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7 Dietary, Functional, and Total Fiber SUMMARY Dietary Fiber consists of nondigestible carbohydrates and lignin that are intrinsic and intact in plants. Functional Fiber consists of isolated, nondigestible carbohydrates that have beneficial physiological effects in humans. Total Fiber is the sum of Dietary Fiber and Functional Fiber. Fibers have different properties that result in different physiological effects. For example, viscous fibers may delay the gastric emptying of ingested foods into the small intestine, result- ing in a sensation of fullness, which may contribute to weight con- trol. Delayed gastric emptying may also reduce postprandial blood glucose concentrations and potentially have a beneficial effect on insulin sensitivity. Viscous fibers can interfere with the absorption of dietary fat and cholesterol, as well as with the enterohepatic recirculation of cholesterol and bile acids, which may result in reduced blood cholesterol concentrations. Consumption of Dietary and certain Functional Fibers, particularly those that are poorly fermented, is known to improve fecal bulk and laxation and ameliorate constipation. The relationship of fiber intake to colon cancer is the subject of ongoing investigation and is currently unresolved. An Adequate Intake (AI) for Total Fiber in foods is set at 38 and 25 g/d for young men and women, respectively, based on the intake level observed to protect against coronary heart dis- ease. Median intakes of Dietary Fiber ranged from 16.5 to 17.9 g/d for men and 12.1 to 13.8 g/d for women (Appendix Table E-4). There was insufficient evidence to set a Tolerable Upper Intake Level (UL) for Dietary Fiber or Functional Fiber. 339

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340 DIETARY REFERENCE INTAKES BACKGROUND INFORMATION Overview Definitions of Fiber A variety of definitions of fiber exist worldwide (IOM, 2001). Some are based solely on one or more analytical methods for isolating fiber, while others are physiologically based. For instance, in the United States fiber is defined by a number of analytical methods that are accepted by the Asso- ciation of Official Analytical Chemists International (AOAC); these methods isolate nondigestible animal and plant carbohydrates. In Canada, how- ever, a formal definition has been in place that recognizes nondigestible food of plant origin—but not of animal origin—as fiber. As nutrition labeling becomes uniform throughout the world, it is recognized that a single definition of fiber may be needed. Furthermore, new products are being developed or isolated that behave like fiber, yet do not meet the traditional definitions of fiber, either analytically or physiologically. Without an accurate definition of fiber, compounds can be designed or isolated and concentrated using available methods without necessarily providing beneficial health effects, which most people consider to be an important attribute of fiber. Other compounds can be developed that are nondigestible and provide beneficial health effects, yet do not meet the current U.S. definition based on analytical methods. For these reasons, the Food and Nutrition Board, under the oversight of the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, assembled a Panel on the Definition of Dietary Fiber to develop a proposed definition of fiber (IOM, 2001). Based on the panel’s deliberations, consideration of public comments, and subsequent modifications, the following definitions have been developed: Dietary Fiber consists of nondigestible carbohydrates and lignin that are intrinsic and intact in plants. Functional Fiber consists of isolated, nondigestible carbohydrates that have beneficial physiological effects in humans. Total Fiber is the sum of Dietary Fiber and Functional Fiber. This two-pronged approach to define edible, nondigestible carbohydrates recognizes the diversity of carbohydrates in the human food supply that are not digested: plant cell wall and storage carbohydrates that predomi- nate in foods, carbohydrates contributed by animal foods, and isolated and low molecular weight carbohydrates that occur naturally or have been synthesized or otherwise manufactured. These definitions recognize a con- tinuum of carbohydrates and allow for flexibility to incorporate new fiber

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341 D IETARY, FUNCTIONAL, AND TOTAL FIBER sources developed in the future (after demonstration of beneficial physi- ological effects in humans). While it is not anticipated that the new defini- tions will significantly impact recommended levels of intake, information on both Dietary Fiber and Functional Fiber will more clearly delineate the source of fiber and the potential health benefits. Although sugars and sugar alcohols could potentially be categorized as Functional Fibers, for la- beling purposes they are not considered to be Functional Fibers because they fall under “sugars” and “sugar alcohols” on the food label. Distinguishing Features of Dietary Fiber Compared with Functional Fiber Dietary Fiber consists of nondigestible food plant carbohydrates and lignin in which the plant matrix is largely intact. Specific examples are provided in Table 7-1. Nondigestible means that the material is not digested and absorbed in the human small intestine. Nondigestible plant carbohydrates in foods are usually a mixture of polysaccharides that are integral components of the plant cell wall or intercellular structure. This definition recognizes that the three-dimensional plant matrix is respon- sible for some of the physicochemical properties attributed to Dietary Fiber. Fractions of plant foods are considered Dietary Fiber if the plant cells and their three-dimensional interrelationships remain largely intact. Thus, mechanical treatment would still result in intact fiber. Another distinguish- ing feature of Dietary Fiber sources is that they contain other macronutrients (e.g., digestible carbohydrate and protein) normally found in foods. For example, cereal brans, which are obtained by grinding, are anatomical layers of the grain consisting of intact cells and substantial amounts of starch and protein; they would be categorized as Dietary Fiber sources. TABLE 7-1 Characteristics of Dietary Fiber Characteristic Dietary Fiber Nondigestible animal carbohydrate No Carbohydrates not recovered by alcohol precipitationa Yes Nondigestible mono- and disaccharides and polyols No Lignin Yes Resistant starch Some Intact, naturally occurring food source only Yes Resistant to human enzymes Yes Specifies physiological effect No a Includes inulin, oligosaccharides (3–10 degrees of polymerization), fructans, poly- dextrose, methylcellulose, resistant maltodextrins, and other related compounds.

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342 DIETARY REFERENCE INTAKES Resistant starch that is naturally occurring and inherent in a food or created during normal processing of a food, as is the case for flaked corn cereal, would be categorized as Dietary Fiber. Examples of oligosaccharides that fall under the category of Dietary Fiber are those that are normally constituents of a Dietary Fiber source, such as raffinose, stachyose, and verbacose in legumes, and the low molecular weight fructans in foods, such as Jerusalem artichoke and onions. Functional Fiber consists of isolated or extracted nondigestible carbo- hydrates that have beneficial physiological effects in humans. Functional Fibers may be isolated or extracted using chemical, enzymatic, or aqueous steps. Synthetically manufactured or naturally occurring isolated oligosaccharides and manufactured resistant starch are included in this definition. Also included are those naturally occurring polysaccharides or oligosaccharides usually extracted from their plant source that have been modified (e.g., to a shorter polymer length or to a different molecular arrangement). Although they have been inadequately studied, animal-derived carbohy- drates such as connective tissue are generally regarded as nondigestible. The fact that animal-derived carbohydrates are not of plant origin forms the basis for including animal-derived, nondigestible carbohydrates in the Functional Fiber category. Isolated, manufactured, or synthetic oligosaccharides of three or more degrees of polymerization are considered to be Functional Fiber. Nondigestible monosaccharides, disaccharides, and sugar alcohols are not considered to be Functional Fibers because they fall under “sugars” or “sugar alcohols” on the food label. Also, rapidly changing lumenal fluid bal- ance resulting from large amounts of nondigestible mono- and disaccharides or low molecular weight oligosaccharides, such as that which occurs when sugar alcohols are consumed, is not considered a mechanism of laxation for Functional Fibers. Rationale for Definitions Nondigestible carbohydrates are frequently isolated to concentrate a desirable attribute of the mixture from which it was extracted. Distinguish- ing a category of Functional Fiber allows for the desirable characteristics of such components to be highlighted. In the relatively near future, plant and animal synthetic enzymes may be produced as recombinant proteins, which in turn may be used in the manufacture of fiber-like materials. The definition will allow for the inclusion of these materials and will provide a viable avenue to synthesize specific oligosaccharides and polysaccharides that are part of plant and animal tissues. In summary, one definition has been proposed for Dietary Fiber because many other substances in high fiber foods, including a variety of vitamins and minerals, often have made it difficult to demonstrate a significant

