The consumption of bread enriched with betaglucan reduces LDL-cholesterol and improves insulin resistance in patients with type2 diabetes

Fermentation enrichment, structural characterization and immunostimulatory effects of β-glucan from Quinoa

We developed an efficient mixed-strain co-fermentation method to increase the yield of quinoa β-glucan (Q+). Using a 1:1 mass ratio of highly active dry yeast and Streptococcus thermophilus, solid-to-liquid ratio of 1:12 (g/mL), inoculum size of 3.8 % (mass fraction), fermentation at 32 °C for 27 h, we achieved the highest β-glucan yield of (11.13 ± 0.80)%, representing remarkable 100.18 % increase in yield compared to quinoa β-glucan(Q-) extracted using hot water. The structure of Q+ and Q- were confirmed through Fourier Transform Infrared (FTIR) and Nuclear Magnetic Resonance (NMR) spectroscopies. Q+ contained 41.66 % β-glucan, 3.93 % protein, 2.12 % uronic acid; Q- contained 37.21 % β-glucan, 11.49 % protein, and 1.73 % uronic acid. The average molecular weight of Q+(75.37 kDa) was lower than that of Q- (94.47 kDa). Both Q+ and Q- promote RAW264.7 cell proliferation without displaying toxicity. They stimulate RAW264.7 cells through the NF-κB and MAPK signaling pathways, primarily inducing NO and pro-inflammatory cytokines by upregulating CD40 expression. Notably, Q+ exhibited stronger immunostimulatory activity compared to Q-. In summary, the fermentation enrichment method yields higher content of quinoa β-glucan with increased purity and stronger immunostimulatory properties. Further study of its bioimmunological activity and structure-activity relationship may contribute to the development of new immunostimulants.

Effect of special types of bread with select herbal components on postprandial glucose levels in diabetic patients

BACKGROUND

Nutrition recommendations in patients with type 2 diabetes mellitus (T2DM) are to consume rye or integral bread instead of white bread. A positive effect on glucoregulation has been achieved by enriching food with various biologically active substances of herbal origin, so we formulated an herbal mixture that can be used as a supplement for a special type of bread (STB) to achieve better effects on postprandial glucose and insulin levels in patients with T2DM.

AIM

To compare organoleptic characteristics and effects of two types of bread on postprandial glucose and insulin levels in T2DM patients.

METHODS

This trial included 97 patients with T2DM. A parallel group of 16 healthy subjects was also investigated. All participants were given 50 g of rye bread and the same amount of a STB with an herbal mixture on 2 consecutive days. Postprandial blood glucose and insulin levels were compared at the 30th, 60th, 90th and 120th min. A questionnaire was used for subjective estimation of the organoleptic and satiety features of the two types of bread.

RESULTS

Compared to patients who consumed rye bread, significantly lower postprandial blood glucose and insulin concentrations were found in T2DM patients who consumed STB. No relevant differences were found among the healthy subjects. Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread.

CONCLUSION

STB have better effects than rye bread on postprandial glucoregulation in T2DM patients. Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread. Therefore, STB can be recommended for nutrition in T2DM patients.

Effect of viscous soluble dietary fiber on glucose and lipid metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis on randomized clinical trials

Background

The effect of viscous soluble dietary fiber on glucose and lipid metabolism in type 2 diabetes mellitus (T2DM) remains controversial, and the dose-response relationship of its effect on blood glucose and blood lipid level is still unclear.

Methods

We conducted comprehensive searches in several databases up to 17 January 2023. We conducted a dose-response analysis of randomized controlled trials (RCTs) to investigate the effect of viscous dietary fiber on glucose and lipid metabolism in patients with T2DM.

Results

Statistical significance was observed in the decreases of glycosylated hemoglobin (HbA1c) (mean difference) [MD = -0.47; 95%CI: (-0.66, -0.27)], fasting blood glucose (FBG) [MD = -0.93; 95%CI: (-1.46, -0.41)], total cholesterol (TC) [MD = -0.33; 95%CI: (-0.46, -0.21)], and low-density lipoprotein and cholesterol (LDL-C) [MD = -0.24; 95%CI: (-0.35, -0.13)]. Contrarily, no difference was observed regarding the level of high-density lipoprotein cholesterol (HDL-C) or triglyceride (TG). In addition, the effect on fasting insulin remains unclear. Results from the subgroup analyses showed that an intervention duration longer than 6 weeks had a significant effect on the HbA1c level; a treatment dosage higher than 8.3 g/day had a significant effect on the FBG level.

Conclusions

Supplementation of viscous dietary fiber is beneficial to control blood glucose and blood lipid in T2DM.

Oat Beta-Glucan Alone and in Combination with Hydrochlorothiazide Lowers High Blood Pressure in Male but Not Female Spontaneously Hypertensive Rats

Oats are considered a functional food due to the beneficial health effects associated with their consumption and are suitable to be explored for their ability to prevent or manage chronic disease, such as hypertension. Here, we examined the cardiovascular benefits of an oat beta-glucan extract in male and female spontaneously hypertensive rats (SHRs) to unravel its sex-specific roles when used with an anti-hypertensive medication, hydrochlorothiazide. Five-week-old male and female SHRs and Wistar-Kyoto (WKY) rats were treated with oat beta-glucan and hydrochlorothiazide for 15 weeks. Twenty-week-old male and female SHRs showed high blood pressure (BP), cardiac remodeling, and cardiac dysfunction. These animals also had significantly increased levels of malondialdehyde (MDA), angiotensin II, and norepinephrine. Treatments with beta-glucan and hydrochlorothiazide were able to differentially prevent high BP, cardiac dysfunction, and alterations in malondialdehyde (MDA), angiotensin II, and norepinephrine in 20-week-old male and female SHRs. To conclude, beta-glucan alone and in combination with hydrochlorothiazide may be a promising a strategy for managing hypertension and related cardiac complications.

Effects of Four Different Dietary Fibre Supplements on Weight Loss and Lipid and Glucose Serum Profiles during Energy Restriction in Patients with Traits of Metabolic Syndrome: A Comparative, Randomized, Placebo-Controlled Study

Obesity and its associated complications require various lifestyle changes and treatment options. Dietary supplements are considered an attractive alternative to traditional therapy, mainly because they are accessible to the general population. The aim of this study was to investigate the additive effects of a combination of energy restriction (ER) and four dietary supplements on changes in the anthropometric and biochemical parameters in 100 overweight or obese participants who were randomly assigned one of the dietary fibre supplements containing different dietary fibres or a placebo for 8 weeks. The results confirmed that fibre supplements plus ER significantly (p < 0.01) reduced the body weight, body mass index (BMI), fat mass, and visceral fat and ameliorated the lipid profile and inflammation at 4 and 8 weeks after the start of the study, while in the placebo group, significant differences in some parameters were observed only after 8 weeks of ER. A fibre supplement containing glucomannan, inulin, psyllium, and apple fibre was the most effective at reducing the BMI, body weight, and CRP (p = 0.018 for BMI and body weight and p = 0.034 for CRP compared to placebo at the end of the intervention). Overall, the results suggest that dietary fibre supplements in combination with ER may have additional effects on weight loss and the metabolic profile. Therefore, taking dietary fibre supplements may be a feasible approach to improve weight and metabolic health in obese and overweight individuals.

