Intake and Dietary Food Sources of Fibre in Spain: Differences with Regard to the Prevalence of Excess Body Weight and Abdominal Obesity in Adults of the ANIBES Study

Associations between Constipation and Use of Levodopa with Nutritional Status, Polypharmacy, and Stage of Parkinson's Disease

INTRODUCTION

Parkinson's disease (PD) is a highly prevalent disease characterized by motor and non-motor symptoms; the latter include constipation, which is considered a prodromal symptom. On the other hand, sarcopenia, polypharmacy, and malnutrition due to deficits are common in PD and lead to poorer health and quality of life.

OBJECTIVE

to associate constipation and use of levodopa with nutritional status, sarcopenia, duration and stage of the disease, and polypharmacy in individuals with PD.

MATERIALS AND METHODS

analytical cross-sectional observational study where an online survey was applied to 161 people suffering from PD.

RESULTS

a significant association is observed between constipation and BMI (p = 0.022), as well as between the use of levodopa with BMI (p = 0.049) and polypharmacy (p = 0.046). On the other hand, there is a relationship between the average time of PD diagnosis and constipation (p = 0.0047). Finally, there is a relationship between SARC-F score applied to those over 60 years of age (p = 0.0446) and the use of levodopa. Having sarcopenia, being overweight, and having had the disease for less than five years is associated with a higher probability of experiencing constipation, according to the logistic regression analysis (p > 0.005).

CONCLUSION

nutritional assessment and subsequent follow-up is of vital importance to avoid complications that could be associated with levodopa use, constipation, and sarcopenia.

Chagas disease is related to structural changes of the gut microbiota in adults with chronic infection (TRIPOBIOME Study)

BACKGROUND

The implications of the gut microbial communities in the immune response against parasites and gut motility could explain the differences in clinical manifestations and treatment responses found in patients with chronic Chagas disease.

METHODOLOGY/PRINCIPAL FINDINGS

In this pilot prospective cross-sectional study, we included 80 participants: 29 with indeterminate CD (ICD), 16 with cardiac CD (CCD), 15 with digestive CD (DCD), and 20 controls without CD. Stool was collected at the baseline visit and faecal microbial community structure DNA was analyzed by whole genome sequencing. We also performed a comprehensive dietary analysis. Ninety per cent (72/80) of subjects were of Bolivian origin with a median age of 47 years (IQR 39-54) and 48.3% (29/60) had received benznidazole treatment. There were no substantial differences in dietary habits between patients with CD and controls. We identified that the presence or absence of CD explained 5% of the observed microbiota variability. Subjects with CD exhibited consistent enrichment of Parabacteroides spp, while for Enterococcus hirae, Lactobacillus buchneri and Megamonas spp, the effect was less clear once excluded the outliers values. Sex, type of visceral involvement and previous treatment with benznidazole did not appear to have a confounding effect on gut microbiota structure. We also found that patients with DCD showed consistent Prevotella spp enrichment.

CONCLUSIONS

We found a detectable effect of Chagas disease on overall microbiota structure with several potential disease biomarkers, which warrants further research in this field. The analysis of bacterial diversity could prove to be a viable target to improve the prognosis of this prevalent and neglected disease.

Association between plant-based diets and metabolic syndrome in obese adults from Iran: a cross-sectional study

BACKGROUND

Metabolic syndrome (MetS) is a common chronic disease with several complications. Given that, studies on the association of plant-based diet indices (PDIs) with risk of MetS among adults with obesity, are limited, we aimed to examine the association between PDIs (including overall PDI, healthy PDI (hPDI), unhealthy PDI (uPDI)) and MetS in Iranian adults with obesity.

METHODS

In Tabriz, Iran, a total of 347 adults between the ages of 20 and 50 participated in this cross-sectional research study. We created an overall PDI, hPDI, and uPDI from validated semi-quantitative food-frequency questionnaire (FFQ) data. To investigate the association between hPDI, overall PDI, uPDI, and MetS and its components, a binary logistic regression analysis was performed.

