Arabinoxylan fibre improves metabolic control in people with Type II diabetes

The effects of a fibre-enriched bakery product on glucose, insulin values and appetite. A pilot randomised cross-over trial

Brewers spent grain (BSG) is a valuable source of arabinoxylans with potential beneficial effects on glucose values. This pilot randomised crossover double-blind trial compared the effects of panettone, a sweet baked-product, enriched with BSG-fibre (p-rich) to unenriched panettone (p-standard) on glucose and insulin blood values and appetite scores. Ten healthy volunteers consumed each food in a random order. Blood variables and appetite scores were assessed at fasting and at different intervals after each food consumption. Glucose values were significantly higher after p-standard intake at 90-min (89.9 ± 16.1 vs 74.6 ± 19.4 mg/dL) and 120-min (81.1 ± 9.85 vs 72.1 ± 14.0 mg/dL). The areas-under-the-curve (AUCs) were lower for both glucose (p = .043) and insulin values (p = .036) with p-rich. At 240-min, satiety was higher (p = .006), and desire-to-eat lower (p = .008) with p-rich; desire-to-eat AUC was lower with p-rich too (p = .029). The integration of a small amount of BSG-derived fibre into a sweet food led to improved glycaemic control and appetite regulation.

Wheat bran arabinoxylans: Chemical structure, extraction, properties, health benefits, and uses in foods

Wheat bran (WB) is a well-known and valuable source of dietary fiber. Arabinoxylan (AX) is the primary hemicellulose in WB and can be isolated and used as a functional component in various food products. Typically, AX is extracted from the whole WB using different processes after mechanical treatments. However, WB is composed of different layers, namely, the aleurone layer, pericarp, testa, and hyaline layer. The distribution, structure, and extractability of AX vary within these layers. Modern fractionation technologies, such as debranning and electrostatic separation, can separate the different layers of WB, making it possible to extract AX from each layer separately. Therefore, AX in WB shows potential for broader applications if it can be extracted from the different layers separately. In this review, the distribution and chemical structures of AX in WB layers are first discussed followed by extraction, physicochemical properties, and health benefits of isolated AX from WB. Additionally, the utilization of AX isolated from WB in foods, including cereal foods, packaging film, and the delivery of food ingredients, is reviewed. Future perspectives on challenges and opportunities in the research field of AX isolated from WB are highlighted.

Role of Synbiotics (Prebiotics and Probiotics) as Dietary Supplements in Type 2 Diabetes Mellitus Induced Health Complications

Diabetes is a metabolic disorder whose prevalence has become a worrying condition in recent decades. Chronic diabetes can result in serious health conditions such as impaired kidney function, stroke, blindness, and myocardial infarction. Despite a variety of currently available treatments, cases of diabetes and its complications are on the rise. This review article provides a comprehensive account of the ameliorative effect of prebiotics and probiotics individually or in combination i.e. synbiotics on health complications induced by Type 2 Diabetes Mellitus (T2DM). Recent advances in the field underscore encouraging outcomes suggesting the consumption of synbiotics leads to favorable changes in the gut microbiota. These changes result in the production of bioactive metabolites such as short-chain fatty acids (crucial for lowering blood sugar levels), reducing inflammation, preventing insulin resistance, and encouraging the release of glucagon-like peptide-1 in the host. Notably, novel strategies supplementing synbiotics to support gut microbiota are gaining attraction as pivotal interventions in mitigating T2DM-induced health complications. Thus, by nurturing a symbiotic relationship between prebiotics and probiotics i.e. synbiotics, these interventions hold promise in reshaping the microbial landscape of the gut thereby offering a multifaceted approach to managing T2DM and its associated morbidities. Supporting the potential of synbiotics underscores a paradigm shift toward holistic and targeted interventions in diabetes management, offering prospects for improved outcomes and enhanced quality of life for affected individuals. Nevertheless, more research needs to be done to better understand the single and multispecies pre/pro and synbiotics in the prevention and management of T2DM-induced health complications.

Potential roles of cereal bioactive compounds in the prevention and treatment of type 2 diabetes: A review of the current knowledge

Diabetes is one of the most common non-communicable diseases in both developed and underdeveloped countries with a 9.3% prevalence. Unhealthy diets and sedentary lifestyles are among the most common reasons for type 2 diabetes mellitus (T2DM). Diet plays a crucial role in both the etiology and treatment of T2DM. There are several recommendations regarding the carbohydrate intake of patients with T2DM. One of them is about reducing the total carbohydrate intake and/or changing the type of carbohydrate to reduce the glycaemic index. Cereals are good sources of carbohydrates in the diet with a significant amount of soluble and non-soluble fiber content. Apart from fiber, it has been shown that the bioactive compounds present in cereals such as proteins, phenolic compounds, carotenoids, and tocols have beneficial impacts in the prevention and treatment of T2DM. Moreover, cereal by-products especially the by-products of milling processes, which are bran and germ, have been reported to have anti-diabetic activities mainly because of their fiber and polyphenols content. Considering the potential functions of cereals in patients with T2DM, this review focuses on the roles of cereal bioactive compounds in the prevention and treatment of type 2 diabetes.

