Effect Of Fiber Supplementation Research Articles

Global, distinctive, and personal changes in molecular and microbial profiles by specific fibers in humans

Dietary fibers act through the microbiome to improve cardiovascular health and prevent metabolic disorders and cancer. To understand the health benefits of dietary fiber supplementation, we investigated two popular purified fibers, arabinoxylan (AX) and long-chain inulin (LCI), and a mixture of five fibers. We present multiomic signatures of metabolomics, lipidomics, proteomics, metagenomics, a cytokine panel, and clinical measurements on healthy and insulin-resistant participants. Each fiber is associated with fiber-dependent biochemical and microbial responses. AX consumption associates with a significant reduction in LDL and an increase in bile acids, contributing to its observed cholesterol reduction. LCI is associated with an increase in Bifidobacterium. However, at the highest LCI dose, there is increased inflammation and elevation in the liver enzyme alanine aminotransferase. This study yields insights into the effects of fiber supplementation and the mechanisms behind fiber-induced cholesterol reduction, and it shows effects of individual, purified fibers on the microbiome.

Fibre supplementation for the prevention of type 2 diabetes and improvement of glucose metabolism: the randomised controlled Optimal Fibre Trial (OptiFiT)

Aims/hypothesisInsoluble cereal fibres have been shown in large prospective cohort studies to be highly effective in preventing type 2 diabetes, but there is a lack of interventional data. Our 2 year randomised double-blind prospective intervention study compared the effect of an insoluble oat fibre extract with that of placebo on glucose metabolism and incidence of diabetes.MethodsA total of 180 participants with impaired glucose tolerance underwent a modified version of the 1 year lifestyle training programme PREvention of DIAbetes Self-management (PREDIAS) and were randomised to receive a fibre supplement (n = 89; 7.5 g of insoluble fibre per serving) or placebo (n = 91; 0.8 g of insoluble fibre per serving) twice daily for 2 years. Eligible participants were men and women, were at least 18 years old and did not report corticosteroid or other intensive anti-inflammatory treatment, fibre intolerance or any of the following disorders: overt diabetes, chronic or malignant disease, or severe cardiopulmonary, endocrine, psychiatric, gastrointestinal, autoimmune or eating disorder. Participants were recruited at two clinical wards in Berlin and Nuthetal. The allocation was blinded to participants and study caregivers (physicians, dietitians, study nurses). Randomisation was conducted by non-clinical staff, providing neutrally numbered supplement tins. Both supplements were similar in their visual, olfactory and gustatory appearance. Intention-to-treat analysis was applied to all individuals.ResultsAfter 1 year, 2 h OGTT levels decreased significantly in both groups but without a significant difference between the groups (fibre −0.78 ± 1.88 mmol/l [p ≤ 0.001] vs placebo −0.46 ± 1.80 mmol/l [p = 0.020]; total difference 0.32 ± 0.29 mmol/l; not significant). The 2 year incidence of diabetes was 9/89 (fibre group) compared with 16/91 (placebo group; difference not significant). As secondary outcomes, the change in HbA1c level was significantly different between the two groups (−0.2 ± 4.6 mmol/mol [−0.0 ± 0.0%; not significant] vs +1.2 ± 5.2 mmol/mol [+0.1 ± 0.0%; not significant]; total difference 1.4 ± 0.7 mmol/mol [0.1 + 0.0%]); p = 0.018); insulin sensitivity and hepatic insulin clearance increased in both groups. After 2 years, improved insulin sensitivity was still present in both groups, although the effect size had diminished. Separate analysis of the sexes revealed a significantly greater reduction in 2 h glucose levels for women in the fibre group (−0.88 ± 1.59 mmol/l [p ≤ 0.001] vs −0.22 ± 1.52 mmol/l [p = 0.311]; total difference 0.67 ± 0.31 mmol/l; p = 0.015). Levels of fasting glucose, adipokines and inflammatory markers remained unchanged in the two groups. Significantly increased fibre intake was restricted to the fibre group, despite dietary counselling for both groups. No severe side effects occurred.Conclusions/interpretationWe cannot currently provide strong evidence for a beneficial effect of insoluble cereal fibre on glycaemic metabolism, although further studies may support minor effects of fibre supplementation in reducing glucose levels, insulin resistance and the incidence of type 2 diabetes.Trial registration:clinicaltrials.gov NCT01681173Funding: German Diabetes Foundation (grant no. 232/11/08)

Erratum: Effect of Fibre Supplementation on Body Weight and Composition, Frequency of Eating and Dietary Choice in Overweight Individuals Nutrients 2017, 9, 149.

