in 2002 hypothesized, based on a cereal
intervention involving a volumetric diet and ber-rich
foods, that adopting such a diet will reduce energy
intake as well as fat mass [39]. In a study named The
New Dietary Interventions to Enhance the Treatments
for weight loss (New DIETs), researchers investigated
the effects of a weight loss intervention using a plant-
based diet composed of fruits, vegetables, whole grains,
and legumes/beans; providing evidence that a plant-
based diet could be a short-term healthy approach to
reduce weight [41].
Conclusions
This study examined probable relationships between
DF and obesity, by analyzing experimental, cross-
sectional and cohort studies. Heterogeneous results
were identied, even when using the same protocol,
or diet assessment tools. Therefore, variations in
results may be due to subjective anthropometric and
physiological variations, and the period of follow
up, for example. In short, research on the use of DF
may have wide-ranging opportunities relating to the
treatment of obesity. However, further research is
required to investigate stronger associations between
DF intake and obesity.
Acknowledgements
All work has been carried by the authors. There was
no conict of interests. Also, we would like to thank
Dr. Llion Roberts, Lecturer of Human Physiology,
School of Allied Health Sciences, Grifth University,
for English editing.

None to report.
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... Modern society has entered an age that is characterized by high fat diets, food satiation, and exercise deficiency due to automation and convenience. This has led to increases in lifestyle-related diseases including obesity, a large social problem [12,13]. Overeating and/or sedentary lifestyles can cause an accumulation of fat tissue in the body, and the infiltration of inflammatory cells such as macrophages into such tissues [1,14]. ...
... Chronic inflammation is, therefore, likely to negatively affect aging, disease susceptibility, and people's healthy life expectancy [1,15]. Such chronic diseases are also increasing globally, with the World Health Organization (WHO) collectively naming lifestyle-related diseases, allergies, and cancers as noncommunicable diseases (NCD) and highlighting them as key issues for future medicine, healthcare, and public health [10,12,13]. ...
... Exercise can increase energy consumption, while preventing or improving obesity, diabetes, dyslipidemia, and hypertension [12,19,57]. Exercise is also effective in preventing atherosclerotic diseases such as ischemic heart disease or cerebrovascular disease and cancer [10,49,58]. ...
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Reduced levels of physical activity in people's daily lives cause the development of metabolic syndromes or age-related disorders. Chronic inflammation is now understood to be an underlying pathological condition in which inflammatory cells such as neutrophils and monocyte/macrophages infiltrate into fat and other tissues and accumulate when people become obese due to overeating and/or physical inactivity. Pro-inflammatory mediators such as cytokines that are secreted in excess from inflammatory cells will not only lead to the development of arteriosclerosis when they chronically affect blood vessels but also bring tissue degeneration and/or dysfunction to various organs. Chronic inflammation is also involved in sarcopenia that brings hypofunction in the elderly, dementia, osteoporosis, or cancer and negatively affects many chronic diseases and people's healthy life expectancy. In this paper, outlines of such studies are introduced in terms of homeostatic inflammation, which occurs chronically due to the innate immune system and its abnormalities, while focusing on the efficacy of exercise from aspects of immunology and oxidative stress. The preventative effects of functional food ingredients in combination with exercise are also introduced and described. The challenges and future directions in understanding the role of exercise in the control of chronic inflammation are discussed.
... In this study, we found differences in fiber intake, vitamins, iron, manganese, and omega-3 between participants in the obese and non-obese groups. A review article that summarized findings from published studies from 1980 to 2018 demonstrated that the majority of cross-sectional and cohort studies reported a positive association between dietary fiber intake and a reduction in obesity or overweight risk [22]. A possible explanation for this positive effect on obesity risk could be explained by stimulation of gut hormones by fiber such as glucagon-like-peptide-1 (GLP-1) and peptide YY (PYY), which lead to reduced appetite, and altered metabolism of bile and cholesterol [23]. ...
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Background and aims Research has investigated and established the role of dietary intake and risk factors for obesity. Due to the impact of changes in the Saudi dietary pattern and an increased consumption of high calorie food on obesity risk among the Saudi population, it is important to investigate the effect of dietary intake and its association with obesity risk. We aimed to investigate correlations between dietary intake and obesity risk factors in healthy Saudi adults. Methods This cross-sectional study recruited 60 healthy Saudi participants, which included both men and women (between 18-55 years and BMI between 18-40 kg/m²) from King Abdulaziz University, Jeddah, Saudi Arabia. The three-days food record method was used to collect dietary information. The data were analyzed using an independent sample t-test and linear regression. Results Statistically significant differences were found between participants in the obese and non-obese groups regarding several B vitamins and omega-3 intake (p < 0.01). Compared to the group with high consumption of omega-3, the low consumption group showed 5.7 [2.4 to 8.9; 95% confidence interval (CI)] - and 20.5 (5.4 to 35.6; 95% CI)-times increased risk of higher body mass index and waist circumference, respectively. Conclusion Our findings indicated that a low intake of omega-3 is associated with increased obesity risk.