Prebiotics Progress Shifts in the Intestinal Microbiome That Benefits Patients with Type 2 Diabetes Mellitus

Hypoglycemic medications that could be co-administered with prebiotics and functional foods can potentially reduce the burden of metabolic diseases such as Type 2 Diabetes Mellitus (T2DM). The efficacy of drugs such as metformin and sulfonylureas can be enhanced by the activity of the intestinal microbiome elaborated metabolites. Functional foods such as prebiotics (e.g., oligofructose) and dietary fibers can treat a dysbiotic gut microbiome by enhancing the diversity of microbial niches in the gut. These beneficial shifts in intestinal microbiome profiles include an increased abundance of bacteria such as Faecalibacterium prauznitzii, Akkermancia muciniphila, Roseburia species, and Bifidobacterium species. An important net effect is an increase in the levels of luminal SCFAs (e.g., butyrate) that provide energy carbon sources for the intestinal microbiome in cross-feeding activities, with concomitant improvement in intestinal dysbiosis with attenuation of inflammatory sequalae and improved intestinal gut barrier integrity, which alleviates the morbidity of T2DM. Oligosaccharides administered adjunctively with pharmacotherapy to ameliorate T2DM represent current plausible treatment modalities.

Folate Enrichment of Whole-Meal Spaghetti Using Durum Wheat Debranning Fractions

Durum wheat debranning fractions (fine and coarse bran) were obtained and included as an ingredient in the formulation of whole-meal spaghetti to study their chemical-nutritional characteristics, in particular folate levels and sensorial properties. Experimental raw pasta had a higher folate content (40.5 µg/100 g) than commercial whole-meal pasta (28.3 µg/100 g), meeting the requirements for the health claim on folate (Reg. EU 432/2012) and for the nutritional claim on dietary fiber. After cooking, folate retention in pasta formulated with coarse bran was 80% and scored an overall "good" sensorial acceptability. Results indicate that whole-meal pasta formulated with folate-rich debranning fractions may represent a natural functional food that, integrated into the diet, could improve the health status of the population.

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.

Gastrointestinal Effects and Tolerance of Nondigestible Carbohydrate Consumption

Nondigestible carbohydrates (NDCs) are food components, including nonstarch polysaccharides and resistant starches. Many NDCs are classified as dietary fibers by the US FDA. Because of their beneficial effects on human health and product development, NDCs are widely used in the food supply. Although there are dietary intake recommendations for total dietary fiber, there are no such recommendations for individual NDCs. NDCs are heterogeneous in their chemical composition and physicochemical properties-characteristics that contribute to their tolerable intake levels. Guidance on tolerable intake levels of different NDCs is needed because overconsumption can lead to undesirable gastrointestinal side effects, further widening the gap between actual and suggested fiber intake levels. In this review, we synthesize the literature on gastrointestinal effects of NDCs that the FDA accepts as dietary fibers (β-glucan, pectin, arabinoxylan, guar gum, alginate, psyllium husk, inulin, fructooligosaccharides and oligofructose, galactooligosaccharides, polydextrose, cellulose, soy fiber, resistant maltodextrin/dextrin) and present tolerable intake dose recommendations for their consumption. We summarized the findings from 103 clinical trials in adults without gastrointestinal disease who reported gastrointestinal effects, including tolerance (e.g., bloating, flatulence, borborygmi/rumbling) and function (e.g., transit time, stool frequency, stool consistency). These studies provided doses ranging from 0.75-160 g/d and lasted for durations ranging from a single-meal tolerance test to 28 wk. Tolerance was NDC specific; thus, recommendations ranged from 3.75 g/d for alginate to 25 g/d for soy fiber. Future studies should address gaps in the literature by testing a wider range of NDC doses and consumption forms (solid compared with liquid). Furthermore, future investigations should also adopt a standard protocol to examine tolerance and functional outcomes across studies consistently.

The Effects of Soluble Dietary Fibers on Glycemic Response: An Overview and Futures Perspectives

The properties of each food, composition, and structure affect the digestion and absorption of nutrients. Dietary fiber (DF), especially viscous DF, can contribute to a reduction in the glycemic response resulting from the consumption of carbohydrate-rich foods. Target and control of postprandial glycemic values are critical for diabetes prevention and management. Some mechanisms have been described for soluble DF action, from the increase in chyme viscosity to the production of short-chain fatty acids resulting from fermentation, which stimulates gastrointestinal motility and the release of GLP-1 and PYY hormones. The postprandial glycemic response due to inulin and resistant starch ingestion is well established. However, other soluble dietary fibers (SDF) can also contribute to glycemic control, such as gums, β-glucan, psyllium, arabinoxylan, soluble corn fiber, resistant maltodextrin, glucomannan, and edible fungi, which can be added alone or together in different products, such as bread, beverages, soups, biscuits, and others. However, there are technological challenges to be overcome, despite the benefits provided by the SDF, as it is necessary to consider the palatability and maintenance of their proprieties during production processes. Studies that evaluate the effect of full meals with enriched SDF on postprandial glycemic responses should be encouraged, as this would contribute to the recommendation of viable dietary options and sustainable health goals.

Novel processing strategies to enhance the bioaccessibility and bioavailability of functional components in wheat bran

Dietary fiber, polysaccharides and phenols are the representative functional components in wheat bran, which have important nutritional properties and pharmacological effects. However, the most functional components in wheat bran exist in bound form with low bioaccessibility. This paper reviews these functional components, analyzes modification methods, and focuses on novel solid-state fermentation (SSF) strategies in the release of functional components. Mining efficient microbial resources from traditional fermented foods, exploring the law of material exchange between cell populations, and building a stable self-regulation co-culture system are expected to strengthen the SSF process. In addition, emerging biotechnology such as synthetic biology and genome editing are used to transform the mixed fermentation system. Furthermore, combined with the emerging physical-field pretreatment coupled with SSF strategies applied to the modification of wheat bran, which provides a theoretical basis for the high-value utilization of wheat bran and the development of related functional foods and drugs.

