Plant fiber. Carbohydrate and lipid metabolism

Comparison of the effects of magnesium hydroxide and a bulk laxative on lipids, carbohydrates, vitamins A and E, and minerals in geriatric hospital patients in the treatment of constipation

In a crossover study the effects of magnesium hydroxide on serum lipids, carbohydrates, vitamins A and E, uric acid and whole blood minerals were compared with those of a bulk laxative containing plantago rind and sorbitol in 64 constipated, elderly long-stay patients, 55 of whom were receiving diuretics. Hypomagnesaemia occurred in 11 (17%) patients after bulk laxative and in two (2%) patients after magnesium hydroxide treatment. There was a slight reduction in low values of high-density lipoprotein cholesterol and high values of triglycerides after magnesium hydroxide treatment. There were no significant differences in plasma lipids, whole blood minerals or vitamins A and E using either laxative. Negative correlations were found between the increase in serum concentrations of magnesium and glycosylated haemoglobin A1 (P less than 0.02) and the serum level of uric acid (P less than 0.01). These results suggest that the long-term effects of magnesium hydroxide and bulk laxative on the absorption of nutrients may not be significantly different. Magnesium hydroxide, however, may have beneficial effects on lipid disorders, impaired glucose tolerance and hyperuricaemia in magnesium deficiency due to diuretics and thus may be a favourable laxative for use in bedridden geriatric patients receiving diuretics.

Possible metabolic consequences of fermentation in the colon for humans

We postulate that the short chain fatty acids, produced in the large gut by the microbial fermentation of dietary fiber, improve glucose tolerance and inhibit hepatic cholesterol and fibrinogen synthesis, probably by preventing an increase in serum levels of free fatty acids, and by improving insulin sensitivity. Since hypercholesterolemia, hyperfibrinogenemia and glucose intolerance are important risk factors for coronary heart disease, this could serve as a basis for recommendations that Western populations at risk should increase their dietary intake of substrates for short chain fatty acids.

The medium-term effect of natural or extractive dietary fibres on plasma amino acids and lipids in type 1 diabetics

We evaluated the effect of a diet rich in natural (NF) or extractive fibres (guar gum) on 12 male IDD (insulin-dependent diabetes) out-patients. The treatment lasted for 2 months. During the first month the patients were on an isocaloric diet containing 30 g of fibres and then they were randomly subdivided into two groups. One group followed an isocaloric diet rich in fibres (70 g/day), the second group an isocaloric diet enriched by guar (9 g of guar added to 30 g of natural fibres/day). Reduced serum levels of HbA1c and several amino acids showed that metabolic control significantly improved under each dietary regimen.

Glucose and insulin response in diabetic subjects: acute effect of carbohydrate level and the addition of soy polysaccharide in defined-formula diets

This single-meal pilot study compared the plasma glucose and serum insulin response to defined-formula diets with two levels of carbohydrate (CHO) (55% and 30% of the kilocalories) with and without added soy polysaccharide (10 g) in subjects with type 2 diabetes mellitus. Subjects received each of the four liquid-formula test meals in a randomly assigned order: 1) high CHO, low fiber (HC, LF), 2) high CHO, high fiber (HC, HF), 3) low CHO, low fiber (LC, LF), and 4) low CHO, high fiber (LC, HF). On the day of each test meal the formula was consumed, eight blood samples were drawn for plasma glucose and serum insulin measurements, and a 4-h urine collection was obtained for measuring glucose excretion. Our results showed that area increments under glucose and insulin curves were significantly lower with both low-CHO formulas (p less than 0.001). The addition of soy polysaccharide to the liquid formula did not result in statistically different area increments for glucose or insulin.