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343 D IETARY, FUNCTIONAL, AND TOTAL FIBER health benefit specifically attributable to the fiber in foods. Thus, it is difficult to separate out the effect of fiber per se from the high fiber food. Attempts have been made to do this, particularly in epidemiological studies, by controlling for other substances in those foods, but these attempts were not always successful. The advantage, then, of adding isolated non- digestible carbohydrates as a fiber source to a food is that one may be able to draw conclusions about Functional Fiber itself with regard to its physi- ological role rather than that of the vehicle in which it is found. The proposed definitions do not preclude research directed towards the health benefits of Dietary Fiber in foods, but it is not necessary to demonstrate a physiological effect in order for a food fiber to be listed as Dietary Fiber. An important aspect of the recommended definitions is that a sub- stance is required to demonstrate a beneficial physiological effect to be classified as Functional Fiber. Research has shown that extraction or isola- tion of a polysaccharide, usually through chemical, enzymatic, or aqueous means, can either enhance its health benefit (usually because it is a more concentrated source) or diminish the beneficial effect. These recommen- dations should be helpful in evaluating diet and disease relationship studies as it will be possible to classify fiber-like components as Functional Fibers due to their documented health benefits. Although databases are not cur- rently constructed to delineate potential beneficial effects of specific fibers, there is no reason that this could not be accomplished in the future. Examples of Dietary and Functional Fibers As described in the report, Dietary Reference Intakes: Proposed Definition of Dietary Fiber (IOM, 2001), Dietary Fiber includes plant nonstarch poly- saccharides (e.g., cellulose, pectin, gums, hemicellulose, β-glucans, and fibers contained in oat and wheat bran), plant carbohydrates that are not recovered by alcohol precipitation (e.g., inulin, oligosaccharides, and fructans), lignin, and some resistant starch. Potential Functional Fibers for food labeling include isolated, nondigestible plant (e.g., resistant starch, pectin, and gums), animal (e.g., chitin and chitosan), or commercially produced (e.g., resistant starch, polydextrose, inulin, and indigestible dextrins) carbohydrates. How the Definitions Affect the Interpretation of This Report The reason that a definition of fiber is so important is that what is or is not considered to be dietary fiber in, for example, a major epidemiological study on fiber and heart disease or fiber and colon cancer, could deter- mine the results and interpretation of that study. In turn, that would affect recommendations regarding fiber intake. Clearly, the definitions described

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344 DIETARY REFERENCE INTAKES above were developed after the studies cited in this report, which form the basis for fiber intake recommendations. However, that should not detract from the relevance of the recommendations, as the database used to mea- sure fiber for these studies will be noted. For example, most epidemiological studies use the U.S. Department of Agriculture (USDA) database for fiber, along with other databases and data added by the investigators for missing values (Hallfrisch et al., 1988; Heilbrun et al., 1989; Miller et al., 1983; Platz et al., 1997). Such a database represents Dietary Fiber, since Functional Fibers that serve as food ingredients contribute a minor amount to the Total Fiber content of foods. In 1987, the U.S. Food and Drug Administration (FDA) adopted AOAC method 985.29 for regulatory purposes to identify fiber as a mixture of nonstarch poly- saccharides, lignin, and some resistant starch (FDA, 1987). Related methods that isolated the same components as AOAC method 985.29 were developed independently and accepted by AOAC and FDA in subsequent years. These methods exclude all oligosaccharides (3 to 9 degrees of poly- merization) from the definition and include all polysaccharides, lignin, and some of the resistant starch that is resistant to the enzymes (protease, amylase, and amyloglucosidase) used in the AOAC methods. It is these methods that are used to measure the fiber content of foods that is entered into the USDA database. Other epidemiological studies have assessed intake of specific high fiber foods, such as legumes, breakfast cereals, fruits, and vegetables (Hill, 1997; Thun et al., 1992). Intervention studies often use specific fiber supplements such as pectin, psyllium, and guar gum, which would, by the above definition, be considered Functional Fibers if their role in human health is documented. For the above reasons, the type of fiber (Dietary, Functional, or Total Fiber) used in the studies discussed later in this chapter is identified. Description of the Common Dietary and Functional Fibers Below is a description of the Dietary Fibers that are most abundant in foods and the Functional Fibers that are commonly added to foods or pro- vided as supplements. To be classified as a Functional Fiber for food labeling purposes, a certain level of information on the beneficial physiological effects in humans will be needed. For some of the known beneficial effects of Dietary and potential Functional Fibers, see “Physiological Effects of Iso- lated and Synthetic Fibers” and “Evidence Considered for Estimating the Requirement for Dietary Fiber and Functional Fiber.” Cellulose. Cellulose, a polysaccharide consisting of linear β-(1,4)−linked glucopyranoside units, is the main structural component of plant cell walls.

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345 D IETARY, FUNCTIONAL, AND TOTAL FIBER Humans lack digestive enzymes to cleave β-(1,4) linkages and thus cannot absorb glucose from cellulose. Powdered cellulose is a purified, mechani- cally disintegrated cellulose obtained as a pulp from wood or cotton and is added to food as an anticaking, thickening, and texturizing agent. Dietary cellulose can be classified as Dietary Fiber or Functional Fiber, depending on whether it is naturally occurring in food (Dietary Fiber) or added to foods (Functional Fiber). Chitin and Chitosan. Chitin is an amino-polysaccharide containing β-(1,4) linkages as is present in cellulose. Chitosan is the deacetylated product of chitin. Both chitin and chitosan are found in the exoskeletons of arthropods (e.g., crabs and lobsters) and in the cell walls of most fungi. Neither chitin nor chitosan is digested by mammalian digestive enzymes. Chitin and chitosan are primarily consumed as a supplement and poten- tially can be classified as Functional Fibers if sufficient data on physiological benefits in humans are documented. β-Glucans. β-glucans are homopolysaccharides of branched glucose resides. These β-linked D-glucopyranose polymers are constituents of fungi, algae, and higher plants (e.g., barley and oats). Naturally occurring β-glucans can be classified as Dietary Fibers, whereas added or isolated β-glucans are potential Functional Fibers. Gums. Gums consist of a diverse group of polysaccharides usually iso- lated from seeds and have a viscous feature. Guar gum is produced by the milling of the endosperm of the guar seed. The major polysaccharide in guar gum is galactomannan. Galactomannans are highly viscous and are therefore used as food ingredients for their thickening, gelling, and stabi- lizing properties. Gums in the diet can be classified as Dietary or Functional Fibers. Hemicelluloses. Hemicelluloses are a group of polysaccharides found in plant cell walls that surround cellulose. These polymers can be linear or branched and consist of glucose, arabinose, mannose, xylose, and galact- uronic acid. Dietary hemicelluoses are classified as Dietary Fibers. Inulin, Oligofructose, and Fructooligosaccharides. Inulin and oligofructose are naturally occurring in a variety of plants. Most of the commercially available inulin and oligofructose is either synthesized from sucrose or extracted and purified from chicory roots. Oligofructose is also formed by partial hydrolysis of inulin. Inulin is a polydisperse β-(2,1)-linked fructan with a glucose molecule at the end of each fructose chain. The chain length is usually 2 to 60 units, with an average degree of polymerization of

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346 DIETARY REFERENCE INTAKES ten. The β-(2,1) linkage is resistant to enzymatic digestion. Synthetic oligofructose contains β-(2,1) fructose chains with and without terminal glucose units. The chain ranges from two to eight monosaccharide residues. Synthetic fructooligosaccharides have the same chemical and structural composition as oligofructose, except that the degree of polymerization ranges from two to four. Because many current definitions of dietary fiber are based on methods involving ethanol precipitation, oligosaccharides and fructans that are endogenous in foods, but soluble in ethanol, are not analyzed as dietary fiber. Thus, the USDA database does not currently include these fiber sources. With respect to the definitions outlined in this chapter, the naturally occurring fructans that are found in plants, such as chicory, onions, and Jerusalem artichoke, would be classified as Dietary Fibers; the synthesized or extracted fructans could be classified as Func- tional Fibers when there are sufficient data to show positive physiological effects in humans. Lignin. Lignin is a highly branched polymer comprised of phenyl- propanoid units and is found within “woody” plant cell walls, covalently bound to fibrous polysaccharides (Dietary Fibers). Although not a carbo- hydrate, because of its association with Dietary Fiber, and because it affects the physiological effects of Dietary Fiber, lignin is classified as a Dietary Fiber if it is relatively intact in the plant. Lignin isolated and added to foods could be classified as Functional Fiber given sufficient data on positive physi- ological effects in humans. Pectins. Pectins, which are found in the cell wall and intracellular tissues of many fruits and berries, consist of galacturonic acid units with rhamnose interspersed in a linear chain. Pectins frequently have side chains of neutral sugars, and the galactose units may be esterified with a methyl group, a feature that allows for its viscosity. While fruits and veg- etables contain 5 to 10 percent naturally occurring pectin, pectins are industrially extracted from citrus peels and apple pomace. Isolated, high methoxylated pectins are mainly added to jams due to their gelling prop- erties with high amounts of sugar. Low methoxylated pectins are added to low-calorie gelled products, such as sugar-free jams and yogurts. Thus, pectins in the diet are classified as Dietary and/or Functional Fiber. Polydextrose. Polydextrose is a polysaccharide that is synthesized by random polymerization of glucose and sorbitol. Polydextrose serves as a bulking agent in foods and sometimes as a sugar substitute. Polydextrose is not digested or absorbed in the small intestine and is partially fermented in the large intestine, with the remaining excreted in the feces. Polydextrose

