Lancet study: High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases

16 Jan

The Mayo Clinic wrote in Dietary fiber: Essential for a healthy diet:

What is dietary fiber?
Dietary fiber, also known as roughage or bulk, includes the parts of plant foods your body can’t digest or absorb. Unlike other food components, such as fats, proteins or carbohydrates — which your body breaks down and absorbs — fiber isn’t digested by your body. Instead, it passes relatively intact through your stomach, small intestine and colon and out of your body.
Fiber is commonly classified as soluble, which dissolves in water, or insoluble, which doesn’t dissolve.
• Soluble fiber. This type of fiber dissolves in water to form a gel-like material. It can help lower blood cholesterol and glucose levels. Soluble fiber is found in oats, peas, beans, apples, citrus fruits, carrots, barley and psyllium.
• Insoluble fiber. This type of fiber promotes the movement of material through your digestive system and increases stool bulk, so it can be of benefit to those who struggle with constipation or irregular stools. Whole-wheat flour, wheat bran, nuts, beans and vegetables, such as cauliflower, green beans and potatoes, are good sources of insoluble fiber.
The amount of soluble and insoluble fiber varies in different plant foods. To receive the greatest health benefit, eat a wide variety of high-fiber foods.
Benefits of a high-fiber diet
A high-fiber diet:
• Normalizes bowel movements. Dietary fiber increases the weight and size of your stool and softens it. A bulky stool is easier to pass, decreasing your chance of constipation. If you have loose, watery stools, fiber may help to solidify the stool because it absorbs water and adds bulk to stool.
• Helps maintain bowel health. A high-fiber diet may lower your risk of developing hemorrhoids and small pouches in your colon (diverticular disease). Studies have also found that a high-fiber diet likely lowers the risk of colorectal cancer. Some fiber is fermented in the colon. Researchers are looking at how this may play a role in preventing diseases of the colon.
• Lowers cholesterol levels. Soluble fiber found in beans, oats, flaxseed and oat bran may help lower total blood cholesterol levels by lowering low-density lipoprotein, or “bad,” cholesterol levels. Studies also have shown that high-fiber foods may have other heart-health benefits, such as reducing blood pressure and inflammation.
• Helps control blood sugar levels. In people with diabetes, fiber — particularly soluble fiber — can slow the absorption of sugar and help improve blood sugar levels. A healthy diet that includes insoluble fiber may also reduce the risk of developing type 2 diabetes.
• Aids in achieving healthy weight. High-fiber foods tend to be more filling than low-fiber foods, so you’re likely to eat less and stay satisfied longer. And high-fiber foods tend to take longer to eat and to be less “energy dense,” which means they have fewer calories for the same volume of food.
• Helps you live longer. Studies suggest that increasing your dietary fiber intake — especially cereal fiber — is associated with a reduced risk of dying from cardiovascular disease and all cancers…. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983

See, Dietary fiber: Why do we need it? https://www.medicalnewstoday.com/articles/146935.php

Science Daily reported: High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases

People who eat higher levels of dietary fibre and whole grains have lower rates of non-communicable diseases compared with people who eat lesser amounts, while links for low glycaemic load and low glycaemic index diets are less clear. Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fibre a day, according to a series of systematic reviews and meta-analyses published in The Lancet.
The results suggest a 15-30% decrease in all-cause and cardiovascular related mortality when comparing people who eat the highest amount of fibre to those who eat the least. Eating fibre-rich foods also reduced incidence of coronary heart disease, stroke, type 2 diabetes and colorectal cancer by 16-24%. Per 1,000 participants, the impact translates into 13 fewer deaths and six fewer cases of coronary heart disease.
In addition, a meta-analysis of clinical trials suggested that increasing fibre intakes was associated with lower bodyweight and cholesterol, compared with lower intakes.
The study was commissioned by the World Health Organization to inform the development of new recommendations for optimal daily fibre intake and to determine which types of carbohydrate provide the best protection against non-communicable diseases (NCDs) and weight gain.
Most people worldwide consume less than 20 g of dietary fibre per day. In 2015, the UK Scientific Advisory Committee on Nutrition recommended an increase in dietary fibre intake to 30 g per day, but only 9% of UK adults manage to reach this target. In the US, fibre intake among adults averages 15 g a day. Rich sources of dietary fibre include whole grains, pulses, vegetables and fruit….
The researchers included 185 observational studies containing data that relate to 135 million person years and 58 clinical trials involving 4,635 adult participants. They focused on premature deaths from and incidence of coronary heart disease, cardiovascular disease and stroke, as well as incidence of type 2 diabetes, colorectal cancer and cancers associated with obesity: breast, endometrial, esophageal and prostate cancer. The authors only included studies with healthy participants, so the findings cannot be applied to people with existing chronic diseases.
For every 8g increase of dietary fibre eaten per day, total deaths and incidence of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 5-27%. Protection against stroke, and breast cancer also increased. Consuming 25g to 29g each day was adequate but the data suggest that higher intakes of dietary fibre could provide even greater protection.
For every 15g increase of whole grains eaten per day, total deaths and incidence of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 2-19%. Higher intakes of whole grains were associated with a 13-33% reduction in NCD risk — translating into 26 fewer deaths per 1,000 people from all-cause mortality and seven fewer cases of coronary heart disease per 1,000 people. The meta-analysis of clinical trials involving whole grains showed a reduction in bodyweight. Whole grains are high in dietary fibre, which could explain their beneficial effects.
The study also found that diets with a low glycaemic index and low glycaemic load provided limited support for protection against type 2 diabetes and stroke only. Foods with a low glycaemic index or low glycaemic load may also contain added sugars, saturated fats, and sodium. This may account for the links to health being less clear…. https://www.sciencedaily.com/releases/2019/01/190110184737.htm