Postprandial Glycemic and Insulinemic Response by a Brewer’s Spent Grain Extract-Based Food Supplement in Subjects with Slightly Impaired Glucose Tolerance: A Monocentric, Randomized, Cross-Over, Double-Blind, Placebo-Controlled Clinical Trial

Dietary fiber exerts beneficial effects on human health reducing the risk factors of metabolic related diseases such as hyperglycemia, insulin resistance, and hypercholesterolemia. The aim of this study is to demonstrate the efficacy of a food supplement based on brewer’s spent grain (BSG) extract in the reduction of postprandial glycemia and insulinemia in normoglycemic subjects. BSG was chemically characterized, revealing the presence of resistant starch (14.64 g/100 g), arabinoxylans (7.50 g/100 g), β-glucans (1.92 g/100 g) and other soluble fibers (6.43 g/100 g), and bioaccessible ferulic acid (91.3 mg/100 g). For the clinical study, 40 normoglycemic subjects were randomized into two groups, 1 and 2 (n = 20), for a cross-over clinical design and received either BSG extract-based food supplement or placebo. Postprandial blood glucose values were significantly lower than corresponding values in the placebo group after 90 and 120 min, while at the baseline and in the first 60 min, the two glycemic curves overlapped substantially. This improved clinical outcome was corroborated by significant reductions in postprandial insulinemia. None of the subjects reported adverse effects. This study showed that the tested BSG extract-based food supplement improves glucose metabolism and insulinemic response in normoglycemic subjects with at most a mild insulin resistance.

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.

Whole grain germinated brown rice regulates intestinal immune homeostasis and gastrointestinal hormones in type 2 diabetic patients-a randomized control trial

Background: Whole grains present distinguished benefits to a handful of metabolic syndromes (MetS). However, the preventive effects of germinated brown rice (GBR), a new type of brown rice, on patients with type 2 diabetes (T2DM) are rarely reported. Objectives: To investigate whether replacing 100 g refined white rice (RWR) with equal GBR per day is effective in T2DM and its underlying mechanisms. Methods: Ninety-nine qualified T2DM patients (64.58 ± 5.06 years old) were recruited. All patients were randomly divided into GBR group (100 g d^-1 GBR for 12 weeks) and control group (keep the regular diet). Food frequency questionnaires, and fresh stool and serum samples were collected before and after the intervention, followed by various measurements. Results: Fasting blood glucose was obviously decreased after GBR intervention with an effective rate of 62%. Glycated hemoglobin (HbA1c) levels were decreased in the GBR group with no significance. In the GBR group, the abundance of beneficial bacteria in feces was increased, while harmful bacteria were decreased. The percentage of Bacteroides (57.2%) was largely increased. In addition, three types of short-chain fatty acids (SCFAs) including acetic acid, propanoic acid, and butyric acid were increased significantly by GBR (p < 0.05). The secretion of GLP and PYY in serum, two kinds of gastrointestinal hormones downstream of SCFAs, was stimulated by GBR (p < 0.01). Meanwhile, GBR intervention could balance the ratio of Treg/Th17 immune cells in PBMCs and reduce the levels of inflammatory factors including IL-6, IL-8, and LPS in serum, which improved the permeability of intestinal mucosa. Conclusions: GBR (100 g d^-1 for 12 weeks) has positive improvement in the fasting blood glucose for T2DM patients, which attributed to the recovery of intestinal homeostasis.

Global, distinctive, and personal changes in molecular and microbial profiles by specific fibers in humans

Dietary fibers act through the microbiome to improve cardiovascular health and prevent metabolic disorders and cancer. To understand the health benefits of dietary fiber supplementation, we investigated two popular purified fibers, arabinoxylan (AX) and long-chain inulin (LCI), and a mixture of five fibers. We present multiomic signatures of metabolomics, lipidomics, proteomics, metagenomics, a cytokine panel, and clinical measurements on healthy and insulin-resistant participants. Each fiber is associated with fiber-dependent biochemical and microbial responses. AX consumption associates with a significant reduction in LDL and an increase in bile acids, contributing to its observed cholesterol reduction. LCI is associated with an increase in Bifidobacterium. However, at the highest LCI dose, there is increased inflammation and elevation in the liver enzyme alanine aminotransferase. This study yields insights into the effects of fiber supplementation and the mechanisms behind fiber-induced cholesterol reduction, and it shows effects of individual, purified fibers on the microbiome.

Prebiotics as a Tool for the Prevention and Treatment of Obesity and Diabetes: Classification and Ability to Modulate the Gut Microbiota

Diabetes and obesity are metabolic diseases that have become alarming conditions in recent decades. Their rate of increase is becoming a growing concern worldwide. Recent studies have established that the composition and dysfunction of the gut microbiota are associated with the development of diabetes. For this reason, strategies such as the use of prebiotics to improve intestinal microbial structure and function have become popular. Consumption of prebiotics for modulating the gut microbiota results in the production of microbial metabolites such as short-chain fatty acids that play essential roles in reducing blood glucose levels, mitigating insulin resistance, reducing inflammation, and promoting the secretion of glucagon-like peptide 1 in the host, and this accounts for the observed remission of metabolic diseases. Prebiotics can be either naturally extracted from non-digestible carbohydrate materials or synthetically produced. In this review, we discussed current findings on how the gut microbiota and microbial metabolites may influence host metabolism to promote health. We provided evidence from various studies that show the ability of prebiotic consumption to alter gut microbial profile, improve gut microbial metabolism and functions, and improve host physiology to alleviate diabetes and obesity. We conclude among other things that the application of systems biology coupled with bioinformatics could be essential in ascertaining the exact mechanisms behind the prebiotic–gut microbe–host interactions required for diabetes and obesity improvement.