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347 D IETARY, FUNCTIONAL, AND TOTAL FIBER can potentially be classified as a Functional Fiber when sufficient data on physiological benefits in humans are documented. Psyllium. Psyllium refers to the husk of psyllium seeds and is a very viscous mucilage in aqueous solution. The psyllium seed, also known as plantago or flea seed, is small, dark, reddish-brown, odorless, and nearly tasteless. P. ovata, known as blond or Indian plantago seed, is the species from which husk is usually derived. P. ramosa is known as Spanish or French psyllium seed. Psyllium, also known as ispaghula husk, may be classified as a Functional Fiber. Resistant Dextrins. Indigestible components of starch hydrolysates, as a result of heat and enzymatic treatment, yield indigestible dextrins that are also called resistant maltodextrins. Unlike gums, which have a high viscosity that can lead to problems in food processing and unpleasant organoleptic properties, resistant maltodextrins are easily added to foods and have a good mouth feel. Resistant maltodextrins are produced by heat/acid treat- ment of cornstarch, followed by enzymatic (amylase) treatment. The average molecular weight of resistant maltodextrins is 2,000 daltons and consists of polymers of glucose containing α-(1-4) and α-(1-6) glucosidic bonds, as well as 1-2 and 1-3 linkages. Resistant dextrins can potentially be classified as Functional Fibers when sufficient data on physiological benefits in humans are documented. Resistant Starch. Resistant starch is naturally occurring, but can also be produced by the modification of starch during the processing of foods. Starch that is included in a plant cell wall and thus physically inaccessible to α-amylase is called RS1. Native starch that can be made accessible to the enzyme by gelatinization is called RS2. Resistant starch that is formed during processing is called RS3 or RS4 and is considered to be fiber that is isolated rather than intact and naturally occurring. RS3 (retrograded starch) is formed from the cooking and cooling or extrusion of starchy foods (e.g., potato chips and cereals). RS4 (chemically modified starch) includes starch esters, starch ethers, and cross-bonded starches that have been produced by the chemical modification of starch. RS3 and RS4 are not digested by mammalian intestinal enzymes and are partly fermented in the colon (Cummings et al., 1996; Englyst et al., 1992). Resistant starch is estimated to be approximately 10 percent (2 to 20 percent) of the amount of starch consumed in the Western diet (Stephen et al., 1983). Thus, RS1 and RS2 are classified as Dietary Fibers, and RS3 and RS4 may be classified as Functional Fibers.

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348 DIETARY REFERENCE INTAKES Physiology of Absorption, Metabolism, and Excretion By definition, Dietary Fiber and Functional Fiber are not digested by mam- malian enzymes. Therefore, they pass into the large intestine relatively intact. Along the gastrointestinal tract, properties of fiber result in differ- ent physiological effects. Effect on Gastric Emptying and Satiety Consumption of viscous fibers delays gastric emptying (Low, 1990; Roberfroid, 1993) and expands the effective unstirred layer, thus slowing the process of absorption once in the small intestine (Blackburn et al., 1984). This in turn can cause an extended feeling of fullness (Bergmann et al., 1992). A slower emptying rate means delayed digestion and absorp- tion of nutrients (Jenkins et al., 1978; Ritz et al., 1991; Roberfroid, 1993; Truswell, 1992), resulting in decreased absorption of energy (Heaton, 1973). For example, Stevens and coworkers (1987) showed an 11 percent reduction in energy intake with psyllium gum intake. Postprandial glucose concentration in the blood is thus lower after the consumption of viscous fiber than after consumption of digestible carbohydrate alone (Benini et al., 1995; Holt et al., 1992; Leathwood and Pollet, 1988). The extended presence of nutrients in the upper small intestine may promote satiety (Sepple and Read, 1989). Fermentation Fibers may be fermented by the colonic microflora to carbon dioxide, methane, hydrogen, and short-chain fatty acids (primarily acetate, propi- onate, and butyrate). Foods rich in hemicelluloses and pectins, such as fruits and vegetables, contain Dietary Fiber that is more completely ferment- able than foods rich in celluloses, such as cereals (Cummings, 1984; Cummings and Englyst, 1987; McBurney and Thompson, 1990). There appears to be no relationship between the level of Dietary Fiber intake and fermentability up to very high levels (Livesey, 1990). Resistant starch is highly fermentable (van Munster et al., 1994). Butyrate, a four-carbon, short-chain fatty acid, is the preferred energy source for colon cells (Roediger, 1982), and lack of butyrate production, absorption, or metabo- lism is thought by some to contribute to ulcerative colitis (Roediger, 1980; Roediger et al., 1993). Others have suggested that butyrate may be protec- tive against colon cancer (see “Dietary Fiber and the Prevention of Colon Cancer”). However, the relationship between butyrate and colon cancer is controversial and the subject of ongoing investigation (Lupton, 1995).

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349 D IETARY, FUNCTIONAL, AND TOTAL FIBER Contribution of Fiber to Energy When a metabolizable carbohydrate is absorbed in the small intestine, its energy value is 16.7 kJ/g (4 kcal/g); when fiber is anaerobically fer- mented by colonic microflora in the large intestine, short-chain fatty acids (e.g., butyrate, acetate, and propionate) are produced and absorbed as an energy source. Once absorbed into the colon cells, butyrate can be used as an energy source by colonocytes (Roediger, 1982); acetate and propionate travel through the portal vein to the liver, where propionate is then utilized by the liver. Acetate can be metabolized peripherally. A small proportion of energy from fermented fiber is used for bacterial growth and mainte- nance, and bacteria are excreted in feces, which also contain short-chain fatty acids (Cummings and Branch, 1986). Differences in food composi- tion, patterns of food consumption, the administered dose of fiber, the metabolic status of the individual (e.g., obese, lean, malnourished), and the digestive capability of the individual influence the digestible energy consumed and the metabolizable energy available from various dietary fibers. Because the process of fermentation is anaerobic, less energy is recovered from fiber than the 4 kcal/g that is recovered from carbohy- drate. While it is still unclear as to the energy yield of fibers in humans, current data indicate that the yield is in the range of 1.5 to 2.5 kcal/g (Livesey, 1990; Smith et al., 1998). Physiological Effects of Isolated and Synthetic Fibers This section summarizes the fibers for which there is a sufficient data- base that documents their beneficial physiological human effects, which is the rationale for categorizing them as Functional Fibers. It is important to note that discussions on the potential benefits of what might eventually be classified as Functional Fibers should not be construed as endorsements of those fibers. While plant-based foods are a good source of Dietary Fiber, isolated or synthetic fibers have been developed for their use as food ingredients and because of their beneficial role in human health. In 1988 Health Canada published guidelines for what they considered to be “novel fiber sources” and food products containing them that could be labeled as a source of fiber in addition to those included in their 1985 definition (Health Canada, 1988). The rationale for these guidelines was that there were safety issues unique to novel sources of fiber, and if a product was represented as containing fiber, it should have the beneficial physiological effects associated with dietary fiber that the public expects. The guidelines indicated that both safety and efficacy of the fiber source had to be estab- lished in order for the product to be identified as a source of dietary fiber in Canada, and this had to be done through experiments using humans.