Serum lipid response to a fat-modified, oatmeal-enhanced diet

The purpose of this study was to confirm and extend previous findings that serum cholesterol response to a fat-modified diet is enhanced by oat fiber. Participants (n = 236) were recruited from the Continental Illinois National Bank in Chicago. Data including weight, serum lipid level, lipoproteins, and 3-day food records were collected at baseline and every 4 weeks for 12 weeks. All participants were instructed to follow the fat-modified (Phase II) diet recommended by the American Heart Association (AHA). After 4 weeks, participants were randomly assigned to one of two groups. While both groups continued to follow the AHA diet, Group 1 was instructed to include 2 oz (56 g, dry wt) of oatmeal, isocalorically substituted for other carbohydrate foods. Group 2 served as the control and consumed no oat products throughout the study. Serum cholesterol values at baseline and after 4 weeks of the AHA diet were similar for both groups (203.9 and 193.0 mg/dl for Group 1 and 205.3 and 194.5 mg/dl for Group 2). After 4 weeks of oatmeal intervention, mean group differences were -6.8 and -2.1 mg/dl (P = 0.008 one-tailed t test) for Groups 1 and 2, respectively. Following an additional 4 weeks of oatmeal intervention, the Group 1 mean cholesterol increased slightly (0.9 mg/dl), while the Group 2 level decreased slightly (-0.7 mg/dl). Overall serum cholesterol responses for the two groups from Visit 2 to Visit 4 were -6.0 and -2.8 mg/dl for Groups 1 and 2, respectively (P = 0.074, one tail). Changes in weight were small and nonsignificant. Subgroup analyses revealed greater reductions in serum cholesterol among participants with the highest baseline serum cholesterol (-8.0 mg/dl vs -1.7 mg/dl for Subgroups 1 and 2, respectively). These data support previous findings that inclusion of oatmeal in a fat-modified diet is helpful in lowering serum cholesterol, particularly for individuals with elevated serum cholesterol levels.

Effect of pectin, wheat bran and cellulose on serum lipids and lipoproteins in rats fed on a low- or high-fat diet

1. Four groups of adult male Sprague-Dawley rats were fed for 6 weeks on a diet with a low-fat content (50 g/kg) and another four groups were given a diet rich in fat (250 g/kg) and cholesterol (12 g/kg). In both cases, the basal diets were either fibre-depleted or supplemented with cellulose (60 g/kg), wheat bran (100 g/kg) or low-methoxyl pectin (100 g/kg). 2. Low-methoxyl pectin displayed the most hypocholesterolaemic effect and decreased the cholesterol content of the very-low-density lipoproteins (VLDL) and low-density lipoproteins (LDL), when the low-fat diet was given. When rats were fed on the high-fat diet, pectin no longer had a hypocholesterolaemic effect but still decreased the VLDL-cholesterol content. Pectin lowered serum triglyceride and VLDL-triglyceride levels only when the low-fat diet was given. 3. Wheat bran exerted no hypocholesterolaemic effect in rats fed on the low- and high-fat diets, but decreased the cholesterol content of VLDL and lowered serum triglycerides and VLDL-triglycerides when the high-fat diet was given. 4. Purified cellulose had no significant effect on plasma lipids. 5. As shown by multivariance analysis, low-methoxyl pectin and wheat bran both beneficially modified the serum triglyceride and cholesterol variables except VLDL-triglycerides. However, the magnitude of the effect of each individual type of fibre was dependent on the fat and cholesterol content of the diet, suggesting the existence of different mechanisms of action.

The role of dietary carbohydrate in the decreased glucose tolerance of the elderly

In this study we have attempted to evaluate the role of dietary carbohydrate (CHO) in the decreased glucose tolerance of aging. Eighteen healthy young (mean age, 27 +/- 1 standard error of the mean) (SEM) and 18 old (71 +/- 1 SEM) subjects matched for relative weight and socioeconomic group were studied. Oral glucose tolerance tests were performed while eating ad lib diet and after being given high (85%), medium (45%), and low (20% to 30%) CHO formula diets for at least three days. A three- to seven-day food record was used to determine the major nutrients including CHO and fiber intake in the ad lib diet at home. Our older subjects consumed significantly less total calories and slightly less carbohydrate but there was no difference in dietary fiber, protein, and fat intake. When studies were performed on matched CHO diets, decreased glucose tolerance was present in the older group. However, the mechanism(s) involved may vary with dietary CHO and with age. During the low CHO formula diet and the medium CHO ad lib diet, impaired insulin secretion was prominent in the elderly but was not present in the young. During the high CHO formula diet, insulin response was adequate in both old and young, but decreased glucose tolerance persisted in the older group, suggesting that insulin resistance may be the major contributing factor. We conclude that decreased glucose tolerance in the elderly is modified by CHO intake, but is present even when dietary CHO variability is acutely controlled.(ABSTRACT TRUNCATED AT 250 WORDS)