RESULTS

The average age was 40.78 ± 9.23 years, and the average body mass index was 32.62 ± 4.80 kg/m². There was no significant association between overall PDI (OR: 0.87; 95% CI: 0.54-1.47), hPDI (OR: 0.82; 95% CI: 0.48-1.40), and uPDI (OR: 0.83; 95% CI: 0.87-2.46) with MetS, even after adjustment for confounders. Moreover, our findings showed that participants with the highest adherence to uPDI had a higher chance of hyperglycemia (OR: 2.50; 95% CI: 1.13-5.52). Also, this association was significant in the first (OR: 2.51; 95% CI: 1.04-6.04) and second (OR: 2.58; 95% CI: 1.05-6.33) models, after controlling for covariates. However, in both adjusted and crude models, we did not find a significant association between hPDI and PDI scores and MetS components such as high triglyceride, high waist circumference, low High-density lipoprotein cholesterol, raised blood pressure, and hyperglycemia. Moreover, those in the top tertile of uPDI had higher fasting blood sugar and insulin levels when compared with those in the first tertile, and subjects in the last tertile of hPDI compared with participants in the first tertile had lower weight, waist-to-hip ratio, and fat-free mass.

CONCLUSION

We found a direct significant association between uPDI and odds of hyperglycemia in the whole population of study. Future large-scale, prospective studies on PDIs and the MetS are necessary to confirm these findings.

The Association between Plant-Based Diet Indices and Metabolic Syndrome in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey

Objectives: To investigate the association between a plant-based diet and metabolic syndrome (MetS) among Chinese adults. Methods: Based on the data from the 2004–2015 China Health and Nutrition Survey and the corresponding edition of China Food Composition, we calculated the healthy plant-based diet indices (hPDI) and unhealthy plant-based diet indices (uPDI). The Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for MetS. Mediation analysis was further conducted to explore the mediator role of Body Mass Index (BMI) in the association between hPDI and MetS. Results: We included 10,013 participants, and over a median follow-up of 5 years, 961 patients (9.60%) developed MetS. Compared to those in the lowest quintile of hPDI score, we found that those in the highest quintile of hPDI score had a 28% lower ([HR]: 0.72, 95% CI 0.56–0.93, Ptrend = 0.021) risk of developing MetS and had a 20% lower (hazard ratio [HR]: 0.80, 95% CI 0.70–0.92, Ptrend = 0.004) risk of developing abdominal obesity. No significant associations were observed between uPDI and the MetS, but those in the highest quintile of uPDI score had a 36% higher (hazard ratio [HR]: 1.36, 95% CI 1.20–1.64, Ptrend < 0.001) risk of developing abdominal obesity, compared to those in the lowest quintile of uPDI score. In exploratory analysis, we observed that BMI at baseline mediated 27.8% of the association between hPDI and incident MetS, and BMI at baseline mediated 29.7% of the association between hPDI and abdominal obesity. Conclusion: The current findings reveal a possible causal relationship between a healthy plant-based diet and a reduced risk of MetS, especially abdominal obesity. It is observed that BMI may mediate the relationship between hPDI score and MetS. Controlling early dietary patterns and BMI may help reduce the risk of MetS.

[Relationship of demographic and dietary hygiene factors with the pathology found in outpatient colonoscopies performed in a Castilla y León Health Service center]

Introduction

Background: colorectal cancer (CRC) is one of the most frequent tumors in terms of incidence and mortality. Several elements, both inherited and environmental, have been related with its pathogenesis. Aims: to analyze the influence of age, gender and nutritional factors on the diagnosis of colonic polyps and CRC. Methods: a prospective, descriptive study over outpatients from the Health Area of León who took a colonoscopy between 09/09/2012 and 06/30/2013. Patients were asked to fill a semiquantitative food frecuency questionnaire with data such a sociodemographic, toxic and dietetic facts. Differences in diagnosis according to sociodemographic and hygiene-dietetic data were analyzed with a multivariate analysis by forward stepwise logistic regression. Results: data were collected from 1390 patients. Mean age was 57.88 (15.17) years and 47.8 % were male. CRC was diagnosed in 5 % of colonoscopies, and polyps in 20.4 %, with 9.4 % of them being HRA. Risk of polyps and HRA was higher in males (26.9 % vs 14.5 %) and (12.6 % vs 6.3 %), respectively (p < 0.001). Mean age was significantly higher in patients who presented polyps (56.51 (15.45) vs 63.22 (12.69) years; p < 0.001). Among the group who reported intake of smoked and salted food, the risk of polyps doubled (2.9 % vs 6.7 %, p = 0.002). In relation to alcohol intake we found that subjects with daily alcohol consumption showed a higher incidence of polyps whe compared to occasional drinkers and teetotallers (32 % vs 20 % vs 18.6 %, p = 0.002) Conclusions: age correlated with higher risk of polyps, HRA and CRC. Moreover, male gender also was associated with a high risk of polyps and HRA. Alcohol and red and processed meat intake increased polyp risk.

