fiber basics and beyond - kellogg's nutrition healthcare ......cellulose, pectin and gums....

Fiber Basics and Beyond

There‘s More to Know

About Fiber

®, ™, © 2010 Kellogg NA Co.

22

Overview

• Research continues to show that dietary fiber is essential for good health,

yet nine out of 10 Americans consume less than half the recommended

daily amounts of fiber.

• Recent research suggests consumers are confused about where to find

fiber and consume very few foods that provide at least a good source of

fiber. This may be contributing to Americans‘ fiber deficit.

• Innovations in the development of functional fibers, also called ‗novel‘ or

‗isolated‘ fibers, which are added to foods can help consumers meet fiber

recommendations through a wider variety of food options.

• Although different types of fiber offer different health benefits, all fibers

that can demonstrate a physiological benefit are beneficial to health.

• Health professionals can provide practical guidance on the importance of

increasing fiber intake and where to look for fiber in foods.


33

Learning Objectives

• Become familiar with the most updated IOM definition of fiber, including

the fundamental properties of ―dietary‖ fibers and ―functional‖ fibers.

• Understand the science supporting the health benefits of fiber and

know the mechanisms that explain their beneficial effects.

• Review consumer research that helps explain why consumers are

falling short of fiber recommendations.

• Discuss the role of whole foods and fiber-enhanced foods in helping to

meet fiber recommendations.

• Discover resources to guide discussions with clients and patients to

increase their fiber knowledge and skills for seeking out fiber-containing

foods.


44

ContentsA. Fiber Basics

A. What it is

B. How it works

C. Categorizing fiber

D. Where it comes from

E. Summary

B. Health Benefits of Fiber

A. Overview: fiber and health

B. Heart health

C. Diabetes

D. Healthy weight

E. Digestive health

F. Certain cancers

G. For children

H. Summary

C. Fiber Recommendations and Current Intakes

A. Daily fiber recommendations

B. Dietary fiber intake

C. Dietary fiber sources

D. Closing the fiber gap

E. Summary

D. Consumer Interest and Understanding of Fiber

A. Interest in fiber

B. Understanding of fiber

C. A look at whole grain/fiber confusion

D. Is consumer confusion fueling the fiber deficit?

E. Summary

E. Conclusions and Next Steps

A. Role of nutrition professionals

B. Fiber messages for consumers

C. Fiber resources

D. Conclusions®, ™, © 2010 Kellogg NA Co.

55

Fiber Basics

• What it is

• How it works

• Categorizing fiber

• Where it comes from

• Summary


66

Fiber: What it is

• Dietary fiber is the edible parts of plants or analogous carbohydrates

that are resistant to digestion and absorption in the human small

intestine with complete or partial fermentation in the large intestine.

• Dietary fiber includes polysaccharides, oligosaccharides, lignin, and

associated plant substances.

• Dietary fibers promote beneficial physiological effects including

laxation, and/or blood cholesterol attenuation, and/or blood glucose

attenuation.

The fact that fiber is not digested by the body is part of what makes it so

beneficial to health.

The Definition of Dietary Fiber: report of the dietary fiber definition committee to the board of directors of the American Association of

Cereal Chemists. Cereal Foods World. 2001;46(3):112-126.


77

Fiber: How it works

• As a non-digestible carbohydrate, fiber offers health benefits from one

or more of the following mechanisms:

– Bulking: Absorbs water to provide bulk, which improves laxation.

– Viscosity: Forms a gel-like substance that helps lower serum

cholesterol and modulate blood glucose (e.g. beta-glucan found in

oat fiber).

– Fermentation: Produces short-chain fatty acids (SCFA) from the

fermentation of fiber by beneficial bacteria in the gut, providing

energy to the cells lining the digestive tract which helps to promote

gastrointestinal health.

• Emerging research also suggests a role for SCFA in promoting

a healthy immune system, possibly by promoting a healthy

barrier function in the intestinal tract.

• Some fibers that undergo fermentation also have prebiotic

function – selectively feeding and stimulating the growth of the

beneficial bacteria over other bacteria found in the gut. ®, ™, © 2010 Kellogg NA Co.

88

Categorizing fiber

• Humans lack the digestive enzymes to break down fiber, which is why it

passes through the digestive system without being broken down.

• Generally, plant sources provide three types of fiber:

– Polysaccharides: most fiber types fall into this category, such as

cellulose, pectin and gums. Found in most vegetable/plant foods.

– Non-Digestible Oligosaccharides and Resistant Starches:

these substances resist digestion in the upper digestive tract and

feed and stimulate growth of friendly bacteria in the lower digestive

tract (i.e. serve as prebiotics). Found in some fruits and vegetables,

seeds and grains.

– Lignin: technically is not a carbohydrate, this is the tough, fibrous

part of plant cell walls, including stalks and skins. As plants mature,

their concentration of lignin increases, which is why celery and

carrots get tougher as they age.

Anderson JW, Baird P, Davis RH et al. Health benefits of dietary fiber. Nutr Rev. 2009;67:188-205.

Brown, A. Understanding Food: Principles and Preparation, 2nd Ed. 2004.


