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  1. Seal CJ, Nugent AP, Tee ES, Thielecke F
    Br J Nutr, 2016 06;115(11):2031-8.
    PMID: 27082494 DOI: 10.1017/S0007114516001161
    Increased whole-grain (WG) consumption reduces the risk of CVD, type 2 diabetes and some cancers, is related to reduced body weight and weight gain and is related to improved intestinal health. Definitions of 'WG' and 'WG food' are proposed and used in some countries but are not consistent. Many countries promote WG consumption, but the emphasis given and the messages used vary. We surveyed dietary recommendations of fifty-three countries for mentions of WG to assess the extent, rationale and diversity in emphasis and wording of any recommendations. If present, recommendations were classified as either 'primary', where the recommendation was specific for WG, or 'secondary', where recommendations were made in order to achieve another (primary) target, most often dietary fibre intake. In total, 127 organisations were screened, including government, non-governmental organisations, charities and professional bodies, the WHO and European Food Safety Authority, of which forty-nine including WHO provide a WG intake recommendation. Recommendations ranged from 'specific' with specified target amounts (e.g. x g WG/d), 'semi-quantitative' where intake was linked to intake of cereal/carbohydrate foods with proportions of WG suggested (e.g. x servings of cereals of which y servings should be WG) to 'non-specific' based on 'eating more' WG or 'choosing WG where possible'. This lack of a harmonised message may result in confusion for the consumer, lessen the impact of public health messages and pose barriers to trade in the food industry. A science-based consensus or expert opinion on WG recommendations is needed, with a global reach to guide public health decision making and increase WG consumption globally.
    Matched MeSH terms: Dietary Fiber/administration & dosage
  2. Freisling H, Pisa PT, Ferrari P, Byrnes G, Moskal A, Dahm CC, et al.
    Eur J Nutr, 2016 Sep;55(6):2093-104.
    PMID: 26303194 DOI: 10.1007/s00394-015-1023-x
    PURPOSE: Various food patterns have been associated with weight change in adults, but it is unknown which combinations of nutrients may account for such observations. We investigated associations between main nutrient patterns and prospective weight change in adults.

    METHODS: This study includes 235,880 participants, 25-70 years old, recruited between 1992 and 2000 in 10 European countries. Intakes of 23 nutrients were estimated from country-specific validated dietary questionnaires using the harmonized EPIC Nutrient DataBase. Four nutrient patterns, explaining 67 % of the total variance of nutrient intakes, were previously identified from principal component analysis. Body weight was measured at recruitment and self-reported 5 years later. The relationship between nutrient patterns and annual weight change was examined separately for men and women using linear mixed models with random effect according to center controlling for confounders.

    RESULTS: Mean weight gain was 460 g/year (SD 950) and 420 g/year (SD 940) for men and women, respectively. The annual differences in weight gain per one SD increase in the pattern scores were as follows: principal component (PC) 1, characterized by nutrients from plant food sources, was inversely associated with weight gain in men (-22 g/year; 95 % CI -33 to -10) and women (-18 g/year; 95 % CI -26 to -11). In contrast, PC4, characterized by protein, vitamin B2, phosphorus, and calcium, was associated with a weight gain of +41 g/year (95 % CI +2 to +80) and +88 g/year (95 % CI +36 to +140) in men and women, respectively. Associations with PC2, a pattern driven by many micro-nutrients, and with PC3, a pattern driven by vitamin D, were less consistent and/or non-significant.

    CONCLUSIONS: We identified two main nutrient patterns that are associated with moderate but significant long-term differences in weight gain in adults.