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411 D IETARY, FUNCTIONAL, AND TOTAL FIBER Jenkins DJA, Wolever TMS, Leeds AR, Gassull MA, Haisman P, Dilawari J, Goff DV, Metz GL, Alberti KGMM. 1978. Dietary fibres, fibre analogues, and glucose tolerance: Importance of viscosity. Br Med J 1:1392–1394. Jenkins DJA, Wolever TMS, Collier GR, Ocana A, Rao AV, Buckley G, Lam Y, Mayer A, Thompson LU. 1987. Metabolic effects of a low-glycemic-index diet. Am J Clin Nutr 46:968–975. Jenkins DJA, Vuksan V, Kendall CWC, Würsch P, Jeffcoat R, Waring S, Mehling CC, Vidgen E, Augustin LSA, Wong E. 1998. Physiological effects of resistant starches on fecal bulk, short chain fatty acids, blood lipids and glycemic index. J Am Coll Nutr 17:609–616. Jenkins DJA, Kendall CWC, Vuksan V, Vidgen E, Parler T, Faulkner D, Mehling CC, Garsetti M, Testolin G, Cunnane SC, Ryan MA, Corey PN. 2002. Soluble fiber intake at a dose approved by the US Food and Drug Administration for a health claim of health benefits: Serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial. Am J Clin Nutr 75:834–839. Jennings CD, Boleyn K, Bridges SR, Wood PJ, Anderson JW. 1988. A comparison of the lipid-lowering and intestinal morphological effects of cholestyramine, chitosan, and oat gum in rats. Proc Soc Exp Biol Med 189:13–20. Jie Z, Bang-Yao L, Ming-Jie X, Hai-Wei L, Zu-Kang Z, Ting-Song W, Craig SAS. 2000. Studies on the effects of polydextrose intake on physiologic function in Chinese people. Am J Clin Nutr 72:1503–1509. Judd PA, Truswell AS. 1981. The effect of rolled oats on blood lipids and fecal steroid excretion in man. Am J Clin Nutr 34:2061–2067. Kang JY, Doe WF. 1979. Unprocessed bran causing intestinal obstruction. Br Med J 1:1249–1250. Kato I, Akhmedkhanov A, Koenig K, Toniolo PG, Shore RE, Riboli E. 1997. Pro- spective study of diet and female colorectal cancer: The New York University Women’s Health Study. Nutr Cancer 28:276–281. Kay RM, Truswell AS. 1977. Effect of citrus pectin on blood lipids and fecal steroid excretion in man. Am J Clin Nutr 30:171–175. Kelsay JL, Behall KM, Prather ES. 1978. Effect of fiber from fruits and vegetables on metabolic responses of human subjects. I. Bowel transit time, number of defecations, fecal weight, urinary excretions of energy and nitrogen and appar- ent digestibilities of energy, nitrogen, and fat. Am J Clin Nutr 31:1149–1153. Key TJA, Thorogood M, Appleby PN, Burr ML. 1996. Dietary habits and mortality in 11,000 vegetarians and health conscious people: Results of a 17 year follow up. Br Med J 313:775–779. Khaw K, Barrett-Connor E. 1987. Dietary fiber and reduced ischemic heart disease mortality rates in men and women: A 12-year prospective study. Am J Epidemiol 126:1093–1102. Kirby RW, Anderson JW, Sieling B, Rees ED, Chen W-JL, Miller RE, Kay RM. 1981. Oat-bran intake selectively lowers serum low-density lipoprotein cholesterol concentrations of hypercholesterolemic men. Am J Clin Nutr 34:824–829. Kleessen B, Sykura B, Zunft HJ, Blaut M. 1997. Effects of inulin and lactose on fecal microflora, microbial activity, and bowel habit in elderly constipated persons. Am J Clin Nutr 65:1397–1402. Klurfeld DM. 1992. Dietary fiber-mediated mechanisms in carcinogenesis. Cancer Res 52:2055S–2059S. Knekt P, Steineck G, Järvinen R, Hakulinen T, Aromaa A. 1994. Intake of fried meat and risk of cancer: A follow-up study in Finland. Int J Cancer 59:756–760.

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412 DIETARY REFERENCE INTAKES Knox TA, Kassarjian Z, Dawson-Hughes B, Golner BB, Dallal GE, Arora S, Russell RM. 1991. Calcium absorption in elderly subjects on high- and low-fiber diets: Effect of gastric acidity. Am J Clin Nutr 53:1480–1486. Kochen MM, Wegscheider K, Abholz HH. 1985. Prophylaxis of constipation by wheat bran: A randomized study in hospitalized patients. Digestion 31:220–224. Krishnamachar S, Mickelsen O. 1987. The influence of different carbohydrate sources on blood glucose levels and satiety: Effect of physical activity on blood glucose response. Hum Nutr Food Sci Nutr 41F:29–39. Kromhout D, Bosschieter EB, de Lezenne Coulander C. 1982. Dietary fibre and 10-year mortality from coronary heart disease, cancer, and all causes. The Zutphen Study. Lancet 2:518–522. Krotkiewski M. 1987. Effect of guar gum on the arterial blood pressure. Acta Med Scand 222:43–49. Kushi LH, Lew RA, Stare FJ, Ellison CR, el Lozy M, Bourke G, Daly L, Graham I, Hickey N, Mulcahy R, Kevaney J. 1985. Diet and 20-year mortality from coronary heart disease. The Ireland-Boston Diet-Heart Study. N Engl J Med 312:811–818. Lagier F, Cartier A, Somer J, Dolovich J, Malo JL. 1990. Occupational asthma caused by guar gum. J Allergy Clin Immunol 85:785–790. Landin K, Holm G, Tengborn L, Smith U. 1992. Guar gum improves insulin sensi- tivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am J Clin Nutr 56:1061–1065. Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. 1990. Anaphylaxis following ingestion of a psyllium-containing cereal. J Am Med Assoc 264:2534–2536. Lanza E. 1990. National Cancer Institute Satellite Symposium on Fiber and Colon Cancer. In: Kritchevsky D, Bonfield C, Anderson JW, eds. Dietary Fiber: Chemistry, Physiology, and Health Effects. New York: Plenum Press. Pp. 383–387. Larson DE, Hunter GR, Williams MJ, Kekes-Szabo T, Nyikos I, Goran MI. 1996. Dietary fat in relation to body fat and intraabdominal adipose tissue: A cross- sectional analysis. Am J Clin Nutr 64:677–684. Leathwood P, Pollet P. 1988. Effects of slow release carbohydrates in the form of bean flakes on the evolution of hunger and satiety in man. Appetite 10:1–11. Lee HP, Gourley L, Duffy SW, Estève J, Lee J, Day NE. 1991. Dietary effects on breast-cancer risk in Singapore. Lancet 337:1197–1200. Lei KY, Davis MW, Fang MM, Young LC. 1980. Effect of pectin on zinc, copper and iron balances in humans. Nutr Rep Int 22:459–466. Lev R. 1990. Malignant potential of adenomatous polyps. In: Adenomatous Polyps of the Colon: Pathobiological and Clinical Features. New York: Springer-Verlag. Pp. 53–89. Levin EG, Miller VT, Muesing RA, Stoy DB, Balm TK, LaRosa JC. 1990. Compari- son of psyllium hydrophilic mucilloid and cellulose as adjuncts to a prudent diet in the treatment of mild to moderate hypercholesterolemia. Arch Intern Med 150:1822–1827. Levine AS, Billington CJ. 1994. Dietary fiber: Does it affect food intake and body weight? In: Fernstrom JD, Miller GD, eds. Appetite and Body Weight Regulation: Sugar, Fat, and Macronutrient Substitutes. Boca Raton, FL: CRC Press. Pp. 191–200. Librenti MC, Cocchi M, Orsi E, Pozza G, Micossi P. 1992. Effect of soya and cellu- lose fibers on postprandial glycemic response in type II diabetic patients. Diabetes Care 15:111–113.