... The lack of DF in the diet often leads to gastrointestinal diseases and increased risk of cardiovascular diseases [88]. The consumption of high-fibre foods contributes to a reduction in blood pressure [89] and cholesterol levels [90] and is associated with a lower risk of obesity [91]. The recommended level of total DF intake depends on sex and age and ranges from 21 to 38 g per day [87]. ...
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Wheat pasta is one of the most important cereal products and is becoming increasingly popular worldwide because of its convenience, simple formulation, long shelf life, and high energetic value. Wheat pasta is usually obtained from refined flour rich in carbohydrates but with low content of phytochemicals, micronutrients, and fibre. The increased demand of consumers for healthy foods has generated interest among both researchers and food producers in developing functional food products. This review showcases the current trends in pasta fortification. Changes in the nutritional value, cooking quality, sensory attributes, and antioxidant properties of durum and common wheat pasta enriched with both plant and animal raw materials are discussed.
... Additional models were adjusted for self-reported diabetes at baseline (yes/no) (model 3), BMI (in kg/m 2 ) (model 4), total energy intake (MJ/d) using the standard multivariate method (24) (model 5), and all factors combined (model 6). Diabetes risk, BMI, and energy intake are considered potential mediators (25)(26)(27). ...
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Background: Pancreatic cancer is a highly deadly disease with a poor prognosis. There is limited knowledge about prevention of the disease; thus, identification of risk factors is important to reduce the disease incidence. Objective: The aim of the present study was to prospectively investigate associations between incidence of pancreatic cancer and whole-grain intake measured in 2 ways: as whole-grain product intake (g whole-grain products/d) and as whole-grain intake (grams of whole grains/d). Moreover, the intake of subgroups of these was also investigated: whole-grain products (rye bread, whole-grain bread, and oatmeal/muesli) and cereals (rye, wheat, and oats). Methods: In total, 55,995 Danish adults aged 50-64 y, of whom 446 developed pancreatic cancer (17.5 y mean follow-up), were included in the study. Detailed information on daily intake of whole-grain products was available from a validated self-administered FFQ, and intake of whole-grain cereals (wheat, rye, and oats) was estimated using information from a 24-h dietary recall. The association between the whole-grain exposures and incidence of pancreatic cancer was investigated by Cox regression analyses adjusted for potential confounders. Results: Total whole-grain product intake was associated with a 7% lower incidence of pancreatic cancer per serving (50 g/d) (HR: 0.93; 95% CI: 0.86, 1.00), and in the sex-specific analyses, an inverse association was found only in men. No association was found for total whole-grain intake (per 16-g serving size; HR: 0.96; 95% CI: 0.89, 1.03). When investigating specific whole-grain products and cereals individually, none were alone associated with lower incidence of pancreatic cancer. Conclusion: Our findings indicate that intake of whole grains is associated with lower risk of pancreatic cancer in middle-aged men. Consuming ample amounts of whole grains may prove beneficial in terms of lowering pancreatic cancer risk.