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.

A wheat aleurone-rich diet improves oxidative stress but does not influence glucose metabolism in overweight/obese individuals: Results from a randomized controlled trial

BACKGROUND AND AIMS

Aleurone is the innermost layer of wheat bran, rich in fiber, minerals, vitamins, phenolic compounds, and betaine. The metabolic effects of aleurone rich foods are still unknown. Our aim was to investigate the effects of consuming a Wheat Aleurone rich diet vs. a Refined Wheat diet for 8 weeks on fasting and postprandial glycemic and lipid metabolism, inflammation, and oxidative stress in overweight/obese individuals.

METHODS AND RESULTS

According to a randomized cross-over study design, 23 overweight/obese individuals, age 56 ± 9 years (M±SD), were assigned to two isoenergetic diet - Wheat Aleurone and Refined Wheat diets - for 8 weeks. The diets were similar for macronutrient composition but different for the aleurone content (40-50 g/day in the Wheat Aleurone diet). After each diet, fasting and postprandial plasma metabolic profile, ferulic acid metabolites and 8-isoprostane concentrations in 24-h urine samples were evaluated. Compared with the Refined Wheat Diet, the Wheat Aleurone Diet increased fasting plasma concentrations of betaine by 15% (p = 0.042) and decreased the excretion of 8-isoprostane by 33% (p = 0.035). Conversely, it did not affect the fasting and postprandial glucose, insulin and triglyceride responses, homocysteine, and C-Reactive Protein concentrations, nor excretion of phenolic metabolites.

CONCLUSION

An 8-week Wheat Aleurone Diet improves the oxidative stress and increases plasma betaine levels in overweight/obese individuals with an increased cardiometabolic risk. However, further studies with longer duration and larger sample size are needed to evaluate the benefits of aleurone-rich foods on glucose and lipid metabolism in individuals with more severe metabolic abnormalities.

CLINICAL TRIAL REGISTRY NUMBER

NCT02150356, (https://clinicaltrials.gov).

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.

Rejuvenated Brewer's Spent Grain: EverVita Ingredients as Game-Changers in Fibre-Enriched Bread

Brewer's spent grain (BSG) is the main side-stream of brewing. BSG is a potential source for nutritionally enriched cereal products due to its high content of fibre and protein. Two novel ingredients originating from BSG, EverVita FIBRA (EVF) and EverVita PRO (EVP), were incorporated into bread in two addition levels to achieve a 'source of fibre' (3 g/100 g) and a 'high in fibre' (6 g/100 g) nutrition claim for the breads. The impact of those two ingredients on dough and bread quality as well as on nutritional value was investigated and compared to baker's flour (C1) and wholemeal flour (C2) breads. The addition of EVF performed outstandingly well in the bread system achieving high specific volumes (3.72-4.66 mL/g), a soft crumb texture (4.77-9.03 N) and a crumb structure comparable with C1. Furthermore, EVF barely restricted gluten network development and did not influence dough rheology. EVP increased the dough resistance (+150%) compared to C1 which led to a lower specific volume (2.17-4.38 mL/g) and a harder crumb (6.25-36.36 N). However, EVP increased the nutritional value of the breads by increasing protein content (+36%) and protein quality by elevating the amount of indispensable amino acids. Furthermore, a decrease in predicted glycaemic index by 26% was achieved and microbial shelf life was extended by up to 3 days. Although both ingredients originated from the same BSG, their impact on bread characteristics and nutritional value varied. EVF and EVP can be considered as game-changers in the development of bread fortified with BSG, increasing nutritional value, and promoting sustainability.

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.

Dietary Fibre Modulates the Gut Microbiota

Dietary fibre has long been established as a nutritionally important, health-promoting food ingredient. Modern dietary practices have seen a significant reduction in fibre consumption compared with ancestral habits. This is related to the emergence of low-fibre “Western diets” associated with industrialised nations, and is linked to an increased prevalence of gut diseases such as inflammatory bowel disease, obesity, type II diabetes mellitus and metabolic syndrome. The characteristic metabolic parameters of these individuals include insulin resistance, high fasting and postprandial glucose, as well as high plasma cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Gut microbial signatures are also altered significantly in these cohorts, suggesting a causative link between diet, microbes and disease. Dietary fibre consumption has been hypothesised to reverse these changes through microbial fermentation and the subsequent production of short-chain fatty acids (SCFA), which improves glucose and lipid parameters in individuals who harbour diseases associated with dysfunctional metabolism. This review article examines how different types of dietary fibre can differentially alter glucose and lipid metabolism through changes in gut microbiota composition and function.