OCR for page 339
413 D IETARY, FUNCTIONAL, AND TOTAL FIBER Lichtenstein AH, Ausman LM, Jalbert SM, Vilella-Bach M, Jauhiainen M, McGladdery S, Erkkila AT, Ehnholm C, Frohlich J, Schaefer EJ. 2002. Efficacy of a Therapeutic Lifestyle Change/Step 2 diet in moderately hypercholes- terolemic middle-aged and elderly female and male subjects. J L ipid Res 43:264–273. Lipid Research Clinics Program. 1984. The Lipid Research Clinics Coronary Pri- mary Prevention Trial results. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. J Am Med Assoc 251:365–374. Little J, Logan RFA, Hawtin PG, Hardcastle JD, Turner ID. 1993. Colorectal adenomas and diet: A case-control study of subjects participating in the Nottingham Faecal Occult Blood Screening Programme. Br J Cancer 67:177–184. Livesey G. 1990. Energy values of unavailable carbohydrate and diets: An inquiry and analysis. Am J Clin Nutr 51:617–637. Loening-Baucke V. 1993. Chronic constipation in children. G astroenterology 105:1557–1564. Lovegrove JA, Clohessy A, Milon H, Williams CM. 2000. Modest doses of β-glucan do not reduce concentrations of potentially atherogenic lipoproteins. Am J Clin Nutr 72:49–55. Low AG. 1990. Nutritional regulation of gastric secretion, digestion and emptying. Nutr Res Rev 3:229–252. LSRO (Life Sciences Research Office). 1987. Physiological Effects and Health Conse- quences of Dietary Fiber. Bethesda, MD: LSRO. Lubin F, Wax Y, Modan B. 1986. Role of fat, animal protein, and dietary fiber in breast cancer etiology: A case-control study. J Natl Cancer Inst 77:605–612. Luo J, Rizkalla SW, Alamowitch C, Boussairi A, Blayo A, Barry J-L, Laffitte A, Guyon F, Bornet FRJ, Slama G. 1996. Chronic consumption of short-chain fructo- oligosaccharides by healthy subjects decreased basal hepatic glucose produc- tion but had no effect on insulin-stimulated glucose metabolism. Am J Clin Nutr 63:939–945. Lupton JR. 1995. Butyrate and colonic cytokinetics: Differences between in vitro and in vivo studies. Eur J Cancer Prev 4:373–378. Lupton JR, Morin JL, Robinson MC. 1993. Barley bran flour accelerates gastro- intestinal transit time. J Am Diet Assoc 93:881–885. Lyon JL, Mahoney AW, West DW, Gardner JW, Smith KR, Sorenson AW, Stanish W. 1987. Energy intake: Its relationship to colon cancer risk. J Natl Cancer Inst 78:853–861. Macfarlane GT, Englyst HN. 1986. Starch utilization by the human large intestinal microflora. J Appl Bacteriol 60:195–201. MacLennan R, Macrae F, Bain C, Battistutta D, Chapuis P, Gratten H, Lambert J, Newland RC, Ngu M, Russell A, Ward M, Wahlqvist ML. 1995. Randomized trial of intake of fat, fiber, and beta carotene to prevent colorectal adenomas. J Natl Cancer Inst 87:1760–1766. MacMahon M, Carless J. 1998. Ispaghula husk in the treatment of hypercholester- olemia: A double-blind controlled study. J Cardiovasc Risk 5:167–172. Macquart-Moulin G, Riboli E, Cornée J, Charnay B, Berthezène P, Day N. 1986. Case-control study on colorectal cancer and diet in Marseilles. Int J Cancer 38:183–191. Macquart-Moulin G, Riboli E, Cornée J, Kaaks R, Berthezène P. 1987. Colorectal polyps and diet: A case-control study in Marseilles. Int J Cancer 40:179–188.

OCR for page 339
414 DIETARY REFERENCE INTAKES Manousos O, Day NE, Tzonou A, Papadimitriou C, Kapetanakis A, Polychronopoulou- Trichopoulou A, Trichopoulos D. 1985. Diet and other factors in the aetiology of diverticulosis: An epidemiological study in Greece. Gut 26:544–549. Marlett JA. 1992. Content and composition of dietary fiber in 117 frequently con- sumed foods. J Am Diet Assoc 92:175–186. Marlett JA, Longacre MJ. 1996. Comparison of in vitro and in vivo measures of resistant starch in selected grain products. Cereal Chem 73:63–68. Mathur KS, Khan MA, Sharma RD. 1968. Hypocholesterolaemic effect of Bengal gram: A long-term study in man. Br Med J 1:30–31. McBurney MI. 1991. Potential water-holding capacity and short-chain fatty acid production from purified fiber sources in a fecal incubation system. Nutrition 7:421–424. McBurney MI, Thompson LU. 1990. Fermentative characteristics of cereal brans and vegetable fibers. Nutr Cancer 13:271–280. McCann SE, Freudenheim JL, Marshall JR, Brasure JR, Swanson MK, Graham S. 2000. Diet in the epidemiology of endometrial cancer in western New York (United States). Cancer Causes Control 11:965–974. McCann SE, Moysich KB, Mettlin C. 2001. Intakes of selected nutrients and food groups and risk of ovarian cancer. Nutr Cancer 39:19–28. McClung HJ, Boyne LJ, Linsheid T, Heitlinger LA, Murray RD, Fyda J, Li BUK. 1993. Is combination therapy for encopresis nutritionally safe? P ediatrics 91:591–594. McClung HJ, Boyne L, Heitlinger L. 1995. Constipation and dietary fiber intake in children. Pediatrics 96:999–1001. McKeown-Eyssen GE, Bright-See E, Bruce WR, Jazmaji V. 1994. A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps. J Clin Epidemiol 47:525–536. McRorie JW, Daggy BP, Morel JG, Diersing PS, Miner PB, Robinson M. 1998. Psyllium is superior to docusate sodium for treatment of chronic constipation. Aliment Pharmacol Ther 12:491–497. McRorie J, Kesler J, Bishop L, Filloon T, Allgood G, Sutton M, Hunt T, Laurent A, Rudolph C. 2000. Effects of wheat bran and Olestra on objective measures of stool and subjective reports of GI symptoms. Am J Gastroenterol 95:1244–1252. Mennen LI, Witteman JCM, den Breeijen JH, Schouten EG, de Jong PTVM, Hofman A, Grobbee DE. 1997. The association of dietary fat and fiber with coagulation factor VII in the elderly: The Rotterdam Study. Am J Clin Nutr 65:732–736. Meyer KA, Kushi LH, Jacobs DR, Slavin J, Sellers TA, Folsom AR. 2000. Carbo- hydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr 71:921–930. Miller AB, Howe GR, Jain M, Craib KJP, Harrison L. 1983. Food items and food groups as risk factors in a case-control study of diet and colo-rectal cancer. Int J Cancer 32:155–161. Miller WC, Niederpruem MG, Wallace JP, Lindeman AK. 1994. Dietary fat, sugar, and fiber predict body fat content. J Am Diet Assoc 94:612–615. Modan B, Barell V, Lubin F, Modan M, Greenberg RA, Graham S. 1975. Low-fiber intake as an etiologic factor in cancer of the colon. J Natl Cancer Inst 55:15–18. Morais MB, Vítolo MR, Aguirre ANC, Fagundes-Neto U. 1999. Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. J Pediatr Gastroenterol Nutr 29:132–135.