Galactomannans are the most effective soluble dietary fibers in type 2 diabetes: a systematic review and network meta-analysis

BACKGROUND

Soluble dietary fibers are known to reduce the levels of blood glucose and lipids in patients with type 2 diabetes mellitus (type 2 diabetes). Although several different dietary fiber supplements are utilized, to our knowledge, no previous study has ranked their efficacy yet.

OBJECTIVES

We performed this systematic review and network meta-analysis to rank the effects of different types of soluble dietary fibers.

METHODS

We performed our last systematic search on November 20, 2022. Eligible randomized controlled trials (RCTs) included adult patients with type 2 diabetes and compared the intake of soluble dietary fibers with that of another type of dietary fiber or no fiber. The outcomes were related to glycemic and lipid levels. The Bayesian method was used to perform a network meta-analysis and calculate the surface under the cumulative ranking (SUCRA) curve values to rank the interventions. The Grading of Recommendations Assessment, Development, and Evaluation system was applied to evaluate the overall quality of the evidence.

RESULTS

We identified 46 RCTs, including data from 2685 patients who received 16 types of dietary fibers as intervention. Galactomannans had the highest effect on reducing the levels of HbA1c (SUCRA: 92.33%) and fasting blood glucose (SUCRA: 85.92%). With regard to fasting insulin level, HOMA-IR, β-glucans (SUCRA: 73.45%), and psyllium (SUCRA: 96.67%) were the most effective interventions. Galactomannans were ranked first in reducing the levels of triglycerides (SUCRA: 82.77%) and LDL cholesterol (SUCRA: 86.56%). With regard to cholesterol and HDL cholesterol levels, xylo-oligosaccharides (SUCRA: 84.59%) and gum arabic (SUCRA: 89.06%) were the most effective fibers. Most comparisons had a low or moderate certainty of evidence.

CONCLUSIONS

Galactomannans were the most effective dietary fiber for reducing the levels of HbA1c, fasting blood glucose, triglycerides, and LDL cholesterol in patients with type 2 diabetes. This study was registered at PROSPERO as ID CRD42021282984.

The separate effects of whole oats and isolated beta-glucan on lipid profile: A systematic review and meta-analysis of randomized controlled trials

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.

The Effect of Regular Consumption of Reformulated Breads on Glycemic Control: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Bread is a major source of grain-derived carbohydrates worldwide. High intakes of refined grains, low in dietary fiber and high in glycemic index, are linked with increased risk for type 2 diabetes mellitus (T2DM) and other chronic diseases. Hence, improvements in the composition of bread could influence population health. This systematic review evaluated the effect of regular consumption of reformulated breads on glycemic control among healthy adults, adults at cardiometabolic risk or with manifest T2DM. A literature search was performed using MEDLINE, Embase, Web of Science and the Cochrane Central Register of Controlled Trials. Eligible studies employed a bread intervention (≥2 wk) in adults (healthy, at cardiometabolic risk or manifest T2DM) and reported glycemic outcomes (fasting blood glucose, fasting insulin, HOMA-IR, HbA1c, and postprandial glucose responses). Data were pooled using generic inverse variance with random-effects model and presented as mean difference (MD) or standardized MD between treatments with 95% CIs. Twenty-two studies met the inclusion criteria (n = 1037 participants). Compared with "regular" or comparator bread, consumption of reformulated intervention breads yielded lower fasting blood glucose concentrations (MD: -0.21 mmol/L; 95% CI: -0.38, -0.03; I² = 88%, moderate certainty of evidence), yet no differences in fasting insulin (MD: -1.59 pmol/L; 95% CI: -5.78, 2.59; I² = 38%, moderate certainty of evidence), HOMA-IR (MD: -0.09; 95% CI: -0.35, 0.23; I² = 60%, moderate certainty of evidence), HbA1c (MD: -0.14; 95% CI: -0.39, 0.10; I² = 56%, very low certainty of evidence), or postprandial glucose response (SMD: -0.46; 95% CI: -1.28, 0.36; I² = 74%, low certainty of evidence). Subgroup analyses revealed a beneficial effect for fasting blood glucose only among people with T2DM (low certainty of evidence). Our findings suggest a beneficial effect of reformulated breads high in dietary fiber, whole grains, and/or functional ingredients on fasting blood glucose concentrations in adults, primarily among those with T2DM. This trial was registered at PROSPERO as CRD42020205458.

Effect of oats and oat ß-glucan on glycemic control in diabetes: a systematic review and meta-analysis of randomized controlled trials

Introduction

Current health claims recognize the ability of oat ß-glucan to lower blood cholesterol; however, its ability to improve glycemic control is less certain. We undertook a systematic review and meta-analysis of randomized controlled trials (RCTs) to update the evidence on the effect of oats and oat ß-glucan on glycemic control in individuals with diabetes.

Research design and methods

MEDLINE, EMBASE and Cochrane were searched (June 2021) for RCTs of ≥2 weeks investigating the effect of oat ß-glucan on glycemic control in diabetes. The outcomes were hemoglobin A1c (HbA1c), fasting glucose, 2-hour postprandial glucose (2h-PG) from a 75 g oral glucose tolerance test, homeostatic model assessment of insulin resistance (HOMA-IR) and fasting insulin. Independent reviewers extracted the data and assessed the risk of bias. Data were pooled using the generic inverse variance method. Heterogeneity was assessed (Cochran Q) and quantified (I2). Pooled estimates were expressed as mean difference (MD) with 95% CI. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach.

Results

Eight trial comparisons (n=407) met the eligibility criteria. All trials were in adults with type 2 diabetes who were predominantly middle-aged, overweight and treated by antihyperglycemic medications or insulin. A median dose of 3.25 g of oat ß-glucan for a median duration of 4.5 weeks improved HbA1c (MD, −0.47% (95% CI −0.80 to −0.13), pMD=0.006), fasting glucose (−0.75 mmol/L (−1.20 to –0.31), pMD<0.001), 2h-PG (−0.42 mmol/L (−0.70 to –0.14), pMD=0.003) and HOMA-IR (−0.88 (−1.55 to –0.20), pMD=0.011). There was a non-significant reduction in fasting insulin (−4.30 pmol/L (−11.96 to 3.35), pMD=0.271). The certainty of evidence was high for fasting glucose, moderate for HOMA-IR and fasting insulin (downgraded for imprecision), and low for HbA1c and 2h-PG (downgraded for imprecision and inconsistency).

Conclusions

Consumption of oats and oat ß-glucan results in generally small improvements in established markers of fasting and postprandial glycemic control beyond concurrent therapy in adults with type 2 diabetes. The current evidence provides a very good indication for reductions in fasting glucose and less of an indication for reductions in HbA1c, 2h-PG, fasting insulin and HOMA-IR in this population.

Trial registration number

NCT04631913.

Therapeutic potential of non-starch polysaccharides on type 2 diabetes: from hypoglycemic mechanism to clinical trials

Non-starch polysaccharides (NSPs) have been reported to exert therapeutic potential on managing type 2 diabetes mellitus (T2DM). Various mechanisms have been proposed; however, several studies have not considered the correlations between the anti-T2DM activity of NSPs and their molecular structure. Moreover, the current understanding of the role of NSPs in T2DM treatment is mainly based on in vitro and in vivo data, and more human clinical trials are required to verify the actual efficacy in treating T2DM. The related anti-T2DM mechanisms of NSPs, including regulating insulin action, promoting glucose metabolism and regulating postprandial blood glucose level, anti-inflammatory and regulating gut microbiota (GM), are reviewed. The structure-function relationships are summarized, and the relationships between NSPs structure and anti-T2DM activity from clinical trials are highlighted. The development of anti-T2DM medication or dietary supplements of NSPs could be promoted with an in-depth understanding of the multiple regulatory effects in the treatment/intervention of T2DM.