    Matched MeSH terms: Dietary Fiber/administration & dosage
  3. Tan SL, Juliana S, Sakinah H
    Malays J Nutr, 2011 Dec;17(3):287-99.
    PMID: 22655451 MyJurnal
    Introduction: Compliance with medical nutrition therapy is important to improve patient outcomes. The purpose of this study was to determine dietary compliance and its association with glycemic control among outpatients with poorly controlled type 2 diabetes mellitus (T2DM) in Hospital Universiti Sains Malaysia (HUSM).
    Methods: In this cross-sectional study, patients who had a glycosylated hemoglobin (HbA1c) level of at least 6.5%, after attending a diet counseling session at the Outpatient Dietetic Clinic, HUSM, were enrolled. Out of 150 diabetic patients reviewed between 2006 and 2008, 61 adults (32 men and 29 women) agreed to participate in this study. A questionnaire-based interview was used to collect socio-demographic, clinical and diabetes self-care data. The patient’s dietary compliance rate was determined by the Summary of Diabetes Self-Care Activities (SDSCA) measure. Anthropometric and biological measurements were also taken.
    Results: Only 16.4% of the respondents adhered to the dietary regimen provided by dietitians. Among the 7 dietary self-care behaviours, item number 6 (eat lots of food high in dietary fibre such as vegetable or oats) had the highest compliant rate (54.1%); whereas item number 3 (eat five or more servings of
    fruits and vegetables per day) had the lowest compliant rate (23.0%). There was a significant association between gender (p=0.037) and fasting blood sugar (FBS) (p=0.007) with the compliance status. Conclusion: Dietary non-compliance is still common among T2DM patients. Dietitians need to improve their skills and use more effective intervention approaches in providing dietary counseling to patients.
    Keywords: Dietary compliance, diet counseling, type 2 diabetes mellitus
    Matched MeSH terms: Dietary Fiber/administration & dosage
  4. Robert SD, Ismail AA, Rosli WI
    Eur J Nutr, 2016 Oct;55(7):2275-80.
    PMID: 26358163 DOI: 10.1007/s00394-015-1037-4
    PURPOSE: This study aimed to determine whether fenugreek seed powder could reduce the glycemic response and glycemic index (GI) when added to buns and flatbreads.

    METHODS: In a randomised, controlled crossover trial, ten healthy human subjects (five men, five women) were given 50 g glucose (reference food, twice); buns (0 and 10 % fenugreek seed powder); and flatbreads (0 and 10 % fenugreek seed powder) on six different occasions. Finger prick capillary blood samples were collected at 0, 15, 30, 45, 60, 90 and 120 min after the start of the meal. The palatability of the test meals was scored using Likert scales.

    RESULTS: The incremental areas under the glucose curve value of buns and flatbreads with 10 % fenugreek (138 ± 17 mmol × min/L; 121 ± 16 mmol × min/L) were significantly lower than those of 0 % fenugreek bun and flatbreads (227 ± 15 mmol × min/L; 174 ± 14 mmol × min/L, P = <0.01). Adding 10 % fenugreek seed powder reduced the GI of buns from 82 ± 5 to 51 ± 7 (P 