OCR for page 339
415 D IETARY, FUNCTIONAL, AND TOTAL FIBER Morales M, Llopis A. 1992. Breast cancer and diet in Spain. J Environ Pathol Toxicol Oncol 11:157–167. Morris JN, Marr JW, Clayton DG. 1977. Diet and heart: A postscript. Br Med J 2:1307–1314. Moshfegh AJ, Friday JE, Goldman JP, Ahuja JKC. 1999. Presence of inulin and oligofructose in the diets of Americans. J Nutr 129:1407S–1411S. National Cholesterol Education Program. 1991. Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. NIH Publication No. 91-2732. Bethesda, MD: National Heart, Lung, and Blood Institute. Neugut AI, Garbowski GC, Lee WC, Murray T, Nieves JW, Forde KA, Treat MR, Waye JD, Fenoglio-Preiser C. 1993. Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps. A case-control study. Ann Intern Med 11:91–95. Niemi MK, Keinänen-Kiukaanniemi SM, Salmela PI. 1988. Long-term effects of guar gum and microcrystalline cellulose on glycaemic control and serum lipids in type 2 diabetes. Eur J Clin Pharmacol 34:427–429. Niho N, Tamura T, Toyoda K, Uneyama C, Shibutani M, Hirose M. 1999. A 13- week subchronic toxicity study of chitin in F344 rats. Kokuritsu Iyakuhin Shokuhin Eisei Kenkyusho Hokoku 117:129–134. Nishimune T, Sumimoto T, Konishi Y, Yakushiji T, Komachi Y, Mitsuhashi Y, Nakayama I, Okazaki K, Tsuda T, Ichihashi A, Adachi T, Imanaka M, Kirigaya T, Ushio H, Kasuga Y, Saeki K, Yamamoto Y, Ichikawa T, Nakahara S, Oda S. 1993. Dietary fiber intake of Japanese younger generations and the recom- mended daily allowance. J Nutr Sci Vitaminol (Tokyo) 39:263–278. Noble JA, Grannis FW. 1984. Acute esophageal obstruction by a psyllium-based bulk laxative. Chest 86:800. NRC (National Research Council). 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: National Academy Press. Obarzanek E, Sacks FM, Vollmer WM, Bray GA, Miller ER, Lin P-H, Karanja NM, Most-Windhauser MM, Moore TJ, Swain JF, Bales CW, Proschan MA. 2001. Effects on blood lipids of a blood pressure-lowering diet: The Dietary Approaches to Stop Hypertension (DASH) Trial. Am J Clin Nutr 74:80–89. O’Brien KO, Allen LH, Quatromoni P, Siu-Caldera M-L, Vieira NE, Perez A, Holick MF, Yergey AL. 1993. High fiber diets slow bone turnover in young men but have no effect on efficiency of intestinal calcium absorption. J N utr 123:2122–2128. Ohkuma K, Wakabayashi S. 2001. Fibersol-2: A soluble, non-digestible, starch- derived dietary fibre. In: McCleary BV, Prosky L, eds. Advanced Dietary Fibre Technology. Oxford: Blackwell Science. Pp. 510–523. Ohno Y, Yoshida O, Oishi K, Okada K, Yamabe H, Schroeder FH. 1988. Dietary β- carotene and cancer of the prostate: A case-control study in Kyoto, Japan. Cancer Res 48:1331–1336. Olesen M, Gudmand-Høyer E. 2000. Efficacy, safety, and tolerability of fructo- oligosaccharides in the treatment of irritable bowel syndrome. Am J Clin Nutr 72:1570–1575. Olson BH, Anderson SM, Becker MP, Anderson JW, Hunninghake DB, Jenkins DJA, LaRose JC, Rippe JM, Roberts DCK, Stoy DB, Summerbell CD, Truswell AS, Wolever TMS, Morris DH, Fulgoni VL. 1997. Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: Results of a meta-analysis. J Nutr 127:1973–1980.

OCR for page 339
416 DIETARY REFERENCE INTAKES Pastors JG, Blaisdell PW, Balm TK, Asplin CM, Pohl SL. 1991. Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non- insulin-diabetes mellitus. Am J Clin Nutr 53:1431–1435. Patrick PG, Gohman SM, Marx SC, DeLegge MH, Greenberg NA. 1998. Effect of supplements of partially hydrolyzed guar gum on the occurrence of constipa- tion and use of laxative agents. J Am Diet Assoc 98:912–914. Pedersen A, Sandstrom B, Van Amelsvoort JM. 1997. The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healthy females. Br J Nutr 78:215–222. Penagini R, Velio P, Vigorelli R, Bozzani A, Castagnone D, Ranzi T, Bianchi PA. 1986. The effect of dietary guar on serum cholesterol, intestinal transit, and fecal output in man. Am J Gastroenterol 81:123–125. Petrakis NL, King EB. 1981. Cytological abnormalities in nipple aspirates of breast fluid from women with severe constipation. Lancet 2:1203–1204. Phillips J, Muir JG, Birkett A, Lu ZX, Jones GP, O’Dea K, Young GP. 1995. Effect of resistant starch on fecal bulk and fermentation-dependent events in humans. Am J Clin Nutr 62:121–130. Pick ME, Hawrysh ZJ, Gee MI, Toth E, Garg ML, Hardin RT. 1996. Oat bran concentrate bread products improve long-term control of diabetes: A pilot study. J Am Diet Assoc 96:1254–1261. Pietinen P, Rimm EB, Korhonen P, Hartman AM, Willett WC, Albanes D, Virtamo J. 1996. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Circulation 94:2720–2727. Pietinen P, Malila N, Virtanen M, Hartman TJ, Tangrea JA, Albanes D, Virtamo J. 1999. Diet and risk of colorectal cancer in a cohort of Finnish men. Cancer Causes Control 10:387–396. Pittler MH, Abbot NC, Harkness EF, Ernst E. 1999. Randomized, double-blind trial of chitosan for body weight reduction. Eur J Clin Nutr 53:379–381. Platz EA, Giovannucci E, Rimm EB, Rockett HRH, Stampfer MJ, Colditz GA, Willett WC. 1997. Dietary fiber and distal colorectal adenoma in men. Cancer Epidemiol Biomarkers Prev 6:661–670. Prior A, Whorwell PJ. 1987. Double blind study of ispagula in irritable bowel syndrome. Gut 28:1510–1513. Raben A, Tagliabue A, Christensen NJ, Madsen J, Holst JJ, Astrup A. 1994. Resis- tant starch: The effect on postprandial glycemia, hormonal response, and satiety. Am J Clin Nutr 60:544–551. Ranhotra GS, Gelroth JA, Leinen SD. 1997. Hypolipidemic effect of resistant starch in hamsters is not dose dependent. Nutr Res 17:317–323. Razdan A, Pettersson D. 1994. Effect of chitin and chitosan on nutrient digestibility and plasma lipid concentrations in broiler chickens. Br J Nutr 72:277–288. Razdan A, Pettersson D. 1996. Hypolipidaemic, gastrointestinal and related responses of broiler chickens to chitosans of different viscosity. Br J Nutr 76:387–397. Razdan A, Pettersson D, Pettersson J. 1997. Broiler chicken body weights, feed intakes, plasma lipid and small-intestinal bile acid concentrations in response to feeding of chitosan and pectin. Br J Nutr 78:283–291. Rigaud D, Ryttig KR, Angel LA, Apfelbaum M. 1990. Overweight treated with energy restriction and a dietary fibre supplement: A 6-month randomized, double-blind, placebo-controlled trial. Int J Obes 14:763–769. Rigaud D, Paycha F, Meulemans A, Merrouche M, Mignon M. 1998. Effect of psyllium on gastric emptying, hunger feeling and food intake in normal vol- unteers: A double blind study. Eur J Clin Nutr 52:239–245.