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Excessive deposition of abdominal fat is a public concern in the yellow chicken industry related to human nutrition. The common practice of nutritionists is to increase the fiber content in feed to control abdominal fat deposition of chickens. Corncob meal (CCM) is the cheapest ingredient widely used in animal diets. The possible effects of CCM on chicken abdominal fat deposition and the possible mechanism involving cecal microbiota remain unknown. The objectives of this study were to investigate the effects of CCM in modulating abdominal fat deposition and the role of the cecal microbiota and their metabolites. A total of 200 90-d-old Huxu female chickens were divided into 2 dietary treatments, each with 10 replicates of 10 birds, and were fed two finisher diets, from 90 to 135 d. The diets were a typical corn-soybean control diet (CON) and that diet with CCM partially replacing corn and corn gluten meal. Results showed that the CCM diet markedly decreased live weight and abdominal fat percentage (P < 0.05); chickens fed the CCM diet exhibited lower (P < 0.01) expression in abdominal fat of fatty acid binding protein 4 (FABP4), stearoyl-CoA desaturase (SCD), fatty acid synthase (FAS), and peroxisome proliferator-activated receptor γ (PPARγ) but higher (P < 0.05) expression of estrogen receptor alpha (ESR1). The CCM increased the abundance of Akkermansia (P < 0.05) and markedly reduced the relative cecal abundance of Phascolarctobacterium (P < 0.01), Rikenellaceae (P < 0.05) and Faecalibacterium (P < 0.01). The metabolomic and biochemical analyses demonstrated that the CCM diet increased (P < 0.05) the concentrations of butyrate in cecal contents. The majority of the metabolites in cecal digesta with differences in abundance were organic acids. The CCM diet increased (P < 0.05) contents of (R)-5-diphosphomevalote, pantothenic acid, 2-epi-5-epi-valiolone 7-phosphate, D-ribose 5-diphosphate, arbutin 6-phosphate, D-ribitol 5-phosphate, undecanoic acid, nicotinic acid, 4-methyl-2-oxovaleric acid, while decreasing (P < 0.05) those of oleic acid, glutaric acid, adipic acid, suberic acid, and L-fuculose 1-phosphate. In conclusion, these findings demonstrated that the dietary CCM treatment significantly decreased abdominal fat and altered the cecal microbiota and metabolite profiles of the yellow chickens.
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Objective: The aim of this study was to investigate the associations between dietary patterns and abdominal obesity among middle-aged and elderly Japanese people, using both waist circumference (WC) and visceral fat (VF) as indices. Methods: A cross-sectional study was conducted with 829 adults (534 men and 295 women), 40 to 79 y of age, who participated in the Waseda Alumni's Sports, Exercise, Daily Activity, Sedentariness and Health Study (WASEDA'S Health Study). Dietary patterns were derived from principal component analysis. VF was measured using magnetic resonance imaging. To examine the associations of each dietary pattern with WC and VF, we calculated multivariate-adjusted means and 95% confidence intervals (CIs) of WC and VF for the tertile of each dietary pattern score. Results: Two main dietary patterns were identified: "healthy Japanese" and "seafood and alcohol." The healthy Japanese dietary pattern score was inversely associated with WC and VF in men only. WC measurements were 84.9 cm (95% CI, 83.7-86.1), 83.9 cm (95% CI, 82.7-85.1), and 82.4 cm (95% CI, 81.2-83.6); Ptrend = 0.006, and VF measurements were 94.0 cm2 (95% CI, 85.6-102.4), 89.4 cm2 (95% CI, 81.1-97.7), and 80.4 cm2 (95% CI, 72.5-88.4); Ptrend = 0.027 for the lowest through the highest tertile of healthy Japanese dietary pattern scores in men. The seafood and alcohol dietary pattern was not associated with WC and VF. Conclusion: The healthy Japanese dietary pattern was negatively associated with WC and VF in middle-aged and elderly Japanese men.
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Objective: Previous interventions have reported desirable effects of diets rich in whole grains or rich in fruits and vegetables on cardiovascular disease (CVD) risk factors and weight management. However, data are lacking regarding the effect of these fiber sources separately. The aim of this randomized clinical feeding trial was to investigate the effects of fiber-rich diets with different sources of fiber (fruits, vegetables, and whole grains) on weight loss and CVD risk factors in overweight and obese women. Methods: Overweight and obese women (N = 75) were randomized to one of three weight loss diets that were rich in whole grains, fruits and vegetables, or both for 10 weeks. Body weight, waist circumference, and risk factors of CVD were examined at baseline and 10 weeks. Results: During the 10-week dietary intervention phase, the reductions in weight (p = 0.03), waist circumference (p = 0.001), systolic blood pressure (p = 0.04), fasting blood sugar (p = 0.03), and triglycerides (p = 0.001) were higher in the whole grains group compared with the fruits and vegetables group or the combination diet group. Also, the whole grain group had a greater increase (p = 0.01) in high-density lipoprotein cholesterol compared to the other groups. The change in other risk factors, including diastolic blood pressure and low-density lipoprotein cholesterol, was not different among the three diet groups. Within-group comparisons revealed significant reductions in weight, waist circumference, and fasting blood sugar in all groups. Only the fruits and vegetables group and the whole grains group had significant decreases in low-density lipoprotein cholesterol over 10 weeks (p ≤ 0.03). Conclusions: This trial suggests that in overweight and obese women, a weight loss diet rich in whole grains may have a more beneficial effect on CVD risk factors than diets rich in fruits and vegetables or a combination of whole grains and fruits and vegetables.
