NMDF121. Session 3 FIBRE AND WATER. Nutritional Medicine Department. Endeavour College of Natural Health endeavour.edu.au 1
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1 NMDF121 Session 3 FIBRE AND WATER Nutritional Medicine Department Endeavour College of Natural Health endeavour.edu.au 1
2 Topic Summary o Fibre and Water Definitions Functions Requirements Therapeutic uses Endeavour College of Natural Health endeavour.edu.au 2
3 Fibre Endeavour College of Natural Health endeavour.edu.au 3
4 Dietary Fibre What is dietary fibre? Indigestible portion of plant foods Complete or partial fermentation in the large intestines Vegetables, fruits, whole grains, legumes Soluble and insoluble (Rolfes, Pinna & Whitney, 2012) Endeavour College of Natural Health endeavour.edu.au 4
5 Structures include: Dietary Fibre Non-starch polysaccharides (NSP) - cellulose, hemicelluloses, pectins, gums and mucilages Non-polysaccharides - lignins, cutins and tannins Resistant starches Whole or partially milled grains Legumes Unripe bananas (Rolfes, Pinna & Whitney, 2012) Endeavour College of Natural Health endeavour.edu.au 5
6 Functions Distinct compositions of different fibres attribute to their properties Water retention capacity Absorption properties Tendency to form gels Viscosity Fermentability Ability to modify gut microbiota (Sanchez-Muniz, 2012) Endeavour College of Natural Health endeavour.edu.au 6
7 Colon Fermentation Carbohydrates susceptible to colonic fermentation Undigested/resistant starch (8-40g/day) Endogenous CHOs mucin and glycoproteins (3-5g/day) Non-starch Polysaccharides (8-18g/day) Fructans inulin Sorbitol (2-10g/day) Lactose (lactase deficiency) (Garrow et al., 1998) Endeavour College of Natural Health endeavour.edu.au 7
8 Non-Starch Polysaccharides Responsible for the rigidity of plant walls. Soluble CHO degraded nearly completely by gut microbes Insoluble CHO fermented to a lesser extent Endeavour College of Natural Health endeavour.edu.au 8
9 Gut Microbiota View the following video clip (14 mins) Meet your microbes bes In which instances may the ability of the gut microbes be impaired? Consider diet and lifestyle Disease conditions Endeavour College of Natural Health endeavour.edu.au 9
10 Non-starch Polysaccharides: Moderate transit time Functions Provide substrates for production of SCFA s, Vitamin B12 and Vitamin K Depending on substrate and species SCFA s such as acetate, propionate, butyrate What are the benefits of SCFA s? Endeavour College of Natural Health endeavour.edu.au 10
11 Resistant Starch Resists digestion in the small intestine Non-glycaemic Produces beneficial SCFA butyric acid Found in legumes, beans and peas, whole and intact grains Grinding into flours and processing breaks down into absorbable particles Endeavour College of Natural Health endeavour.edu.au 11
12 Soluble Fibres Soluble fibers are viscous and can be digested by intestinal bacteria. Found in oats, fruits, legumes and vegetables Pectins, gums, and some hemicelluloses (Rolfes, Pinna & Whitney, 2012) Endeavour College of Natural Health endeavour.edu.au 12
13 o Gums and Pectins Soluble Fibres NSP s Slow gastric emptying Bind cholesterol and bile acids Provide fermentable material for colonic bacteria Carageenan - apples Xanthan gum - carrots Alginate - citrus (Kohlmeier, 2003) Endeavour College of Natural Health endeavour.edu.au 13
14 Insoluble Fibres o Non-fermentable fibres Increase microbe proliferation in colon which is important for detoxification and increasing faecal bulk Increased microbial scavenging of and sequestering of substances and toxins Decrease activity of enzymes which convert procarcinogens to carcinogens Endeavour College of Natural Health endeavour.edu.au 14
15 Insoluble Fibres Lignin Antioxidant; bind bile acids and metals Linseeds and bran Hemicellulose Mostly insoluble Holds water, increases stool bulk Corn, wheat bran and psyllium (Kohlmeier, 2003) Endeavour College of Natural Health endeavour.edu.au 15
16 Insoluble Fibres o Cellulose is main dietary fibre found in plant cell walls. o Insoluble and is often referred to as roughage. o Cellulose aids the digestive tract by acting as a hydrophilic bulking agent for faeces Endeavour College of Natural Health endeavour.edu.au 16
17 Food Values Food Serving Fibre (g) Navy beans, ckd 1 cup % Bran cereal 1 cup 17.6 Kidney beans, ckd 1 cup 16.4 Lentils, ckd 1 cup 15.6 Prunes 1 cup, pitted 12.1 Quinoa, ckd 1 cup 9.3 Artichoke hearts 1 cup 9.1 Raspberries 1 cup 8.0 Spinach, frozen, ckd 1 cup 7.0 Oat bran ckd 1 cup 5.7 Instant oatmeal, ckd 1 cup 3.7 Rice, long-grained brown, ckd 1 cup 3.5 Mushrooms 1 cup 3.4 (Adapted from Higdon, 2005) Endeavour College of Natural Health endeavour.edu.au 17