OCR for page 339
417 D IETARY, FUNCTIONAL, AND TOTAL FIBER Rimm EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. 1996. Vegetable, fruit, and cereal fiber intake and risk of coronary heart dis- ease among men. J Am Med Assoc 275:447–451. Ripsin CM, Keenan JM, Jacobs DR, Elmer PJ, Welch RR, Van Horn L, Liu K, Turnbull WH, Thye FW, Kestin M, Hegsted M, Davidson DM, Davidson MH, Dugan LD, Demark-Wahnefried W, Beling S. 1992. Oat products and lipid lowering. A meta-analysis. J Am Med Assoc 267:3317–3325. Risch HA, Jain M, Marrett LD, Howe GR. 1994. Dietary fat intake and risk of epithelial ovarian cancer. J Natl Cancer Inst 86:1409–1415. Ritz P, Krempf M, Cloarec D, Champ M, Charbonnel B. 1991. Comparative continuous-indirect-calorimetry study of two carbohydrates with different glycemic indices. Am J Clin Nutr 54:855–859. Rivellese A, Riccardi G, Giacco A, Pacioni D, Genovese S, Mattioli PL, Mancini M. 1980. Effect of dietary fibre on glucose control and serum lipoproteins in diabetic patients. Lancet 2:447–450. Roberfroid M. 1993. Dietary fiber, inulin, and oligofructose: A review comparing their physiological effects. Crit Rev Food Sci Nutr 33:103–148. Roberts PL, Veidenheimer MC. 1990. Diverticular disease of the colon. In: Bayless TM, ed. Current Therapy in Gastroenterology and Liver Disease—3. Toronto: Decker Mosby. Pp. 416–419. Roediger WEW. 1980. The colonic epithelium in ulcerative colitis: An energy- deficiency disease? Lancet 2:712–715. Roediger WEW. 1982. Utilization of nutrients by isolated epithelial cells of the rat colon. Gastroenterology 83:424–429. Roediger WE, Duncan A, Kapaniris O, Millard S. 1993. Reducing sulfur compounds of the colon impair colonocyte nutrition: Implications for ulcerative colitis. Gastroenterology 104:802–809. Rohan TE, McMichael AJ, Baghurst PA. 1988. A population-based case-control study of diet and breast cancer in Australia. Am J Epidemiol 128:478–489. Rohan TE, Howe GR, Friedenreich CM, Jain M, Miller AB. 1993. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: A cohort study. Cancer Causes Control 4:29–37. Rohan TE, Howe GR, Burch JD, Jain M. 1995. Dietary factors and risk of prostate cancer: A case-control study in Ontario, Canada. Cancer Causes Control 6:145–154. Roma E, Adamidis D, Nikolara R, Constantopoulos A, Messaritakis J. 1999. Diet and chronic constipation in children: The role of fiber. J Pediatr Gastroenterol Nutr 28:169–174. Ronco A, De Stefani E, Boffetta P, Deneo-Pellegrini H, Mendilaharsu M, Leborgne F. 1999. Vegetables, fruits, and related nutrients and risk of breast cancer: A case-control study in Uruguay. Nutr Cancer 35:111–119. Rose DP. 1990. Dietary fiber and breast cancer. Nutr Cancer 13:1–8. Rose DP. 1992. Dietary fiber, phytoestrogens, and breast cancer. Nutrition 8:47–51. Rose DP, Goldman M, Connoly JM, Strong LE. 1991. High-fiber diet reduces serum estrogen concentrations in premenopausal women. Am J Clin Nutr 54:520–525. Rössner S, von Zweigbergk D, Öhlin A, Ryttig K. 1987. Weight reduction with dietary fibre supplements. Results of two double-blind randomized studies. Acta Med Scand 222:83–88. Ryttig KR, Tellnes G, Haegh L, Boe E, Fagerthun H. 1989. A dietary fibre supple- ment and weight maintenance after weight reduction: A randomized, double- blind, placebo-controlled long-term trial. Int J Obes 13:165–171.

OCR for page 339
418 DIETARY REFERENCE INTAKES Saku K, Yoshinaga K, Okura Y, Ying H, Harada R, Arakawa K. 1991. Effects of polydextrose on serum lipids, lipoproteins, and apolipoproteins in healthy subjects. Clin Ther 13:254–258. Salmerón J, Ascherio A, Rimm EB, Colditz GA, Spiegelman D, Jenkins DJ, Stampfer MJ, Wing AL, Willett WC. 1997a. Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20:545–550. Salmerón J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC. 1997b. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. J Am Med Assoc 277:472–477. Sandberg AS, Ahderinne R, Andersson H, Hallgren B, Hulten L. 1983. The effect of citrus pectin on the absorption of nutrients in the small intestine. Hum Nutr Clin Nutr 37:171–183. Sandstead HH. 1992. Fiber, phytates, and mineral nutrition. Nutr Rev 50:30–31. Schatzkin A, Lanza E, Corle D, Lance P, Iber F, Caan B, Shike M, Weissfeld J, Burt R, Cooper MR, Kikendall JW, Cahill J. 2000. Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. N Engl J Med 342:1149–1155. Sepple CP, Read NW. 1989. Gastrointestinal correlates of the development of hunger in man. Appetite 13:183–191. Shetty PS, Kurpad AV. 1986. Increasing starch intake in the human diet increases fecal bulking. Am J Clin Nutr 43:210–212. Shultz TD, Howie BJ. 1986. In vitro binding of steroid hormones by natural and purified fibers. Nutr Cancer 8:141–147. Silvester KR, Englyst HN, Cummings JH. 1995. Ileal recovery of starch from whole diets containing resistant starch measured in vitro and fermentation of ileal effluent. Am J Clin Nutr 62:403–411. Simpson HCR, Simpson RW, Lousley S, Carter RD, Geekie M, Hockaday TDR, Mann JI. 1981. A high carbohydrate leguminous fibre diet improves all aspects of diabetic control. Lancet 1:1–15. Simpson KM, Morris ER, Cook JD. 1981. The inhibitory effect of bran on iron absorption in man. Am J Clin Nutr 34:1469–1478. Slavin JL. 1987. Dietary fiber: Classification, chemical analyses, and food sources. J Am Diet Assoc 87:1164–1171. Slavin JL, Marlett JA. 1980. Influence of refined cellulose on human bowel function and calcium and magnesium retention. Am J Clin Nutr 33:1932–1939. Slavin J, Jacobs D, Marquart L. 1997. Whole-grain consumption and chronic dis- ease: Protective mechanisms. Nutr Cancer 27:14–21. Sleet R, Brightwell J. 1990. FS-Teratology Study in Rats. Raffinerie Tirlemontoise Internal Report. Photocopy. Smith T, Brown JC, Livesey G. 1998. Energy balance and thermogenesis in rats consuming nonstarch polysaccharides of various fermentabilities. Am J Clin Nutr 68:802–819. Spencer H, Norris C, Derler J, Osis D. 1991. Effect of oat bran muffins on calcium absorption and calcium, phosphorus, magnesium and zinc balance in men. J Nutr 121:1976–1983. Steinmetz KA, Kushi LH, Bostick RM, Folsom AR, Potter JD. 1994. Vegetables, fruit, and colon cancer in the Iowa Women’s Health Study. Am J Epidemiol 139:1–15. Stephen AM, Haddad AC, Phillips SF. 1983. Passage of carbohydrate into the colon. Direct measurements in humans. Gastroenterology 85:589–595.

OCR for page 339
419 D IETARY, FUNCTIONAL, AND TOTAL FIBER Stevens J, Levitsky DA, VanSoest PJ, Robertson JB, Kalkwarf HJ, Roe DA. 1987. Effect of psyllium gum and wheat bran on spontaneous energy intake. Am J Clin Nutr 46:812–817. Stone-Dorshow T, Levitt MD. 1987. Gaseous response to ingestion of a poorly absorbed fructo-oligosaccharide sweetener. Am J Clin Nutr 46:61–65. Strobel S, Ferguson A, Anderson DM. 1982. Immunogenicity of foods and food additives—In vivo testing of gums arabic, karaya, and tragacanth. Toxicol Lett 14:247–252. Sugano M, Fujikawa T, Hiratsuji Y, Nakashima K, Fukuda N, Hasegawa Y. 1980. A novel use of chitosan as a hypocholesterolemic agent in rats. Am J Clin Nutr 33:787–793. Sundell IB, Ranby M. 1993. Oat husk fiber decreases plasminogen activator inhibi- tor type 1 activity. Haemostasis 23:45–50. Taioli E, Nicolosi A, Wynder EL. 1991. Dietary habits and breast cancer: A com- parative study of United States and Italian data. Nutr Cancer 16:259–265. Thompson LU. 1994. Antioxidants and hormone-mediated health benefits of whole grains. Crit Rev Food Sci Nutr 34:473–497. Thun MJ, Calle EE, Namboodiri MM, Flanders WD, Coates RJ, Byers T, Boffetta P, Garfinkel L, Heath CW. 1992. Risk factors for fatal colon cancer in a large prospective study. J Natl Cancer Inst 84:1491–1500. Todd S, Woodward M, Tunstall-Pedoe H, Bolton-Smith C. 1999. Dietary antioxidant vitamins and fiber in the etiology of cardiovascular disease and all-causes mortality: Results from the Scottish Heart Health Study. A m J Epidemiol 150:1073–1080. Tokunaga K, Matsuoka A. 1999. Effects of a Food for Specified Health Use (FOSHU) which contains indigestible dextrin as an effective ingredient on glucose and lipid metabolism. J Jpn Diabetes Soc 42:61–65. Tomlin J, Read NW. 1988. A comparative study of the effects on colon function caused by feeding ispaghula husk and polydextrose. Aliment Pharmacol Ther 2:513–519. Tomlin J, Read NW. 1990. The effect of resistant starch on colon function in humans. Br J Nutr 64:589–595. Tomlin J, Lowis C, Read NW. 1991. Investigation of normal flatus production in healthy volunteers. Gut 32:665–669. Tremblay A, Lavallée N, Alméras N, Allard L, Després J-P, Bouchard C. 1991. Nutritional determinants of the increase in energy intake associated with a high-fat diet. Am J Clin Nutr 53:1134–1137. Trock B, Lanza E, Greenwald P. 1990. Dietary fiber, vegetables, and colon cancer: Critical review and meta-analyses of the epidemiologic evidence. J Natl Cancer Inst 82:650–661. Truswell AS. 1992. Glycaemic index of foods. Eur J Clin Nutr 46:S91–S101. Tuohy KM, Kolida S, Lustenberger AM, Gibson GR. 2001. The prebiotic effects of biscuits containing partially hydrolysed guar gum and fructo-oligosaccharides— A human volunteer study. Br J Nutr 86:341–348. Tuyns AJ, Haelterman M, Kaaks R. 1987. Colorectal cancer and the intake of nutri- ents: Oligosaccharides are a risk factor, fats are not. A case-control study in Belgium. Nutr Cancer 10:181–196. Tzonou A, Hsieh C-C, Polychronopoulou A, Kaprinis G, Toupadaki N, Trichopoulou A, Karakatsani A, Trichopoulos D. 1993. Diet and ovarian cancer: A case- control study in Greece. Int J Cancer 55:411–414.