Inadequate Intake of Dietary Fibre in Adolescents, Adults, and Elderlies: Results of Slovenian Representative SI. Menu Study

Dietary fibre has proven to promote healthy body mass and reduce the risk of non-communicable diseases. To date, in Slovenia, there were only a few outdated studies of dietary fibre intake; therefore, we explored the dietary fibre intake using food consumption data collected in the SI.Menu project. Following the EU Menu methodology, data were collected on representative samples of adolescents, adults, and elderlies using a general questionnaire, a food propensity questionnaire, and two 24 h recalls. The results indicate that the intake of dietary fibre in Slovenia is lower than recommended. The proportion of the population with inadequate fibre intakes (<30 g/day) was 90.6% in adolescents, 89.6% in adults, and 83.9% in elderlies, while mean daily fibre intakes were 19.5, 20.9, and 22.4 g, respectively. Significant determinants for inadequate dietary fibre intake were sex in adolescents and adults, and body mass index in adults. The main food groups contributing to dietary fibre intake were bread and other grain products, vegetables and fruits, with significant differences between population groups. Contribution of fruits and vegetables to mean daily dietary fibre intake was highest in elderlies (11.6 g), followed by adults (10.6 g) and adolescents (8.5 g). Public health strategies, such as food reformulation, promoting whole-meal alternatives, consuming whole foods of plant origin, and careful planning of school meals could beneficially contribute to the overall dietary fibre intake in the population.

[Gut microbiota and grain fiber: evidence and practical recommendations]

Modulation of the human gut microbiota is emerging as a plausible approach to promoting health and preventing and treating disease. Changes in dietary macronutrients, mainly in carbohydrates, exert specific effects on the human gut microbiota. Specifically, there is evidence that supports that dietary fiber may influence the abundance, diversity, and metabolism of the human gut microbiota. This work contributes to the understanding of the impact of intact cereal fiber consumption on the gut microbiota of healthy adults. The strongest evidence points to the role of wheat bran and wholegrain wheat fiber promoting gut microbiota diversity, since wheat fiber demonstrated the most consistent prebiotic effects, with demonstrable effects, with an increase in wheat fiber as low as 6 g/day.

Gut Microbiota Profile and Its Association with Clinical Variables and Dietary Intake in Overweight/Obese and Lean Subjects: A Cross-Sectional Study

We aimed to differentiate gut microbiota composition of overweight/obese and lean subjects and to determine its association with clinical variables and dietary intake. A cross-sectional study was performed with 96 overweight/obese subjects and 32 lean subjects. Anthropometric parameters were positively associated with Collinsella aerofaciens, Dorea formicigenerans and Dorea longicatena, which had higher abundance the overweight/obese subjects. Moreover, different genera of Lachnospiraceae were negatively associated with body fat, LDL and total cholesterol. Saturated fatty acids (SFAs) were negatively associated with the genus Intestinimonas, a biomarker of the overweight/obese group, whereas SFAs were positively associated with Roseburia, a biomarker for the lean group. In conclusion, Dorea formicigenerans, Dorea longicatena and Collinsella aerofaciens could be considered obesity biomarkers, Lachnospiraceae is associated with lipid cardiovascular risk factors. SFAs exhibited opposite association profiles with butyrate-producing bacteria depending on the BMI. Thus, the relationship between diet and microbiota opens new tools for the management of obesity.

Status and trends in consumption of grains and dietary fiber among Chinese adults (1982-2015)

The objectives of this review were to investigate the status and characteristics of national grain consumption and dietary fiber intake among Chinese adults (aged ≥20 years) and to examine trends in consumption from 1982 to 2015. Data from 5 national surveys that collected dietary information using a household food weighing method and 24-hour dietary recall over 3 consecutive days were analyzed. In 2015, mean grain consumption was 281.1 g/per capita/d (rice 145.6 g, wheat flour 120.7 g, other grains 14.8 g). Total dietary fiber intake was 9.7 g/per capita/d, of which 3.8 g/per capita/d came from grains and accounted for nearly 40% of total dietary fiber intake for adults. The other major sources of dietary fiber were vegetables and fruits. The data indicates consumption of grains and dietary fiber in the Chinese population has been continuously declining since 1982 and the consumption of refined grains has increased. In order for the Chinese population to meet dietary recommendations for whole grain and dietary fiber intake, increasing the availability of more appealing whole grain products and public education are recommended.