18 Food Values o Generally speaking Fruit and vegetables contain 1-8g / serve Refined carbohydrates 0.3-1g / serve Whole grains 2-4g / serve Endeavour College of Natural Health endeavour.edu.au 18
19 Food Food Values Serving Sizes Meat, chicken, fish, eggs Cereals Vegetables Fruit Dairy Endeavour College of Natural Health endeavour.edu.au 19
20 NHMRC ADI (NHMRC, NRVs 2005) Endeavour College of Natural Health endeavour.edu.au 20
21 Review Questions 1. List the 3 different structures of plant molecules which are considered forms of fibre? 2. What are the main functions of fibre? 3. What important substances do NSP s produce in the colon? 4. Why are SCFA s important for health? Endeavour College of Natural Health endeavour.edu.au 21
22 Activity Log onto your Foodzone nutrient analysis website account. Alternatively utilise the link below or calculate approximate values manually using the provided worksheet and values displayed on the previous slides. Download your worksheet and complete a food diary for what you have eaten on the previous day Enter these into one of the calculators to discover your fibre intake for the day Endeavour College of Natural Health endeavour.edu.au 22
23 Therapeutic Benefits Constipation (Wald, 2000) Diverticulitis coli (Ye, Losada & West, 2005) Colorectal cancer (Martinez, 2005) Diabetes mellitus (Gray, 1995) Coronary heart disease (Hu & Willet, 2002) From what you have learned so far, why do you think fibre may be protective in these instances? Endeavour College of Natural Health endeavour.edu.au 23
24 Potential Issues of Excessive Intake Displaces energy and nutrient-dense foods Abdominal discomfort and distention Increases water requirements May interfere with nutrient absorption How could this be prevented? Endeavour College of Natural Health endeavour.edu.au 24
25 Measurements and Medical Tests Complete Digestive Stool Analysis (CDSA) Biochemical measurements of digestion/mal-digestion Metabolic markers of intestinal metabolism Identification of bacterial microflora, including pathogenic and imbalanced flora. Detection of parasites and abnormal gut mycology (Healthscope pathology) Endeavour College of Natural Health endeavour.edu.au 25
26 Activity continued o With the previous information you gathered on your dietary fibre intake what are some specific changes you could make to optimise your intake? o What are some of the long-term implications of your intake? o Summarise the most important points for your learning initially in small groups then with the class o Online students should discuss these in the relevant weekly forum Endeavour College of Natural Health endeavour.edu.au 26
27 Water Endeavour College of Natural Health endeavour.edu.au 27
28 Water Water is defined as an essential nutrient. All biochemical reactions occur in water. Required for digestion, absorption, transportation, elimination Thermoregulation. Maintains blood and cell volume (Rolfes, Pinna & Whitney, 2009) Endeavour College of Natural Health endeavour.edu.au 28
29 Water Water comprises 72% of fat free weight of the human body and >60% of overall weight. 60% of red blood cells 75% of muscle tissue 92% of blood plasma (Rolfes, Pinna & Whitney, 2009) Endeavour College of Natural Health endeavour.edu.au 29
30 Water: Sources and Processing Water is sourced and treated in many ways, all affecting the health benefits. Tap Water: Rivers, streams, lakes, groundwater. Treatment may include use of minerals and chemicals such as chlorine. May still have traces of contamination. (Haas, 1992) Endeavour College of Natural Health endeavour.edu.au 30
31 Water Sources and Processing Well/Bore Water Groundwater Mineral content varies Potential toxic and industrial pollutants Spring Water Underground supplies Bottled water may contain chlorine (Haas, 1992) Endeavour College of Natural Health endeavour.edu.au 31
32 Water Sources and Processing Rain Water Clean source Beware of residues Filtered Water Must clean filters regularly! Distilled/Demineralised Water Contains no minerals Boiled Water May concentrate solutes (Haas, 1992) Endeavour College of Natural Health endeavour.edu.au 32
33 Activity View the following video clip (6 mins) Water and Humans and consider the following questions Identify the major sources of pollution in our water 2. What types of pollutants can be in agricultural runoff? 3. Where does un-recycled garbage go? Endeavour College of Natural Health endeavour.edu.au 33
