Sources of Dietary Fiber and the Association of Fiber Intake with Childhood Obesity Risk (in 2–18 Year Olds) and Diabetes Risk of Adolescents 12–18 Year Olds: NHANES 2003–2006
23 Aug 2012-Journal of Nutrition and Metabolism (Hindawi Publishing Corporation)-Vol. 2012, pp 736258-736258
TL;DR: Results indicate a beneficial effect of higher fiber density in children's diets, which are predominantly foods that are low in dietary fiber, but are consumed at high levels.
Abstract: Increased fiber intake has been linked with lower risk of overweight and obesity in adults, but data are sparse for children. To address this issue, NHANES 2003–2006 data was used to evaluate (1) the food sources of fiber in children, (2) the dietary fiber density levels and risk of being classified as overweight/obese, and (3) the association between fiber intake level and impaired glucose metabolism in children. Analyses were restricted to the subsample of children with biological plausible diet reports (𝑁=4,667) and stratified by 2–11 year olds (𝑛=2072) and 12–18 year olds (𝑛=2595). Results showed that the food sources are predominantly foods that are low in dietary fiber, but are consumed at high levels. In 2–18 year old plausible reporters, the risk for overweight/obesity decreased by 17% from children in the medium tertile of fiber density intake compared to the lowest tertile (OR=0.83, P value = 0.043) and by 21% between the highest compared to the lowest tertile (OR=0.79, P value = 0.031). There was a protective effect of being in the medium tertile of dietary fiber density (OR=0.68, P value <0.001) on impaired glucose metabolism. These results indicate a beneficial effect of higher fiber density in children’s diets.
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01 Feb 2014
TL;DR: The balance of evidence indicates that dietary patterns that are high in energy-dense, high-fat and low-fibre foods predispose young people to later overweight and obesity, and highlights that examining multiple dietary factors within a dietary pattern may better explain obesity risk than individual nutrients or foods.
Abstract: A range of individual nutrients and foods have been suggested to increase obesity risk in childhood, but the evidence is inconsistent. Dietary patterns that summarise the whole diet may, however, be more informative. The aim of the present paper was to systematically review the current evidence pertaining to overall dietary patterns in childhood and later obesity risk. Studies eligible for review identified childhood dietary patterns using an empirical method, i.e. principal components analysis, factor analysis or reduced rank regression, and reported their prospective associations with an obesity-related outcome. Literature searches identified 166 studies and of these, seven met the eligibility criteria. Despite differences between studies, a common dietary pattern was identified in all seven studies that was high in energy-dense, high-fat and low-fibre foods. The quality of studies varied, however; the four studies reporting positive associations between this type of dietary pattern and later obesity risk were of consistently higher quality than those reporting null associations. The balance of evidence from this systematic review indicates that dietary patterns that are high in energy-dense, high-fat and low-fibre foods predispose young people to later overweight and obesity. It also highlights that examining multiple dietary factors within a dietary pattern may better explain obesity risk than individual nutrients or foods. However, more prospective studies are needed and dietary pattern research requires greater rigour and focus, to further clarify the role of dietary factors in the aetiology of obesity and inform future interventions.
153 citations
Cites background from "Sources of Dietary Fiber and the As..."
...A range of specific nutrients and foods have been suggested as important dietary determinants of obesity in childhood and adolescence, including but not limited to, fruit and vegetables((1)), fibre((2)), fat((3)), fast food((4)) and sugary drinks((5))....
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...Another review recently concluded that energy-dense diets((35)) are a risk factor for obesity in children, but there is less evidence specifically for dietary fibre((2)) and dietary fat((3))....
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TL;DR: Tooth loss in adults is associated with lower diet quality and reduced intake of most nutrients; this may partly explain for the higher risk of chronic diseases in this population.
104 citations
Cites methods from "Sources of Dietary Fiber and the As..."
...For ratio of family income to poverty, it was recoded to a three-level categorical variable.(54) Because previous studies found physical activity(55) and smoking were associated with tooth loss, they were included as covariates in the present study....
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TL;DR: A narrative review of many natural polysaccharides extracted from various food resources which mainly contribute their health beneficial functions via intestinal fermentation are given.
Abstract: With the rapid development of modern society, many chronic diseases are increasing including diabetes, obesity, cardiovascular diseases, etc., which further cause an increased death rate worldwide. A high caloric diet with reduced natural polysaccharides, typically indigestible polysaccharides, is considered a health risk factor. With solid evidence accumulating that indigestible polysaccharides can effectively prevent and/or ameliorate symptoms of many chronic diseases, we give a narrative review of many natural polysaccharides extracted from various food resources which mainly contribute their health beneficial functions via intestinal fermentation.