Are all fibres created equal with respect to lipid lowering? Comparing the effect of viscous dietary fibre to non-viscous fibre from cereal sources: a systematic review and meta-analysis of randomised controlled trials

Although compelling evidence from observational studies supports a positive association between consumption of cereal fibre and CVD risk reduction, randomised controlled trials (RCT) often target viscous fibre type as the prospective contributor to lipid lowering to reduce CVD risk. The objective of our study is to compare the lipids-lowering effects of viscous dietary fibre to non-viscous, cereal-type fibre in clinical studies. RCT that evaluated the effect of viscous dietary fibre compared with non-viscous, cereal fibre on LDL cholesterol and alternative lipid markers, with a duration of ≥ 3 weeks, in adults with or without hypercholesterolaemia were included. Medline, EMBASE, CINAHL and the Cochrane Central Register were searched through October 19, 2021. Data were extracted and assessed by two independent reviewers. The generic inverse variance method with random effects model was utilised to pool the data which were expressed as mean differences (MD) with 95 % CI. Eighty-nine trials met eligibility criteria (n 4755). MD for the effect of viscous dietary fibre compared with non-viscous cereal fibre were LDL cholesterol (MD = -0·26 mmol/l; 95 % CI: -0·30, -0·22 mmol/l; P < 0·01), non-HDL cholesterol (MD = -0·33 mmol/l; 95 % CI: -0·39, -0·28 mmol/l; P < 0·01) and Apo-B (MD = -0·04 g/l; 95 % CI: -0·06, -0·03 g/l; P < 0·01). Viscous dietary fibre reduces LDL cholesterol and alternative lipid markers relative to the fibre from cereal sources, hence may be a preferred type of fibre-based dietary intervention targeting CVD risk reduction.

Effects of whole grain intake on glycemic control: a meta-analysis of randomized controlled trials

Aims/Introduction

Although mounting evidence has suggested an inverse association between the intake of whole grains and glycemic control, findings from randomized controlled trials are still conflicting. The current study was carried out to evaluate the effect of medium/long‐term whole grain intake on glycemic control in metabolic syndrome and healthy populations.

Materials and Methods

A literature search was carried out to identify qualified studies up to July 2021. The effects of whole grain consumption on glycemic control were calculated using a fixed effects model. Subgroup analysis was used to study whether grouping factors were important influencing factors of heterogeneity between research results.

Results

A total of 32 randomized controlled trials with 2,060 participants were included in the analyses. Whole grain consumption showed a significant inverse regulatory effect on fasting glucose concentration, but no significant effect was found for other glycemic measures, such as fasting insulin, homeostatic model assessment for insulin resistance, glycated hemoglobin and 2‐h glucose, in the pooled analysis. Through subgroup analyses, a significant decrease in fasting glucose concentration was observed for studies with a higher whole grain dose, with participants of normal glycemia, and with mixed types of whole grain.

Conclusions

Medium‐/long‐term whole grain intake reduced the fasting glucose concentration compared with similar refined foods. Appropriate intervention dose and accurate population selection might be the key links for whole grain consumption to exert its glycemic control effect.

Thirty‐two RCTs with 2060 participants were included in analyses. The whole grain consumption showed significant inverse regulation effect on fasting glucose concentration.

Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials

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.

Exploring diet associations with Covid-19 and other diseases: a Network Analysis-based approach

The current global pandemic, Covid-19, is a severe threat to human health and existence especially when it is mutating very frequently. Being a novel disease, Covid-19 is impacting the patients with comorbidities and is predicted to have long-term consequences, even for those who have recovered from it. To clearly recognize its impact, it is important to comprehend the complex relationship between Covid-19 and other diseases. It is also being observed that people with good immune system are less susceptible to the disease. It is perceived that if a correlation between Covid-19, other diseases, and diet is realized, then caregivers would be able to enhance their further course of medical action and recommendations. Network Analysis is one such technique that can bring forth such complex interdependencies and associations. In this paper, a Network Analysis-based approach has been proposed for analyzing the interplay of diets/foods along with Covid-19 and other diseases. Relationships between Covid-19, diabetes mellitus type 2 (T2DM), non-alcoholic fatty liver disease (NAFLD), and diets have been curated, visualized, and further analyzed in this study so as to predict unknown associations. Network algorithms including Louvain graph algorithm (LA), K nearest neighbors (KNN), and Page rank algorithms (PR) have been employed for predicting a total of 60 disease-diet associations, out of which 46 have been found to be either significant in disease risk prevention/mitigation or in its progression as validated using PubMed literature. A precision of 76.7% has been achieved which is significant considering the involvement of a novel disease like Covid-19. The generated interdependencies can be further explored by medical professionals and caregivers in order to plan healthy eating patterns for Covid-19 patients. The proposed approach can also be utilized for finding beneficial diets for different combinations of comorbidities with Covid-19 as per the underlying health conditions of a patient. Graphical abstract.

Impact of fiber-fortified food consumption on anthropometric measurements and cardiometabolic outcomes: A systematic review, meta-analyses, and meta-regressions of randomized controlled trials

The consumption of processed and refined food lacking in fiber has led to global prevalence of obesity and cardiometabolic diseases. Fiber-fortification into these foods can yield potential health improvements to reduce disease risk. This meta-analyses aimed to evaluate how fiber-fortified food consumption changes body composition, blood pressure, blood lipid-lipoprotein panel, and glycemic-related markers. Searches were performed from 5 databases, with 31 randomized controlled trial eventually analyzed. Hedges' g values (95% confidence interval [CI]) attained from outcome change values were calculated using random-effects model. Fiber-fortified food significantly reduced body weight (-0.31 [-0.59, -0.03]), fat mass (-0.49 [-0.72, -0.26]), total cholesterol (-0.54 [-0.71, -0.36]), low-density lipoprotein cholesterol (-0.49 [-0.65, -0.33]), triglycerides (-0.24 [-0.36, -0.12]), fasting glucose (-0.30 [-0.49, -0.12]), and HbA1c (-0.44 [-0.74, -0.13]). Subgroup analysis differentiated soluble fiber as significantly reducing triglycerides and insulin while insoluble fiber significantly reduced body weight, BMI, and HbA1c. Greater outcome improvements were observed with solid/semi-solid food state than liquid state. Additionally, fiber fortification of <15 g/day induced more health outcome benefits compared to ≥15 g/day, although meta-regression found a dose-dependent improvement to waist circumference (p-value = 0.036). Findings from this study suggest that consuming food fortified with dietary fiber can improve anthropometric and cardiometabolic outcomes.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2053658.

Valorization of cereal by-product hemicelluloses: Fractionation and purity considerations

The biomass from cereal side streams is rich in valuable components, such as hemicelluloses. Among the hemicelluloses, arabinoxylans and β-glucans are the most acknowledged for potential health benefits. Numerous publications discuss the potential to use purified forms of these hemicelluloses for various applications. However, as the purification of hemicelluloses may not be economically feasible to upscale, sustainable and cost-effective methods are needed to make their valorization more realistic for industrial applications. Co-components present in hemicellulose-rich fractions may also provide added functionality, such as flavonoid content and antioxidant capacity. This review provides an overview on the feasibility of sustainably upscaling hemicellulose extraction processes, focusing on by-products from different cereal streams. We describe the hemicelluloses' physicochemical properties and provide various possible applications of pure and impure fractions from small scale to pilot and industrial scale. Furthermore, real case examples on the industrial utilization of cereal side streams are enclosed. This review provides pathways for future research for developing the hemicellulose extraction methods to obtain fractions with optimized purity, and offers suggestions to valorize them.