99

Categorizing fiber: traditional

• Traditionally, fiber has been classified based on its ability to dissolve in

water; i.e. soluble or insoluble. Both types are intrinsic in plant foods,

and they can be isolated and added to other foods.

– Soluble fiber: Dissolves in water, often absorbs the water and may

form a viscous gel that is fermented in the colon. Food sources

include legumes, oats, barley, nuts, some fruits and vegetables,

and psyllium.

– Insoluble fiber: Does not dissolve in water but rather swells like a

sponge and passes through the intestines mostly unchanged. Food

sources include wheat bran and bran cereals, nuts and seeds,

some vegetables, and skins of some fruits.

• Classifying fiber as soluble vs. insoluble has many limitations due to the

many variations and overlap in functions.

• More recently, there has been a movement to classify fiber in a

different way, based on its origin.


1010

Categorizing fiber: modern

• In 2005, the Institute of Medicine (IOM) created a new classification for

fibers based on the food source:1

– Dietary Fiber: non-digestible carbohydrates and lignin that are

intrinsic and intact in plant cell walls.

– Functional Fiber: isolated, non-digestible carbohydrates that have

beneficial physiological effects in humans.

• May be extracted from fruits, vegetables, legumes, and seeds;

modified forms of traditional fibers (e.g. fructooligosaccharides,

or FOS, from inulin) or manufactured from other ingredients

such as corn or wheat. These are often referred to as novel,

added and/or isolated fiber.

– Total Fiber: the sum of dietary fiber and functional fiber

1. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Energy, Carbohydrates, Fiber, Fat, Fatty Acids,

Cholesterol, Protein and Amino Acids. Washington, DC: National Academies Press; 2002/2005.


11

• It is important to note that in order to be classified as a functional

fiber, the ingredient must demonstrate a physiological benefit 1.

• Non-digestible carbohydrates (NDC), whether ―dietary‖ or ―functional,‖

are not differentiated within the intestinal tract2 and provide at least one

physiological benefit - such as laxation, reducing blood cholesterol, or a

lower glycemic index.3

– Studies on non-digestible oligosaccharides (shorter-chain NDCs)

have found that the body recognizes them as dietary fiber,

contributing to laxation and healthy gastrointestinal bacterial

growth.2

– Examples of NDCs include fructooligosaccharides (FOS), inulin,

resistant starch, galactooligosaccharides (GOS) and polydextrose.

1. Report by the AACC Dietary Fiber Technical Committee: All dietary fiber is fundamentally functional. Cereal Foods World, 2003, vol 48, no. 3

2. Gordon, DT. Contribution of nondigestible oligosaccharides (NDO) in meeting dietary fiber needs: laxation and bacterial growth. Poster, DF2009

3. Anderson JW et al. Health benefits of dietary fiber. Nutr Rev. 2009;67:188-205.

Categorizing fiber: modern


1212

Fiber: Where it comes from

• “Dietary” or intrinsic fibers (as defined by the IOM) come from a

variety of plant foods:

– Fruits, vegetables

– Legumes (e.g., beans, lentils)

– Nuts and seeds

– Whole grains (such as brown rice, whole wheat, popcorn)

• Within each of these categories of foods, the fiber content varies.

• Other essential nutrients are also provided by these foods and may

work with fiber to provide health benefits.

– According to the IOM, much of what we have learned about the

positive physiological aspects of fiber has been obtained through

the study of isolated or synthetic fiber sources. The study of

traditional fibers is often done from whole foods and, therefore, the

data are confounded by other nutrients provided from those foods.Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Energy, Carbohydrates, Fiber, Fat, Fatty Acids,

Cholesterol, Protein and Amino Acids. Washington, DC: National Academies Press; 2002/2005.


1313


• “Functional” or isolated fibers (as defined by the IOM) are isolated,

non-digestible carbohydrates extracted from fruits, vegetables,

legumes, and seeds, or made from other ingredients, like corn or

wheat.

– These fiber ingredients can be added to foods, much like fortifying

foods with vitamins and minerals.

– As previously mentioned, in order to be classified as fiber, it must

provide at least one physiological benefit of fiber - such as laxation,

reducing blood cholesterol, or a lower glycemic index.

– Examples include pectins, gums, polydextrose, maltodextrin, and

inulin and other oligosaccharides.

– Other common fiber ingredients added to foods such as beta-

glucan (from oats and barley), psyllium (used in fiber supplements)

and wheat fiber would be classified as functional fibers if they were

isolated from their original source.


1414


• Functional or “isolated” fibers, cont.

– There is growing recognition of the positive health benefits of

functional or isolated fibers.

– These newer fibers can often be added to foods with minimal

perceptible differences in taste.

– Adding functional fibers to processed foods may help people reach

their fiber intake goals.