Bioprocessed Brewers' Spent Grain Improves Nutritional and Antioxidant Properties of Pasta

Brewers' spent grain (BSG), the by-product of brewing, was subjected to a xylanase treatment followed by fermentation with Lactiplantibacillus plantarum PU1. Bioprocessed BSG has been used as ingredient to obtain a fortified semolina pasta which can be labeled as "high fiber" and "source of protein" according to the European Community Regulation No. 1924/2006. Compared to native BSG, the use of bioprocessed BSG led to higher protein digestibility and quality indices (essential amino acid index, biological value, protein efficiency ratio, nutritional index), as well as lower predicted glycemic index. Bioprocessing also improved the technological properties of fortified pasta. Indeed, brightfield and confocal laser scanning microscopy revealed the formation of a more homogeneous protein network, resulting from the degradation of the arabinoxylan structure of BSG, and the release of the components entrapped into the cellular compartments. The extensive cell wall disruption contributed to the release of phenols, and conferred enhanced antioxidant activity to the fortified pasta. The persistence of the activity was demonstrated after in vitro-mimicked digestion, evaluating the protective effects of the digested pasta towards induced oxidative stress in Caco-2 cells cultures. The fortified pasta showed a peculiar sensory profile, markedly improved by the pre-treatment, thus confirming the great potential of bioprocessed BSG as health-promoting food ingredient.

Wheat bran, as the resource of dietary fiber: a review

Wheat bran is a major by-product of white flour milling and had been produced in large quantities around the world; it is rich in dietary fiber and had already been used in many products such as whole grain baking or high dietary fiber addition. It has been confirmed that a sufficient intake of dietary fiber in wheat bran with appropriate physiological functions is beneficial to human health. Wheat bran had been considered as the addition with a large potential for improving the nutritional condition of the human body based on the dietary fiber supplement. The present review summarized the available information on wheat bran related to its dietary fiber functions, which may be helpful for further development of wheat bran as dietary fiber resource.

Depletion and bridging flocculation of oil droplets in the presence of β-glucan, arabinoxylan and pectin polymers: Effects on lipolysis

The aim of this study was to investigate the influence of food polysaccharides from different sources on microstructural and rheological properties, and in vitro lipolysis of oil-in-water emulsions of canola oil stabilised by whey protein isolate. The polysaccharides used were β-glucan (BG) from oat, arabinoxylan (AX) from wheat, and pectin (PTN) from apple. All polysaccharides added at 1 % w/v increased the viscosity of emulsions and promoted flocculation but with different mechanisms, BG and AX by depletion flocculation and PTN by bridging flocculation. Depletion flocculation was associated with an increase in viscosity of BG or AX-stabilised emulsions compared with BG/AX alone, whereas bridging flocculation with PTN caused a decrease in viscosity. All three polysaccharides reduced lipid digestion rate and extent, but the bridging flocculation induced by PTN had the greatest effect. This study has implications for better understanding the influence of carbohydrate polymers from cereals and fruits on lipid digestibility.

Unravelling the involvement of gut microbiota in type 2 diabetes mellitus

Type 2 diabetes mellitus is the most prevalent metabolic disorder characterized by hyperglycemia, hyperlipidemia as well as insulin resistance and is affecting the lives of a huge population across the globe. Genetic mutations, obesity and lack of physical activity constitute the possible factors that can lead to onset and progression of this disorder. However, there is another major factor that can be the root cause of type 2 diabetes mellitus and that is an imbalance in the microorganisms that inhabit the gut. The gut microbiome is a vital component that needs to be given significant attention because any "dysbiosis" in the colonic microorganisms can transform the host from a state of health to a state of disease. This transformation is quite obvious since the gut barrier integrity, host metabolism such as sensitivity to insulin and maintaining blood glucose level are carried out by the tiny organisms inhabiting our intestine. In fact, the normal functioning of the human body is accredited to the microbes, particularly the bacteria, because they generate their metabolites that communicate with host cells and maintain normal physiology. Giving importance to gut health is, therefore, necessary to prevent metabolic diseases that can be maintained by the intake of prebiotics, probiotics, synbiotics along with healthy diet. The tiny microorganisms in the gut that keep our body free of disorders such as type 2 diabetes mellitus need to be in a state of 'eubiosis', else the consequences of disturbance in gut microbes can progress to serious complications in the host.

Interactions between Cellulose and (1,3;1,4)-β-glucans and Arabinoxylans in the Regenerating Wall of Suspension Culture Cells of the Ryegrass Lolium multiflorum

Plant cell walls (PCWs) form the outer barrier of cells that give the plant strength and directly interact with the environment and other cells in the plant. PCWs are composed of several polysaccharides, of which cellulose forms the main fibrillar network. Enmeshed between these fibrils of cellulose are non-cellulosic polysaccharides (NCPs), pectins, and proteins. This study investigates the sequence, timing, patterning, and architecture of cell wall polysaccharide regeneration in suspension culture cells (SCC) of the grass species Lolium multiflorum (Lolium). Confocal, superresolution, and electron microscopies were used in combination with cytochemical labeling to investigate polysaccharide deposition in SCC after protoplasting. Cellulose was the first polysaccharide observed, followed shortly thereafter by (1,3;1,4)-β-glucan, which is also known as mixed-linkage glucan (MLG), arabinoxylan (AX), and callose. Cellulose formed fibrils with AX and produced a filamentous-like network, whereas MLG formed punctate patches. Using colocalization analysis, cellulose and AX were shown to interact during early stages of wall generation, but this interaction reduced over time as the wall matured. AX and MLG interactions increased slightly over time, but cellulose and MLG were not seen to interact. Callose initially formed patches that were randomly positioned on the protoplast surface. There was no consistency in size or location over time. The architecture observed via superresolution microscopy showed similarities to the biophysical maps produced using atomic force microscopy and can give insight into the role of polysaccharides in PCWs.