    Matched MeSH terms: Dietary Fiber/administration & dosage
  5. Romieu I, Ferrari P, Chajès V, de Batlle J, Biessy C, Scoccianti C, et al.
    Int J Cancer, 2017 Jan 15;140(2):316-321.
    PMID: 27599758 DOI: 10.1002/ijc.30415
    Alcohol intake has been related to an increased risk of breast cancer (BC) while dietary fiber intake has been inversely associated to BC risk. A beneficial effect of fibers on ethanol carcinogenesis through their impact on estrogen levels is still controversial. We investigated the role of dietary fiber as a modifying factor of the association of alcohol and BC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). This study included 334,850 women aged 35-70 years at baseline enrolled in the ten countries of the EPIC study and followed up for 11.0 years on average. Information on fiber and alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. Hazard ratios (HR) of developing invasive BC according to different levels of alcohol and fiber intake were computed. During 3,670,439 person-years, 11,576 incident BC cases were diagnosed. For subjects with low intake of fiber (<18.5 g/day), the risk of BC per 10 g/day of alcohol intake was 1.06 (1.03-1.08) while among subjects with high intake of fiber (>24.2 g/day) the risk of BC was 1.02 (0.99-1.05) (test for interaction p = 0.011). This modulating effect was stronger for fiber from vegetables. Our results suggest that fiber intake may modulate the positive association of alcohol intake and BC. Alcohol is well known to increase the risk for BC, while a fiber-rich diet has the opposite effect. Here the authors find a significant interaction between both lifestyle factors indicating that high fiber intake can ease the adverse effects associated with alcohol consumption. Consequently, women with high alcohol intake and low fiber intake (<18.5 g/day) had the highest risk for BC. Specific benefits were associated with fibers from vegetable, warranting further investigations into specific fiber sources and their mechanistic interactions with alcohol-induced BC risk.
    Matched MeSH terms: Dietary Fiber/administration & dosage*
  6. Karupaiah T, Aik CK, Heen TC, Subramaniam S, Bhuiyan AR, Fasahat P, et al.
    J Sci Food Agric, 2011 Aug 30;91(11):1951-6.
    PMID: 21480266 DOI: 10.1002/jsfa.4395
    BACKGROUND: We evaluated glycaemic response of a brown rice variant (BR) developed by cross-breeding. Subjects (n = 9) consumed 50 g carbohydrate equivalents of BR, white rice (WR) and the polished brown rice (PR) in comparison to 50 g glucose reference (GLU) in a cross-over design. Plasma glucose and insulin at 0, 15, 45, 60, 90, 120 and 180 min were measured and incremental area under the curve (IAUC) and indices for glucose (GI) and insulin (II) calculated.
    RESULTS: BR compared to PR or WR produced the lowest postprandial glycaemia (GI: 51 vs 79 vs 86) and insulinaemia (II: 39 vs 63 vs 68) irrespective of amylose content (19 vs 23 vs 26.5%). Only BR was significantly different from GLU for both plasma glucose (P = 0.012) and insulin (P = 0.013) as well as IAUC(glu) (P = 0.045) and IAUC(ins) (P = 0.031). Glycaemic and insulinaemic responses correlated positively (r = 0.550, P < 0.001). Linear trends for IAUC(glu) and IAUC(ins) indicated a greater secretion of insulin tied in with a greater glycaemic response for WR (r(2) = 0.848), moderate for PR (r(2) = 0.302) and weakest for BR (r(2) = 0.122).
    CONCLUSION: The brown rice variant had the lowest GI and II values but these advantages were lost with polishing.
    Matched MeSH terms: Dietary Fiber/administration & dosage
  7. Lee YY, Yu S, Khurana S, Rao SS
    Gastroenterology, 2014 Apr;146(4):1133-4.
    PMID: 24576735 DOI: 10.1053/j.gastro.2013.12.043
    Matched MeSH terms: Dietary Fiber/administration & dosage*
  8. Wong JE, Skidmore PM, Williams SM, Parnell WR
    J Nutr, 2014 Jun;144(6):937-42.
    PMID: 24744308 DOI: 10.3945/jn.113.188375
    Adoption of optimal dietary habits during adolescence is associated with better health outcomes later in life. However, the associations between a pattern of healthy dietary habits encapsulated in an index and sociodemographic and nutrient intake have not been examined among adolescents. This study aimed to develop a behavior-based diet index and examine its validity in relation to sociodemographic factors, nutrient intakes, and biomarkers in a representative sample of New Zealand (NZ) adolescents aged 15-18 y (n = 694). A 17-item Healthy Dietary Habits Score for Adolescents (HDHS-A) was developed based on dietary habits information from the 2008/2009 NZ Adult Nutrition Survey. Post hoc trend analyses were used to identify the associations between HDHS-A score and nutrient intakes estimated by single 24-h diet recalls and selected nutritional biomarkers. Being female, not of Maori or Pacific ethnicity, and living in the least-deprived socioeconomic quintile were associated with a higher HDHS-A score (all P < 0.001). HDHS-A tertile was associated positively with intake of protein, dietary fiber, polyunsaturated fatty acid, and lactose and negatively with sucrose. Associations in the expected directions were also found with most micronutrients (P < 0.05), urinary sodium (P < 0.001), whole blood (P < 0.05), serum (P < 0.01), and RBC folate (P < 0.05) concentrations. This suggests that the HDHS-A is a valid indicator of diet quality among NZ adolescents.
    Matched MeSH terms: Dietary Fiber/administration & dosage
  9. Erdogan A, Rao SS, Thiruvaiyaru D, Lee YY, Coss Adame E, Valestin J, et al.
    Aliment Pharmacol Ther, 2016 07;44(1):35-44.
    PMID: 27125883 DOI: 10.1111/apt.13647
    BACKGROUND: Fibre supplements are useful, but whether a plum-derived mixed fibre that contains both soluble and insoluble fibre improves constipation is unknown.

