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The Cholesterol-Lowering Effect of Coconut Flakes in Humans with Moderately Raised Serum Cholesterol


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This study investigated the effect of coconut flakes on serum cholesterol levels of humans with moderately raised serum cholesterol in 21 subjects. The serum total cholesterol of subjects differed and ranged from 259 to 283 mg/dL. The study was conducted in a double-blind randomized crossover design on a 14-week period, consisting of four 2-week experimental periods, with each experimental period separated by a 2-week washout period. The test foods were as follows: corn flakes as the control food, oat bran flakes as the reference food, and corn flakes with 15% and 25% dietary fiber from coconut flakes (made from coconut flour production). Results showed a significant percent reduction in serum total and low-density lipoprotein (LDL) cholesterol (in mg/dL) for all test foods, except for corn flakes, as follows: oat bran flakes, 8.4 +/- 1.4 and 8.8 +/- 6.0, respectively; 15% coconut flakes, 6.9 +/- 1.1 and 11.0 +/- 4.0, respectively; and 25% coconut flakes, 10.8 +/- 1.3 and 9.2 +/- 5.4, respectively. Serum triglycerides were significantly reduced for all test foods: corn flakes, 14.5 +/- 6.3%; oat bran flakes, 22.7 +/- 2.9%; 15% coconut flakes, 19.3 +/- 5.7%; and 25% coconut flakes, 21.8 +/- 6.0%. Only 60% of the subjects were considered for serum triglycerides reduction (serum triglycerides >170 mg/dL). In conclusion, both 15% and 25% coconut flakes reduced serum total and LDL cholesterol and serum triglycerides of humans with moderately raised serum cholesterol levels. Coconut flour is a good source of both soluble and insoluble dietary fiber, and both types of fiber may have significant role in the reduction of the above lipid biomarker. To our knowledge, this is the first study conducted to show a relationship between dietary fiber from a coconut by-product and a lipid biomarker. Results from this study serves as a good basis in the development of coconut flakes/flour as a functional food, justifying the increased production of coconut and coconut by-products.
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J Med Food 7 (2) 2004, 136–140
© Mary Ann Liebert, Inc. and Korean Society of Food Science and Nutrition
The Cholesterol-Lowering Effect of Coconut Flakes in Humans with Moderately
Raised Serum Cholesterol
Trinidad P. Trinidad,
Anacleta S. Loyola,
Aida C. Mallillin,
Divinagracia H. Valdez,
Faridah C. Askali,
Joan C. Castillo,
Rosario L. Resaba,
and Dina B. Masa
Department of Science and Technology, Food and Nutrition Research Institute, Bicutan, Taguig; and
Philippine Coconut Authority, Diliman, Quezon City, Metro Manila, Philippines
ABSTRACT This study investigated the effect of coconut flakes on serum cholesterol levels of humans with moderately
raised serum cholesterol in 21 subjects. The serum total cholesterol of subjects differed and ranged from 259 to 283 mg/dL.
The study was conducted in a double-blind randomized crossover design on a 14-week period, consisting of four 2-week ex-
perimental periods, with each experimental period separated by a 2-week washout period. The test foods were as follows:
corn flakes as the control food, oat bran flakes as the reference food, and corn flakes with 15% and 25% dietary fiber from
coconut flakes (made from coconut flour production). Results showed a significant percent reduction in serum total and low-
density lipoprotein (LDL) cholesterol (in mg/dL) for all test foods, except for corn flakes, as follows: oat bran flakes, 8.4
1.4 and 8.8 6.0, respectively; 15% coconut flakes, 6.9 1.1 and 11.0 4.0, respectively; and 25% coconut flakes, 10.8
1.3 and 9.2 5.4, respectively. Serum triglycerides were significantly reduced for all test foods: corn flakes, 14.5 6.3%;
oat bran flakes, 22.7 2.9%; 15% coconut flakes, 19.3 5.7%; and 25% coconut flakes, 21.8 6.0%. Only 60% of the sub-
jects were considered for serum triglycerides reduction (serum triglycerides 170 mg/dL). In conclusion, both 15% and 25%
coconut flakes reduced serum total and LDL cholesterol and serum triglycerides of humans with moderately raised serum cho-
lesterol levels. Coconut flour is a good source of both soluble and insoluble dietary fiber, and both types of fiber may have
significant role in the reduction of the above lipid biomarker. To our knowledge, this is the first study conducted to show a
relationship between dietary fiber from a coconut by-product and a lipid biomarker. Results from this study serves as a good
basis in the development of coconut flakes/flour as a functional food, justifying the increased production of coconut and co-
conut by-products.
coconut flakes/flour
dietary fiber
serum cholesterol
, including oat prod-
dried beans,
soy polysac-
guar gum,
and pectin,
have been
shown to produce a significant lowering of serum choles-
terol in humans. The principle behind the cholesterol-low-
ering effect of dietary fiber is the prevention of the re-ab-
sorption of bile acids via the enterohepatic circulation. Once
the bile acid is re-absorbed, it can form cholesterol and cir-
culate in the blood. Because of the viscosity of dietary fiber,
bile acids can bind with dietary fiber and be excreted in the
On the other hand, fermentable soluble fiber pro-
duced short-chain fatty acids in the large intestine and may
reduce serum cholesterol through the inhibition of choles-
terol synthesis in the liver.