Effect of Dietary Acetic Acid Supplementation on Plasma Glucose, Lipid Profiles, and Body Mass Index in Human Adults: A Systematic Review and Meta-analysis

BACKGROUND

Acetic acid is a short-chain fatty acid that has demonstrated biomedical potential as a dietary therapeutic agent for the management of chronic and metabolic illness comorbidities. In human beings, its consumption may improve glucose regulation and insulin sensitivity in individuals with cardiometabolic conditions and type 2 diabetes mellitus. Published clinical trial evidence evaluating its sustained supplementation effects on metabolic outcomes is inconsistent.

OBJECTIVE

This systematic review and meta-analysis summarized available evidence on potential therapeutic effects of dietary acetic acid supplementation via consumption of acetic acid-rich beverages and food sources on metabolic and anthropometric outcomes.

METHODS

A systematic search was conducted in Medline, Scopus, EMBASE, CINAHL Plus, and Web of Science from database inception until October 2020. Randomized controlled trials conducted in adults evaluating the effect of dietary acetic acid supplementation for a minimum of 1 week were included. Meta-analyses were performed using a random-effects model on fasting blood glucose (FBG), triacylglycerol (TAG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), glycated hemoglobin (HbA1c), body mass index (BMI), and body fat percentage. Statistical heterogeneity was assessed by calculation of Q and I² statistics, and publication bias was assessed by calculation of Egger's regression asymmetry and Begg's test.

RESULTS

Sixteen studies were included, involving 910 participants who consumed between 750 and 3600 mg acetic acid daily in interventions lasting an average of 8 weeks. Dietary acetic acid supplementation resulted in significant reductions in TAG concentrations in overweight and obese but otherwise healthy individuals (mean difference [MD] = -20.51 mg/dL [95% confidence intervals = -32.98, -8.04], P = .001) and people with type 2 diabetes (MD = -7.37 mg/dL [-10.15, -4.59], P < .001). Additionally, acetic acid supplementation significantly reduced FBG levels (MD = -35.73 mg/dL [-63.79, -7.67], P = .01) in subjects with type 2 diabetes compared with placebo and low-dose comparators. No other changes were seen for other metabolic or anthropometric outcomes assessed. Five of the 16 studies did not specify the dose of acetic acid delivered, and no studies measured blood acetate concentrations. Only one study controlled for background acetic acid-rich food consumption during intervention periods. Most studies had an unclear or high risk of bias.

CONCLUSION

Supplementation with dietary acetic acid is well tolerated, has no adverse side effects, and has clinical potential to reduce plasma TAG and FBG concentrations in individuals with type 2 diabetes, and to reduce TAG levels in people who are overweight or obese. No significant effects of dietary acetic acid consumption were seen on HbA1c, HDL, or anthropometric markers. High-quality, longer-term studies in larger cohorts are required to confirm whether dietary acetic acid can act as an adjuvant therapeutic agent in metabolic comorbidities management.

Plant origin prebiotics affect duodenal brush border membrane functionality and morphology, in vivo (Gallus Gallus)

The intra-amniotic administration approach has been used to evaluate the effects of plant origin prebiotics on intestinal health and on brush border membrane functionality and morphology. Prebiotics are fermentable dietary fibers, which can positively affect the host by selectively stimulating the growth and activity of colon bacteria, thus improving intestinal health. The consumption of prebiotics increases digestive tract motility, which leads to hyperplasia and/or hypertrophy of intestinal cells, increasing nutrient digestive and absorptive surface area. This review collates information about the effects and relationship between prebiotic consumption on small intestinal brush border membrane functionality and morphology by utilizing the intra-amniotic administration approach. To date, research has shown that the intra-amniotic administration of prebiotics affects the expression of key brush border membrane functional proteins, intestinal surface area (villi height/width), and goblet cell number/size. These effects may improve brush border membrane functionality and digestive/absorptive capabilities.

The role of short-chain fatty acids in immunity, inflammation and metabolism

Short-chain fatty acids (SCFAs) are carboxylic acids with carbon atom numbers less than 6, which are important metabolites of gut microbiome. Existing research shows that SCFAs play a vital role in the health and disease of the host. First, SCFAs are the key energy source for colon and ileum cells, and affect the intestinal epithelial barrier and defense functions by regulating related gene expression. Second, SCFAs regulate the function of innate immune cells to participate in the immune system, such as macrophages, neutrophils and dendritic cells. Third, SCFAs can also regulate the differentiation of T cells and B cells and the antigen-specific adaptive immunity mediated by them. Besides, SCFAs are raw materials for sugar and lipid synthesis, which provides a theoretical basis for studying the potential role of SCFAs in regulating energy homeostasis and metabolism. There are also studies showing that SCFAs inhibit tumor cell proliferation and promote apoptosis. In this article, we summarized in detail the role of SCFAs in immunity, inflammation and metabolism, and briefly introduced the role of SCFAs in tumor cell survival. It provides a systematic theoretical basis for the study of SCFAs as potential drugs to promote human health.