Metabolic variables of obese dogs with insulin resistance supplemented with yeast beta-glucan

Background

Obesity is one of the most common nutritional disorders in dogs and cats and is related to the development metabolic comorbidities. Weight loss is the recommended treatment, but success is difficult due to the poor satiety control. Yeast beta-glucans are known as biological modifiers because of their innumerable functions reported in studies with mice and humans, but only one study with dogs was found. This study aimed to evaluate the effects of a diet supplemented with 0.1% beta-glucan on glucose, lipid homeostasis, inflammatory cytokines and satiety parameters in obese dogs. Fourteen dogs composed three experimental groups: Obese group (OG) with seven dogs with body condition score (BCS) 8 or 9; Lean group (LG) included seven non-obese dogs with a BCS of 5; and Supplemented Obese group (SOG) was the OG dogs after 90 days of consumption of the experimental diet.

Results

Compared to OG, SOG had lower plasma basal glycemic values (p = 0.05) and reduced serum cholesterol and triglyceride levels. TNF-α was lower in SOG than in OG (p = 0.05), and GLP-1 was increased in SOG compared to OG and LG (p = 0.02).

Conclusion

These results are novel and important for recognizing the possibility of using beta-glucan in obesity prevention and treatment.

An Oat β-Glucan Beverage Reduces LDL Cholesterol and Cardiovascular Disease Risk in Men and Women with Borderline High Cholesterol: A Double-Blind, Randomized, Controlled Clinical Trial

BACKGROUND

High-molecular-weight (MW) oat β-glucan (OBG), consumed at 3-4 g/d, in solid foods reduces LDL cholesterol by a median of ∼6.5%.

OBJECTIVES

We evaluated the effect of a beverage providing 3 g/d high-MW OBG on reduction of LDL cholesterol (primary endpoint) when compared with placebo.

METHODS

We performed a parallel-design, randomized clinical trial at a contract research organization; participants, caregivers, and outcome assessors were blinded to treatment allocation. Participants with LDL cholesterol between 3.0 and 5.0 mmol/L, inclusive [n = 538 screened, n = 260 ineligible, n = 23 lost, n = 48 withdrawn (product safety); n = 207 randomly assigned, n = 7 dropped out, n = 9 withdrawn (protocol violation); n = 191 analyzed; n = 72 (37.7%) male, mean ± SD age: 43.3 ± 14.3 y, BMI: 29.7 ± 5.2 kg/m2], were randomly assigned to consume, 3 times daily for 4 wk, 1 g OBG (n = 104, n = 96 analyzed) or rice powder (Control, n = 103, n = 95 analyzed) mixed into 250 mL water. Treatment effects were assessed as change from baseline and differences analyzed using a 2-sided t test via ANOVA with baseline characteristics as covariates.

RESULTS

After 4 wk, change from baseline least-squares-mean LDL cholesterol on OBG (-0.195 mmol/L) was less than on Control (0.012 mmol/L) by mean: 0.207 mmol/L (95% CI: 0.318, 0.096 mmol/L; P = 0.0003); the following secondary endpoints were also reduced as follows: total cholesterol (TC) (0.226 mmol/L; 95% CI: 0.361, 0.091 mmol/L; P = 0.001), TC:HDL cholesterol ratio (0.147; 95% CI: 0.284, 0.010; P = 0.036), non-HDL cholesterol (0.194 mmol/L; 95% CI: 0.314, 0.073 mmol/L; P = 0.002), and Framingham cardiovascular disease (CVD) risk (0.474; 95% CI: 0.900, 0.049, P = 0.029). Changes in HDL cholesterol, triglycerides, glucose, and insulin did not differ between treatment groups (P > 0.05). Lipid treatment effects were not significantly modified by age, sex, BMI, or hypertension treatment. There were no major adverse events, but both treatments transiently increased gastrointestinal symptoms.

CONCLUSIONS

Consuming a beverage containing 1 g high-MW OBG 3 times daily for 4 wk significantly reduced LDL cholesterol by ∼6% and CVD risk by ∼8% in healthy adults with LDL cholesterol between 3 and 5 mmol/L.This trial was registered at clinicaltrials.gov as NCT03911427.

PROTOCOL: The association between whole-grain dietary intake and noncommunicable diseases: A systematic review and meta-analysis

Our primary research questions are: (1) What is the association between whole grains (WG) intake and the prevalence of NCDs (i.e., type 2 diabetes, cardiovascular disease, obesity, cancer, mortality) and their biomarkers? (2) Which biomarker(s) has/have the greatest association with WG intake when combining multiple biomarkers together in the same analysis? Our secondary research question is: (3) Are there dose-response relationships between WG intake and biomarkers and prevalence of NCDs which could help inform a universal recommendation for WG intake?

Higher intake of microbiota-accessible carbohydrates and improved cardiometabolic risk factors: a meta-analysis and umbrella review of dietary management in patients with type 2 diabetes

BACKGROUND

Microbiota-accessible carbohydrates (MACs) are critical substrates for intestinal microbes; the subsequent production of SCFAs may have some potential benefits for patients with type 2 diabetes mellitus (T2DM).

OBJECTIVES

We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the effects of higher compared with lower MAC intakes on cardiovascular risk factors in T2DM patients and performed an umbrella review of RCTs to evaluate the evidence quality concerning existing dietary T2DM interventions.

METHODS

Publications were identified by searching MEDLINE, EMBASE, and CINAHL. In the meta-analysis, random-effects models were used to calculate pooled estimates, and sensitivity analyses, meta-regression, subgroup analyses, and Egger's test were performed. For the umbrella review, we summarized pooled estimates, 95% CIs, heterogeneity, and publication bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) and modified NutriGrade were used to assess the quality of evidence in the meta-analysis and umbrella review, respectively.

RESULTS

Forty-five RCTs with 1995 participants were included in the meta-analysis. High MAC intake significantly reduced glycated hemoglobin (HbA1c) (weighted mean difference [WMD] -0.436% [-0.556, -0.315]), fasting glucose (WMD -0.835 mmol/L [-1.048, -0.622]), total cholesterol (WMD -0.293 mmol/L [-0.397, -0.190]), triglycerides (WMD -0.118 mmol/L [-0.308, -0.058]), BMI (WMD -0.476 [-0.641, -0.312]), and systolic blood pressure (WMD -3.066 mmHg [-5.653, -0.478]), with a moderate-to-high quality of evidence, compared with low intake. Region, dose, and MAC type were key variables. The umbrella review of all dietary interventions for cardiovascular risk factors in patients with T2DM included 26 meta-analyses with 158 pooled estimates. The evidence quality of MACs, dietary fiber, high-protein diet, ω-3 (n-3), viscous fiber, vitamin D, and vitamin E intake was moderate to high.

CONCLUSIONS

When compared with lower intake, increased MAC intake improved glycemic control, blood lipid, body weight, and inflammatory markers for people with T2DM. This trial was registered at PROSPERO (https://www.crd.york.ac.uk/PROSPERO/#recordDetails) as CRD42019120531.