1515

Fiber: Where it comes from• Below is a sample list of the most common functional fibers

and reported physiological benefits, according to the most

recent IOM report on Dietary Reference Intakes for Fiber.(1)

1. Institute of Medicine (IOM). Dietary, Functional, and Total Fiber. In: Food and Nutrition Board (FNB), editor. Institute of Medicine Expert Panel on Dietary Reference

Intakes for Macronutrients .Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC:

National Academies Press; 2002/2005. p. 339-42

2. Human studies are inconclusive

3. As seen in animal studies

Isolated Fiber (Functional

Fiber)

Demonstrated Benefit (2) Primary Source

Cellulose Laxation Plant foods

Chitin/Chitosan Blood lipid lowering (3) Fungi or shellfish

Guar Gum Blood lipid lowering

Attenuates blood glucose response

May promote gut health

Guar bean (legume)

Inulin/Oligofructose/

Fructooligosaccharide (FOS)

Laxation

Blood lipid lowering

Chicory root

Jerusalem artichoke

Synthesized from

simple

carbohydrates

β-glucan (beta-glucan) and

oat bran



Oats and Barley

Pectin Blood lipid lowering


Plant foods

Polydextrose Laxation


Synthesized from

dextrose (glucose)

Psyllium Laxation


Psyllium husk

(plant)

Resistant Dextrins Blood lipid lowering


Corn and wheat

Resistant Starch Laxation


Plant foods


1616

Fiber: A summary

• The definition and classification of dietary fiber has evolved as our

understanding of fiber has increased.

• Due to advances in food technology, there are a variety of newer fiber

sources available as components of fiber are being extracted (isolated)

from plant foods or synthesized from corn or other ingredients.

• According to the IOM, much of what we have learned about the benefits

of dietary fiber has been obtained through the study of isolated or

synthetic fibers.

• These newer fibers are not differentiated from intrinsic fibers in the

digestive tract, and they offer the same health benefits as dietary fibers.

In fact, when added to commonly eaten foods they may help Americans

reach their fiber intake goals.

• To gain the multiple benefits of a diet high in fiber, a mixture of dietary

fibers from a variety of food sources is desirable.


1717

Health Benefits of Fiber

• Overview: Fiber and Health

• Heart Health

• Diabetes

• Healthy Weight

• Digestive Health

• Certain Cancers

• For Children

• Summary


1818

Overview: Fiber and Health

Higher-fiber diets have been associated with:

– Improving serum lipid concentrations, e.g. certain soluble fibers

help lower LDL cholesterol

– Lowering blood pressure

– Helping with weight management

– Improving glucose tolerance and insulin response

– Maintaining a healthy digestive system

– Reducing cancer risk

Source: Fiber evidence analysis project. ADA Evidence Analysis Library: http://www.adaevidencelibrary.com/topic.cfm?cat=1586


1919

Fiber and Heart Health: Health Claims

• Evidence of the inverse relationship between fiber and heart disease is

strong enough to support two FDA-approved health claims:

– ―Diets low in saturated fat and cholesterol and rich in fruits,

vegetables and grain products that contain some types of dietary

fiber, particularly soluble fiber, may reduce the risk of heart disease,

a disease associated with many factors.‖1

– ―Soluble fiber from foods such as oat bran, rolled oats, whole oat

flour, oatrim, whole grain barley, and soluble fiber from psyllium

husk, as part of a diet low in saturated fat and cholesterol, may

reduce the risk of heart disease.‖2

• Foods bearing a psyllium seed husk health claim must also

indicate the need to consume the product with sufficient liquid.

1. Fruits, Vegetables and Grain Products that contain Fiber, particularly Soluble Fiber, and Risk of Coronary Heart Disease

(21 CFR 101.77)

2. Soluble Fiber from Certain Foods and Risk of Coronary Heart Disease (21 CFR 101.81)


2020

Example Evidence Supporting Fiber and

Heart Health

• Pereira et al. 2004 (meta-analysis)

– Compared intakes of total dietary fiber with coronary heart disease

(CHD) risk.

– Analysis of 10 large prospective studies reported that for each 10g

per day increment in dietary fiber intake, there was a 14% decrease

in CHD risk.

– Fiber from cereals and fruits had a strong, inverse association with

CHD risk (10% and 16% reduction in risk, respectively).

– In terms of coronary deaths, association was stronger: 27%

reduction in risk associated with total fiber, 24% reduction with

cereal fiber, and 30% reduction with fruit fiber.

Pereira et al . Dietary Fiber and Risk of Coronary Heart Disease. Arch Int Med . 2004;64: 370-376


2121


Heart Health (cont.)

• Life Sciences Research Office (2008)

– Conducted a review of intervention and observational studies on

whole grains to evaluate the effect of applying the FDA definition of

whole grains on the scientific evidence for the whole-grain health

claim on reduced risk for CVD and type 2 diabetes.

– Health claims about whole grain and reduced risk of CVD is

supported only when a broader concept of whole grain (including

fiber-rich bran and germ as well as whole grain) is applied.

– The results support the positive effects of fiber (particularly bran) in

heart health.

Life Science Research Office, Whole-Grain Intake and Cardiovascular Disease and Whole-Grain Intake and Diabetes:

A Review, Nov. 2008. http://www.lsro.org/articles/wholeGrainIntake.html

De Moura FF et al. Applying the FDA definition of whole grains to the evidence for cardiovascular disease health claims J. Nutr

2009 139: 2220S-2226S.


2222

Fiber and Diabetes

Higher fiber diets are associated with reduced risk of type 2 diabetes

and metabolic syndrome.

– The exact mechanism is unclear, but likely due to a combination of

improving glucose tolerance and insulin response, and weight

management.