Associations between normal weight central obesity and cardiovascular disease risk factors in Japanese middle-aged adults: a cross-sectional study

BACKGROUND

Several studies have shown that normal weight central obesity (NWCO) is associated with cardiovascular disease (CVD) risk factors. However, studies conducted in the Japanese population have been very limited. Thus, the relationships between normal weight central obesity, classified using body mass index (BMI), the waist-to-height ratio (WHtR), and CVD risk factors in middle-aged Japanese adults were investigated.

METHODS

The participants were Japanese adults aged 40-64 years who had undergone periodic health examinations in Japan during the period from April 2013 to March 2014. The participants were categorized into the following four groups: normal weight (BMI 18.5-24.9 kg/m²) and no central obesity (WHtR < 0.5) (NW); normal weight and central obesity (WHtR ≥ 0.5) (NWCO); obesity (BMI ≥ 25 kg/m²) and no central obesity (OB); and obesity and central obesity (OBCO). Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or taking medication for hypertension. Dyslipidemia was defined as LDL-C ≥ 140 mg/dl, HDL-C < 40 mg/dl, triglyceride ≥ 150 mg/dl, or taking medication for dyslipidemia. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dl, random plasma glucose ≥ 200 mg/dl, HbA1c ≥ 6.5%, or receiving medical treatment for diabetes mellitus. A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension, dyslipidemia, and diabetes.

RESULTS

A total of 117,163 participants (82,487 men and 34,676 women) were analyzed. The prevalence of NWCO was 15.6% in men and 30.2% in women. With reference to NW, the ORs for hypertension (adjusted OR 1.22, 95% CI 1.17-1.27 in men, 1.23, 1.16-1.31 in women), dyslipidemia (1.81, 1.74-1.89 in men, 1.60, 1.52-1.69 in women), and diabetes (1.35, 1.25-1.46 in men, 1.60, 1.35-1.90 in women) were significantly higher in NWCO.

CONCLUSIONS

Normal weight with central obesity was associated with CVD risk factors, such as hypertension, dyslipidemia, and diabetes, compared with normal weight without central obesity, regardless of sex. It is important to focus on normal weight with central obesity for the prevention of CVD in Japanese middle-aged adults.

Dietary patterns associated with obesity and overweight: When should misreporters be included in analysis?

OBJECTIVE

The aim of the study was to identify dietary patterns associated with overweight and obesity and to examine the effect of including and excluding misreporters on the analysis of these dietary patterns and on the associations between identified dietary patterns and anthropometric parameters.

METHODS

The study was carried out with adult participants in an observational case-control manner. The participants' diet was assessed using 3-d dietary records. To identify misreporters, the Goldberg and Black cutoff method was used. Dietary patterns were evaluated using factor analysis and dietary indices.

RESULTS

Among 410 participants, 100 were underreporters and 1 was an overreporter. The nutritional value of the diets and the relative intake of several groups of food products differed between those with normal and increased body weight. Excluding misreporters affected the differences between body weight groups in energy; dietary fiber; empty calories; cholesterol; sodium; magnesium; folate; vitamins C, PP, and A; groats; vegetables; coffee; and water intake. The Western diet (WD) factor correlated positively with the waist circumference and the amount of fat tissue, whereas the healthy diet (HD) factor correlated negatively with body weight, waist circumference, and the fat tissue amount. The coefficients of the correlation between the HD factor and the anthropometric parameters were stronger when misreporters were excluded, whereas those between the WD factor and the parameters did not change much after exclusion of misreporters.

CONCLUSIONS

There is a positive relationship between the WD pattern and obesity. The exclusion of misreporters from the data set may positively affect the association between the HD pattern and anthropometric parameters.