Moreover, viscous fiber
slows down the absorption of carbohydrates
and may
diminish the insulin response. Insulin has been shown to
stimulate cholesterol synthesis, and a reduced concentration
of insulin may affect plasma cholesterol concentrations
and further offer protection against coronary heart disease.
Coconut flakes are produced from coconut residue, a by-
product of the coconut milk industry. When pulverized into
flour they contain 60% dietary fiber: 56% insoluble and 4%
Coconut flakes have been shown to produce short-
chain fatty acids such as acetate, propionate, and butyrate.
A previous study has shown that bakery products supple-
mented with 15%–25% coconut flour have a low glycemic
Low glycemic index foods have been shown to
lower serum cholesterol levels in humans.
This study was conducted to investigate the effect of co-
conut flakes on the serum cholesterol levels of human sub-
jects with moderately raised serum cholesterol.
Manuscript received 31 July 2003. Revision accepted 29 November 2003.
Address reprint requests to: Trinidad P. Trinidad, Department of Science and Technol-
ogy, Food and Nutrition Research Institute, Bicutan, Taguig, Metro Manila, 1631 Philip-
pines, E-mail:
Forty subjects were recruited for the study. The subjects
were physically examined by a medical doctor and selected
based on the following criteria: moderately raised cholesterol
level (250–300 mg of cholesterol/100 g of serum); 30–55
years old; no cholesterol-lowering drug intake; and no com-
plications. They were interviewed to obtain data on their
usual 3-day food intake, physical activity, and smoking
habits. Twenty-two human subjects, four men and 18 women,
met the inclusion criteria. However, three female subjects
dropped out because they could not withstand eating 25% di-
etary fiber from coconut flakes. Another two female subjects
were recruited and passed the inclusion criteria. The total
number of subjects in the study was 21. One of the subjects
was not able to consume one test food (15% coconut flakes).
The study was conducted upon approval of the National Hu-
man Ethics Committee, Philippine Council for Health Re-
search and Development, Department of Science and Tech-
nology. All subjects signed an informed consent form.
Test foods
The test foods containing 50 g of available carbohydrates
were as follows: corn flakes (Nestle, Pasig City, Philippines)
with 15% or 25% dietary fiber from coconut flakes; corn
flakes as the control food; and organic oat bran flakes
(Health Valley, A Hain Food Group Company, Irwindale,
CA) as the reference food.
Coconut flakes were obtained from coconut flour pro-
duction (Philippine Coconut Authority/Sirawan Industries,
Davao City, Philippines). The flakes were made from the
by-product of the coconut milk industry, the coconut residue
or “sapal” left after extraction of coconut milk, dried, and
placed in an expeller to produce the flakes. Flakes were pul-
verized into flour. The fat content of the flakes/flour was
controlled to 10%. For every 12,000 kg of coconut, 400 kg
of flakes/flour is produced.
Study design
The study was conducted in a double-blind randomized
crossover design on a 14-week period (3.5 months), con-
sisting of four 2-week experimental periods with each ex-
perimental period separated by a 2-week washout period for
a total of three washout periods. The subjects fasted
overnight (10–12 hours of fasting) prior to the study. They
were weighed, their blood pressure was measured, and a
sample of blood from their forearm vein was taken. The sub-
jects were given the test foods to consume every day to en-
sure compliance of the subjects, except on Fridays when
three test foods were given to include Saturday and Sunday
intakes. The subjects recorded their respective food intakes
for the duration of the experimental study. On day 15, blood
was drawn from the subjects after an overnight fast. Blood
samples were taken into plain glass tubes from the forearm
vein, left to clot at room temperature, and centrifuged, and
the serum was separated. Total cholesterol, high-density
lipoprotein (HDL) cholesterol, and triglycerides were mea-
sured in a clinical chemistry analyzer (ARTAX, Menarini
Diagnostic, Florence, Italy) against standards (all from Sen-
tinel CH, Milan, Italy: cholesterol, Cholesterol Standard,
200 mg/dL; HDL cholesterol, Cholesterol Standard, 50
mg/dL; and triglycerides, Glycerol Standard, 200 mg/dL).
The amount of low-density liporotein (LDL) was estimated
from the formula used by Wolever et al.
as follows:
LDL (total cholesterol HDL) (triglycerides/2.2)
Subjects served as their own control.
Statistical analysis
The sample size was chosen to achieve 80% power at 5%
level of significance. The data were tested for normal dis-
tribution using the one-way Kolmogorov–Smirnov test prior
to analysis of variance, and the data followed normal dis-
tribution. Differences between test foods and between bio-
markers were determined by two-way analysis of variance
and Duncan’s Multiple Range Test using the Statistical
Analysis System Program (SAS Institute Inc., Cary, NC).