The effects of nondigestible fermentable carbohydrates on adults with overweight or obesity: a meta-analysis of randomized controlled trials

CONTEXT

Nondigestible fermentable carbohydrates (NDFCs) can be fermented by microbiota, thereby yielding metabolites that have a beneficial role in the prevention and treatment of obesity and its complications. However, to our knowledge, no meta-analysis has been conducted to evaluate the effects of NDFCs on obesity.

OBJECTIVE

To conduct a meta-analysis of randomized controlled trials (RCTs) to summarize existing evidence on the effects of numerous NDFCs on adiposity and cardiovascular risk factors in adults with overweight or obesity with ≥2 weeks of follow-up.

DATA SOURCES

The following databases were searched: MEDLINE, Embase, and CINAHL.

DATA EXTRACTION

Seventy-seven RCTs with 4535 participants were identified for meta-analysis from the 3 databases.

DATA ANALYSIS

The findings suggest that increased intake of NDFCs is significantly effective in reducing body mass index by 0.280 kg/m2, weight by 0.501 kg, hip circumference by 0.554 cm, waist circumference by 0.649 cm, systolic blood pressure by 1.725 mmHg, total cholesterol by 0.36 mmol/L, and low-density lipoprotein by 0.385 mmol/L, with evidence of moderate-to-high quality.

CONCLUSION

Convincing evidence from meta-analyses of RCTs indicates that increased NDFC intake improves adiposity, blood lipid levels, and systolic blood pressure in people with overweight and obesity.

Effects of different delivering matrices of β-glucan on lipids in mildly hypercholesterolaemic individuals: a meta-analysis of randomised controlled trials

β-Glucan has been reported for its health benefits on blood lipids in hypercholesterolaemic individuals for years. However, people have paid little attention to the effects of β-glucan in populations with mild hypercholesterolaemia as well as the various delivering matrices. Our objective was to perform a meta-analysis to analyse the effects of β-glucan with different delivering matrices in mildly hypercholesterolaemic individuals. After conducting a comprehensive search in Web of Science, PubMed, Scopus and Cochrane Library, a total of twenty-one randomised controlled trials involving 1120 participants were identified to measure the pooled effect. The overall results indicated that consuming a dose of ≥3 g/d of β-glucan for at least 3 weeks could significantly reduce total cholesterol (TC) (-0·27 mmol/l, 95 % CI -0·33, -0·21, P < 0·001) and LDL-cholesterol (-0·26 mmol/l, 95% CI -0·32, -0·20, P < 0·001) compared with the control group in mildly hypercholesterolaemic individuals, while no significant difference was observed in TAG (-0·03 mmol/l, 95% CI -0·11, 0·06, P = 0·521) and HDL-cholesterol (0·01 mmol/l, 95% CI -0·03, 0·04, P = 0·777). There was evidence for modest unexplained heterogeneity in the meta-analysis. In conclusion, β-glucan can significantly reduce risk factors like TC and LDL-cholesterol for CVD in mildly hypercholesterolaemic individuals; furthermore, it appears that the effects of food matrices with both 'solid products' and 'liquid products' where β-glucan was incorporated into were ranked as the best way to exert its beneficial properties, while 'liquid' and 'solid' products were ranked as the second and third positions, respectively.

Global review of heart health claims for oat beta-glucan products

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.

β-Glucan Metabolic and Immunomodulatory Properties and Potential for Clinical Application

β-glucans are complex polysaccharides that are found in several plants and foods, including mushrooms. β-glucans display an array of potentially therapeutic properties. β-glucans have metabolic and gastro-intestinal effects, modulating the gut microbiome, altering lipid and glucose metabolism, reducing cholesterol, leading to their investigation as potential therapies for metabolic syndrome, obesity and diet regulation, gastrointestinal conditions such as irritable bowel, and to reduce cardiovascular and diabetes risk. β-glucans also have immune-modulating effects, leading to their investigation as adjuvant agents for cancers (solid and haematological malignancies), for immune-mediated conditions (e.g., allergic rhinitis, respiratory infections), and to enhance wound healing. The therapeutic potential of β-glucans is evidenced by the fact that two glucan isolates were licensed as drugs in Japan as immune-adjuvant therapy for cancer in 1980. Significant challenges exist to further clinical testing and translation of β-glucans. The diverse range of conditions for which β-glucans are in clinical testing underlines the incomplete understanding of the diverse mechanisms of action of β-glucans, a key knowledge gap. Furthermore, important differences appear to exist in the effects of apparently similar β-glucan preparations, which may be due to differences in sources and extraction procedures, another poorly understood issue. This review will describe the biology, potential mechanisms of action and key therapeutic targets being investigated in clinical trials of β-glucans and identify and discuss the key challenges to successful translation of this intriguing potential therapeutic.

Effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND & AIMS

Soluble dietary fiber is prompted as an important part of reducing blood glucose, ameliorating insulin resistance and controlling body weight. Thus, we performed this systematic review and meta-analysis of randomized controlled trials (RCTs) to quantify and synthesize the effects of soluble fiber supplementation on glycemic control and BMI modification in adults with type 2 diabetes.

METHODS

We searched MEDLINE, Embase, Web of Science, ClinicalTrials.gov, and Cochrane databases until February 13, 2020 to identify RCTs that detected the effects of soluble fiber supplementation on glycemic control in adults with type 2 diabetes. A random-effects model with the generic inverse variance method was used to analyze the pooled data. The meta-regression and subgroup analyses were conducted to identify the variables that influenced the pooled results. The robust error meta-regression model was used to conduct the dose-response test. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was undertaken to evaluate the overall quality of the evidence.

RESULTS

A total of 29 RCTs (33 comparisons) involving 1517 participants were identified in this meta-analysis. Results showed that supplemental soluble dietary fiber significantly reduced glycosylated hemoglobin (HbA1c, MD -0.63%, 95% CI [-0.90, -0.37]; P < 0.00001), fasting plasma glucose (FPG, MD -0.89 mmol/L, 95% CI [-1.28, -0.51]; P < 0.00001), fasting insulin (SMD -0.48, 95% CI [-0.80, -0.17]; P = 0.003), homeostatic model assessment of insulin resistance (HOMA-IR, SMD -0.58, 95% CI [-0.86, -0.29], P < 0.0001), fructosamine (SMD -1.03, 95% CI [-1.51, -0.55]; P < 0.0001), 2-h postprandial plasma glucose (SMD -0.74, 95% CI [-1.00, -0.48]; P < 0.00001), and BMI (SMD -0.31, 95% CI [-0.61, -0.00], P = 0.05) compared with control diets in patients with type 2 diabetes. Specifically, dose-response meta-analyses presented that a daily dosage of 7.6-8.3 g was recommended.

CONCLUSION

Intake of soluble fiber supplementation is effective in improving glycemic control and BMI level in type 2 diabetes and is also a convenient way to help individuals meet standard dietary fiber needs. But due to the evidence of substantial heterogeneity in most pooled estimates, further long-term and high-quality RCTs are needed.