2323


Diabetes

• 2008 Cochrane Collaboration (an international not-for-profit

organization)1

– A systematic review of the literature found that eating a fiber-rich

diet (28-37% of total intake) may help reduce the risk for diabetes

by about one-third.

• 2008 United Kingdom Scientific Advisory Committee on Nutrition2

– A comprehensive review of the health effects of fiber found nine out

of 11 prospective studies concluded that increasing cereal-fiber

intake significantly reduced the risk of developing type 2 diabetes.

1. Cochrane Database of Systematic Reviews. Priebe MG et al. Whole grain foods for the prevention of type 2 diabetes mellitus.

2008. http://www.cochrane.org/reviews/en/ab006061.html.

2. Scientific Advisory committee on Nutrition (2008). Statement on Dietary Fibre.

http://www.sacn.gov.uk/pdfs/final_draft_sacnstatement_on_dietary_fibre_for_website.pdf


2424

Fiber and Healthy Weight

• Fiber can play a key role in managing weight by:

– Slowing down the rate of eating because foods higher in fiber take

longer to chew.

– Absorbing fluid (as much as 15 times its own weight) to create a

feeling of fullness.

– Helping reduce calories, i.e., a higher-fiber diet is a lower energy

density diet because fiber doesn‘t contribute substantially to caloric

intake and can replace higher-calorie ingredients.

• Emerging science suggests that fiber‘s role in feeding friendly bacteria

in the gut and possibly other mechanisms may be associated with a

reduced risk for overweight and obesity.1

1. Fava F et al. The potential role of the intestinal gut microbiota in obesity and the metabolic syndrome. Food SciTech Bull Func

Foods. 2008; 5(7):71-92


2525


Healthy Weight

• Nurses Health Study (2003)1 and the U.S. Health Professionals Follow-up

Study(2004)2

– Prospective studies, tracking 74,000 female nurses and 51,500 male

health professionals, respectively.

– Increasing fiber is associated with less weight gain over the study

period (12 years and 8 years, respectively).

• National Health and Nutrition Examination Survey (NHANES) 1999-2004 3

– Increased consumption of dietary fiber was associated with lower BMI

and waist circumference in women, and lower waist circumference in

men.1. Liu S et al. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development o

obesity among middle-aged women. Am J Clin Nutr. 2003;78:920-7.

2. Koh-Banerjee P et al. Changes in whole grain, bran, and cereal fiber consumption in relation to 8-year weight gain among men. Am

J Clin Nutr. 2004;80:1237-45.

3. Cho S et al. Consumption of fiber is associated with lower body weight measure in U.S. adults: The National Health and Nutrition

Examination Survey (NHANES) 1999-2004. FASEB J. 2009 [Abstract LB485]


2626


Healthy Weight (cont.)

• Tucker et al. 20091

– Increasing dietary fiber significantly reduces the risk of gaining

weight and fat in women. For each 1 g increase in total fiber

consumed, weight was lower by 0.25 kg.

• Yao et al. 20012

– People eating diets low in fat and high in fiber lose weight three

times faster than those eating low-fat, low-fiber diets.

1. Tucker LA and Thomas KS. Increasing total fiber intake reduces risk of weight and fat gains in women. J Nutr. 2009;139:576-

81.

2. Yao et al. Dietary energy density and weight regulation. Nutr Rev. 2001;59:247-58.


2727

Fiber and Digestive Health

• Increasing fiber intake (particularly insoluble fibers such as wheat bran)

may contribute to digestive health by:

– Providing more bulk, making it easier for the muscles of the

digestive tract to move its contents along.

– This in turn promotes regularity and prevents constipation, as waste

moves more quickly through the digestive tract (i.e. decreases

transit time).

• An emerging area of research is on prebiotics and dietary fiber and

associated positive effects on digestive health and the immune

response.1

1. Douglas LC, Sanders ME. Probiotics and prebiotics in dietetics practice. J Am Diet Assoc. 2008;108:510-21.


2828


Digestive Health

• Considerable evidence suggests that dietary fiber may play a role in

prevention and treatment in several gastrointestinal disorders:1,2

– GERD (Gastroesophageal reflux disease/‖acid reflux‖), duodenal

ulcers, diverticulitis, constipation, hemorrhoids, and in some cases

of irritable bowel syndrome and inflammatory bowel disease.

1. Guamer et al. Gut flora in health and disease. Lancet. 2003;360:512-519 .

2. Gibson et al. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics.

J Nutr. 1995;125:1401-1412.


2929

Fiber and Cancer

• A diet rich in fiber may reduce the risk of developing certain types of

cancer by:

– Promoting the health of the digestive tract.

– Speeding the passage of food waste, thereby reducing the time

certain toxic substances stay in the body and improving the balance

of beneficial bacteria in the gut.

– Increasing the intake of antioxidants, i.e., foods rich in fiber tend to

be rich in vitamins, minerals, and phytochemicals linked to cancer

prevention.

– Altering hormone levels in the body, particularly lowering estrogens

linked to breast cancer risk.


3030


Cancer

• 2003 European Prospective Investigation into Cancer and Nutrition

(EPIC) 1

– A 10-country study involving more than 500,000 subjects found that

doubling fiber intake (from approximately 15 g/day) may reduce the

risk of bowel cancer by 40%.