The Relationship between In Vitro and In Vivo Starch Digestion Kinetics of Breads Varying in Dietary Fibre

The relationship between in vitro and in vivo starch digestion kinetics was studied in portal vein catheterised pigs fed breads varying in dietary fibre (DF) content and composition. The breads were a low DF white wheat bread, two high DF whole grain rye breads without and with whole kernels and two experimental breads with added arabinoxylan or oat β-glucan concentrates, respectively. In vitro, samples were collected at 0, 5, 10, 15, 30, 60, 120 and 180 min and the cumulative hydrolysis curve for starch was modelled, whereas the in vivo cumulative absorption models for starch were based on samples taken every 15 min up to 60 min and then every 30 min up to 240 min. The starch hydrolysis rate in vitro (0.07 to 0.16%/min) was far higher than the rate of glucose appearance in vivo (0.017 to 0.023% absorbed starch/min). However, the ranking of the breads was the same in vitro and in vivo and there was a strong relationship between the kinetic parameters.

Effects of whey protein and dietary fiber intake on insulin sensitivity, body composition, energy expenditure, blood pressure, and appetite in subjects with abdominal obesity

BACKGROUND

Recently, we demonstrated that whey protein (WP) combined with low dietary fiber improved lipemia, a risk factor for cardiovascular disease in subjects with abdominal obesity. In the present study, we investigated the effects of intake of WP and dietary fiber from enzyme-treated wheat bran on other metabolic parameters of the metabolic syndrome.

METHODS

The study was a 12-week, double-blind, randomized, controlled, parallel intervention study. We randomized 73 subjects with abdominal obesity to 1 of 4 iso-energetic dietary interventions: 60 g per day of either WP hydrolysate or maltodextrin (MD) combined with high-fiber (HiFi; 30 g dietary fiber/day) or low-fiber (LoFi; 10 g dietary fiber/day) cereal products. We assessed changes in insulin sensitivity, gut hormones (GLP-1, GLP-2, GIP, and peptide YY), body composition, 24-h BP, resting energy expenditure and respiratory exchange ratio (RER), and appetite.

RESULTS

Sixty-five subjects completed the trial. Subjective hunger ratings were lower after 12 weeks of WP compared with MD, independent of fiber content (P = 0.02). We found no effects on ratings of satiety, fullness or prospective food consumption for either of the interventions. Intake of WP combined with LoFi increased the postprandial peptide YY response. There were no effects of WP or fiber on insulin sensitivity, body composition, energy expenditure, incretins, or 24-h BP.

CONCLUSIONS

WP consumption for 12 weeks reduced subjective ratings of hunger in subjects with abdominal obesity. Neither WP nor dietary fiber from wheat bran affected insulin sensitivity, 24-h BP, gut hormone responses, body composition, or energy expenditure compared with MD and low dietary fiber.

Protective role of three differently processed corn bran on glucose and lipid concentrations in d-galactose-induced mice model

In this research, the effects of three differently processed corn bran (corn bran soluble hemicellulose (HEM), hemicellulose hydrolyzed by oxalic acid (HOA), Amberlite XAD-2 eluate (XE)) on the changes of glucose and lipid concentrations of d-galactose (d-gal)-induced mice were investigated. The mice were divided into five groups and intragastric administration HEM, HOA, and XE at 200 mg/kg Body Weight (BW) for continuously 6 weeks. Mice were submitted under oral glucose tolerance test (OGTT).Then, the serum insulin, glucagon-like peptide-1(GLP-1), serum C-peptide, hepatic glycogen (HG), muscle glycogen (MG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) of all the mice were detected. As we can see, by inducing with d-gal, the glucose and lipid concentrations of aging mice could be effectively regulated by HEM, HOA, and XE. High degree of esterification feruloylated oligosaccharides has the most obvious effect of regulating glucose and lipid concentrations. PRACTICAL APPLICATIONS: Corn bran has not been fully paid attention owing to the rough taste and the poor water solubility. Actually, corn bran, a renewable resource available in a large quantity, could be a goods source of valuable consumer products. The results of this study indicated that three differently processed corn brans could regulate glucose and lipid concentrations and XE had the most obvious effect of regulating glucose and lipid concentrations. Corn bran could advantage as a new type of environmentally and inexpensive food supplements on reducing blood glucose and lipid concentrations.

From role of gut microbiota to microbial-based therapies in type 2-diabetes

The incidence of type 2 diabetes mellitus (T2DM) has increased dramatically at an alarming level around the world.T2DM is associated with changeable risk factors in lifestyle as well as genetic and family associated risk factors. More importantly, imbalanced or impaired gut microbial distribution (dysbiosis) has been reported as a contributing risk factor in insulin resistance progression in T2DM. Dysbiosis may restructure the metabolic and functional pathways in the intestine which are involved in the development of T2DM. However, several studies have indicated the constructive and helpful effect of prebiotics, probiotics, and fecal microbiota transplantation (FMT) on the improvement of gut microbiota (GM) and accordingly host metabolism. In this review, the association between GM and T2DM have been evaluated and the role of prebiotics, probiotics and FMT, as potential therapeutic approaches have been discussed. Relevant studies were obtained randomly from online databases such as PubMed/Medline and ISI Web of Science.