Intakes and Food Sources of Dietary Fibre and Their Associations with Measures of Body Composition and Inflammation in UK Adults: Cross-Sectional Analysis of the Airwave Health Monitoring Study

The purpose of this study was to investigate the associations between intakes of fibre from the main food sources of fibre in the UK diet with body mass index (BMI), percentage body fat (%BF), waist circumference (WC) and C-reactive protein (CRP). Participants enrolled in the Airwave Health Monitoring Study (2007-2012) with 7-day food records (n = 6898; 61% men) were included for cross-sectional analyses. General linear models evaluated associations across fifths of fibre intakes (total, vegetable, fruit, potato, whole grain and non-whole grain cereal) with BMI, %BF, WC and CRP. Fully adjusted analyses showed inverse linear trends across fifths of total fibre and fibre from fruit with all outcome measures (ptrend < 0.0001). Vegetable fibre intake showed an inverse association with WC (ptrend 0.0156) and CRP (ptrend 0.0005). Fibre from whole grain sources showed an inverse association with BMI (ptrend 0.0002), %BF (ptrend 0.0007) and WC (ptrend 0.0004). Non-whole grain cereal fibre showed an inverse association with BMI (Ptrend 0.0095). Direct associations observed between potato fibre intake and measures of body composition and inflammation were attenuated in fully adjusted analyses controlling for fried potato intake. Higher fibre intake has a beneficial association on body composition, however, there are differential associations based on the food source.

Construction of Wood-Based Lamella for Increased Load on Seating Furniture

The research on population shows that the count of overweight people has been constantly growing. Therefore, designing and modifying utility items, e.g., furniture should be brought into focus. Indeed, furniture function and safety is associated with the weight of a user. Current processes and standards dealing with the design of seating furniture do not meet the requirements of overweight users. The research is aimed at designing flexible chairs consisting of lamellae using the finite element method (FEM). Three types of glued lamellae based on wood with different number of layers and thickness were made and subsequently, their mechanical properties were tested. Values for modulus of elasticity and modulus of rupture were used to determine stress and deformation applying the FEM method for modelling flexible chairs. In this research, the methodology for evaluating the ultimate state of flexible chairs used to analyse deformation and stability was defined. The analysis confirms that several designed constructions meet the requirements of actual standards (valid for the weight of a user up to 110 kg) but fail to meet the requirements for weight gain of a population.

Analysis to Improve the Strength of Beds Due to the Excess Weight of Users in Slovakia

Good quality sleep is a prerequisite for regenerating the human body, hence, beds should be optimized for specific group of users, taking into consideration their size or age. Current research studies show similar trends in adult populations around the world, where increases in height as well as in weight can be observed. Not only the ergonomics but also the safety of beds, which is determined by the quality and dimensions of structural elements, must be taken into account in bed design. Designing the structural elements for users with a high body weight is presented in the paper. The properties of a bed’s structural elements, which ensure comfort as well as the safety of a bed are affected by the excess weight of users. New requirements for cross sections, suitable materials and construction of structural elements were set in accordance with the standard EN 1725:1998 [1]. Also, an analysis of stresses was done using the finite element method (FEM) and the calculation of allowable stresses related to a user weighing 150 kg. The results of our research provide complete standards and regulations associated with the safety requirements of bedroom furniture for users with a weight more than 110 kg to ensure that the manusfacture of quality products in Slovakia.

Research partnerships between Coca-Cola and health organizations in Spain

Background

The reduction of soda intake in the population remains an important goal to improve population health. Concerns exist about how industry-sponsored studies in nutrition tend to favour the interest of the sponsor. We describe the scope of partnerships between Coca-Cola and health organizations in Spain, examining marketing strategies contained in scientific papers funded by Coca-Cola.

Methods

Funding for health organizations in Spain during 2010–2016 was retrieved of the Coca-Cola transparency list. We systematically searched research projects and publications (by PubMed) of all the recipient organizations. In addition, we characterize the research agenda and the level of alignment of sponsored authors with marketing strategies used by Coca-Cola.

Results

A total of 74 health organizations received funding from Coca-Cola between 2010 and 2016. Nutritional and cardiology organizations received the highest financial support. A total of 20 articles derived of two research projects were identified. Most publications (14 out of 20) were aligned with marketing strategies used by Coca-Cola (e.g. focusing on physical inactivity as the main cause of obesity). Authors identified did not disclose having previous conflicts of interest.