Absence of diabetes in a rural West African population with a high carbohydrate/cassava diet

1028 (99%) of the 1038 inhabitants of the West African village of Agbave and a random sample of 353 (12.4%) of the population of 2850 in Kati, another West African village, were screened for diabetes. Also recorded were their anthropometric data, dietary habits, possession of antibodies to malaria, and serum IgG concentrations. About 85% of the study population consumed cassava root at least once a day. The mean (SD) capillary random blood glucose concentration was 5.1 (1.1) mmol/l in men and 5.1 (0.6) in women. The mean (SD) body mass index was 20.2 (1.8) in men and 20.7 (2.3) in women. The mean blood glucose was similar whether cassava was consumed once daily, more than once daily, or less than once daily. None of the 1381 subjects examined had diabetes. This finding suggests that a high carbohydrate/cassava intake (84% of a mean daily supply of 1916 calories) combined with a low protein consumption (8% of caloric supply) does not cause diabetes. This does not support the World Health Organisation hypothesis that malnutrition-related diabetes exists, at least not in this West African rural population.

Effects of soy polysaccharide on postprandial plasma glucose, insulin, glucagon, pancreatic polypeptide, somatostatin, and triglyceride in obese diabetic patients

The effect of soy polysaccharide on postprandial plasma glucose levels was examined in a crossover experiment involving seven obese noninsulin dependent maturity-onset diabetic patients fed a standard meal without or with 10 g of this fiber source. Postprandial concentrations of plasma insulin, glucagon, pancreatic polypeptide, and somatostatin were measured to explore the mechanism of action. The effect on plasma triglyceride levels was also studied. Supplementation of soy polysaccharide significantly enhanced return of serum glucose levels towards fasting level during the latter half of the meal test. Addition of soy polysaccharide had no effect on plasma insulin levels but appeared (p greater than 0.05) to lessen postprandial increases in glucagon and pancreatic polypeptide levels while it raised somatostatin levels. Soy polysaccharide significantly reduced the rise of postprandial plasma triglyceride levels. The changes in plasma glucagon, pancreatic polypeptide, and somatostatin levels may have been instrumental in the observed postprandial glucose and triglyceride effects.

In vitro binding of steroid hormones by natural and purified fibers

The in vitro binding of estrone, estradiol-17 beta, estriol, testosterone, dihydrotestosterone, and estrone-3-glucuronide by wheat, oat, and corn brans, oat hulls, cellulose, lignin, and cholestyramine resin was measured. The extent of steroid sequestration was characteristic and reproducible for each hormone. Cholestyramine bound an average of 90% of all the steroids tested, whereas cellulose bound the least (12%). Of the other substances tested, each bound the following percentage of unconjugated hormones: lignin, 87%; wheat and oat brans, 45% each; corn bran 44%; and oat hulls, 32%. The conjugated steroid was less likely to bind than the unconjugated steroids. Lignin appeared to be an important component in the interaction with steroid hormones. The results support the hydrophobic nature of adsorption and suggest that the components of fiber in diet should be considered separately when evaluating in vivo metabolic effects.

Non-soluble dietary fiber effects on lipid absorption and blood serum lipid patterns

Generalized effects of dietary fiber on lipid absorption and blood serum lipid patterns of humans have not been defined and may not even exist. The term dietary fiber covers a wide variety of materials with different chemical and physical characteristics. The ability of pectins and mucilages, often classed as soluble fibers, to lower blood and liver lipids has been demonstrated repeatedly and consistently. However, demonstrated hypolipidemic effects of feeding such non-soluble fibers as cellulose, hemicellulose and bran are by no means consistent. On the basis of pooled data, it appears that hypolipidemic response or non-response of humans to inclusion of non-soluble fibers in diets is in part related to the degree of fecal bulking as a result of in vitro water holding capacity and in part related to pre-study blood serum lipid levels of the individual subjects.