• Women‘s Cohort Study (2007)2 and the Malmo Diet and Cancer Cohort

(2004)3

– Changing the diet to one rich in high-fiber foods may help protect

against developing breast cancer.

1. Bingham et al. Dietary fiber in food and protection against colorectal cancer in the European Prospective Investigation into Cancer

and Nutrition (EPIC): an observational study. Lancet. 2003;361:1496-1501

2. Cade et al. Dietary Fiber and risk of breast cancer in the UK Women's Cohort Study. Int J Epid. 2007;36:231-238

3. Mattisson et al. Intakes of plant foods, fiber and fat and risk of breast cancer - a prospective study in the Malmo Diet and Cancer

Cohort. Br J Cancer. 2004;90: 22-127


3131

Fiber and Children

• Adequate intake of fiber for children (2 years and older) promotes

overall health by:

– Helping to keep the digestive system healthy so it can function.

properly and ―do its job,‖ such as absorbing nutrients from the diet.

– Developing and maintaining a healthy population of gastrointestinal

bacteria. 1

– Promote regularity and bowel function. 1

– Establishing healthful eating habits that are more likely to be

sustained throughout life. 1

1. Pereira et al. Dietary Fiber and body weight regulation. Observations and mechanisms. Pediatr Clin North Am. 2001;48: 969-980


3232


Children

• Pereira at al. 20011

– A review of observational studies show that children with higher-fiber

intakes are less likely to be overweight compared to children with

low-fiber intakes.

• Williams et al. 20082

– Higher-fiber diets during childhood have been shown to be inversely

related to blood cholesterol levels.

1. Pereira et al. Dietary Fiber and body weight regulation. Observations and mechanisms. Pediatr Clin North Am. 2001;48: 969-980

2. Williams CL et al. Childhood diet, overweight and CVD risk factors: the Healthy Start Project. Prev Cardiol. 2008;11:11-20


33

Summary

• There is consistent and strong data for the role of dietary fiber in a

number of health outcomes and throughout the life cycle, as supported

by epidemiological, prospective and intervention studies.

– Heart disease, diabetes, weight management, digestive health and

cancer are among them.


3434

Fiber Recommendations and

Current Intakes

• Daily Fiber Recommendations

• Dietary Fiber Intake

• Dietary Fiber Sources

• Closing the Fiber Gap

• Summary


3535

Daily Fiber Recommendations

• The IOM established an Adequate Intake (AI) level for fiber as part of

the Dietary Reference Intake (DRIs) for macronutrients (14 grams of

fiber for each 1,000 calories for individuals ages 1 year and older). The

AIs were based on amounts that had been observed in adults to

decrease the risk of heart disease. There is no Tolerable Upper Intake

Level (UL) for fiber.

Fiber Recommendations by Age and Gender Recommended

Daily Fiber Intake

• Children ages 1-3 years old 19 grams

• Children ages 4-8 years old 25 grams

• Young boys ages 9-13 years old 31 grams

• Young girls ages 9-13 years old 26 grams

• Teenage boys ages 14-18 years old 38 grams

• Teenage girls ages 14-18 years old 26 grams

• Adult men ages 19-50 years old 38 grams

• Adult women ages 19-50 years old 25 grams

• Older adult men ages 50 years and older 30 grams

• Older adult women ages 50 years and older 21 grams

• Pregnant women 28 grams

• Lactating women 29 grams

Adapted from: Institute of Medicine, Dietary Reference Intakes; Energy, Carbohydrate, Fiber, Fat Fatty Acids, Cholesterol, Protein

and Amino Acids. Washington, DC. National Academies Press 2002/2005.®, ™, © 2010 Kellogg NA Co.

3636

Dietary Recommendations –

U.S. Dietary Guidelines for Americans• In the 2005 Dietary Guidelines for Americans, fiber is identified as a

―nutrient of concern‖ for adults and children and is highlighted in other

sections, including:

– Food Groups to Encourage:

• ―Diets rich in foods containing fiber, such as fruits, vegetables,

and whole grains, may reduce the risk of coronary heart

disease.‖

– Carbohydrate Key Recommendation:

• ―Choose fiber-rich fruits, vegetables, and whole grains.‖

– Carbohydrate Recommendation:

• ―Diets rich in dietary fiber have been shown to have a number

of beneficial effects, including decreased risk of coronary heart

disease and improvement in laxation. There is also interest in

the potential relationship between diets containing fiber-rich

foods and lower risk of type 2 diabetes.‖®, ™, © 2010 Kellogg NA Co.

3737

Dietary Fiber Intake

• Nine out of 10 adults and children do not meet current fiber

recommendations.1

• According to intake data2, Americans‘ average consumption of fiber is

about half of the recommended amount with:

– women eating about 14 grams per day.

– men eating about 18 grams per day.

– children (ages 2-19) eating about 13 grams per day.