Table 1 shows the characteristics of the subjects. There
were four men and 17 women for a total of 21 subjects. The
initial serum total cholesterol for all subjects ranged from 259
to 283 mg/dL. The serum LDL cholesterol was significantly
higher in females than in males (P .05), while serum
triglycerides were significantly higher in males than in fe-
1. C
Age Body mass
Subjects Number (years) index Total LDL HDL Triglycerides
Male 4 50 325 2 271 12 120 7
45 6 277 24
Female 17 48 125 1 270 40 156 6
48 5 174 16
Data are mean SEM values.
Significant differences between males and females at P .05.
males (P .05; Table 1). All other parameters were similar
in both males and females. All subjects did not drink alcohol.
Table 2 shows the composition of the test foods. The 25%
coconut flakes had the highest dietary fiber, fat, protein, and
ash content. Oat bran flakes had the highest moisture con-
tent. The mean energy intake of the subjects for the dura-
tion of the experimental study as estimated from the food
record collected for 14 days for each test food fed was
1,413.0 38.5 kilocalories/day. Protein, fat, and carbohy-
drate intake, estimated as percentages of total calories, were
12.1 0.2%, 18.4 1.7%, and 70.5 1.4%, respectively.
Protein and fat sources were beef, pork, and chicken. The
type of fat consumed by the subjects was mostly saturated
fat. Only one subject ate fish frequently, while the others
had very low intake of fish. Carbohydrate sources came
mainly from rice, bread, and noodles. Vegetables and fruits
were only eaten once or not even once a day.
Table 3 shows the serum total, LDL, and HDL choles-
terol and triglycerides of subjects before and after feeding
of the different test foods. Serum total cholesterol was sig-
nificantly lower after consumption of oat bran, 15% coconut
flakes, and 25% coconut flakes for 14 days (P .05; Table
3). Similar results were also observed for LDL cholesterol.
For all test foods there was a significant reduction in serum
triglycerides (P .05; Table 3). There was no increase in
HDL cholesterol observed in the study (Table 3).
Table 4 shows the percent reduction in serum total cho-
lesterol, LDL cholesterol, and triglycerides of subjects fed
with the different test foods. After feeding the subjects with
15% and 25% dietary fiber from coconut flakes for 14 con-
secutive days, 6.9% and 10.8% reductions, respectively,
were observed in serum total cholesterol (P .05; Table
4). These were comparable with that of oat bran flakes,
with an 8.4% reduction in serum total cholesterol. The per-
cent reduction of serum total cholesterol for the 25% di-
etary fiber coconut flakes was significantly greater than
that for the 15% dietary fiber coconut flakes (P .05;
Table 4). However, values after both 15% and 25% co-
conut flakes did not differ significantly from that after oat
bran flakes (Table 4). Similar results were also observed
in the percent reduction of LDL cholesterol from all foods,
except for corn flakes (Table 4). Although corn flakes did
not lower serum total and LDL cholesterol, it caused a
14.5% reduction in serum triglycerides and was compara-
ble to oat bran and 15% and 25% coconut flakes (Table
4). Only 60% of the subjects had serum triglycerides
greater than 170 mg/dL (normal is 60–170 mg/dL) and
were included in the analysis.
2. C
Corn flakes
Oatbran 15% DF from 25% DF from
Component Corn flakes flakes coconut flakes coconut flakes
Total amount fed to subjects/day 51.0* 59.5* 65.8 75.7
Carbohydrates 50.0* 50.0* 50.0 50.0
DF 1.0* 8.5* 16.0 1.0
26.0 0.9
Fat 0.04 0.03
0.86 0.06
2.50 0.02
4.16 0.02
Protein 3.1* 5.4* 4.8 0.1
6.0 0.1
Ash 2.03 0.00
1.35 0.04
2.42 0.00
2.67 0.01
Moisture 1.68 0.00
3.11 0.02
2.38 0.02
2.84 0.02
Data are mean values (in g). DF, dietary fiber.
*From food label.
Significant differences between test foods at P .05.
3. S
, LDL,
Total LDL HDL Triglycerides
Test food Before After Before After Before After Before After
Corn flakes 276 7 280 10 144.3 7.0 145.6 6.8 47.4 4 45.3 5 277 18 236 15
Oat bran 296 10 271 9
154.0 3.7 140.4 4.9
50.2 5 45.2 4 233 16 180 13
15% coconut flakes 288 7 268 7
152.6 5.0 135.8 5.0
53.3 4 44.3 4 327 24 264 23
25% coconut flakes 296 10 264 10
168.7 4.8 153.1 3.1
41.7 3 38.1 2 243 19 190 16
Data are mean SEM values.
Significantly different at P .05.
Epidemiological data suggested that high intakes of di-
etary fiber reduced the risk of coronary heart disease.