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Response to Comments by Vuksan V. et al., Nutrients 2017, 9, 398, Regarding an Article by Solah V.A. et al., Nutrients 2017, 9, 149.

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Comments to Article by Solah VA et al., Nutrients 2017, 9, 149.

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Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults.

Chronic idiopathic constipation is a common symptom-based gastrointestinal disorder responsible for a substantial economic health service burden. Current guidelines recommend the use of fibre as a first-line treatment. To investigate the effect of fibre (including prebiotic) supplementation on global symptom response, stool output, gut microbiota composition and adverse events in adults with chronic idiopathic constipation. Medline, EmBase, Web of Science, Scopus and the Cochrane central register of controlled trials were searched through to February 2016. Conference proceedings from 2003 to 2015 were hand-searched. There were no language restrictions. Forest plots with 95% CIs were generated using a random-effects model. The search strategy generated 1072 citations, of which seven individual randomised controlled trials were eligible. Overall, 113 of 147 (77%) patients assigned to fibre responded to therapy, compared with 61 of 140 (44%) allocated to placebo (RR of success to respond 1.71, 95% CI 1.20-2.42, P = 0.003). Fibre significantly increased stool frequency (SMD, standardised mean difference = 0.39; 95% CI 0.03-0.76; P = 0.03) and softened stool consistency (SMD = 0.35; 95% CI 0.04-0.65; P = 0.02) compared with placebo. Flatulence was significantly higher with fibre compared to placebo (SMD 0.56, 0.12-1.00, P = 0.01). Overall quality of evidence was low. This meta-analysis demonstrates that fibre is moderately effective, but also causes moderate gastrointestinal side effects. However, these findings need to be treated with caution due to a high risk of bias. Accordingly, further large, methodologically rigorous trials are required, before any definitive recommendation regarding its risk-benefit profile can be made. PROSPERO registration number CRD42014007005.

ACP Journal Club: review: fiber supplementation improves symptoms in the irritable bowel syndrome.

Source Citation Moayyedi P, Quigley EM, Lacy BE, et al. The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol. 2014;109:1367-74. 25070054

The Effect of Fiber Supplementation on Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

Fiber has been used for many years to treat irritable bowel syndrome (IBS). This approach had fallen out of favor until a recent resurgence, which was based on new randomized controlled trial (RCT) data that suggested it might be effective. We have previously conducted a systematic review of fiber in IBS, but new RCT data for fiber therapy necessitate a new analysis; thus, we have conducted a systematic review of this intervention. MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched up to December 2013. Trials recruiting adults with IBS, which compared fiber supplements with placebo, control therapy, or "usual management", were eligible. Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy as well as number needed to treat (NNT) with a 95% confidence interval (CI). We identified 14 RCTs involving 906 patients that had evaluated fiber in IBS. There was a significant benefit of fiber in IBS (RR=0.86; 95% CI 0.80-0.94 with an NNT=10; 95% CI=6-33). There was no significant heterogeneity between results (I(2)=0%, Cochran Q=13.85 (d.f.=14), P=0.46). The benefit was only seen in RCTs on soluble fiber (RR=0.83; 95% CI 0.73-0.94 with an NNT=7; 95% CI 4-25) with no effect seen with bran (RR=0.90; 95% CI 0.79-1.03). Soluble fiber is effective in treating IBS. Bran did not appear to be of benefit, although we did not uncover any evidence of harm from this intervention, as others have speculated from uncontrolled data.

Effects of fiber supplementation on glycemic excursions and incidence of hypoglycemia in children with type 1 diabetes.

BackgroundNutritional therapy is an important component of diabetes management. There is data to suggest that fiber content of foods may affect glycemic response.Materials and methods10 children, diagnosed with type 1 diabetes, participated. In the first phase of the study, children followed their usual meal plan. In the second phase, subjects followed the same meal plan except that fiber was added to the diet using a powder supplement (wheat dextrin). Data was collected using a continuous glucose monitoring device. The blood glucose excursion level following each meal was compared between the two phases of the study by fitting a repeated measures regression model. The incidence of hypoglycemia was also compared by fitting a logistic regression model.ResultsThere was no difference in the mean blood glucose excursion after meals or the incidence of hypoglycemia between the two phases. There was a strong negative correlation between the amount of fiber supplemented and the mean maximum post-prandial blood sugar after the lunch and breakfast meals (Spearman rank correlation coefficient = −0.86 lunch and −0.76 breakfast).ConclusionOur study did not show an overall decrease in glucose excursion or incidence of hypoglycemia with fiber supplementation. We did find a strong negative correlation between the amount of fiber added during the supplemental phase and the mean maximum post-prandial blood sugar after the lunch and breakfast meals. We speculate that different types of fiber may have different effects on blood glucose with wheat dextrin having a greater dampening effect.