Treatment strategies for patients with non-insulin-dependent diabetes mellitus

Strategies for the treatment of patients with non-insulin-dependent diabetes mellitus are discussed. In order to achieve treatment goals, diet and exercise remain important components of an overall treatment program that may include sulfonylurea drugs, especially in cases where patients are of normal weight or only slightly obese, have had the disease less than five years, and are taking little or no insulin. Failure to control blood sugar levels with sulfonylurea drugs may lead to combining this therapy with insulin or administering insulin alone, regardless of patients' weights.

Diet therapy for poorly controlled type 2 (non-insulin-dependent) diabetes mellitus

Poorly controlled type 2 diabetes represents a major therapeutic problem. A classification of the disease, based on body weight and presence or absence of adequate insulin-secretion capacity, may be helpful in the choice of correct treatment. Calorie reduction is the most important therapeutic intervention in overweight patients. In the diabetic diet digestible carbohydrates should comprise at least 50 energy%, while the fat content should be reduced below 30 energy%. Controlled clinical studies show that the blood glucose control can be improved and the urinary glucose excretion be diminished by addition of dietary fibre. In obese type 2 diabetics supplemented fasting may be useful to achieve a rapid weight loss and an improved metabolic control. Although our knowledge with regard to the patho-physiology of type 2 diabetes and the effects of dietary treatment has increased during recent years, several important questions remain unanswered. Also there is a great need for education and training programmes to achieve improved compliance to the dietary advice given.

Differential effects of dietary fibers on rat intestinal circular muscle cell size

The relationship between dietary fiber and intestinal circular muscle cell size was investigated in rats by feeding defined diets supplemented with four different sources of fiber. In the first study, a 20% wheat bran supplement was fed to 10 rats for nine weeks. This resulted in larger muscle cell size, with a 22.5% increase in the proximal (P less than 0.02) and 77.9% increase in the distal colon (P less than 0.01) when compared with a control group of 10 rats fed a fiber-free diet. In the second study, which lasted four weeks, a control group of 10 rats was fed a fiber-free diet, while similar sized experimental groups were fed the same basal diet plus either 20% oat bran, 10% pectin, or 10% guar. Muscle cell size was decreased by 20.6% in the proximal jejunum of the oat bran- and pectin-fed groups (P less than 0.05) and by 43% in the proximal colon of the oat bran-fed group, when compared with the controls (P less than 0.05). These results show that the effects of high fiber diets on intestinal muscle cell size depend on the type of fiber consumed.

Influence of culture filtrate of Trichoderma viride and barley on lipid metabolism of laying hens

The suppression of hepatic 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase and cholesterol 7 alpha-hydroxylase, previously noted in studies of the influences of barley and the filtrate of Trichoderma viride culture (CF) on cholesterol metabolism in sexually immature birds, is shown in sexually mature birds. Barley, CF or both were fed in one study from the day of hatching, in another during the period of sexual maturation and, in a third study, CF was fed to mature layers. CF suppressed HMG CoA reductase by 30-50% and cholesterol 7 alpha-hydroxylase by 32-45% when added to the control diet. In birds fed barley rather than corn, the respective activities were 25-36% and 24-31% lower. These effects were expressed in the lowering of plasma cholesterol by 11-36%. Lipogenic activity based on the assays of 4 enzymes was increased 2-3 times by the treatments and plasma triglyceride elevated by 12-86%. The start of egg production by birds fed CF preceded the controls by 17 days. Birds fed barley trailed controls by 11-14 days. CF countered the barley-conditioned delay. Egg yolk cholesterol concentrations were lowered by both treatments. Eggs produced by hens fed barley were lower in weight; CF increased egg and yolk weights. Tissues from birds fed CF or barley for up to 30 weeks appeared to be normal.