Citation:

High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases
Date: January 10, 2019
Source: The Lancet
Summary:
Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fiber a day, according to a series of systematic reviews and meta-analyses.

Andrew Reynolds et al, Carbohydrate quality and human health: a series of systematic reviews and meta-analyses, The Lancet (2019). DOI: 10.1016/S0140-6736(18)31809-9

Here is the press release from the Lancet:

The Lancet: High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases
People who eat higher levels of dietary fiber and whole grains have lower rates of non-communicable diseases compared with people who eat lesser amounts, while links for low glycemic load and low glycemic index diets are less clear
THE LANCET
People who eat higher levels of dietary fibre and whole grains have lower rates of non-communicable diseases compared with people who eat lesser amounts, while links for low glycaemic load and low glycaemic index diets are less clear. Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fibre a day, according to a series of systematic reviews and meta-analyses published in The Lancet.
The results suggest a 15-30% decrease in all-cause and cardiovascular related mortality when comparing people who eat the highest amount of fibre to those who eat the least. Eating fibre-rich foods also reduced incidence of coronary heart disease, stroke, type 2 diabetes and colorectal cancer by 16-24%. Per 1,000 participants, the impact translates into 13 fewer deaths and six fewer cases of coronary heart disease.
In addition, a meta-analysis of clinical trials suggested that increasing fibre intakes was associated with lower bodyweight and cholesterol, compared with lower intakes.
The study was commissioned by the World Health Organization to inform the development of new recommendations for optimal daily fibre intake and to determine which types of carbohydrate provide the best protection against non-communicable diseases (NCDs) and weight gain.
Most people worldwide consume less than 20 g of dietary fibre per day. In 2015, the UK Scientific Advisory Committee on Nutrition recommended an increase in dietary fibre intake to 30 g per day [1], but only 9% of UK adults manage to reach this target. In the US, fibre intake among adults averages 15 g a day [2]. Rich sources of dietary fibre include whole grains, pulses, vegetables and fruit.
“Previous reviews and meta-analyses have usually examined a single indicator of carbohydrate quality and a limited number of diseases so it has not been possible to establish which foods to recommend for protecting against a range of conditions,” says corresponding author Professor Jim Mann, the University of Otago, New Zealand.
“Our findings provide convincing evidence for nutrition guidelines to focus on increasing dietary fibre and on replacing refined grains with whole grains. This reduces incidence risk and mortality from a broad range of important diseases.” [3]
The researchers included 185 observational studies containing data that relate to 135 million person years and 58 clinical trials involving 4,635 adult participants. They focused on premature deaths from and incidence of coronary heart disease, cardiovascular disease and stroke, as well as incidence of type 2 diabetes, colorectal cancer and cancers associated with obesity: breast, endometrial, oesophageal and prostate cancer. The authors only included studies with healthy participants, so the findings cannot be applied to people with existing chronic diseases.
For every 8g increase of dietary fibre eaten per day, total deaths and incidences of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 5-27%. Protection against stroke, and breast cancer also increased. Consuming 25g to 29g each day was adequate but the data suggest that higher intakes of dietary fibre could provide even greater protection.
For every 15g increase of whole grains eaten per day, total deaths and incidences of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 2-19%. Higher intakes of whole grains were associated with a 13-33% reduction in NCD risk – translating into 26 fewer deaths per 1,000 people from all-cause mortality and seven fewer cases of coronary heart disease per 1,000 people. The meta-analysis of clinical trials involving whole grains showed a reduction in bodyweight. Whole grains are high in dietary fibre, which could explain their beneficial effects.
The study also found that diets with a low glycaemic index and low glycaemic load provided limited support for protection against type 2 diabetes and stroke only. Foods with a low glycaemic index or low glycaemic load may also contain added sugars, saturated fats, and sodium. This may account for the links to health being less clear.
“The health benefits of fibre are supported by over 100 years of research into its chemistry, physical properties, physiology and effects on metabolism. Fibre-rich whole foods that require chewing and retain much of their structure in the gut increase satiety and help weight control and can favourably influence lipid and glucose levels. The breakdown of fibre in the large bowel by the resident bacteria has additional wide-ranging effects including protection from colorectal cancer.” says Professor Jim Mann. [3]
While their study did not show any risks associated with dietary fibre, the authors note that high intakes might have ill-effects for people with low iron or mineral levels, for whom high levels of whole grains can further reduce iron levels. They also note that the study mainly relates to naturally-occurring fibre rich foods rather than synthetic and extracted fibre, such as powders, that can be added to foods.
Commenting on the implications and limitations of the study, Professor Gary Frost, Imperial College London, UK, says, “[The authors] report findings from both prospective cohort studies and randomised controlled trials in tandem. This method enables us to understand how altering the quality of carbohydrate intake in randomised controlled trials affects non-communicable disease risk factors and how these changes in diet quality align with disease incidence in prospective cohort studies. This alignment is seen beautifully for dietary fibre intake, in which observational studies reveal a reduction in all-cause and cardiovascular mortality, which is associated with a reduction in bodyweight, total cholesterol, LDL cholesterol, and systolic blood pressure reported in randomised controlled trials… There are some important considerations that arise from this Article. First, total carbohydrate intake was not considered in the systematic review and meta-analysis… Second, although the absence of association between glycaemic index and load with non-communicable disease and risk factors is consistent with another recent systematic review, caution is needed when interpreting these data, as the number of studies is small and findings are heterogeneous. Third, the absence of quantifiable and objective biomarkers for assessing carbohydrate intake means dietary research relies on self-reported intake, which is prone to error and misreporting. Improving the accuracy of dietary assessment is a priority area for nutrition research. The analyses presented by Reynolds and colleagues provides compelling evidence that dietary fibre and whole grain are major determinants of numerous health outcomes and should form part of public health policy.”
###
NOTES TO EDITORS
Peer-reviewed / Meta-analysis and systematic review / People
This study was funded by the Health Research Council of New Zealand, the WHO, the Riddet Centre of Research Excellence, the Healthier Lives National Science Challenge, the University of Otago, and the Otago Southland Diabetes Research Trust. It was conducted by researchers from the University of Otago, the Riddet Centre of Research Excellence, and the University of Dundee.
The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf if you have any questions or feedback, please contact The Lancet press office pressoffice@lancet.com
[1] Scientific Advisory Committee on Nutrition https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf
[2] https://www.ucsfhealth.org/education/increasing_fiber_intake/
[3] Quote direct from author and cannot be found in the text of the Article.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Although, there are minimum suggested daily minimum requirements, one should not overdue the daily intake of fiber.