The Effect of Fiber Supplementation on the Microbiota in Critically Ill Patients

Purpose: Diarrhea is common and impairs outcome in critically ill patients dependent on tube feeding (EN). We hypothesize that conventional EN deprives the microbiota of their usual nutrition, leading to dysbiosis and diarrhea: to determine whether ‘normalization' of the fiber content of tube feeds can prevent this. Methods: Thirteen patients receiving EN for predominantly necrotizing pancreatitis were studied. Management included IV antibiotics and proton pump inhibitors. The study was divided into 2 parts: First, short-term (3-9 days) clinical tolerance and fermentation to short chain fatty acids (SCFA) and breath hydrogen and methane (BHM) during progressive fiber supplementation of EN to requirement levels of 25-28g/d. Second, 4 patients with diarrhea, were followed 2-5 weeks to additionally assess changes in fecal microbiota quantitated by qPCR of 16S rRNA and HITChip microarray. Results: Fecal microbiota mass was dramatically lower in patients compared to matched healthy volunteers consuming a normal diet, as were fecal SCFA, while BHM were high suggesting small bowel bacterial overgrowth. Compositional analysis showed that the major butyrate-producers and starch-degraders (Eubacterium rectale, Roseburia, Faecalibacterium prausnitzi, and Rumminococcus) as well as Bifidobacterium spp. were particularly depleted. Fiber (wheat dextrin) supplementation resolved diarrhea in 5/8 patients, without an increase in abdominal signs or symptoms. This was associated with some evidence (increased BHM, SCFA, butyrate-producers and starch-degraders) of improvement, but not normalization, of fermentation. Conclusion: Our study suggests that the microbiota and butyrate production are dramatically suppressed in critical illness possibly explaining the high prevalence of diarrhea in tube-fed patients. Fiber supplementation was well tolerated but only partly improved fermentation and diarrhea, suggesting other factors, such as antibiotics and PPIs, contribute to dysbiosis.Figure: Changes in some of the indices of bacterial fermentation. Statistics: ** p=0.008, *** p<0.0001, unpaired Student's t test.

Effect of fiber supplementation on the microbiota in critically ill patients.

To determine tolerance to fiber supplementation of semi-elemental tube feeds in critically ill patients and measure its effect on colonic microbiota and fermentation. Thirteen intensive care unit patients receiving jejunal feeding with a semi-elemental diet for predominantly necrotizing pancreatitis were studied. The study was divided into 2 parts: first, short-term (3-9 d) clinical tolerance and colonic fermentation as assessed by fecal short chain fatty acid (SCFA) concentrations and breath hydrogen and methane was measured in response to progressive fiber supplementation increasing from 4 g tid up to normal requirement levels of 8 g tid; second, 4 patients with diarrhea were studied for 2-5 wk with maximal supplementation to additionally assess its influence on fecal microbiota quantitated by quantitative polymerase chain reaction (qPCR) of microbial 16S rRNA genes and Human Intestinal Tract Chip (HITChip) microarray analysis. Nearly all patients were receiving antibiotics (10/13) and acid suppressants (11/13) at some stage during the studies. In group 1, tolerance to progressive fiber supplementation was good with breath hydrogen and methane evidence (P = 0.008 and P < 0.0001, respectively) of increased fermentation with no exacerbation of abdominal symptoms and resolution of diarrhea in 2 of 4 patients. In group 2 before supplementation, fecal microbiota mass and their metabolites, SCFA, were dramatically lower in patients compared to healthy volunteers. From qPCR and HITChip analyses we calculated that there was a 97% reduction in the predominant potential butyrate producers and starch degraders. Following 2-5 wk of fiber supplementation there was a significant increase in fecal SCFA (acetate 28.4 ± 4.1 μmol/g to 42.5 ± 3.1 μmol/g dry weight, P = 0.01; propionate 1.6 ± 0.5 vs 6.22 ± 1.1, P = 0.006 and butyrate 2.5 ± 0.6 vs 5.9 ± 1.1, P = 0.04) and microbial counts of specific butyrate producers, with resolution of diarrhea in 3 of 4 patients. Conventional management of critically ill patients, which includes the use of elemental diets and broad-spectrum antibiotics, was associated with gross suppression of the colonic microbiota and their production of essential colonic fuels, i.e., SCFA. Our investigations show that fiber supplementation of the feeds has the potential to improve microbiota mass and function, thereby reducing the risks of diarrhea due to dysbiosis.