Lipid Research Clinics Coronary Primary Prevention Trial
predicted that for every 1% decrease in serum cholesterol
concentration, there is a decreased risk of coronary heart dis-
ease of 2%.
In a previous meta-analysis of 20 trials, the
daily intake of 3 g of -glucan from oats caused a clinical
reduction of 0.13–0.16 mmol of serum cholesterol/L.
Results of the present study revealed that daily con-
sumption of 15% and 25% dietary fiber from coconut flakes
with the usual meal reduced serum total and LDL choles-
terol and triglycerides in humans (Table 4). Interestingly,
the greatest reduction in serum total and LDL cholesterol as
well as triglycerides was observed in subjects fed with 25%
dietary fiber from coconut flakes but did not differ signifi-
cantly from that of oat bran flakes (P .05; Table 4). Co-
conut flakes are made from the production of coconut flour
containing 60% dietary fiber: 56% insoluble and 4% solu-
It produced short-chain fatty acids with butyrate ac-
etate propionate after fermentation in the large intestine.
A study revealed that coconut kernel contained water-solu-
ble galactomannans.
The galactomannans from coconut
have been shown to be the leguminous type
with a man-
nose:galactose ratio of 2:1, similar to guar gum.
tomannans are not digested in the small intestine but are me-
tabolized by the microflora in the large intestine and produce
short-chain fatty acids. One interesting component of co-
conut that may have also contributed to lowering serum cho-
lesterol levels is its content of uronic acid, also present in
Uronic acid increases as coconut matures.
It is
also fermentable in the large intestine and produces short-
chain fatty acids.
The hypocholesterolemic property of di-
etary fiber is associated with the water-soluble fractions of
fiber, e.g., galactomannans, uronic acid, and glucomannans.
However, various water-soluble fibers may differ in their abil-
ity to reduce serum cholesterol.
In this study, oat bran
flakes was given at 8.5 g of dietary fiber, while 15% and 25%
dietary fiber coconut flakes were given at 15.0 and 25.0 g of
dietary fiber, respectively, with percent serum cholesterol re-
ductions of 8.4%, 6.9%, and 10.8%, respectively. There were
no significant differences among the three dietary fiber
sources (P .05; Table 4). The amount of dietary fiber pre-
sent in the 25% coconut flakes (25 g) was more than twice
that of oat bran flakes (8.5 g). Results of the present study re-
vealed that for every gram of dietary fiber from oat bran, 2–3
g of dietary fiber from coconut flakes is needed to obtain a
serum total cholesterol reduction of 6–12%. The present study
also confirmed the U.S. Food and Drug Administration’s
health claim for oat bran’s role in reducing serum cholesterol
level in humans. Oat bran has been shown to decrease serum
total cholesterol in humans in many studies and is preventive
of cardiovascular disease.
Coconut flakes/flour contained greater proportions of in-
soluble fiber than soluble fiber. The fibrous structure of co-
conut flakes/flour may have entrapped, if not bound, the bile
acids and prevented their re-absorption in the liver in the en-
terohepatic circulation and thus caused their excretion in the
There was no significant increase or decrease in HDL
cholesterol levels of all subjects. The concentration of serum
HDL cholesterol is affected by alcohol intake and body mass
However, none of the subjects drank alcohol, and
the body mass indices were not significantly different be-
tween subjects in the duration of the experimental period.
In conclusion, 15% and 25% dietary fiber from coconut
flakes reduced serum total cholesterol, LDL cholesterol, and
triglycerides of humans with moderately raised serum cho-
lesterol levels. Coconut flakes/flour is a good source of both
soluble and insoluble fiber, and both types of dietary fiber
may have played an important role in the significant reduc-
tion of the above lipid biomarkers. To our knowledge, this
is the first study that showed the relationship of dietary fiber
from a coconut by-product and lipid biomarkers. The results
of this study serve as a basis in the development of coconut
flakes/flour as a functional food, thus justifying the in-
creased production of coconut and coconut by-products.
The authors wish to thank Nestle Philippines for provid-
ing us the corn flakes; the Philippine Coconut Authority,
Department of Agriculture through Ms. Divinia Bawalan for
the preparation of the coconut flakes; and the Department
of Science and Technology, Philippine Council for Health
Research and Development for financial support. The au-
thors also wish to thank Ms. Josefina A. Desnacido and Mr.
Zoilo B. Villanueva for their technical assistance and Ms.
Ma. Isabel Z. Cabrera, Supervising Science Research Spe-
4. P
Test food Total cholesterol LDL cholesterol Triglycerides*
Cornflakes 1.3 1.8
0.9 6.3
14.5 6.3
Oat bran flakes 8.4 1.4
8.8 6.7
22.7 2.9
15% coconut flakes 6.9 1.1
11.0 4.0
19.3 5.7
25% coconut flakes 10.8 1.3
9.2 5.4
21.8 6.0
Data are mean SEM values.
*Only 60% of subjects were considered for percent reduction (serum triglycerides 170 mg/dL).
