Cholesterol-lowering effects of dietary fiber: a meta-analysis

Vision for Transformation Strengths: The SHSIP describes a holistic transformation plan and ensures connections between various plan components. The State’s Plan seeks to reward health care providers for better care, smarter spending, and healthier people through higher quality, instead of quantity of services by utilizing valuebased purchasing across public and private payers. The SHSIP provides a well-detailed description of the proposed value-based models of care through the Patient-Centered Medical Home (PCMH) model, resulting in the statewide implementation of Accountable Health Communities (AHCs). The SHSIP outlines a long-term vision of building and expanding the PCMH model into a Community Centered Health Homes (CCHHs) model, which will focus on prevention and collaboration with other communitybased organizations. Another strength identified is the amount of existing PCMHs operating within the State. The SHSIP provides a course of action to assist non-PCMH practices to become nationally certified, as well as, goals for a single, statewide PCMH model to be used by all providers and payers within the state. The implementation of the AHCs will be key in addressing social determinants of health within various communities and seems to align well with the PCMH goals. This focus on population and community health will enable the State to make a broader impact and support the long-term goal of moving towards a CCHH model. The focus on the improvement of clinical, behavioral, and oral health care within the urban, rural, and frontier communities is well aligned and consistent with the SIM goals and the overall Triple Aim initiative. Figure 18: Driver Diagram clearly shows how the State plans to achieve the Triple Aim by 2020.

Department of health & human services

Dietary fibres are believed to reduce subjective appetite, energy intake and body weight. However, different types of dietary fibre may affect these outcomes differently. The aim of this review was to systematically investigate the available literature on the relationship between dietary fibre types, appetite, acute and long-term energy intake, and body weight. Fibres were grouped according to chemical structure and physicochemical properties (viscosity, solubility and fermentability). Effect rates were calculated as the proportion of all fibre-control comparisons that reduced appetite (n = 58 comparisons), acute energy intake (n = 26), long-term energy intake (n = 38) or body weight (n = 66). For appetite, acute energy intake, long-term energy intake and body weight, there were clear differences in effect rates depending on chemical structure. Interestingly, fibres characterized as being more viscous (e.g. pectins, β-glucans and guar gum) reduced appetite more often than those less viscous fibres (59% vs. 14%), which also applied to acute energy intake (69% vs. 30%). Overall, effects on energy intake and body weight were relatively small, and distinct dose-response relationships were not observed. Short- and long-term effects of dietary fibres appear to differ and multiple mechanisms relating to their different physicochemical properties seem to interplay. This warrants further exploration.

Effects of dietary fibre on subjective appetite, energy intake and body weight: a systematic review of randomized controlled trials.

Although fiber has been increasingly recognized as an important dietary constituent, controversy and confusion still exist about the physiologic effects of fiber. Specifically, the independent ability of dietary fiber to lower serum lipid levels is controversial. The purpose of this article is to review available evidence regarding the impact of soluble fibers on serum lipid levels. Soluble fibers appear to have a greater potential to alter serum lipid levels than do insoluble fibers. Significant reduction in the level of serum total cholesterol by soluble fiber was found in 68 of the 77 (88%) human studies reviewed. Of the studies measuring low-density lipoprotein cholesterol, 41 of 49 (84%) reported significant reductions. No significant changes were reported in 43 of the 57 (75%) studies that reported high-density lipoprotein cholesterol and/or in 50 of the 58 (86%) studies that measured triglyceride levels.

Soluble fiber and serum lipids: A literature review

Facteurs de risques d'atherosclerose (lipides, alimentation, hypertension entre autres). Pathologie: mecanismes proposes de la pathologie de l'atherosclerose. Effets des fibres alimentaires sur les facteurs de risques. Revue des fibres alimentaires: gommes, pectine, fibres de cereales, de fruits, de legumineuse. Mecanismes d'actions des fibres. Applications therapeutiques. Revue bibliographique

G Y Khan

Papers

Effect of guar gum on blood lipids.