1. Moshfegh, Alanna; Goldman, Joseph; and Cleveland, Linda; 2005 What We Eat in America, NHANES 2001-2002: Usual Nutrition

Intake From Foods as Compared to Dietary Reference Intakes

2. What We Eat in America, National Health and Nutrition Examination Survey (NHANES) 2005-2006. See www.ars.usda.gov.


http://www.ars.usda.gov/

3838

Dietary Fiber Sources

• According to national data, white flour and white potatoes provide the

most fiber in the U.S. diet, not because they are rich sources of fiber,

but because they are most widely consumed across the population.1

• Current research revealed it takes more than 25 different foods to

deliver the 13.8 grams of fiber people are eating each day, suggesting

Americans are eating very few foods that are good sources of fiber.2

1. Slavin JL. Position of the American Dietetic Association: Health implications of dietary fiber. J Am Diet Assoc. 2008:108:1716-1731.

2. The NPD Group's Nutrient Intake Database – Research for Kellogg Company, 2009: www.kelloggsnutrition.com


39

Closing the Fiber Gap

• Programs and policies implementing the Dietary Guidelines that

promote increased consumption of fruits, vegetables, and whole grains

have not been successful in helping Americans meet fiber

recommendations.

– Overall intakes of fruits, vegetables and whole grains remain low,

and not all foods in these categories are considered a ―good‖

source of fiber.

– A recent modeling exercise using NHANES 2003-2006 intake data

found that in order to achieve intake goals of 28 grams of fiber/day,

adults would need to double their intake of dietary fiber-containing

foods they currently eat. Doing so would also add about 1,042

calories to one‘s daily intake. Conversely, adding fiber to low-fiber

foods that are commonly eaten would result in reaching fiber goals

without a significant calorie increase.1

• Consuming fiber-rich food sources, including foods enhanced with fiber,

helps people reach their recommended daily intake goals.

1. National Health and Nutrition Examination Survey (NHANES) 2003-2006.®, ™, © 2010 Kellogg NA Co.

4040

Summary

• Research reveals it takes more than 25 different foods to deliver the

13.8 grams of fiber people are currently eating each day, suggesting

Americans are eating very few foods that are good sources of fiber.

• Despite the 2005 Dietary Guidelines recommendation to increase

consumption of fruits, vegetables, and whole grains, nine out of 10

Americans continue to fall short of fiber recommendations.

– Overall consumption of foods in these categories remains low, plus

many do not provide a good source of fiber.

• In order to achieve intake goals of 28 grams of fiber/day, adults would

need to double their intake of the dietary fiber-containing foods they

currently eat, resulting in an additional 1,042 calories.

• Adding fiber to commonly eaten, low-fiber foods allows people to

achieve fiber intake goals without a commensurate increase in calories.


4141

Consumer Interest and

Understanding of Fiber

• Interest in Fiber

• Understanding of Fiber

• A Look at Whole Grain/Fiber Confusion

• Is Consumer Confusion Fueling the Fiber Deficit?

• Summary


4242

Interest in Fiber

• According to the 2008 IFIC Food & Health Survey1, consumers

understand that fiber is important.

– 92% of Americans said they‘re trying to get more fiber into their

diets.

• Yet, only one in three consumers recognized they are falling short of

recommended fiber intakes.2

1. International Food Information Council. Food & Health Survey: Consumer Attitudes toward Food, Nutrition & Health, 2008.

2. Kellogg Whole Grains & Fiber Omnibus Survey, 2009: www.kelloggsnutrition.com.


4343

Understanding of Fiber

• Consumer research provides a greater understanding of what

consumers know and understand about fiber.1

• In a recent survey, nearly 70% of consumers surveyed said they are

eating more foods made with whole grains as a way to increase their

fiber intake.

– In fact, they expect those products to contain fiber at significant

levels. About 85% of consumers who are choosing foods made with

whole grain assume that product is a good or excellent source of

fiber.

– About half of those surveyed see fiber and whole grains as one and

the same.

• While many people believe that all products with whole grain-

ingredients are a good source of fiber, this is not the case.

1 . The American Consumer: ―Whole‖ Lot of Fiber Confusion?: www.kelloggsnutrition.com


4444

Whole Grain/Fiber Confusion

• The reality is the fiber content of foods made with whole grain can vary

greatly…

– The fiber content in individual whole grains such as brown rice, oats

and rye ranges from 0.6 grams to 1.7 grams to 2.9 grams per serving,

respectively.1

1. Whole Grains Council: http://www.wholegrainscouncil.org/newsroom/whole-grain-statistics.


4545


• The reality is the fiber content of foods made with whole grain can vary

greatly…(cont.)

– The type of grain, amount of bran, density of the product, and moisture

content are factors that determine the amount of fiber in packaged

foods that are made with whole grain.

– Food packages can be labeled as made with whole grain or similar

claims so long as it contains at least some whole grain – even a small

percentage. Accordingly, fiber content in such foods often is low.

– Additionally, the whole-grain content of foods that meet FDA‘s definition

of a whole-grain food can also vary widely – anywhere from 51-100% of

total grain ingredients1…which, again, can directly impact the total fiber

content.

1. FDA Whole Grain Health Claim 1999/2003/2008.


4646


• An audit* of products available today illustrates that many foods that

carry messages about whole-grain content on the package do not

provide at least a good source of fiber (as consumers believe).

