dietary fibre: an old concept in new light
TRANSCRIPT
Dietary fibre: an old concept in new light
Megan Rossi, PhD RD
www.alpro.com/healthprofessional
Kindly sponsored by an education grant from Alpro UK.
@TheGutHealthDoctor
Evolution of dietary fibre
From this… To this…
#letstalkfibre #plantpower
Overview
What Where
How Why
Practicaltips
#letstalkfibre #plantpower
WhatWhat exactly is fibre?
Wh
at
yo
ur
bo
dy
ab
sorb
s
Where
How Why
Tips
#letstalkfibre #plantpower
@T
heG
utH
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oct
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@berlin_soulfoods
Dietary fibre
Non-starch poly-
saccharideLignin
Non-digestible
oligo-saccharides
(degree of polymerisation
≥3)
Resistant starch
What exactly is fibre?
Carbohydrates that are indigestible by human enzyme
Still provides some energy!
Small intestine
Large intestine (colon)
Communityof microbes (Gut microbiota)
What Where
How Why
Tips
#letstalkfibre #plantpower
Where do we find it? What Where
How Why
Tips
#letstalkfibre #plantpower
Cereals & cereal products, 45%
Cereals & cereal products, 38%
Vegetables & potatoes , 30%
Vegetables & potatoes , 30%
6%
Meat & products
12%
Fruit,10%
Fruit,8%
Other,10%
Other,11%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
IRELAND
UK
Over 1/3rd from potatoes esp. fried & chips
43% from potatoes & potato products
44% pasta, rice, pizza & white bread34% wholemeal & brown breads & High
fibre breakfast cereals
58% from breads (type not specified)9% from breakfast cereals (high/low fibre not specified) W
ho
legra
in C
ou
ncil
@ElpheeSense @NutriWebinar
WhatHow much SHOULD we be having?
OLD: 18g/day (NSP) = 23g/day (new definition)
Where
How Why
Tips
#letstalkfibre #plantpower
@ElpheeSense @NutriWebinar
Age groups (years)
UK IRELAND
Recomm.AOAC g/d
IntakesAOAC g/d
% below recomm
.
Recomm.AOAC g/d
IntakesAOAC
g/d
% below recomm.
2-3 15 10.3 -31% - - -
4-5 15 14 -7% - - -
5-11 20 14 -30% 10-16 12.5 0.25% to -22%
11-16 25 15.3 -39% 16-21 15.4 -4% to -27%
16-18 30 15.3 -49% 21-23 15.4 -27% to -33%
19 - 64 30 19 -37% 25 19.2 -23%
65-74 30 18.4 -39% 25 18.9 -24%
How does it work?
1) Physical properties
What Where
How Why
Tips
#letstalkfibre #plantpower
2) Effect on gut microbiota
What Where
How Why
Tips
Not all fibres have the same effect
#letstalkfibre #plantpower
Included 64 studies, n=2099 participants
RCT with added food or supplement
Fibre intervention higher Bifidobacterium p<0.001 higher Lactobacillus p=0.020 higher faecal butyrate p=0.05
Prebiotic fibres higher Bifidobacterium p<0.001 higher Lactobacillus p=0.002
Other fibres nil differences in microbiota
Gut microbiota
More microbes than human
Not just bacteria
100+ x more genes than humans
Weighs as much as our brain
Produces vitamins & hormones
Harvest energy from food
Fights off infection
WHAT DOES IT DO….
WHAT IS IT….Talks to our brain
What Where
How Why
Tips
#letstalkfibre #plantpower
Gut:brain axis
Tillisch et al. 2013
4 weeksYoghurtLive yoghurt
(B. lactis, Streptococcus thermophiles, L.bulgaricus,& Lactococcus lactis lactis)
No Product
MRI
n=36
MRI
What Where
How Why
Tips
#letstalkfibre #plantpower
Communication pathway What Where
How Why
Tips
#letstalkfibre #plantpowerKoh et al. 2016
ResveratrolIsoflavonesAnthocyanins
Beyond fibre in plant-based eating What Where
How Why
Tips
#letstalkfibre #plantpowerGibson et al. 2017
Beyond fibre in plant-based eating What Where
How Why
Tips
We eat whole foods not single nutrients
Singh et al 2017 #letstalkfibre #plantpower
+fibre+ polyphenols
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• For every 7g increase in fibre:
9% lower risk of cardiovascular disease
7% lower risk of colon cancer
7% lower risk of stroke
6% lower risk of type 2 diabetes
• What does 7g look like?
Health benefits What Where
WhyHow
Tips
#letstalkfibre #plantpower
SCAN 2015
Gut:brain axis- role in mental health
Jacka et al. 2017
7 sessions over12 weeks
n=67
32% 8%
?? ??
What Where
WhyHow
Tips
Closer look at the diet
50g fibre!
Omega 3
Folate
Hydration
B12
Selenium
What Where
WhyHow
Tips
#letstalkfibre #plantpowerJacka et al. 2017
Economic benefit
If 10% of the total population commit to a high adherence of:
Mediterranean diet, societal cost savings in UK over 20 y= £7.53 billion
Soy-containing diet, societal cost savings in UK over 20 y= £10.91 billion
What Where
WhyHow
Tips
#letstalkfibre #plantpower
Environmental benefit
Wholegrain Council, 2018
What Where
WhyHow
Tips
#letstalkfibre #plantpower
Why
Translation in practice: barriers What Where
How
Tips
Translation in practice: strategies
Why
What Where
How
Tips
#letstalkfibre #plantpower
Why
Side effects What Where
How
Tips
n=16 healthy people
Glucose (placebo, 40g) Fructans (40g)
MRI repeated hourly- 5 hrs
Colonic gas volume
Murray et al, Am J Gastro. 2014; 109: 110-119 #letstalkfibre #plantpower
Glucose Fructans
What is IBS?