OCR for page 339
420 DIETARY REFERENCE INTAKES USDA/HHS (U.S. Department of Agriculture/U.S. Department of Health and Human Services). 2000. Nutrition and Your Health: Dietary Guidelines for Ameri- cans. Home and Garden Bulletin No. 232. Washington, DC: U.S. Government Printing Office. van Dokkum W, Wezendonk B, Srikumar TS, van den Heuvel EGHM. 1999. Effect of nondigestible oligosaccharides on large-bowel functions, blood lipid con- centrations and glucose absorption in young healthy male subjects. Eur J Clin Nutr 53:1–7. Van Horn LV, Liu K, Parker D, Emidy L, Liao Y, Pan WH, Giumetti D, Hewitt J, Stamler J. 1986. Serum lipid response to oat product intake with a fat-modified diet. J Am Diet Assoc 86:759–764. van Munster IP, Nagengast FM. 1993. The role of carbohydrate fermentation in colon cancer prevention. Scand J Gastroenterol 200:80–86. van Munster IP, de Boer HM, Jansen MC, de Haan AF, Katan MB, van Amelsvoort JM, Nagengast FM. 1994. Effect of resistant starch on breath-hydrogen and methane excretion in healthy volunteers. Am J Clin Nutr 59:626–630. van’t Veer P, Kolb CM, Verhoef P, Kok FJ, Schouten EG, Hermus RJ, Sturmans F. 1990. Dietary fiber, beta-carotene and breast cancer: Results from a case- control study. Int J Cancer 45:825–828. Verhoeven DTH, Assen N, Goldbohm RA, Dorant E, van’t Veer P, Sturmans F, Hermus RJJ, van den Brandt PA. 1997. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: A prospective cohort study. Br J Cancer 75:149–155. Visek WJ. 1978. Diet and cell growth modulation by ammonia. Am J Clin Nutr 31:S216–S220. Wakabayashi S, Ueda Y, Matsuoka A. 1993. Effects of indigestible dextrin on blood glucose and insulin levels after various sugar loads in rats. J Jpn Soc Nutr Food Sci 46:131–137. Wakabayashi S, Kishimoto Y, Matsuoka A. 1995. Effects of indigestible dextrin on glucose tolerance in rats. J Endocrinol 144:533–538. Watters DAK, Smith AN. 1990. Strength of the colon wall in diverticular disease. Br J Surg 77:257–259. Weaver GA, Krause JA, Miller TL, Wolin MJ. 1988. Short chain fatty acid distribu- tions of enema samples from a sigmoidoscopy population: An association of high acetate and low butyrate ratios with adenomatous polyps and colon cancer. Gut 29:1539–1543. West DW, Slattery ML, Robison LM, Schuman KL, Ford MH, Mahoney AW, Lyon JL, Sorensen AW. 1989. Dietary intake and colon cancer: Sex- and anatomic site-specific associations. Am J Epidemiol 130:883–894. Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer FE. 1990. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med 323:1664–1672. Willett WC, Hunter DJ, Stampfer MJ, Colditz G, Manson JE, Spiegelman D, Rosner B, Hennekens CH, Speizer FE. 1992. Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up. J Am Med Assoc 268:2037–2044. Williams CH, Witherly SA, Buddington RK. 1994. Influence of dietary neosugar on selected bacterial groups of the human faecal microbiota. Microb Ecol Health Dis 7:91–97. Williams CL, Bollella M. 1995. Is a high-fiber diet safe for children? Pediatrics 96:1014–1019.

OCR for page 339
421 D IETARY, FUNCTIONAL, AND TOTAL FIBER Williams CL, Bollella M, Wynder EL. 1995. A new recommendation for dietary fiber in childhood. Pediatrics 96:985–988. Wisker E, Nagel R, Tanudjaja TK, Feldheim W. 1991. Calcium, magnesium, zinc, and iron balances in young women: Effects of a low-phytate barley-fiber con- centrate. Am J Clin Nutr 54:553–559. Witte JS, Ursin G, Siemiatycki J, Thompson WD, Paganini-Hill A, Haile RW. 1997. Diet and premenopausal bilateral breast cancer: A case-control study. Breast Cancer Res Treat 42:243–251. Wolever TMS. 1995. In vitro and in vivo models for predicting the effect of dietary fiber and starchy foods on carbohydrate metabolism. In: Kritchevsky D, Bonfield C, eds. Dietary Fiber in Health and Disease. St. Paul, MN: Eagan Press. Pp. 360–377. Wolever TMS, Jenkins DJA. 1993. Effect of dietary fiber and foods on carbohydrate metabolism. In: Spiller G, ed. CRC Handbook of Dietary Fiber in Human Nutrition. Boca Raton, FL: CRC Press. Pp. 111–162. Wolk A, Manson JE, Stampfer MJ, Colditz GA, Hu FB, Speizer FE, Hennekens CH, Willett WC. 1999. Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. J Am Med Assoc 281:1998–2004. Wood PJ, Braaten JT, Scott FW, Riedel KD, Wolynetz MS, Collins MW. 1994. Effect of dose and modification of viscous properties of oat gum on plasma glucose and insulin following an oral glucose load. Br J Nutr 72:731–743. Woods MN, Gorbach SL, Longcope C, Goldin BR, Dwyer JT, Morrill-LaBrode A. 1989. Low-fat, high-fiber diet and serum estrone sulfate in premenopausal women. Am J Clin Nutr 49:1179–1183. Woods MN, Barnett JB, Spiegelman D, Trail N, Hertzmark E, Longcope C, Gorbach SL. 1996. Hormone levels during dietary changes in premenopausal African- American women. J Natl Cancer Inst 88:1369–1374. Wuolijoki E, Hirvelä T, Ylitalo P. 1999. Decrease in serum LDL cholesterol with microcrystalline chitosan. Methods Find Exp Clin Pharmacol 21:357–361. Wynder EL, Berenson GS. 1984. Preventive strategies for reducing hyperlipidemia in childhood. Prev Med 13:327–329. Yamashita K, Kawai K, Itakura M. 1984. Effects of fructo-oligosaccharides on blood glucose and serum lipids in diabetic subjects. Nutr Res 4:961–966. Younes H, Levrat MA, Demigne C, Remesy C. 1995. Resistant starch is more effective than cholestyramine as a lipid-lowering agent in the rat. Lipids 30:847–853. Yu H, Harris RE, Gao Y-T, Gao R, Wynder RL. 1991. Comparative epidemiology of cancers of the colon, rectum, prostate and breast in Shanghai, China versus the United States. Int J Epidemiol 20:76–81. Yuan J-M, Wang Q-S, Ross RK, Henderson BE, Yu MC. 1995. Diet and breast cancer in Shanghai and Tianjin, China. Br J Cancer 71:1353–1358. Zacour AC, Silva ME, Cecon PR, Bambirra EA, Vieira EC. 1992. Effect of dietary chitin on cholesterol absorption and metabolism in rats. J Nutr Sci Vitaminol (Tokyo) 38:609–613.