• In the cereal aisle:

– At the time of the audit, 72 nationally distributed ready‐to‐eat cereal

products included clearly visible whole‐grain messages on the

package (e.g. ―whole grain guaranteed,‖ made with whole grains,‖

―with whole grains,‖ and ―rich in whole grains‖).

– Of those 72 breakfast cereals, only about half provided a good or

excellent source of fiber. The fiber varied greatly, ranging from 0 to

11 grams per serving.

– Of the cereals that did not provide at least a good source of fiber,

60% provided 1 gram of fiber or less.

The ―claim audit‖ was completed using a syndicated database, capturing items entered into the database from 01/01/05 to 07/24/08.

The database is maintained by an independent research company who pulls packaging from the shelf and puts in a database for the

use of their subscribers. Current product formulations or on-pack messaging may be different from the information reflected in this

report. See Whole Grains Half Truths on www.kelloggsnutrition.com.®, ™, © 2010 Kellogg NA Co.

4747


• In the cereal/granola bar aisle:1

– 46 nationally distributed cereal and granola bars included clearly

visible whole‐grain messaging on the package.

– The fiber content of these granola bars also varied greatly, ranging

from 0 to 9 grams per serving.

– Of the 46 granola bars with whole‐grain messages, nearly all (40)

were found to provide less than a good source of fiber.

– Two‐thirds of the cereal and granola bars – or 26 of 40 ‐ that did

not provide a good source of fiber, provided just 1 gram or less per

serving.

1. Whole Grain Half Truths: www.kelloggsnutrition.com.


4848

Is Consumer Confusion

Fueling the Fiber Deficit?• Consumers are eating more whole grains to get more fiber. Yet, many

products that make whole-grain claims are not a good source of fiber.

• To determine if this confusion contributes to the fiber deficit, an analysis

was conducted:1

– Ready-to-eat cereals are one of the most significant sources of

fiber in the diet, delivering levels of fiber only slightly less than fruits

and vegetables.

– Consumers who eat cereals made with whole-grain ingredients do

have higher daily fiber intakes, get more fiber at breakfast, and get

at least 78% more fiber (1.6 g vs. 0.9 g) from their breakfast.

– However, if those consumers choosing cereals made with whole

grains were to flip to the Nutrition Facts panel to ensure it was at

least a good source of fiber, this could result in a 144% increase in

fiber intake (2.2 g vs. 0.9 g).1. The NPD Group's Nutrient Intake Database – Research for Kellogg Company, 2009: www.kelloggsnutrition.com


4949

• Over a two-week period, if those cereal eaters that were choosing

cereals made with whole grains ensured that the cereal also had a

good source of fiber (3 grams per serving), they would consume more

than 8 extra grams of fiber… equivalent to nearly three extra servings

of cereal, fruit, vegetables or other ―good source of fiber‖ foods every

two weeks.

• If they were to ‗flip for fiber‘ and choose a cereal that was an excellent

source of fiber (5 grams or more per serving) the advantage over time

is further enhanced … adding up to 14 extra grams of fiber over a

two-week period … nearly 5 servings of ―good source‖ cereal.

• This research demonstrates the importance checking the Nutrition

Facts Panel for fiber content rather than assuming it is there based on

front-of-pack messaging about whole-grain content. The NPD Group's Nutrient Intake Database – Research for Kellogg Company, 2009: www.kelloggsnutrition.com .The NPD

Group‘s Nutrient Intake Database is based on 14-day eating frequency diary information gathered at the individual level,

supplemented with average portion size and nutrient composition information from the U.S. government. Cereal made with whole

grain ingredients and fiber was not necessarily chosen each day - data represents the cumulative fiber intake over two weeks.

Is Consumer Confusion

Fueling the Fiber Deficit? (cont.)


http://www.kelloggsnutrition.com/

50

Summary• Most Americans say they‘re trying to get more fiber into their diets yet,

only one in three consumers recognized they are falling short.

• The majority of consumers indicate they are eating more foods made

with whole grains as a way to increase their fiber intake.

• Most consumers assume products with whole-grain messaging are a

good source of fiber but this is not the case. A recent audit revealed:

– Of 72 breakfast cereals examined, only about half provided a good

or excellent source of fiber. The fiber varied greatly, ranging from 0

to 11 grams per serving.

– Of 46 granola bars examined, nearly all (40) were found to provide

less than a good source of fiber.

• If consumers choosing cereals made with whole grains were to flip to

the Nutrition Facts panel to ensure it was at least a good source of fiber

(rather than assume it was), this could result in a 144% increase in

fiber intake.


5151

Conclusions and

Next Steps

• Conclusions

• Role of Nutrition Professionals

• Fiber Messages for Consumers

• Fiber Resources


5252

Conclusions

• The definition and classification of dietary fiber has evolved and there

are a variety of new fiber ingredients available.

• Much of what we know about the benefits of fiber comes from studying

isolated, ―functional‖ fibers.

• Adding these newer fibers to foods consumers eat will provide a

greater variety of fiber-rich foods for consumers to chose from.

• There is growing recognition of the positive health benefits of functional

fibers. In fact, the development and use of these newer-fiber sources

may allow Americans to increase their fiber intake without sacrificing

taste.

• There are consistent and strong data for the role of dietary fiber in a

number of health outcomes, including heart disease, diabetes, weight

management, digestive health and cancer.