Significant differences between test foods at P .05.
Significant differences between serum total cholesterol, LDL cholesterol, and triglycerides at P .05.
cialist, Nutritional Biochemistry Group, Nutrition Science
and Technology Division, Food and Nutrition Research In-
stitute (FNRI), Ms. Celeste C. Tanchoco, Chief, Nutrition
Science and Technology Division, FNRI, Dr. Aida R.
Aguinaldo, FNRI Deputy Director, and Dr. Corazon V.C.
Barba, FNRI Director, for their support.
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... The number of participants ranged from 12 [43] to 191 [77] individuals. Half of the crossover studies had a 14-day washout period [43,44,46,65,68], the other half had washout periods >14 days [42,49,50,66,67]. The quantity of b-glucan ingested for all of the studies (oats and isolated b-glucan) ranged from 1.2 g/ day [51] to 11.2 g/day [45]. ...
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Background & aims It is well known that dietary fiber positively impacts the microbiome and health as a whole. However, the health effects of β-glucan, a dietary fiber extracted from oats, have been questioned when administered alone or incorporated into other foods. The purpose of this systematic review and meta-analysis was to evaluate the impact of oats or β-glucan supplements on the lipid profile. Methods Randomized controlled trials with parallel-arm or crossover blinded interventions at least two weeks in duration, for hyperlipidemic or non-hyperlipidemic men and women ≥18 years of age were selected. Only single (participants blinded) or double-blinded studies that compared oat or isolated β-glucan with a placebo/control group were considered for this review. The databases EMBASE, PubMed, Web of science and CINHAL were searched, from the earliest indexed year available online to the end of January 2022. Random-effects models were used to combine the estimated effects extracted from individual studies, and data were summarized as standardized mean difference (SMD) and 95% confidence interval (95%CI). Results A total of 811 articles were screened for eligibility, and relevant data were extracted from 28 studies, totaling 1494 subjects. Oat interventions TC (−0.61, 95%CI: −0.84;-0.39, p < 0.00001, and −0.70, 95%CI: −1.07;-0.34, p = 0.0002, respectively) and LDL (−0.51, 95%CI: −0.71;-0.31, p < 0.00001, and −0.38, 95%CI: −0.60;-0.15, p = 0.001, respectively). Moreover, isolated β-glucan interventions from parallel-arm studies decreased TC (−0.73, 95%CI: −1.01;-0.45, p < 0.00001), LDL (−0.58, 95%CI: −0.85;-0.32, p < 0.0001) and triglycerides (−0.30, 95%CI: −0.49;-0.12, p = 0.001). HDL was not altered by either oat or isolated β-glucan (p > 0.05). Conclusion Overall, this review showed that both oat and isolated β-glucan interventions improved lipid profiles. Furthermore, the ingestion of oats or isolated β-glucan supplements are effective tools to combat dyslipidemia and should be considered in cardiovascular disease prevention.
... (1) Coconut sweets In day-to-day diet, coconut finds extensive application in the preparation of many traditional Indian sweets. One such sweet which is quite popular in India is coconut "burfi" (Fig. 7) [33]. Coconut "burfi" is a famous Indian delicacy served during festivals. ...
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India is highly diverse ranging from snow-capped mountains to deserts, plateaus, and plain regions. It has a tropical climate with diverse climatic condition that favors the cultivation of wide range of fruit, vegetables, cereals, pulses, cotton, and various crops of medicinal importance making it one of the top producers in the world. India ranks second in the production of coconut grown in coastal regions playing a significant role in the agrarian economy and is known as a Nature's gift to mankind; it is a source of food, beverage, oil seed, fibers, timbers, and health products. Further, it is a highly appreciated fruit with antibacterial, antifungal, antioxidant, antiparasitic, antiviral, and many other qualities. Considering the growing increase in consumption of coconut and its products and the large number of studies that address the theme, it is felt necessary to carry out a bibliographic survey based on the most current and relevant works in the area using books, journal articles, and other available print and electronic resources. This study attempts to gather information on a detailed assessment of the coconut; its uses in rituals, its health benefits, and culinary preparations across India as the delicacies of immemorial ethnic fruit are of rising significance. The importance and significance of documenting this coconut ethnicity in Indian cuisine are an attempt to keep it relevant and take it to broader viewers who admire such unique delicacies. The study reveals coconut has a high value in Indian ritual, and the survey of pharmacological studies on its medicinal uses supports its beneficial properties to human health.
... Linalool is its chief constituent. Coriander has important hypoglycemic, anti-inflammatory, and hypocholesterolemic effect [109]. Moreover, this is also efficient in gastrointestinal complications. ...