103 citations
TL;DR: The roundtable discussions highlighted the need for both consumer and professional education to improve acceptance for and inclusion of grain-based foods with added fiber as one strategy for increasing fiber intakes within daily energy goals.
Abstract: Current fiber intakes are alarmingly low, with long-term implications for public health related to risk of coronary heart disease, stroke, hypertension, certain gastrointestinal disorders, obesity, and the continuum of metabolic dysfunctions including prediabetes and type 2 diabetes. Eating patterns high in certain fibers are known to lower LDL cholesterol and blood pressure, lower blood glucose, and decrease insulin resistance in people with prediabetes and type 2 diabetes; help with both weight loss and maintenance; and improve bowel regularity and gastrointestinal health. With >90% of adults and children who fall short of meeting their daily fiber recommendations, the 2010 Dietary Guidelines for Americans once again classified fiber as a nutrient of concern. Despite efforts over the past decade to promote adequate fiber through fruit, vegetable, and whole-grain intakes, fiber consumption has remained flat at approximately half the daily recommended amount. The public health implications of inadequate fiber intake prompted the roundtable session "Filling America's Fiber Gap: Probing Realistic Solutions," which assembled nutrition researchers, educators, and communicators to identify challenges, opportunities, and realistic solutions to help fill the current fiber gap. The roundtable discussions highlighted the need for both consumer and professional education to improve acceptance for and inclusion of grain-based foods with added fiber as one strategy for increasing fiber intakes within daily energy goals.
99 citations
TL;DR: Hematic steatosis is associated with a greater intake of fat and fried foods, whereas visceral obesity is associatedWith increased consumption of sugar and reduced consumption of fiber in overweight and obese adolescents at risk of type 2 diabetes.
77 citations
Cites background from "Sources of Dietary Fiber and the As..."
...Regular fiber intake is associated with an array of health benefits including reduced risk of obesity (47)....
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References
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TL;DR: These estimates suggest that the increases in body weight are continuing in men and in children and adolescents while they may be leveling off in women; among women, no overall increases in the prevalence of obesity were observed.
Abstract: ContextThe prevalence of overweight in children and adolescents and obesity in adults in the United States has increased over several decades.ObjectiveTo provide current estimates of the prevalence and trends of overweight in children and adolescents and obesity in adults.Design, Setting, and ParticipantsAnalysis of height and weight measurements from 3958 children and adolescents aged 2 to 19 years and 4431 adults aged 20 years or older obtained in 2003-2004 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Data from the NHANES obtained in 1999-2000 and in 2001-2002 were compared with data from 2003-2004.Main Outcome MeasuresEstimates of the prevalence of overweight in children and adolescents and obesity in adults. Overweight among children and adolescents was defined as at or above the 95th percentile of the sex-specific body mass index (BMI) for age growth charts. Obesity among adults was defined as a BMI of 30 or higher; extreme obesity was defined as a BMI of 40 or higher.ResultsIn 2003-2004, 17.1% of US children and adolescents were overweight and 32.2% of adults were obese. Tests for trend were significant for male and female children and adolescents, indicating an increase in the prevalence of overweight in female children and adolescents from 13.8% in 1999-2000 to 16.0% in 2003-2004 and an increase in the prevalence of overweight in male children and adolescents from 14.0% to 18.2%. Among men, the prevalence of obesity increased significantly between 1999-2000 (27.5%) and 2003-2004 (31.1%). Among women, no significant increase in obesity was observed between 1999-2000 (33.4%) and 2003-2004 (33.2%). The prevalence of extreme obesity (body mass index ≥40) in 2003-2004 was 2.8% in men and 6.9% in women. In 2003-2004, significant differences in obesity prevalence remained by race/ethnicity and by age. Approximately 30% of non-Hispanic white adults were obese as were 45.0% of non-Hispanic black adults and 36.8% of Mexican Americans. Among adults aged 20 to 39 years, 28.5% were obese while 36.8% of adults aged 40 to 59 years and 31.0% of those aged 60 years or older were obese in 2003-2004.ConclusionsThe prevalence of overweight among children and adolescents and obesity among men increased significantly during the 6-year period from 1999 to 2004; among women, no overall increases in the prevalence of obesity were observed. These estimates were based on a 6-year period and suggest that the increases in body weight are continuing in men and in children and adolescents while they may be leveling off in women.
9,278 citations
"Sources of Dietary Fiber and the As..." refers result in this paper
...Rates of overweight and obesity in this sample are consistent with previous research [16]....
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TL;DR: Dietary fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids.
Abstract: Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements.
1,778 citations
"Sources of Dietary Fiber and the As..." refers background in this paper
...Considerable evidence supports that increasing consumption of dietary fiber is associated with lower risk of obesity in adults [1]....