• Because different fibers have different physiological benefits, a mixture

of dietary fibers from a variety of food sources is desirable.


53

Conclusions (cont.)

• Nine out of 10 Americans – both children and adults – fall short of their

fiber recommendations. Among the many variables that may be driving

the fiber deficiency:

– Consumers mistakenly believe foods ‗made with whole grain‘ provide

significant levels of fiber.

– Intake of fruits, vegetables and legumes remain low.

– Americans eat very few foods that are at least a good source of fiber.

• To increase fiber intake, dietary advice should continue to emphasize

fruits, vegetables, legumes, whole grains, and nuts and seeds, in

addition to encouraging intake of fiber-enhanced foods.

– Given the lack of fiber-rich foods in today‘s diets, enhancing foods

with fiber, much like adding vitamins and minerals to foods, can play

a positive role in closing the fiber gap.


5454

Role of Nutrition Professionals

• Provide practical guidance on how to incorporate more fiber in daily

diets, including both traditional fiber-containing foods as well as foods

with added fiber.

• Re-train consumers to look specifically at fiber content on the labels of

packaged foods, specifically when choosing foods made with whole-

grain ingredients.

• Help educate consumers and the media about the importance of all

types of fiber in helping to meet fiber-intake recommendations.

• Stay current on fiber research and innovations to provide continued

guidance to consumers.


5555

Fiber Messages for Consumers

• ―Flip for Fiber‖ – Flip to the Nutrition Facts to get the full information on

fiber. Just looking at the front of the package is not enough.

• On the Nutrition Facts label—a good source of fiber provides at least 3

grams or 10% Daily Value (DV) and an excellent source of fiber

provides at least 5 grams or 20% DV.

• To get the most benefits of fiber, choose a variety of fiber-containing

foods, including whole foods such as fruits, vegetables and whole

grains, as well as fiber-enhanced foods.


5656

Fiber Resources: for Nutrition Education

• Kellogg‘s Nutrition: www.kelloggsnutrition.com:

– KNOW Fiber—a downloadable, ready-to-use, consumer-friendly

presentation to use with patients and clients.

– FIBER-pe-dia—a comprehensive resource on fiber basics, benefits,

recommendations, and food sources.

– Fiber Tracker—an online interactive tool to track daily intake of fiber

– ―From the Store to Your Table: Bringing Fiber To Your Family,‖ a

fiber fact sheet and recipe ideas.

– ―Charting Your Fiber Choices,‖ offering month-by-month tips for

increasing fiber and a chart to jot down daily fiber goals.

• WebMD: www.webmd.com:

– ―Why You Need More Fiber,‖ other fiber fact sheets.



http://www.webmd.com/

5757

Fiber Resources: for Professionals

• American Dietetic Association (ADA):

– Slavin JL. Position of the American Dietetic Association: Health

implications of dietary fiber. J Am Diet Assoc. 2008:108:1716-1731.

– Fiber evidence analysis project. ADA Evidence Analysis Library

Web site. http://www.adaevidencelibrary.com/topic.cfm?cat=1586

• International Food Information Council (IFIC): www.foodinsight.org

– ―Fiber Fact Sheet‖

– ―Functional Foods Backgrounder‖

• Kellogg‘s Nutrition: www.kelloggsnutrition.com

– Fact Sheets:

• ―The American Consumer: ‗Whole‘ Lot of Fiber Confusion‖

• ―Whole Grain Half Truths‖

• ―Every Gram Counts: Eating Away at the Fiber Deficit‖

– KNOW Nutrition Network


http://www.adaevidencelibrary.com/topic.cfm?cat=1586

http://www.foodinsight.org/


Glossary of terms

Dietary Fiber: non-digestible carbohydrates and lignin that are intrinsic and intact in plant cell

walls.

Fermentation: A process in which a microorganism (or other agent) transforms organic matter

into other products, such as breaking down fiber into short-chain fatty acids.

Fructooligosaccharides (FOS) – glucose or fructose-terminated polymers of fructose

naturally occurring in a variety of plants

Functional Fiber: isolated, non-digestible carbohydrates that have beneficial physiological

effects in humans. Also: novel, added and/or isolated

Polysaccharide: a carbohydrate, as starch, inulin, or cellulose, containing more than three

monosaccharide units per molecule

Prebiotic: A type of fiber that provide benefits by selectively stimulating the growth and/or

activity of bacteria in the colon.

Total Fiber: the sum of dietary fiber and functional fiber

Viscosity: resistance to flow

Source: Douglas LC and Sanders ME. Probiotics and Prebiotics in Dietetics Practice. J Am Diet Assoc. 2008;108:510-521.

58®, ™, © 2010 Kellogg NA Co.

Acknowledgments

This module was reviewed and approved by:

Penny Kris-Etherton, PhD, RD, FAHA

Penn State University

Amy Mobley, PhD, RD

Purdue University

Joanne Slavin, PhD, RD

University of Minnesota

Jenny Madrid, MPH, RD, CDE, BC-ADM (item writer)

59®, ™, © 2010 Kellogg NA Co.

fiber basics and beyond - kellogg's nutrition healthcare ......cellulose, pectin and gums....

Documents