Effects of insoluble and soluble fibers isolated from barley on blood glucose, serum lipids, liver function and caecal short-chain fatty acids in type 2 diabetic and normal rats

Large prospective cohort studies suggested an important role of cereal insoluble fiber in the prevention and management of type 2 diabetes, which challenge the traditional view that viscosity and solubility are the main driving factors for these beneficial effects of dietary fiber. To evaluate the anti-diabetic effects of insoluble- (BIF) and soluble fibers (BSF) enzymatically isolated from barley, a conventional rat model and a type 2 diabetes rat model were used. Our results showed that 4-week treatment of BIF or BSF effectively reduced FBG in the diabetic condition, with caecal level of propionic acid and minor SCFAs increased by BIF and that of butyric acid and insulin sensitivity improved by BSF, respectively. The two treatments further ameliorated liver function, judged by the recovered serum level of ALT, albumin and total protein levels. BIF and BSF also increased HDL-C and decreased serum MDA. In normal rats, BIF and BSF showed a hypolipidaemic effect in triglycerides and LDL-C, reduced body weight and enhanced the caecal production of minor SCFAs. Furthermore, the two treatments reduced the caecal level of butyric acid while BSF increased that of propionic acid. In conclusion, BIF could exert anti-diabetic effects that might via a different mechanism from BSF.

Dietary fibre from berry-processing waste and its impact on bread structure: a review

The structure and function of by-products of berry-processing industries are reviewed, with particular attention to dietary fibre (DF) and its effects in food products. The complex chemical composition and physicochemical characteristics of DF have been investigated and strategies for extraction of specific fractions that provide tailored technological and physiological functionality have been reviewed. The aim of this review is to describe in detail the structural composition and isolation methods of dietary fibre derived from berry by-products, and to explore their potential functionality in foods. The goal is to introduce DF from berry waste streams into the food chain, for which bread is a major vehicle. However, the appeal of bread lies in its aerated structure, for which DF is generally detrimental. The technological influence of DF on the formation and stabilization of the aerated structure of bread is therefore reviewed, in order to understand how to incorporate DF into bread while maintaining palatability. The aerated structure of bread is stabilized by two mechanisms: the gluten matrix and the liquid film surrounding bubbles. Incorporating DF successfully into bread requires understanding its interactions with both of these mechanisms. DF fractions from berries offer superior nutritional value compared to cereal fibre, potentially with less damage to bread structure, due to the higher proportion of soluble fibre. By-products from berry-processing industries could be used as a source of technologically and nutritionally distinctive DF to fabricate foods with enhanced nutritional value. © 2019 Society of Chemical Industry.

Recent Advances in the Use of Sourdough Biotechnology in Pasta Making

The growing consumers’ request for foods with well-balanced nutritional profile and functional properties promotes research on innovation in pasta making. As a staple food and a common component of diet, pasta can be considered as a vector of dietary fiber, vegetable proteins, vitamins, minerals, and functional compounds. The conventional process for pasta production does not include a fermentation step. However, novel recipes including sourdough-fermented ingredients have been recently proposed, aiming at enhancing the nutritional and functional properties of this product and at enriching commercial offerings with products with new sensorial profiles. The use of sourdough for pasta fortification has been investigated under several aspects, including fortification in vitamin B, the reduction of starch digestibility, and gluten content. Sourdough fermentation has also been successfully applied to non-conventional flours, (e.g., from pseudocereals and legumes), in which an overall increase of the nutritional value and health-promoting compounds, such as a significant decrease of antinutritional factors, were observed. Fermented non-conventional flours, obtained through spontaneous fermentation or using selected starters, have been proposed as pasta ingredients. As the result of wheat replacement, modification in textural properties of pasta may occur. Nonetheless, fermentation represents an efficient tool in improving, besides nutritional and functional profile, the sensory and technological features of fortified pasta.

Nutritional interest of dietary fiber and prebiotics in obesity: Lessons from the MyNewGut consortium

The aim of EU project MyNewGut is to contribute to future public health-related recommendations supported by new insight in gut microbiome and nutrition-host relationship. In this Opinion Paper, we first revisit the concept of dietary fiber, taking into account their interaction with the gut microbiota. This paper also summarizes the main effects of dietary fibers with prebiotic properties in intervention studies in humans, with a particular emphasis on the effects of arabinoxylans and arabinoxylo-oligosaccharides on metabolic alterations associated with obesity. Based on the existing state of the art and future development, we elaborate the steps required to propose dietary guidelines related to dietary fibers, taking into account their interaction with the gut microbiota.

Dietary fiber sources and human benefits: The case study of cereal and pseudocereals

Dietary fiber (DF) includes the remnants of the edible part of plants and analogous carbohydrates that are resistant to digestion and absorption in the human small intestine with complete or partial fermentation in the human large intestine. DF can be classified into two main groups according to its solubility, namely insoluble dietary fiber (IDF) that mainly consists on cell wall components, including cellulose, some hemicelluloses, lignin and resistant starch, and soluble dietary fiber (SDF) that consists of non-cellulosic polysaccharides as non-digestible oligosaccharides, arabinoxylans (AX), β-glucans, some hemicelluloses, pectins, gums, mucilages and inulin. The intake of DF is associated with health benefits. IDF can contribute to the normal function of the intestinal tract and it has an important role in the prevention of colonic diverticulosis and constipation. SDF is extensively fermented by gut microbiota and it is associated with carbohydrate and lipid metabolism, with important health benefits due to its hypocholesterolemic properties. Due to these nutritional and health properties, DF is widely used as functional ingredients in food industry, being whole grain cereals, pulses, fruits and vegetables the main sources of DF. Also some synthetic sources are employed, namely polydextrose, hydroxypropyl methylcellulose or cyclodextrins. The DF content of cereals varies depending on cultivars, their botanical components (pericarp, emdosperm and germ) and the processing conditions they have undergone (baking, extrusion, etc.). In cereal grains, AX are the predominant non-cellulose DF polysaccharides followed by cellulose and β-glucans, while in pseudocereals, pectins are quantitatively predominant.

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.