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Natural products and traditional ethnomedicines are of great effect in therapeutics. Such types of medicine have been practiced in certain areas of the world to treat different health conditions. This pilot investigation aims to review the cumulative health effect of addendums used in betel quid such as areca nut, lime, and tobacco-associated betel quid chewing and without tobacco-associated chewing. This review shows that betel leaf extract and its essential oil could inhibit growth of microbes and damage different gram-positive and gram-negative bacteria as well as various fungus species. Some studies concluded that the combination of Piper leaves essential oil with antibiotics have potential effect on oral microorganisms. Long-term consumption of betel quid with tobacco is known to cause cancer, chromosomal aberrations, and pharynx tumors. However, consumption of betel leaf without tobacco has health benefits because of ethnomedicinal properties. Its essential is oil utilized as raw material for perfumes and mouth fresheners manufacturing. Scientific researches on this plant revealed that it possesses many beneficial activities to be used for developing novel drugs. However, compounds of betel leaves have beneficial natural antioxidant. Chewing and intake of leaves have effect on moving parts of salivary gland which is the main step of digestion. Its components also act as heartbeat regulators in relaxing the blood vessels to reduce hypertension. So this review discussed the natural compounds of betel leaves which is used as traditional medicine to further develop drug discovery.
... Previous studies that support or contradict our finding are limited, although a recent study showed a different effect of cornflakes on lipid profiles. In the double-blind randomized study the effect of different types of flakes on serum lipid profiles of humans (n=40) suffering from moderately raised serum cholesterol was investigated (Trinidad et al., 2004). The authors found that serum TC and LDL-C levels were significantly reduction following consumption of all types of flakes, except for cornflakes. ...
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Accumulating evidence suggests that consumption of whole grains and legumes is associated with reduced risk of cardiovascular disease (CVD), whereas the risk is increased by consuming refined grains and cereals. This study aimed to investigate the association between grain and legume consumption and the risk of CVD. The study was conducted using a convenient sampling method with a total of 399 participants who underwent coronary angiography. Cases and controls were matched by age with a 1:1 ratio. Standardized and validated questionnaires were used to collect socio- demographic, health, lifestyle, and dietary data. Intake of more than 1 serving/d of white bread increased the risk of CVD significantly with an adjusted odds ratio (AOR) of 3.06 [95% confidence interval (CI): 1.37∼6.84], while consuming more than 1 serving/d of wholegrain bread reduced the risk significantly to approximately 53% (AOR: 0.47, 95% CI: 0.24∼0.93). Similar trends between consuming white bread on daily basis and increased risk of CVD, and consuming wholegrain bread and reduced risk of CVD were also observed. In addition, consuming unsweetened cornflakes on a weekly basis had a protective effect against CVD (AOR: 0.15, 95% CI: 0.03∼0.96). Intake of legumes reduced the risk of CVD, although only insignificantly for all the tested legumes. The present study calls for consideration of consuming wholegrain bread prevent CVD in the Jordanian population.
... Coconut flour has been shown in several studies to decrease body fat, body mass index, waist circumference, and visceral adiposity and to lower blood sugar and cholesterol, even in subjects with moderately high serum cholesterol. Based on these favorable health effects, several authors have proposed that coconut flour be considered a functional food (Table 3.4) (Arumugam et al. 2014;Franco et al. 2015;Trinidad et al. 2004Trinidad et al. , 2006. ...
After a short presentation of the technical and legal challenges linked to coconut (Cocos nucifera L.) germplasm collecting, this chapter discusses how emerging ethnological and historical approaches have influenced these collecting activities. Then it discloses (i) the various collecting strategies with emphasis on the collection of germplasm showing tolerance to pests and diseases, (ii) varieties with special traits such as the Compact Dwarfs, and (iii) the contribution of geographical and molecular approaches to germplasm identification. In connection with the launching of the recent strategy of the International Coconut Genetic Resources Network (COGENT), an attempt is made to estimate what germplasm will need to be collected in the next decade and the expected outcomes in terms of the number of varieties and populations conserved ex situ. It is suggested that global coordination is needed to limit duplication in the COGENT’s ex situ germplasm collections. Also, special attention needs to be paid to strengthen the involvement of farmers and other stakeholders in the collecting activities.
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Purpose Oat supplementation interventions (OSIs) may have a beneficial effect on cardiovascular disease (CVD) risk. However, dietary background can modulate such effect. This systematic review assesses the effects of OSIs on CVD risk markers among adults, accounting for different dietary backgrounds or control arms. Methods We included randomized clinical trials (RCTs) that assessed the effect of oat, oat beta-glucan-rich extracts or avenanthramides on CVD risk markers. Results Seventy-four RCTs, including 4937 predominantly hypercholesterolemic, obese subjects, with mild metabolic disturbances, were included in the systematic review. Of these, 59 RCTs contributed to the meta-analyses. Subjects receiving an OSI, compared to control arms without oats, had improved levels of total cholesterol (TC) [weighted mean difference and (95% CI) − 0.42 mmol/L, (− 0.61; − 0.22)], LDL cholesterol [− 0.29 mmol/L, (− 0.37; − 0.20)], glucose [− 0.25 nmol/L, (− 0.36; − 0.14)], body mass index [− 0.13 kg/m², (− 0.26; − 0.01)], weight [− 0.94 kg, (− 1.84: − 0.05)], and waist circumference [− 1.06 cm, (− 1.85; − 0.27)]. RCTs on inflammation and/or oxidative stress markers were scarce and with inconsistent findings. RCTs comparing an OSI to heterogeneous interventions (e.g., wheat, eggs, rice, etc.), showed lowered levels of glycated haemoglobin, diastolic blood pressure, HDL cholesterol and apolipoprotein B. The majority of included RCTs (81.1%) had some concerns for risk of bias. Conclusion Dietary OSIs resulted in lowered levels of blood lipids and improvements in anthropometric parameters among participants with predominantly mild metabolic disturbances, regardless of dietary background or control. Further high-quality trials are warranted to establish the role of OSIs on blood pressure, glucose homeostasis and inflammation markers.