34 What are other sources of Water? Endeavour College of Natural Health endeavour.edu.au 34
35 Main source is food! Water Sources (Pinna, Rolfes & Whitney, 2009, p. 399) Endeavour College of Natural Health endeavour.edu.au 35
36 Factors Increasing Demand Water cannot be stored in the body. Water losses occur through urine output, water vapor from the lung, sweating and faeces. An output of 1450 to 2800 milliliters of water is usually represented by: Kidneys 500 to 1400 ml Skin 450 to 900 ml Lungs 350 ml GI tract 150 ml (Pinna, Rolfes & Whitney, 2009, p. 399) Endeavour College of Natural Health endeavour.edu.au 36
37 Factors Increasing Demand Water Depletion can be caused by: Thirst/drinking mechanism defect Osmoreceptor/antidiuretic mechanism defect Increased water loss endogenous and exogenous factors (Garrow et al., 1998) Endeavour College of Natural Health endeavour.edu.au 37
38 Water AI Recommended Daily Intake ~ 2-3L/day (NHMRC, NRVs 2005) Water (L) = body weight x 0.03 Calculate your daily water requirement. Consider your fluid and food intake, as well as factors which may increase your demand. Are you getting enough? Endeavour College of Natural Health endeavour.edu.au 38
39 Deficiency Signs and Symptoms Table 1: Management of dehydration (Webb and Starr, 2005) Endeavour College of Natural Health endeavour.edu.au 39
40 Toxicity Water intoxication is excessive water contents in all body fluid compartments. Due to excessive intake Failure of water diuresis Or both-usual cause Symptoms include: Nausea; vomiting; confusion; muscle cramping Water toxicity is rare. (Garrow et al., 1998) Endeavour College of Natural Health endeavour.edu.au 40
41 Revision Questions 1. Outline the roles of water in the body? 2. What types of foods contain over 70% water? 3. Which foods contain less than 30% water? 4. How do we calculate individual water requirements? 5. How might dehydration occur? 6. What signs might be noticed in dehydration? Endeavour College of Natural Health endeavour.edu.au 41
42 References ARL Pathology. (2006). Complete Digestive stool anlaysis (CDSA) clinical guide. Retrieved from Garrow, J. S., & James, W. (2000). Human nutrition and dietetics (10th ed.). Edinburgh, England: Churchill Livingstone. Haas, E. & Levin, B. (2006). Staying healthy with nutrition: The complete guide to diet and nutritional medicine (21st-century ed). Berkeley, CA: Celestial Arts. Harvard Medical School. (2016). Eat more fiber-rich foods to foster heart health. Retrieved from Higdon J Fiber. Retrieved from Hu FB, Willet WC Optimal diets for prevention of coronary heart disease. JAMA, 288(20), Retrieved from t.com/login.aspx?direct=true&db=mdc&an= &site=edslive&scope=site Kohlmeier, M. (2003). Nutrient Metabolism. London, England: Academic Press. Mayo Clinic. (2016). Chart of high-fiber foods. Retrieved from National Fiber Council. (2016). Fiber food chart. Retrieved from Endeavour College of Natural Health endeavour.edu.au 42
43 References National Health and Medical Research Council. (2016). Serve Sizes. Retrieved from National Health and Medical Research Council. (2005). Nutrient reference values for Australia and New Zealand. Retrieved from Rolfes, S. R, Pinna, K., & Whitney, E. (2012). Understanding normal and clinical nutrition (9th ed.). Belmont, CA: Wadsworth Cengage. Sánchez-Muniz, F. J. (2012). Dietary fibre and cardiovascular health. Nutricion Hospitalaria, 27(1), doi: /s Wald, A. (2000). Constipation. The Medical Clinics of North America, 84(5), Webb, A., & Starr, M. (2005). Acute gastroenteritis in children. Australian Family Physician, 34(4), Retrieved from Williams, S. R. (1993). Nutrition and diet therapy (7th ed.). St Louis, MO: Mosby. Ye, H., Losada, M., & West, A. B. (2005). Diverticulosis coli: Update on a "Western" disease. Advances In Anatomic Pathology, 12(2), Retrieved from Endeavour College of Natural Health endeavour.edu.au 43
44 COMMONWEALTH OF AUSTRALIA Copyright Regulations 1969 WARNING This material has been reproduced and communicated to you by or on behalf of the Australian College of Natural Medicine Pty Ltd (ACNM) trading as Endeavour College of Natural Health, FIAFitnation, College of Natural Beauty, Wellnation - Pursuant Part VB of the Copyright Act 1968 (the Act). The material in this communication may be subject to copyright under the Act. Any further reproduction or communication of this material by you may be the subject of copyright protection under the Act. Do not remove this notice. Endeavour College of Natural Health endeavour.edu.au 44
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