Lauretta Claussen wrote in the SFGATE article, What Is Maximum Fiber Intake Per Day?

Too Much Fiber
Though fiber is beneficial, there is some risk of negative side effects from eating too much. Excessive amounts of fiber can bind with certain minerals such as calcium, iron, zinc and magnesium, interfering with absorption, warns the University of Maryland Medical Center. However, there is no upper limit set for how much fiber one can safely consume daily. Achieving dangerous levels from food intake alone would be difficult, and would most likely come as a result of excessive fiber supplement use.
Intestinal Problems
Though it is difficult to eat too much fiber, there is a risk of intestinal side effects from eating too much fiber at one sitting. Stomach cramps, gas and bloating can all occur when a dramatic fiber intake occurs suddenly. Once the natural bacteria in the digestive system gets accustomed to a high-fiber diet, these symptoms will likely subside.
Recommended Levels
The average American diet contains far too little fiber. Older children and adults should consume 20 to 35 grams of fiber daily, though most only get approximately 10 to 15. If you find you need to increase your daily fiber, do so slowly– over six to eight weeks– in order to avoid side effects. Drinking at least eight glasses of water daily will also help reduce the risk of negative side effects…. https://healthyeating.sfgate.com/maximum-fiber-intake-per-day-7061.html

The key concept is moderation.

Resources:

Minimum Daily Fiber Requirements                               https://healthyeating.sfgate.com/minimum-daily-fiber-requirements-4436.html

Fiber: How Much Is Too Much?                                   https://www.everydayhealth.com/hs/guide-to-daily-fiber/too-much-fiber/

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One Response to “Lancet study: High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases”

  1. Qunol January 17, 2019 at 9:37 am #

    Yes, fiber has a variety of health benefits! Learn more here: https://www.qunol.com/blogs/blog/the-surprising-health-benefits-of-dietary-fiber?utm_source=listne&utm_medium=blog&utm_campaign=fiber

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