冠心病是全球死亡的首要原因。作为均衡膳食的一部分,食用全 谷物和谷物纤维可以降低罹患冠心病的风险。食品包装上的健康声称 可以有效地帮助消费者选择健康的饮食。1997 年,美国食品和药品管 理局首次批准了一项健康声称,燕麦、燕麦麸和全燕麦粉来源的b-葡 聚糖可溶性纤维可以降低罹患冠心病的风险。目前,只有少数国家批 准了类似的声称。自1997 年以来,针对燕麦b-葡聚糖与冠心病关系的 证据被大量证实并发表。为了帮助其他国家使用该声称,本文综述了 支持该声称的全部数据(包括美国食品和药品管理局用来证实该声称 的证据和自1997 年以来发表的49 项临床试验的结果),也讨论了基于 科学证据的健康声称需要考虑的很多复杂因素,包括加工过程对b-葡 聚糖降低胆固醇功效的影响。
Coronary heart disease (CHD) is the leading cause of death globally. Consumption of whole grains and cereal fiber, as part of a healthy diet, can lower the risk of CHD. Health claims on food products are effective in helping consumers select healthful diets. The US Food and Drug Administration was the first to approve a health claim, in 1997, between beta-glucan soluble fiber from whole oats, oat bran, and whole oat flour and reduced risk of CHD. Only a few countries have approved similar claims. Since 1997, a significant amount of additional evidence has been published on the relationship between oat beta-glucan and CHD. To assist other jurisdictions in potentially utilizing this claim, the full extent of data that supports this claim (ie, the evidence utilized by the US Food and Drug Administration to substantiate the claim, as well as the results of 49 clinical trials published since 1997) are reviewed here. The complexities involved in authoring evidence-based health claims, including the impact of processing on beta-glucan cholesterol-lowering efficacy in approving eligible beta-glucan products, are also discussed.
Fourteen male subjects with hypercholesterolemia received daily supplementation with granulated guar gum or placebo, 15 g/day, during 12 wk in a double-blind, crossover trial. A statistically significant reduction in serum total cholesterol (7.27 ± 0.24 versus 8.23 ± 0.26 mmol/l, mean ± SEM, p < 0.01) which was mainly due to a reduction in low-density lipoprotein cholesterol concentration (4.70 ± 0.19 versus 5.32 ± 0.23 mmol/l, p < 0.05) was observed after 6 wk on guar gum as compared with placebo. Between 6 and 12 wk on guar gum the serum cholesterol and low-density lipoprotein cholesterol levels increased in most subjects, and after 12 wk the difference from placebo was no longer statistically significant. Serum high-density lipoprotein cholesterol levels were unaffected by guar gum. Serum and lipoprotein triglycerides showed no significant changes during the study, and the body weight of the subjects remained unchanged. Serum calcium, magnesium, phosphate, and iron levels, and urinary calcium excretion were not affected by guar gum supplementation. No severe side effects were observed, necessitating reduction of the dose or stopping the treatment. It is concluded that the hypocholesterolemic effect of guar gum seems to decrease during prolonged dietary supplementation. Further controlled studies are needed before the dose response and the long-term effects of guar gum in hypercholesterolemia can be evaluated.
Twenty years ago the very idea of an international conference on the fiber contained in plant food would have been totally inconceivable. At that time fiber was generally viewed as an inert component of food of no nutritional value and consequently consid­ ered as a contaminant, the removal of which would enhance the purity of a product. It was measured by a now obsolete and almost worthless test introduced in the last century for veterinary rather than human nutrition, and what was measured was referred to as "crude fiber," containing part of the cellulose and lignin but none of the numerous components of fiber now known to play important roles in the maintenance of health. There were a few lone voices prior to the last two decades who had extolled the laxative properties of the undigested portion of food, assuming that these were related to its irritant action on the bowel mucosa. In retrospect this was a total misconception, and "softage" would have been a more appropriate term than "roughage," since its presence insured soft, not irritating, colon content.
The Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT), a multicenter, randomized, double-blind study, tested the efficacy of cholesterol lowering in reducing risk of coronary heart disease (CHD) in 3,806 asymptomatic middle-aged men with primary hypercholesterolemia (type II hyperlipoproteinemia). The treatment group received the bile acid sequestrant cholestyramine resin and the control group received a placebo for an average of 7.4 years. Both groups followed a moderate cholesterol-lowering diet. The cholestyramine group experienced average plasma total and low-density lipoprotein cholesterol (LDL-C) reductions of 13.4% and 20.3%, respectively, which were 8.5% and 12.6% greater reductions than those obtained in the placebo group. The cholestyramine group experienced a 19% reduction in risk (P<.05) of the primary end point—definite CHD death and/or definite nonfatal myocardial infarction—reflecting a 24% reduction in definite CHD death and a 19% reduction in nonfatal myocardial infarction. The cumulative seven-year incidence of the primary end point was 7% in the cholestyramine group v8.6% in the placebo group. In addition, the incidence rates for new positive exercise tests, angina, and coronary bypass surgery were reduced by 25%, 20%, and 21%, respectively, in the cholestyramine group. The risk of death from all causes was only slightly and not significantly reduced in the cholestyramine group. The magnitude of this decrease (7%) was less than for CHD end points because of a greater number of violent and accidental deaths in the cholestyramine group. The LRC-CPPT findings show that reducing total cholesterol by lowering LDL-C levels can diminish the incidence of CHD morbidity and mortality in men at high risk for CHD because of raised LDL-C levels. This clinical trial provides strong evidence for a causal role for these lipids in the pathogenesis of CHD.
Psyllium hydrophilic mucilloid was examined for its ability to lower serum cholesterol levels in hypercholesterolemic patients. Seventy-five patients with mild to moderate hypercholesterolemia were evaluated in this randomized, double-blind, placebo-controlled parallel study. Patients were treated with a Step I diet for 12 weeks before receiving placebo or 3.4 g of psyllium (equivalent to 1 teaspoon) three times per day for 8 weeks. Compared with placebo, psyllium achieved an additional 4.8% reduction in total cholesterol level, 8.2% reduction in low-density lipoprotein cholesterol level, and 8.8% reduction in apolipoprotein B level. Psyllium did not significantly affect blood pressure or levels of high-density cholesterol, triglycerides, serum glucose, or iron. Reported adherence to diet and treatment was excellent, and no significant adverse side effects were noted. These results indicate psyllium hydrophilic mucilloid is an effective and well-tolerated adjunct to diet in the management of mild to moderate hypercholesterolemia. (JAMA. 1989;261:3419-3423)
Objectives. —To test the a priori hypothesis that consumption of oats will lower the blood total cholesterol level and to assess modifiers and confounders of this association. Data Sources. —A computerized literature (MEDLINE) search and the Quaker Oats Co identified published and unpublished trials as of March 1991. Raw data were requested for all trials. Study Selection. —Trials were included in summary effect size estimates if they were randomized and controlled, if a formal assessment of diet and body weight changes occurred, and, if raw data were not received, if there was enough information in the published report to perform calculations. Data Synthesis. —Twenty trials were identified. Using the methods of DerSimonian and Laird, a summary effect size for change in blood total cholesterol level of -0.13 mmol/L (-5.9 mg/dL) (95% confidence interval [Cl], -0.19 to -0.017 mmol/L [-8.4 to -3.3 mg/dL]) was calculated for the 10 trials meeting the inclusion criteria. The summary effect size for trials using wheat control groups was -0.11 mmol/L (-4.4 mg/dL) (95% Cl, -0.21 to -0.01 mmol/L [-8.3 to -0.38 mg/dL]). Calculation of Keys scores demonstrated that substituting carbohydrates for dietary fats and cholesterol did not account for the majority of blood cholesterol reduction. Larger reductions were seen in trials in which subjects had initially higher blood cholesterol levels (≥5.9 mmol/L [≥229 mg/dL]), particularly when a dose of 3 g or more of soluble fiber was employed. Conclusion. —This analysis supports the hypothesis that incorporating oat products into the diet causes a modest reduction in blood cholesterol level.(JAMA. 1992;267:3317-3325)
Polysaccharide fractions were measured in coconuts at three stages of maturity, which corresponded to dietary usage in the Tokelau Islands of the South Pacific. Kernel was sequentially extracted with cold water (CW), hot water (HW) hot 0.5% ammonium oxalate (HOX), 1M H2 SO4 and 72% H2 SO4, and the monosaccharide compositions of the fractions determined. Total readily soluble fractions (CW+HW+HOX) were predominantly galactomannan, and decreased from 77% of the polysaccharide in the immature kernel to 8.8% of that in the mature kernel. Insoluble mannan increased during maturation to be the major polysaccharide component in mature kernel. This indicates that marked differences exist between the three stages of maturity examined, in the properties of their dietary fibre. The results suggest that in studies of diets in which coconut is a staple part, there is a need for careful definition of the coconut component with respect to maturity. Furthermore, they show the importance of using dietary fibre methods which are appropriate to the solubility characteristics of the indigestible polysaccharide.