Antioxidant Properties of Sourdoughs Made with Whole Grain Flours of Hull-Less Barley or Conventional and Pigmented Wheat and by Selected Lactobacilli Strains

The use of sourdough fermentation and whole grain flours in baked goods manufacturing are known to enhance their functional and nutritional features. In this context, it is necessary to select the most suitable lactic acid bacteria strains and flour combination to achieve this goal. A characterization of 70 lactobacilli strains based on pro-technological and nutritional properties was carried out. The screening allowed the selection of 10 strains that were used to ferment sourdoughs made with two varieties of common wheat, the conventional red-grained cv Aubusson, a blue-grained variety rich in anthocyanins cv Skorpion, and a hull-less barley variety, cv Rondo. From each fermented sourdough, a water soluble extract was obtained and evaluated for its antioxidant activity performed on cultured cells (RAW 264.7 murine macrophage) by assaying Reactive Oxygen Species (ROS) content. Sourdoughs made with pigmented wheat and barley, had an antioxidant activity greater than that recovered in those made with conventional wheat flour, in spite they have been inoculated with the same LAB strains. Results highlighted the interdependence between flour and the inoculated lactic acid bacteria that has to be taken into account for the development of healthy breads exploiting high functional value cereals through biotechnological processes.

Structural Features, Modification, and Functionalities of Beta-Glucan

Β-glucan is a strongly hydrophilic non-starchy polysaccharide, which, when incorporated in food, is renowned for its ability to alter functional characteristics such as viscosity, rheology, texture, and sensory properties of the food product. The functional properties of β-glucans are directly linked to their origin/source, molecular weight, and structural features. The molecular weight and structural/conformational features are in turn influenced by method of extraction and modification of the β-glucan. For example, whereas physical modification techniques influence only the spatial structures, modification by chemical agents, enzyme hydrolysis, mechanical treatment, and irradiation affect both spatial conformation and primary structures of β-glucan. Consequently, β-glucan can be modified (via one or more of the aforementioned techniques) into forms that have desired morphological, rheological, and (bio)functional properties. This review describes how various modification techniques affect the structure, properties, and applications of β-glucans in the food industry.

Should Viscous Fiber Supplements Be Considered in Diabetes Control? Results From a Systematic Review and Meta-analysis of Randomized Controlled Trials

OBJECTIVE

Evidence from randomized controlled trials (RCTs) suggests that viscous dietary fiber may offer beneficial effects on glycemic control and, thus, an improved cardiovascular disease risk profile. Our purpose was to conduct a systematic review and meta-analysis of RCTs to synthesize the therapeutic effect of viscous fiber supplementation on glycemic control in type 2 diabetes.

RESEARCH DESIGN AND METHODS

MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched through 15 June 2018. We included RCTs ≥3 weeks in duration that assessed the effects of viscous fiber on markers of glycemic control in type 2 diabetes. Two independent reviewers extracted data. Data were pooled using the generic inverse variance method and expressed as mean differences (MD) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I ² statistic). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the overall certainty of the evidence.

RESULTS

We identified 28 eligible trial comparisons (n = 1,394). Viscous fiber at a median dose of ∼13.1 g/day significantly reduced HbA_1c (MD -0.58% [95% CI -0.88, -0.28]; P = 0.0002), fasting blood glucose (MD -0.82 mmol/L [95% CI -1.32, -0.31]; P = 0.001), and HOMA-insulin resistance (IR) (MD -1.89 [95% CI -3.45, -0.33]; P = 0.02) compared with control and in addition to standard of care. The certainty of evidence was graded moderate for HbA_1c, fasting glucose, fasting insulin, and HOMA-IR and low for fructosamine.

CONCLUSIONS

Viscous fiber supplements improve conventional markers of glycemic control beyond usual care and should be considered in the management of type 2 diabetes.

The Effects of Prebiotics and Substances with Prebiotic Properties on Metabolic and Inflammatory Biomarkers in Individuals with Type 2 Diabetes Mellitus: A Systematic Review

BACKGROUND

Intestinal bacteria composition and prebiotics may play a role in the management of type 2 diabetes mellitus (T2DM).

OBJECTIVE

The objective of this systematic review was to evaluate the effect of prebiotics and substances with prebiotic properties on the metabolic and inflammatory biomarkers of individuals with T2DM compared with placebo.

METHODS

A literature search to identify articles published up to March 31, 2018, was conducted utilizing PubMed, Science Direct, and Cochrane Central Register of Controlled Trials. Individuals at aged 18 years or older with T2DM from randomized controlled trials investigating prebiotics or substances with prebiotic properties were included. Metabolic and inflammatory biomarkers associated with T2DM were the primary outcome measures.

RESULTS

Twenty-seven publications were analyzed. All but seven of these publications reported a beneficial effect on metabolic and/or inflammatory biomarkers. Interventions included mostly women, lasted 4 days to 12 weeks, and diabetes duration ranged from 6 months to 11 years. Nineteen publications reported improvements in glycemia, 15 in cardiovascular markers, nine in body weight, and nine in inflammatory markers. Benefits from resistant starch, resistant dextrin, and oligofructose-enriched inulin were most frequent. A smaller number of studies utilizing other substances with prebiotic properties also yielded improvements.

CONCLUSIONS

Based on these results, there is fair evidence that prebiotics and substances with prebiotic properties may improve metabolic and inflammatory biomarkers related to T2DM in women aged 18 years at least. Interventions with resistant starch, resistant dextrin, and oligofructose-enriched inulin exhibited the strongest evidence for improvements due to the quantity of publications and quality grades. Other prebiotics and substances with prebiotic properties show promise but the number of studies is few. Additional studies that are longer in duration, include both sexes, and include other prebiotics or substances with prebiotic properties are needed.

Effect of synbiotic bread containing lactic acid on glycemic indicators, biomarkers of antioxidant status and inflammation in patients with type 2 diabetes: a randomized controlled trial

BACKGROUND

The aim of this randomized, double-blinded, controlled trial was to investigate the effect of daily consumption of a synbiotic bread containing lactic acid on glycemic status, antioxidant biomarkers and inflammation in patients with type 2 diabetes (T2D).

METHODS

T2D patients, aged 20 to 60 years, were randomly assigned to consume synbiotic + lactic acid (n = 30), synbiotic (n = 30), lactic acid (n = 30), or control (n = 30) bread for 8 weeks. Patients consumed bread 3 times a day in a 40 g package for a total of 120 g/day. Glycemic status, antioxidant capacity, and serum hs-CRP were assessed before and after the intervention.

RESULTS

Of a total of 120 patients that were included in the study, 100 completed the trial. In the adjusted analysis, it was found that consumption of synbiotic + lactic acid bread caused a significant decrease in HbA1c compared to the control bread (- 0.41 ± 0.33 vs 0.004 ± 0.10%, respectively; P < 0.001), while it significantly increased serum superoxide dismutase (SOD) (0.87 ± 1.14 vs. 0.18 ± 0.85 mmol/L, P = 0.02). Also, changes in glutathione peroxidase (GSH-Px) were significantly higher following the consumption of synbiotic + lactic acid bread than lactic acid bread. However, it had no significant effect on fasting plasma glucose, serum insulin, and total antioxidant capacity.

CONCLUSION

Overall, daily consumption of a synbiotic bread containing lactic acid for 8 weeks had beneficial effects on HbA1c, SOD, and GSH-Px among T2D patients.Trial registration This study was registered in Iranian Registry of Clinical Trials with number: IRCT201505242709N33 (Registration date: 2015-11-23, http://www.irct.ir/trial/2544).