Review article: uncomplicated diverticular disease of the colon

Diverticular disease of the colon is the fifth most important gastrointestinal disease in terms of direct and indirect health care costs in western countries. Uncomplicated diverticular disease is defined as the presence of diverticula in the absence of complications such as perforation, fistula, obstruction and/or bleeding. The distribution of diverticula along the colon varies worldwide being almost always left-sided and directly related to age in western countries and right-sided where diet is rich in fibre. The pathophysiology of diverticular disease is complex and relates to abnormal colonic motility, changes in the colonic wall, chronic mucosal low-grade inflammation, imbalance in colonic microflora and visceral hypersensitivity. Moreover, there can be genetic factors involved in the development of colonic diverticula. The use of non-absorbable antibiotics is the mainstay of therapy in patients with mild to moderate symptoms, and the effect of fibre-supplementation alone does not appear to be significantly different from placebo, although no definite data are available. More recently, alternative treatments have been reported. Mesalazine acts as a local mucosal immunomodulator and has been shown to improve symptoms and prevent recurrence of diverticulitis. In addition, probiotics have also been shown to be beneficial by re-establishing a normal gut microflora. In this study, the current literature on uncomplicated diverticular disease of the colon is reviewed.

Effect of fibre supplementation on dag formation and flystrike in sheep grazing spring pastures

Sheep on spring pastures may scour excessively due to the low levels of neutral detergent fibre. Scouring leads to dag formation, which predisposes sheep to flystrike, particularly in the breech area, posing a considerable challenge to sheep producers. This trial was undertaken to test whether supplementing sheep on spring pasture with fibre would reduce diarrhoea and thereby reduce dag formation and flystrike. Four hundred first-lambing Merino ewes were randomly allocated to control (no fibre supplementation) and fibre treatment (ad libitum cereal hay or wheat straw supplementation) groups in a 2-paddock crossover trial, which was conducted from August through the spring flush to crutching in October. The bulk fecal egg counts of each group were no different at the start of the trial but the fibre group had a higher (P&lt;0.05) fecal egg count than the control at crutching. Fecal egg count was not correlated with dag score. Fecal dry matter percentage was higher (P&lt;0.05) in the fibre group but there was no difference in dag wet weight or dry matter percentage between the treatment groups. Dag scores of a sample of 100 sheep from each group were significantly (P&lt;0.01) lower at crutching. There was no difference between the groups in the incidence of flystrike, however, there were significantly (P&lt;0.001) more sheep with high dag scores (&gt;3) in the control group than the fibre treatment group. These results indicate that the supplementation of spring pasture with low quality hay or straw can reduce dag formation by improving the consistency of feces and, thereby, reduce the number of sheep with dag scores greater than 3.

The effect of fiber supplementation on lipid profile in children with hypercholesterolemia.

The effect of fiber supplementation on lipid profile in children with hypercholesterolemia.

The effects of fiber supplementation on diet digestibility by silver foxes

A digestibility study with Silver foxes weighing 6.5 ± 0.1 kg was conducted to evaluate five fibers (hemicellulose (X), α-cellulose (C), pectin (P), oat bran (B) and oat hulls (H)) added at 5% to a meat-type diet (A). Apparent digestibility of dry matter in diet P (65.1%) was significantly poorer (P &lt; 0.05) than all others except C (69.1%). Addition of all fibers reduced digestibility of acid detergent fiber. Diet P resulted in weight loss, increased water consumption, and faster rate of passage than diet A (P &lt; 0.05). Key words: Digestibility, oat bran, rate of passage, hemicellulose, fiber, fox

Dietary Fiber in Hospitalized Geriatric Patients

Increased fiber in the diet has been shown in the past to improve bowel function in elderly outpatients and in long-term care institutions. A randomized placebo-controlled, double-blind study was conducted in a geriatric ward of an acute-care hospital to see if a palatable form of fiber would decrease the incidence of constipation and use of laxatives. In this patient sample, no beneficial effect of fiber supplementation could be found when used up to three weeks.

Effect of fiber supplements on the apparent absorption of pharmacological doses of riboflavin

The effect of dietary fiber from wheat bran and psyllium gum on the apparent absorption of riboflavin was studied in 12 healthy women. The test fiber was consumed in crackers that contained approximately 7.5 gm fiber from psyllium gum, wheat bran, or a combination of the two sources. Each subject was given a riboflavin load test after consuming one of the three different fiber supplements or a control supplement that contained 1.3 gm fiber. Fractional urine collections were made for 24 hours, and riboflavin was measured by fluorometric techniques. The psyllium gum and combination supplements reduced the 24-hour apparent absorption of riboflavin from 31.8% to 25.4% and 26.1%, respectively (p less than .01). No effect of the wheat bran supplement on riboflavin was detected.