Dietary fiber and lipoprotein metabolism in the genetically obese Zucker rat

The present investigation was designed to examine the influence of dietary fibers with differing soluble fiber compositions upon the metabolism of lipids in a hyperlipemic animal model, the Zucker fatty rat. The response to fiber was examined using a diet supplemented with cellulose, oat bran, or pectin which have a soluble/insoluble fiber ratio of 0:100, 33:66, and 100:0, respectively. These fibers provided 10% of the total diet weight; the control diet contained no fiber. A rapid increase in plasma triglyceride concentration was observed in all animals given fiber-supplemented diets in correlation with the increased carbohydrate content of the defined diets relative to the prestudy diets. This increase in plasma triglyceride was due to increased production of triglycerides with no change in the rates of clearance. The plasma total cholesterol levels were relatively constant on all diets. However, after 7 weeks on the pectin-supplemented diet, rats showed a 39% elevation in HDL and a 44% reduction in LDL concentration. This diet also resulted in reduced weight gain, in spite of a caloric intake equivalent to the control diets. Our data suggest that the ability of dietary fiber to alter plasma lipoproteins might be predictable from the soluble fiber composition or the pectin content of a given dietary fiber in this model of genetic endogenous hyperlipemia.

The influence of guar gum on intestinal cholesterol transport in the rat

Everted sacs of rat proximal small intestine were used to determine the effect of guar gum (5 g/l) on the uptake of cholesterol (0.1 mM) from a solution of micelles. The uptake of cholesterol was found to be linear both in the presence and absence of guar gum. When guar was present throughout the whole of the incubation medium, the uptake of cholesterol was reduced to approximately 40% of control values. Sacs which had been pre-incubated in guar gum before exposure to cholesterol in a guar-free medium also showed a reduction in cholesterol uptake but this was less pronounced. A two-stage perfusion technique, previously described (Blackburn & Johnson, 1981), was used to determine the effect of a guar layer adsorbed to the mucosal surface on cholesterol absorption in vivo. Such a layer leads to a reduction of approximately 36%; it was concluded that guar slows the absorption of cholesterol from micelles by a mechanism, or mechanisms, involving an increased resistance to diffusion in the aqueous medium. Groups of rats were meal-fed for at least 30 d on semi-synthetic diets with or without the inclusion of guar gum (20 g/kg). Rates of intestinal absorption of cholesterol, glucose and fluid were then determined by the perfusion technique in vivo. There was no reduction in absorption in the test animals compared with the controls. It is proposed that guar gum is able to slow the intestinal transport of cholesterol from a suspension of pre-formed micelles, but only when both are present in the lumen together. No evidence was obtained to suggest that the consumption by rats of a diet containing guar gum, at a level similar to that used in human studies, leads to any adaptive reduction in their rates of cholesterol or glucose absorption.

Metabolic effects of dietary fiber from dehulled soybeans in humans

The normal diet of six healthy volunteers was supplemented by 21 g of dietary fiber from two different soybean seed fiber preparations, either a nonpurified and never-dried soya pulp A (39% dietary fiber) or a purified soya fiber B (79%), for 3 wk each. Mean daily fecal wet weight was increased by 19 and 38% in the fiber periods A and B as compared to a 2-wk control period (p less than 0.05). Stool frequency and transit time remained unchanged. Fecal fiber increased by 52% only during period B. Fecal calcium, magnesium, and iron were increased (p less than 0.05), mainly after higher intakes during both fiber periods. Excretion of neutral steroids remained unchanged, but their concentration was lowered (p less than 0.05). A 21% increase of fecal bile acids by fiber A was specifically due to deoxycholic acid (+32%, p less than 0.01). Oral glucose tolerance was slightly improved after period B. Neither fiber changed serum triglycerides, but fiber B increased low-density lipoprotein-cholesterol by 19% (p less than 0.01) and low-density lipoprotein-phospholipids by 16% (p less than 0.05). The ratio high-density/low-density lipoprotein-cholesterol, however, did not change significantly. Thus, dietary fibers from soybean do not seem to contribute to the hypocholesterolemic effect of soya. The results of this study also demonstrate that two apparently similar dietary fibers, coming from a single source, can exert distinctly different metabolic effects.