Why
What Where
How
Tips
Why
Translation in practice: barriers What Where
How
Tips
n=29 healthy n=29 IBS
Fructans (40g)Fructose (40g) Glucose (placebo, 40g)
Major et al, Gut. 2014
>1 week washout
>1 week washout
Fructans (40g)Fructose (40g) Glucose (placebo, 40g)
Fructans (40g)Fructose (40g) Glucose (placebo, 40g)
MRI repeated hourly- 5 hrs
#letstalkfibre #plantpower
Colonic gas volumeSymptom Intensity
Why
Low FODMAP diet What Where
How
Tips
olyolsSugar alcohols
ono-saccharides‘one’ sugar unit
i-saccharides‘two’ sugar units
ligo-saccharides‘many’ sugar units
ermentable
Fructans, Galacto-oligosaccharides
Lactose
Fructose
e.g sorbitol,mannitol
Short chain CHOF
O
D
M
A
P
nd
#letstalkfibre #plantpower
Restriction (3-6 weeks)
Re-introductionchallenge
(3 day/ challenges)
Personalisation(long term)
3- step process
KEY: total FODMAP load
The low FODMAP process
@TheGutHealthDoctor
Why
What Where
How
Tips
Why
Low FODMAP diet... cautions What Where
How
Tips
#letstalkfibre #plantpower
Negatively impacts microbes
Increases risk of nutrition deficiencies
May trigger disordered eating
May increase sensitivities
Should not be someone’s first resort
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1) Healthy eating and lifestyle
• Alcohol
• Caffeine
• Spicy food
• Fatty food
• Fluid intake
• Eating habits
3) Dietary fibre
2) Milk and dairy restriction
Adapted from McKenzie. J Hum Nutr Diet. 2016; 29: 576-59
BDA guidelines for dietary management of IBS
Why
Fermentation profile of fibres What Where
How
Tips
Rate fermentationHigh low
#letstalkfibre #plantpower
Plant-based diet diversity
Why
What Where
How
Tips
#letstalkfibre #plantpower
Included 25 studies, nearly 2 million participants
Observational studies
For every 10g increase in total fibre 10% risk reduction in developing colon cancer
For every 10g increase in cereal fibre 10% risk reduction in developing colon cancer
Not significant for fruit fibre or vegetable fibre
Guess the grain
Why
What Where
How
Tips
Which grain is not featured above?a) Buckwheatb) Milletc) Barleyd) Quinoae) They’re all featured #letstalkfibre #plantpower
Translation in practice: things to consider
Why
What Where
How
Tips
#letstalkfibre #plantpower
Take home messages
What: indigestible carbohydrates, many types
Where: plant-derived foods, public are choosing lower fibre option
How much: >50% increase to reach target of 30g
How does it work: viscosity, solubility, fermentability;whole plant-based package
Why: health, economic and environmental benefit
Translation: know your client & be practical
@TheGutHealthDoctor
For scientific and practical resources on fibre & plant-based eating from Alpro’s Scientific and Nutrition Department visit us @ www.alpro.com/healthprofessional
Kindly sponsored by an education grant from Alpro UK.
#letstalkfibre#plantpower
@TheGutHealthDoctor
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36
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38
What Where
How Why
Tips
Different fibres have different benefits
Different fibres do different things
39
Understanding the Physics of Functional Fibers in the
Gastrointestinal Tract: An Evidence-Based Approach to
Resolving Enduring Misconceptions about Insoluble and
Soluble Fiber
What Where
How Why
Tips
Fibre and gene richness
40
Protein: plant vs animal
41
Virtanen HEK, Koskinen TT, Voutilainen S, Mursu J, Tuomainen
TP,
Kokko P, Virtanen JK. Intake of different dietary proteins and
risk of
type 2 diabetes in men: the Kuopio Ischaemic Heart Disease
Risk Factor
Study. Br J Nutr 2017;117(6):882–93.
replacing 1% of energy from animal protein with energy from plant protein is associated with a 18% decreased risk of developing T2D (38).
What Where
WhyHow
Tips
Essential amino acids
42
Soya, quinoa and hemp are plant foods
containing all the essential amino acids.
Most other plant proteins provide some,
with each plant providing a different
combination. So, as long as you’re eating a
mixture of different plant proteins you’ll be
getting all the essential amino acids your
body needs.
What Where
WhyHow
Tips
43
What Where
WhyHow
Tips
Fibre and decreased risk of coeliac disease
44
http://www.gastrojournal.org/article/S0016-5085(18)30228-2/pdf
What Where
WhyHow
Tips
45
Why
Translation in practice: the barriers What Where
How
Tips
Lacy et al 2016 #letstalkfibre #plantpower
What Where
How Why
Tips
Mechanisms of actionsF
OD
MA
PS
#letstalkfibre #plantpower
Role in stress management?
Schmidt et al. 2015
3 weeks FOS (5.5g) B-GOS (5.5g) Placebo
Healthy n=45
What Where
WhyHow
Tips
#letstalkfibre #plantpower