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Background/Objectives Higher fibre intakes are associated with risk reduction for chronic diseases. However, many people find difficulty in consuming sufficient fibre through their diet. Supplements may be an effective alternative. We aimed to investigate the effects of PolyGlycopleX® (PGX®), a proprietary polysaccharide complex and a proprietary Psyllium product (PgxSyl™) (PSY) on diet, body weight and composition in overweight and obese individuals. Subjects/Methods This was a double-blind 52 weeks study with 159 people randomized to 3 groups: control (rice flour); PGX (PGX) and proprietary psyllium (PSY). Participants did not change any of their usual habits or diet except they consumed 5 g of supplement taken with a total of 500 ml of water 5–10 min before meals. ResultsWeight was significantly lower in the PGX group compared to control at 3 (−1.6 kg [0.57, 2.67, p = 0.003]), 6 (−2.6 kg [1.01, 4.13, p = 0.001]) and 12 months (−2.6 kg [0.59, 4.64, p = 0.012]) and in the PSY group compared to control group at 3 (−1.1 kg [0.07, 2.12, p = 0.037]) and 6 months (−2.4 kg [0.95, 3.93, p = 0.002]). This was a difference of − 2.8% for the PGX group and − 1.5% for the PSY group compared to control after 12 months supplementation. Body Fat was significantly lower in PGX compared to control at 6 (−1.8 kg [0.63, 2.95, p = 0.003]) and 12 months (−1.9 kg [0.43, 3.36, p = 0.012]) and in PSY compared to control at 6 (−1.9 kg [0.84, 3.04, p = 0.001]) and 12 months (−1.4 kg [0.08, 2.71, p = 0.038]). ConclusionsPGX was better than PSY at maintaining dietary changes and weight loss over the 12 month intervention period, with no change to exercise. A simple strategy of PGX supplementation may offer an effective solution to long-term weight-loss and then management without the need for other nutrient modification. Trial registrationANZCTR: ACTRN12611000415909. Registered 20 April 2011
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Many foods, including margarines and sugary cereals that were once viewed as unhealthy, are being reformulated and repositioned as healthier. A number of companies have launched new products touting fiber. Critics express concern that the increased interest in fiber as a marketing claim is not necessarily a good thing for consumers because many companies are using isolated fiber that does not have all the health benefits as naturally occurring fiber. This research examines whether consumers understand information related to fiber claims by specifically examining their perceptions of the nutrition level and health benefits of products with these claims. Additionally, consumption frequency of these products and consumer knowledge about fiber is assessed. Direction for public policy is provided.
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Background: Cactus (Opuntia ficus-indica) fiber was shown to promote weight loss in a 3-month clinical investigation. As demonstrated by in vitro studies, cactus fiber binds to dietary fat and its use results in reduced absorption, which in turn leads to reduced energy absorption and ultimately the reduction of body weight. Objective: The objective of our study was to elucidate the dietary fat binding capacity of cactus fiber through determination of fecal fat excretion in healthy volunteers. Subjects and Methods: This clinical investigation was performed as a double-blind, randomized, placebo-controlled, crossover study in healthy subjects for a period of approximately 45 days. Twenty healthy volunteer subjects were randomized to receive cactus fiber or placebo, 2 tablets thrice daily with main meals. All subjects were provided with meals during the study period (except washout) according to a standardized meal plan, with 35% of daily energy need coming from fat. Two 24-hour feces samples were collected during both the baseline and treatment periods for analysis of the fat content. Results: Cactus fiber showed an increased fecal fat excretion compared with placebo (mean [SD] = 15.79% [5.79%] vs 4.56% [3.09%]; P < 0.001). No adverse events were reported throughout the study period. Conclusions: Cactus fiber has been shown to significantly promote fecal fat excretion in healthy adults. The results of our study support the hypothesis that cactus fiber helps in reducing body weight by binding to dietary fat and increasing its excretion, thus reducing dietary fat available for absorption. ClinicalTrials.gov identifier: NCT01590667.