Comparison of peripheral glucose uptake after oral glucose loading and a mixed meal

Forearm glucose uptake (FGU) and other metabolic responses were studied in six normal men for three hours after a 75-g oral glucose load and a mixed meal containing 75 g carbohydrate. After the meal the rise in arterial glucose levels was considerably less than that following the oral glucose load but the overall insulin responses from 0 to 180 minutes were not statistically different. Although the initial rise in FGU was more gradual after the meal, the subsequent elevation was more sustained and, at the termination of the study, exceeded significantly that seen after the oral glucose load. The rise in GIP levels during the first hour was similar after the meal and the oral glucose load, but thereafter concentrations following the oral glucose load fell while those after the meal continued to rise. When the incremental area (delta) is used as the index of response, the results show that while the glucose response (delta G) after the meal (19.1 +/- 5.3 units) was only 26% of that after oral glucose loading (72.7 +/- 7.0 units), the corresponding increase in FGU (delta FGU) reached 62% (55.0 +/- 12.8 units after the meal, 89.2 +/- 20.0 units after the oral glucose load). Thus, the increase in peripheral glucose uptake relative to the glycemic response (delta FGU/delta G) was significantly greater after the meal than following the oral glucose load alone (P less than 0.05). In conclusion, relative to the rise in arterial glucose levels, peripheral glucose uptake is greater after a meal than after glucose loading with an equivalent carbohydrate challenge. Furthermore, the present data support previous studies emphasizing the failure of GIP alone to explain the entero insular axis.

The effect of training and diet on lipoprotein cholesterol, tissue lipoprotein lipase and hepatic triglyceride lipase in rats

Treadmill training for 1 hr/day for 10 wk did not significantly affect chylomicron, very low density, low density, or high density lipoprotein cholesterol in rats fed either a high carbohydrate (glucose) or high fat (coconut oil) diet. Lipoprotein lipase activity of heart, adipose tissue, and skeletal muscle fibers was also unaffected by training. Carbohydrate feeding, however, when compared to fat feeding significantly lowered all lipoprotein cholesterol values as well as heart and fast-oxidative-glycolytic muscle fiber lipase activity and, conversely, significantly elevated hepatic triglyceride lipase activity. Thus, in the rat, an alteration in the serum lipid profile did not occur as a result of training, but dietary differences did independently influence serum lipid levels and tissue enzyme activity. It is suggested that human studies need to control for the possible independent influence of dietary differences when investigating the effects of training on lipoprotein metabolism.

The influence of guar gum on the movements of inulin, glucose and fluid in rat intestine during perfusion in vivo

A two-stage perfusion technique was used to study the effect of guar gum on the inulin-accessible space and the uptake of water and glucose in rat intestine. Pre-perfusion of test loops with low concentrations of guar, dispersed in saline, modified the rate of equilibration of inulin with the mucosal fluid space during a subsequent perfusion. The glucose absorption rate in such loops was reduced at a concentration of 50 mM, but not at 100 or 150 mM glucose. Fluid absorption was inhibited by pre-treatment with guar gum at all glucose concentrations tested. These results suggest that guar forms a layer closely associated with the mucosal surface which modifies the viscosity of the immediate fluid compartment, so that its resistance to diffusion is increased by means of an unstirred layer effect.

The effect of replacement of dietary soybean protein by casein on the fecal excretion of neutral steroids in rabbits

Der Einfluß des Ersatzes von Sojaprotein durch Kasein auf die Ausscheidung von Neutralfetten beim Kaninchen

Der Ersatz von Sojaprotein in einer halbsynthetischen Diät durch Kasein führte bei Kaninchen zu einem ständigen Anstieg von Cholesterin im Serum und zwar innerhalb von 15 Tagen um 75%. Gleichzeitig waren die Ausscheidung von Cholesterin und Coprostanol bei Kaseinfütterung signifikant erniedrigt und zwar bereits nach zwei Tagen um etwa 40%. Dieser Prozeß setzte sich in etwa 3 Wochen fort. Es wird vermutet, duß die herabgesetzte Ausscheidung von Neutralfetten mit dem Kot der Kausalfaktor ist für die Entwicklung einer Hypercholesterinämie des Kaninchens bei Kaseinfütterung.