Conclusion

In Spain, numerous health organizations receive financial support from Coca-Cola. We provide evidence that research funded by this beverage company is serving its commercial objectives that, in many cases, are at odds with efforts to improve population health. Problems with transparency among authors and the recipient organizations imply that we are offering very conservative estimates about the impact of this company on public health.

Dietary Fibre Intake in Australia. Paper I: Associations with Demographic, Socio-Economic, and Anthropometric Factors

Dietary fibre is important for regular laxation and reduces chronic disease risk. The National Health and Medical Research Council outlines daily fibre intake targets, yet the proportion of the population that meets these targets is unknown. Using the 2011⁻2012 National Nutrition and Physical Activity Survey, we profiled fibre intake among Australian children and adults. Data from one-day dietary recalls were analysed (n = 12,153, ≥2 years) as well as demographic and anthropometric factors. The median fibre intake was 18.2 g (interquartile range [IQR] 13.2⁻25.0) in children and 20.7 g (IQR 14.3⁻28.7) in adults. We found that 42.3% (95% CI 40.5⁻44.1%) of children and 28.2% (95% CI 27.3⁻29.1%) of adults met the Adequate Intake (AI), and less than 20% of adults met the Suggested Dietary Target (SDT) to reduce the risk of chronic disease. Older children (aged 14⁻18 years), girls, young adults (19⁻30 years), males, and those of lower socio-economic status were less likely to meet the AI (p < 0.001). Those with a higher energy intake were more likely to meet the AI. Anthropometric measures were not associated with fibre intake or the likelihood of meeting the AI. Fibre is a nutrient of concern in Australian diets, with most children and adults falling short of recommendations. Adolescents, girls, young adults, men, and those of lower socio-economic status were less likely to meet the recommendations and may benefit most from public health interventions.

Targeting Aging with Functional Food: Pasta with Opuntia Single-Arm Pilot Study

Interventions to extend life span represent the new perspective in aging investigation. Healthy dietary habits are important modifiable factors that can favor a healthy aging phenotype. Many studies have demonstrated benefits for metabolic syndrome and type 2 diabetes mellitus resulting from the traditional Mediterranean foods. Opuntia Ficus Indica (OFI), widespread in the Mediterranean basin, belongs to the Cactaceae family. It is known for its antioxidant and anti-inflammatory properties. Moreover, products containing extracts from OFI fruits or cladodes have been used to control obesity and other metabolic parameters, such as glycemia and lipid profile. The aim of this study was to analyze the antioxidant and anti-inflammatory effect of pasta with 3% of OFI cladode extracts added to show its beneficial effect in human health. We performed a single arm longitudinal intervention study in 42 healthy volunteers, administrating 500 g/week of this functional pasta for 30 days. Our pasta had antioxidant and anti-inflammatory properties with putative effect on the aging process and related metabolic diseases. We also demonstrated a hypoglycemic effect. The results are preliminary, but it is possible to speculate that our pasta could be considered an effective food for the prevention of age-related metabolic disorders.

Fiber Patterns in Young Adults Living in Different Environments (USA, Spain, and Tunisia). Anthropometric and Lifestyle Characteristics

Benefits of dietary fiber go beyond its effect on chronic diseases associated with development. Consequently, the pattern of fiber intake has been considered an indicator for diet quality. Young adults are especially vulnerable to a food environment that drives an increase in chronic diseases linked to economic development. The aim of this work was to characterize patterns of fiber intake among university students. A cross-sectional study was conducted on a sample of 730 students enrolled at the University of Castilla-La Mancha (Spain), the University of Carthage (Tunisia), and Florida International University (USA). Mean age was 21.2. Food consumption was self-reported in two 24-h recalls. Mean dietary fiber intake was 17.8 g, not reaching the adequate intake. Contrary to expectations, American participants were the highest consumers (p < 0.001), and also exhibited the highest BMI. Cereals, legumes, vegetables and fruit were the main food sources of fiber. Fiber from appetizers, prepared and precooked meals, sauces, spices and condiments accounted for 16.7% in American participants, 7.4% in Spanish participants and 2.6% in Tunisian participants. Total fiber intake increased with energy intake but did not depend on smoking habits and physical activity in any country. It is essential to improve consumers’ interpretation of guidelines on fiber intake.