Lipid profile improvement of food products containing bioactive compounds from unsaponifiable matters of palm fatty acid distillate in hypercholesterolemia rats

BACKGROUND: Unsaponifiable matters (USM) from palm fatty acid distillate (PFAD) contains vitamin E (mainly tocotrienols), phytosterols, and squalene that have ability to reduce blood cholesterol. Fortification of USM into food products is a way for hypercholesterolemia management. OBJECTIVE: This study evaluated effects of fortification of USM from PFAD into instant noodle, bread, and biscuit on lipid profile improvement of hypercholesterolemia rats. It was also aimed to compare the effects of different type of foods as USM carrier that represented different processing steps and nutritional composition. METHODS: Rats were divided into control-standard diet and atherogenic diet fed groups, and 6 hypercholesterolemia groups fed by instant noodle, plain bread, and biscuit with 1% USM fortification and without fortification for 8 weeks. Lipid profile (total cholesterol, triglyceride, LDL cholesterol, and HDL cholesterol) was analysed at week 0, 4, and 8. Hepatic and fecal cholesterol and bile acid were also examined at the end of experiment to elucidate some mechanism of cholesterol lowering due to USM fortified foods administration. RESULTS: Some bioactive compounds lost during USM fortified food preparation and the highest retention was found in biscuit. Lipid profile improvement was indicated by reduction of total cholesterol, triglyceride, and LDL cholesterol, meanwhile HDL cholesterol increased. Type of fortified foods affected the level of alteration of lipid profile. Degree of lipid profile improvement was affected by nutritional composition of fortified foods, food intake of the rats, and level of bioactive content. Bioactive compounds in USM fortified foods inhibited cholesterol absorption that indicated by higher fecal cholesterol and bile acid compared to atherogenic diet fed group. Modulation of cholesterol synthesis was likely to occur that indicated by lower hepatic cholesterol and higher bile acids. CONCLUSIONS: Feeding of USM fortified food products improved lipid profile of hypercholesterolemia rats.

Processing of oat: the impact on oat's cholesterol lowering effect

Epidemiological and interventional studies have clearly demonstrated the beneficial impact of consuming oat and oat-based products on serum cholesterol and other markers of cardiovascular disease. The cholesterol-lowering effect of oat is thought to be associated with the β-glucan it contains. However, not all food products containing β-glucan seem to lead to the same health outcome. Overall, highly processed β-glucan sources (where the oat tissue is highly disrupted) appear to be less effective at reducing serum cholesterol, but the reasons are not well understood. Therefore, the mechanisms involved still need further clarification. The purpose of this paper is to review current evidence of the cholesterol-lowering effect of oat in the context of the structure and complexity of the oat matrix. The possibility of a synergistic action and interaction between the oat constituents promoting hypocholesterolaemia is also discussed. A review of the literature suggested that for a similar dose of β-glucan, (1) liquid oat-based foods seem to give more consistent, but moderate reductions in cholesterol than semi-solid or solid foods where the results are more variable; (2) the quantity of β-glucan and the molecular weight at expected consumption levels (∼3 g day-1) play a role in cholesterol reduction; and (3) unrefined β-glucan-rich oat-based foods (where some of the plant tissue remains intact) often appear more efficient at lowering cholesterol than purified β-glucan added as an ingredient.

Dietary Fiber Intake and Type 2 Diabetes Mellitus: An Umbrella Review of Meta-analyses

Objective

The purpose of this study was to review previously published meta-analyses on the effectiveness of dietary fiber on type 2 diabetes.

Methods

An umbrella review of all published meta-analyses was performed. A PubMed search from January 1, 1980, to April 30, 2017, was conducted using the following search strategy: (fiber OR glucan OR psyllium) AND (meta-analysis OR systematic review). Only English-language publications that provided quantitative statistical analysis on type 2 diabetes, fasting blood glucose concentrations, or glycosylated hemoglobin were retrieved.

Results

Sixteen meta-analyses were retrieved for inclusion in this umbrella review. In the meta-analyses comparing highest versus lowest dietary fiber intake, there was a statistically significant reduction in the relative risk (RR) of type 2 diabetes (RR = 0.81-0.85), with the greatest benefit coming from cereal fibers (RR = 0.67-0.87). However, statistically significant heterogeneity was observed in all of these meta-analyses. In the meta-analyses of supplementation studies using β-glucan or psyllium fibers on type 2 diabetic participants, statistically significant reductions were identified in both fasting blood glucose concentrations and glycosylated hemoglobin percentages.

Conclusion

This review suggests that those consuming the highest amounts of dietary fiber, especially cereal fiber, may benefit from a reduction in the incidence of developing type 2 diabetes. There also appears to be a small reduction in fasting blood glucose concentration, as well as a small reduction in glycosylated hemoglobin percentage for individuals with type 2 diabetes who add β-glucan or psyllium to their daily dietary intake.

Clinical and Physiological Perspectives of β-Glucans: The Past, Present, and Future

β-Glucans are a group of biologically-active fibers or polysaccharides from natural sources with proven medical significance. β-Glucans are known to have antitumor, anti-inflammatory, anti-obesity, anti-allergic, anti-osteoporotic, and immunomodulating activities. β-Glucans are natural bioactive compounds and can be taken orally, as a food supplement, or as part of a daily diet, and are considered safe to use. The medical significance and efficiency of β-glucans are confirmed in vitro, as well as using animal- and human-based clinical studies. However, systematic study on the clinical and physiological significance of β-glucans is scarce. In this review, we not only discuss the clinical and physiological importance of β-glucans, we also compare their biological activities through the existing in vitro and animal-based in vivo studies. This review provides extensive data on the clinical study of β-glucans.

Identification of weak and gender specific effects in a short 3 weeks intervention study using barley and oat mixed linkage β-glucan dietary supplements: a human fecal metabolome study by GC-MS

INTRODUCTION

Mixed-linkage (1→3),(1→4)-β-d-glucans (BG) reduce cholesterol level and insulin response in humans. Despite this, their role in human metabolism and a mode of action remains largely unknown.

OBJECTIVES

To investigate the effects of three structurally different BG on human fecal metabolome in a full cross-over intervention using GC-MS metabolomics.

METHODS

Over three weeks of intervention, young healthy adults received food supplemented with BG from oat, two different BG from barley or a non-fiber control in a full cross-over design. Untargeted metabolomics and short chain fatty acid analysis was performed on day three fecal samples. ANOVA-simultaneous component analysis was applied to partition the data variation according to the study design, and PLS-DA was used to select most discriminative metabolite markers.

RESULTS

Univariate and multivariate data analysis revealed a dominating effect of inter-individual variances followed by a gender effect. Weak effects of BG intake were identified including an increased level of gamma-amino-butyrate and palmitoleic acid in males and a decreased level of enterolactone in females. Barley and oat derived BG were found to influence the human fecal metabolome differently. Barley BG increased the relative level of formate in males and isobutyrate, isovalerate, 2-methylbutyrate in females. In total 15, 3 and 11 human fecal metabolites were significantly different between control vs. BG, control vs. oat BG, and barley BG vs. oat BG, respectively.

CONCLUSIONS

The study show that human fecal metabolome largely reflects individual (∼28% variation) and gender (∼15% variation) differences, whereas the treatment effect of the BG (∼8% variation) only manifests in a few key metabolites (primarily by the metabolites: d-2-aminobutyric acid, palmitoleic acid, linoleic acid and 11-eicosenoic acid).

