Dietary fibre: an old concept in new light
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1 Dietary fibre: an old concept in new light Megan Rossi, PhD RD Kindly sponsored by an education grant from Alpro UK.
2 Evolution of dietary fibre From this To this
3 Overview Practical tips
4 your body exactly is
5 exactly is fibre? Carbohydrates that are indigestible by human enzyme Still provides some energy! Dietary fibre Community of microbes (Gut microbiota) Lignin Non-starch polysaccharide Nondigestible oligosaccharides (degree of polymerisation 3) Small intestine Resistant starch (colon) Large intestine
6 do we find it? 44% pasta, rice, pizza & white bread 34% wholemeal & brown breads & High fibre breakfast cereals Over 1/3 rd from potatoes esp. fried & chips UK Cereals & cereal products, 38% Vegetables & potatoes, 30% Meat & products 12% Fruit, 8% IRELAND Cereals & cereal products, 45% Vegetables & potatoes, 30% 6% Fruit, 10% Other, 10% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 43% from potatoes & potato products 58% from breads (type not specified) 9% from breakfast cereals (high/low fibre not specified) Wholegrain Council
7 much SHOULD we be having? OLD: 18g/day (NSP) = 23g/day (new definition) Age groups (years) Recomm. AOAC Intakes AOAC g/d % below recomm. Recomm. AOAC g/d IRELAND Intakes AOAC g/d % below recomm % % % % to -22% % % to -27% % % to -33% % % % %
8 does it work? 1) Physical properties 2) Effect on gut microbiota
9 Not all fibres have the same effect Included 64 studies, n=2099 participants RCT with added food or supplement Fibre intervention higher Bifidobacterium p<0.001 higher Lactobacillus p=0.020 higher faecal butyrate p=0.05 Prebiotic fibres higher Bifidobacterium p<0.001 higher Lactobacillus p=0.002 Other fibres nil differences in microbiota
10 Gut microbiota Not just bacteria Weighs as much as our brain More microbes than human 100+ x more genes than humans WHAT IS IT. WHAT DOES IT DO. Produces vitamins & hormones Harvest energy from food Talks to our brain Fights off infection
11 Gut:brain axis n=36 MRI 4 weeks Live yoghurt (B. lactis, Streptococcus thermophiles, L.bulgaricus, & Lactococcus lactis lactis) Yoghurt No Product MRI Tillisch et al. 2013
12 Communication pathway Koh et al. 2016
13 Beyond fibre in plant-based eating Resveratrol Isoflavones Anthocyanins Gibson et al. 2017
14 Beyond fibre in plant-based eating +fibre + polyphenols We eat whole foods not single nutrients Singh et al 2017
15 Health benefits For every 7g increase in fibre: 9% lower risk of cardiovascular disease 7% lower risk of colon cancer 7% lower risk of stroke 6% lower risk of type 2 diabetes does 7g look like? SCAN
16 Gut:brain axis- role in mental health n=67 7 sessions over 12 weeks???? 32% 8% Jacka et al. 2017
17 Closer look at the diet Omega 3 50g fibre! B12 Selenium Folate Hydration Jacka et al. 2017
18 Economic benefit If 10% of the total population commit to a high adherence of: Mediterranean diet, societal cost savings in UK over 20 y= 7.53 billion Soy-containing diet, societal cost savings in UK over 20 y= billion
19 Environmental benefit Wholegrain Council, 2018
20 Translation in practice: barriers
21 Translation in practice: strategies
22 Side effects n=16 healthy people Glucose (placebo, 40g) Fructans (40g) MRI repeated hourly- 5 hrs Colonic gas volume Murray et al, Am J Gastro. 2014; 109: Glucose Fructans
23 is IBS?
24 Translation in practice: barriers n=29 healthy n=29 IBS >1 week washout Fructose (40g) Fructans (40g) Glucose (placebo, 40g) >1 week washout Fructose (40g) Fructans (40g) Glucose (placebo, 40g) Fructose (40g) Fructans (40g) Glucose (placebo, 40g) MRI repeated hourly- 5 hrs Colonic Symptom gas Intensity volume Major et al, Gut. 2014
25 Low FODMAP diet F ermentable Short chain CHO O D M A P ligo-saccharides many sugar units i-saccharides two sugar units ono-saccharides one sugar unit nd olyols Sugar alcohols Fructans, Galactooligosaccharides Lactose Fructose e.g sorbitol, mannitol
26 The low FODMAP process 3- step process Restriction (3-6 weeks) Re-introduction challenge (3 day/ Personalisation (long term) KEY: total FODMAP load
27 Low FODMAP diet... cautions Negatively impacts microbes Increases risk of nutrition deficiencies May trigger disordered eating May increase sensitivities Should not be someone s first resort
28 BDA guidelines for dietary management of IBS 1) Healthy eating and lifestyle Alcohol Caffeine Spicy food Fatty food Fluid intake Eating habits 2) Milk and dairy restriction 3) Dietary fibre Adapted from McKenzie. J Hum Nutr Diet. 2016; 29:
29 Fermentation profile of fibres High Rate fermentation low
30 Plant-based diet diversity Included 25 studies, nearly 2 million participants Observational studies For every 10g increase in total fibre 10% risk reduction in developing colon cancer For every 10g increase in cereal fibre 10% risk reduction in developing colon cancer Not significant for fruit fibre or vegetable fibre
31 Guess the grain Which grain is not featured above? a) Buckwheat b) Millet c) Barley d) Quinoa e) They re all featured
32 Translation in practice: things to consider
33 Take home : indigestible carbohydrates, many types : plant-derived foods, public are choosing lower fibre option much: >50% increase to reach target of 30g does it work: viscosity, solubility, fermentability; whole plant-based package : health, economic and environmental benefit Translation: know your client & be practical
34 @TheGutHealthDoctor Kindly sponsored by an education grant from Alpro UK. #letstalkfibre #plantpower For scientific and practical resources on fibre & plant-based eating from Alpro s Scientific and Nutrition Department visit
35 35
36 36
37 37
38 Different fibres have different benefits 38
39 Different fibres do different things Understanding the Physics of Functional Fibers in the Gastrointestinal Tract: An Evidence-Based Approach to Resolving Enduring Misconceptions about Insoluble and Soluble Fiber 39
40 Fibre and gene richness 40
41 Protein: plant vs animal replacing 1% of energy from animal protein with energy from plant protein is associated with a 18% decreased risk of developing T2D (38). Virtanen HEK, Koskinen TT, Voutilainen S, Mursu J, Tuomainen TP, Kokko P, Virtanen JK. Intake of different dietary proteins and risk of type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Br J Nutr 2017;117(6):
42 Essential amino acids Soya, quinoa and hemp are plant foods containing all the essential amino acids. Most other plant proteins provide some, with each plant providing a different combination. So, as long as you re eating a mixture of different plant proteins you ll be getting all the essential amino acids your body needs. 42
43 43
44 Fibre and decreased risk of coeliac disease (18) /pdf 44
45 45
46 Translation in practice: the barriers Lacy et al 2016
47 Mechanisms of actions FODMAPS
48 Role in stress management? Healthy n=45 3 weeks B-GOS (5.5g) FOS (5.5g) Placebo Schmidt et al. 2015
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