Article
Background: The development of high-protein, fiber-rich foods targeting appetite control could be an efficient tool in obesity prevention. Objectives: We investigated whether ad libitum energy intake (EI), appetite, and metabolic markers in a meal context were affected by 1) fiber addition (rye bran and pea fiber) to pork meatballs, 2) the food matrix of the fiber (fiber meatballs compared with fiber bread), or 3) the protein source (animal compared with vegetable protein patties). Methods: In a crossover design, 40 healthy men [mean ± SD: body mass index (BMI; in kg/m²), 22.2 ± 1.9; age, 23.3 ± 2.9 y] consumed 4 test meals: a low-fiber meal consisting of pork meatballs plus wheat bread (LF meal); pork meatballs plus fiber bread; fiber meatballs plus wheat bread, and vegetable patties with a natural fiber content plus wheat bread (∼3000 kJ; protein ∼18% of energy, carbohydrate ∼50% of energy, fat ∼30% of energy; 13 g fiber in the fiber meals). Ad libitum EI after 4 h was the primary endpoint. Moreover, appetite sensations and postprandial responses of glucose, insulin, glucagon-like peptide-1, peptide YY 3–36, and plasma amino acids were measured. Results: Ad libitum EI did not differ significantly between the meals. Satiety and fullness increased 11% and 13%, respectively, and hunger and prospective intake decreased 17% and 15%, respectively, after the meal of fiber meatballs plus wheat bread compared with the LF meal (P < 0.01). Hormonal and metabolic responses did not differ between the meals. In general, plasma amino acid concentrations were higher after the fiber-rich meals than after the LF meal. Conclusions: Meals based on meatballs and bread with differences in the fiber content, food matrix of fiber, and protein source had similar effects on ad libitum EI in healthy men. However, fiber addition to pork meatballs favorably affected appetite sensations but without changes in hormonal and metabolic responses. Moreover, animal- and vegetable-protein–based, fiber-matched meals had similar effects on appetite regulation. This trial was registered at clinicaltrials.gov as NCT02521805.
Article
Background & aims: The purpose of this randomized, double-blind, placebo-controlled study was to assess the effects of yellow pea fiber intake on body composition and metabolic markers in overweight/obese adults. Methods: Participants (9 M/41 F; age 44 ± 15 y, BMI 32.9 ± 5.9 kg/m(2)) received isocaloric doses of placebo (PL) or pea fiber (PF; 15 g/d) wafers for 12 weeks. Outcome measures included changes in anthropometrics, body composition (DXA), oral glucose tolerance test (OGTT), food intake (ad libitum lunch buffet), and biochemical indices. Results: The PF group lost 0.87 ± 0.37 kg of body weight, primarily due to body fat (-0.74 ± 0.26 kg), whereas PL subjects gained 0.40 ± 0.39 kg of weight over the 12 weeks (P = 0.022). The PF group consumed 16% less energy at the follow-up lunch buffet (P = 0.026), whereas the PL group did not change. During the OGTT, glucose area under the curve (AUC) was lower in PF subjects at follow-up (P = 0.029); insulin increased in both groups over time (P = 0.008), but more so in the PL group (38% higher AUC vs. 10% higher in the PF group). There were no differences in gut microbiota between groups. Conclusions: In the absence of other lifestyle changes, incorporating 15 g/day yellow pea fiber may yield small but significant metabolic benefits and aid in obesity management. Clinical Trial Registry: ClinicalTrials.gov NCT01719900.
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Fruit, vegetable, and dietary fiber intake have been associated with lower risk of cardiovascular disease (CVD); however, little is known about their role in obesity prevention. Our goal was to investigate whether intake of fruits, vegetables, and dietary fiber is associated with weight change and the risk of becoming overweight and obese. We studied 18,146 women aged ≥45 y from the Women's Health Study free of CVD and cancer with an initial body mass index (BMI) of 18.5 to <25 kg/m(2). Fruit, vegetable, and dietary fiber intakes were assessed at baseline through a 131-item food-frequency questionnaire, along with obesity-related risk factors. Women self-reported body weight on annual questionnaires. During a mean follow-up of 15.9 y, 8125 women became overweight or obese (BMI ≥25 kg/m(2)). Intakes of total fruits and vegetables, fruits, and dietary fiber were not associated with the longitudinal changes in body weight, whereas higher vegetable intake was associated with greater weight gain (P-trend: 0.02). In multivariable analyses, controlling for total energy intake and physical activity along with other lifestyle, clinical, and dietary factors, women in the highest vs. lowest quintile of fruit intake had an HR of 0.87 (95% CI: 0.80, 0.94; P-trend: 0.01) of becoming overweight or obese. No association was observed for vegetable or dietary fiber intake. The association between fruit intake and risk of becoming overweight or obese was modified by baseline BMI (P-interaction: <0.0001) where the strongest inverse association was observed among women with a BMI <23 kg/m(2) (HR: 0.82; 95% CI: 0.71, 0.94). Our results suggest that greater baseline intake of fruit, but not vegetables or fiber, by middle-aged and older women with a normal BMI at baseline is associated with lower risk of becoming overweight or obese. © 2015 American Society for Nutrition.