The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials

Oats are a rich source of β-glucan, a viscous, soluble fibre recognised for its cholesterol-lowering properties, and are associated with reduced risk of CVD. Our objective was to conduct a systematic review and meta-analysis of randomised-controlled trials (RCT) investigating the cholesterol-lowering potential of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for the risk reduction of CVD. MEDLINE, Embase, CINAHL and Cochrane CENTRAL were searched. We included RCT of ≥3 weeks of follow-up, assessing the effect of diets enriched with oat β-glucan compared with controlled diets on LDL-cholesterol, non-HDL-cholesterol or apoB. Two independent reviewers extracted data and assessed study quality and risk of bias. Data were pooled using the generic inverse-variance method with random effects models and expressed as mean differences with 95 % CI. Heterogeneity was assessed by the Cochran's Q statistic and quantified by the I 2-statistic. In total, fifty-eight trials (n 3974) were included. A median dose of 3·5 g/d of oat β-glucan significantly lowered LDL-cholesterol (-0·19; 95 % CI -0·23, -0·14 mmol/l, P<0·00001), non-HDL-cholesterol (-0·20; 95 % CI -0·26, -0·15 mmol/l, P<0·00001) and apoB (-0·03; 95 % CI -0·05, -0·02 g/l, P<0·0001) compared with control interventions. There was evidence for considerable unexplained heterogeneity in the analysis of LDL-cholesterol (I 2=79 %) and non-HDL-cholesterol (I 2=99 %). Pooled analyses showed that oat β-glucan has a lowering effect on LDL-cholesterol, non-HDL-cholesterol and apoB. Inclusion of oat-containing foods may be a strategy for achieving targets in CVD reduction.

High wholegrain barley β-glucan lowers food intake but does not alter small intestinal macronutrient digestibility in ileorectostomised rats

Using barley cultivars differing widely in β-glucan content, we aimed to determine their effects on small intestinal macronutrient digestion in 24 ileorectostomised rats. The rats were fed 1 of 4 experimental diets, each containing a different barley variety, for 11 d. The diets had a content of 0, 2.1, 2.6 and 4.3 g of β-glucan/100 g. Feed intake and faecal excretion of fat, protein, starch, and non-starch polysaccharides were determined in the final 5 d of the study and apparent macronutrient digestibility calculated. Higher dietary levels of β-glucan (2.6% and 4.3%) lowered feed intake (by 15 and 19%, respectively) but final body weight was only lowered by the 4.3% β-glucan diet relative to rats fed the 0% β-glucan diet (all ps < 0.05). Protein, lipid and starch digestibility was unrelated to the dietary β-glucan content. Higher dietary levels of barley β-glucan lower feed intake of ileorectostomised rats, which is independent of intestinal fermentation and unrelated to macronutrient digestibility.

Effect of Oat β-Glucan Intake on Glycaemic Control and Insulin Sensitivity of Diabetic Patients: A Meta-Analysis of Randomized Controlled Trials

Many individual studies on oat β-glucan (OBG) confirmed its functionality in improving type 2 diabetes mellitus (T2DM), but disagreements were identified among those results. To derive a pooled estimate of these results, relevant articles, published before 5 September 2015, were collected from four electronic databases (Pubmed, Cochrane Library, Scopus, and Web of Science) and subjected to meta-analysis in the present work. In total, four articles, dealing with 350 T2DM patients combined, met the inclusion criteria. Compared to control, T2DM patients administrated OBG from 2.5 to 3.5 g/day for 3 to 8 weeks presented significantly lowered concentrations in fasting plasma glucose (FPG) by -0.52 (95% CI: -0.94, -0.10) mmol/L (p = 0.01) and glycosylated hemoglobin (HbA1c) by -0.21% (95% CI: -0.40, -0.02) (p = 0.03). However, OBG intake did not significantly lower the fasting plasma insulin (FPI) concentration. In conclusion, mediate-term OBG intake (3-8 weeks) favored the glycaemic control of T2DM patients but did not improve their insulin sensitivity. Regrettably, data upon the effects of long-term OBG intake on glycaemic control and insulin sensitivity were scarce, which is of much importance and should be addressed in future research.

The Metabolic Effects of Oats Intake in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c) (MD, −0.42%; 95% CI, −0.61% to −0.23%), fasting blood glucose (FBG) (MD, −0.39 mmol/L; 95% CI, −0.58 to −0.19 mmol/L), total cholesterol (TC) (MD, −0.49 mmol/L; 95% CI, −0.86 to −0.12 mmol/L), low-density lipoprotein cholesterol (LDL-C) (MD, −0.29 mmol/L; 95% CI, −0.48 to −0.09 mmol/L). Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required.

Cholesterol-lowering properties of oat β-glucan and the promotion of cardiovascular health: did Health Canada make the right call?

In 2010, Health Canada approved a heath claim acknowledging the link between increased oats (Avena sativa)-soluble fibre consumption and a reduction in total serum cholesterol levels. The approval also recognized the relationship between decreased total blood cholesterol concentration and a reduced risk of coronary heart disease. The functional food ingredient believed to be responsible for the hypocholesterolemic property of oats is β-glucan, a highly viscous, soluble fibre composed of d-glucose monomers linked by a combination of β-(1→4) and β-(1→3) glycosidic bonds. Found mainly in the endosperm cell wall of oats, β-glucan is thought to reduce total serum and low-density lipoprotein cholesterol by forming a viscous mass in the small intestine thus limiting intestinal absorption of dietary cholesterol as well as the re-absorption of bile acids. Given the evolution of research information with time as a result of the continual, rapid generation of new research data by laboratories around the world, it became imperative to examine the compatibility of the conclusion reached by Health Canada on the basis of the body of evidence contained in the initial petition submitted in January 2007, with newer post-2006 data. After careful evaluation, this work concludes on the basis of new research information that a dose of 3 g/day oat β-glucan consumed as part of a diet “free of saturated fatty acids” or “low in saturated fatty acids” could help to promote cardiovascular health.

Wholegrain barley β-glucan fermentation does not improve glucose tolerance in rats fed a high-fat diet

Fermentation of oat and barley β-glucans is believed to mediate in part their metabolic health benefits, but the exact mechanisms remain unclear. In this study, we sought to test the hypothesis that barley β-glucan fermentation raises circulating incretin hormone levels and improves glucose control, independent of other grain components. Male Sprague-Dawley rats (n = 30) were fed a high-fat diet for 6 weeks and then randomly allocated to 1 of 3 dietary treatments for 2 weeks. The low- (LBG, 0% β-glucan) and high- (HBG, 3% β-glucan) β-glucan diets contained 25% wholegrain barley and similar levels of insoluble dietary fiber, available carbohydrate, and energy. A low-fiber diet (basal) was included for comparison. Immediately prior to the dietary intervention, gastric emptying rate (using the (13)C-octanoic breath test) and postprandial glycemic response of each diet were determined. At the end of the study, circulating gut hormone levels were determined; and a glucose tolerance test was performed. The rats were then killed, and indices of cecal fermentation were assessed. Diet did not affect live weight; however, the HBG diet, compared to basal and LBG, reduced food intake, tended to slow gastric emptying, increased cecal digesta mass and individual and total short-chain fatty acid pools, and lowered digesta pH. In contrast, circulating levels of glucose, insulin, gastric-inhibitory peptide, and glucagon-like peptide-1, and glucose tolerance were unaffected by diet. In conclusion, wholegrain barley β-glucan suppressed feed intake and increased cecal fermentation but did not improve postprandial glucose control or insulin sensitivity.