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TL;DR: A high intake of dietary fiber, particularly of the soluble type, above the level recommended by the ADA, improves glycemic control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients with type 2 diabetes.
Abstract: Background The effect of increasing the intake of dietary fiber on glycemic control in patients with type 2 diabetes mellitus is controversial. Methods In a randomized, crossover study, we assigned 13 patients with type 2 diabetes mellitus to follow two diets, each for six weeks: a diet containing moderate amounts of fiber (total, 24 g; 8 g of soluble fiber and 16 g of insoluble fiber), as recommended by the American Diabetes Association (ADA), and a highfiber diet (total, 50 g; 25 g of soluble fiber and 25 g of insoluble fiber) containing foods not fortified with fiber (unfortified foods). Both diets, prepared in a research kitchen, had the same macronutrient and energy content. We compared the effects of the two diets on glycemic control and plasma lipid concentrations. Results Compliance with the diets was excellent. During the sixth week of the high-fiber diet, as compared with the sixth week of the ADA diet, mean daily preprandial plasma glucose concentrations were 13 mg per deciliter (0.7 mmol per liter) lower (95 percent confidence interval, 1 to 24 mg per deciliter [0.1 to 1.3 mmol per liter]; P=0.04) and mean daily urinary glucose excretion was 1.3 g lower (median difference, 0.23 g; 95 percent confidence interval, 0.03 to 1.83; P=0.008). The high-fiber diet also lowered the area under the curve for 24-hour plasma glucose and insulin concentrations, which were measured every two hours, by 10 percent (P=0.02) and 12 percent (P=0.05), respectively. The high-fiber diet reduced plasma total cholesterol concentrations by 6.7 percent (P=0.02), triglyceride concentrations by 10.2 percent (P=0.02), and very-low-density lipoprotein cholesterol concentrations by 12.5 percent (P=0.01). Conclusions A high intake of dietary fiber, particularly of the soluble type, above the level recommended by the ADA, improves glycemic control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients with type 2 diabetes. (N Engl J
1,046 citations
"Sources of Dietary Fiber and the As..." refers methods in this paper
...preprandial plasma glucose and area under the curve for 24hour plasma glucose compared to those who consumed a diet with 25 g of fiber that was identical in macronutrient and energy content [29]....
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TL;DR: Efforts to increase dietary fiber in individuals consuming <25 g/day may help to decrease the currently high national prevalence of obesity.
Abstract: The influence of dietary fiber on energy regulation remains controversial. This review summarizes published studies on the effects of dietary fiber on hunger, satiety, energy intake, and body composition in healthy individuals. Under conditions of fixed energy intake, the majority of studies indicate that an increase in either soluble or insoluble fiber intake increases postmeal satiety and decreases subsequent hunger. When energy intake is ad libitum, mean values for published studies indicate that consumption of an additional 14 g/day fiber for >2 days is associated with a 10% decrease in energy intake and body weight loss of 1.9 kg over 3.8 months. Furthermore, obese individuals may exhibit a greater suppression of energy intake and body weight loss (mean energy intake in all studies was reduced to 82% by higher fiber intake in overweight/obese people versus 94% in lean people; body weight loss was 2.4 kg versus 0.8 kg). These amounts are very similar to the mean changes in energy intake and body weight changes observed when dietary fat content is lowered from 38% to 24% of energy intake in controlled studies of nonobese and obese subjects. The observed changes in energy intake and body weight occur both when the fiber is from naturally high-fiber foods and when it is from a fiber supplement. In view of the fact that mean dietary fiber intake in the United States is currently only 15 g/day (i.e., approximately half the American Heart Association recommendation of 25-30 g/day), efforts to increase dietary fiber in individuals consuming <25 g/day may help to decrease the currently high national prevalence of obesity.
1,001 citations
"Sources of Dietary Fiber and the As..." refers background in this paper
...Postprandial glucose levels and increased insulin sensitivity are associated with the increased viscosity of soluble fiber intake which has been associated with delayed gastric emptying, altering of gastrointestinal myoelectrical activity, decreased glucose diffusion through the water layer, and decreased accessibility of substrates to α-amylase—thus increasing satiety [23, 24]....
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...One possible venue for the beneficial effect of fiber on weight status could be the increase in satiety [23]....
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TL;DR: The average fiber intake of adults in the United States is less than half recommended levels and is lower still among those who follow currently popular low-carbohydrate diets, such as Atkins and South Beach.
876 citations
"Sources of Dietary Fiber and the As..." refers background in this paper
...A recent review of the literature suggested a number of mechanisms by which dietary fiber intake might help downregulate body weight in adults [17]....
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