    AIM: To investigate the efficacy and tolerability of mixed soluble/insoluble fibre vs. psyllium in a randomized double-blind controlled trial.

    METHODS: Constipated patients (Rome III) received mixed fibre or psyllium, 5 g b.d., for 4 weeks. Daily symptoms and stool habit were assessed using stool diary. Subjects with ≥1 complete spontaneous bowel movement/week above baseline for ≥2/4 weeks were considered responders. Secondary outcome measures included stool consistency, bowel satisfaction, straining, gas, bloating, taste, dissolvability and quality of life (QoL).

    RESULTS: Seventy-two subjects (mixed fibre = 40; psyllium = 32) were enrolled and two from psyllium group withdrew. The mean complete spontaneous bowel movement/week increased with both mixed fibre (P < 0.0001) and psyllium (P = 0.0002) without group difference. There were 30 (75%) responders with mixed fibre and 24 (75%) with psyllium (P = 0.9). Stool consistency increased (P = 0.04), straining (P = 0.006) and bloating scores decreased (P = 0.02) without group differences. Significantly more patients reported improvement in flatulence (53% vs. 25%, P = 0.01) and felt that mixed fibre dissolved better (P = 0.02) compared to psyllium. QoL improved (P = 0.0125) with both treatments without group differences.

    CONCLUSIONS: Mixed fibre and psyllium were equally efficacious in improving constipation and QoL. Mixed fibre was more effective in relieving flatulence, bloating and dissolved better. Mixed fibre is effective and well tolerated.

    Matched MeSH terms: Dietary Fiber/administration & dosage*
  10. Barakatun Nisak MY, Ruzita AT, Norimah AK, Gilbertson H, Nor Azmi K
    J Am Coll Nutr, 2010 Jun;29(3):161-70.
    PMID: 20833988 DOI: 10.1080/07315724.2010.10719830
    OBJECTIVES: This randomized controlled study was conducted to determine the effect of low glycemic index (GI) dietary advice on eating patterns and dietary quality in Asian patients with type 2 diabetes (T2DM).

    METHODS: Asian patients with T2DM (N  =  104) were randomized into 2 groups that received either low GI or conventional carbohydrate exchange (CCE) dietary advice for 12 weeks. Nutritional prescriptions were based on the medical nutrition therapy for T2DM, with the difference being in the GI component of the carbohydrates. Dietary intake and food choices were assessed with the use of a 3-day food record.

    RESULTS: At week 12, both groups achieved the recommendations for carbohydrate (52 ± 4% and 54 ± 4% of energy) and fat (30 ± 4% and 28 ± 5% of energy) intake. There were no significant differences in the reported macronutrient intake in both groups. With the low GI diet, crude fiber and dietary calcium intake increased, while the dietary GI reduced. Subjects in the lowest dietary glycemic index/glycemic load (GI/GL) quartile consumed more parboiled/basmati rice, pasta, milk/dairy products, fruits, and dough, which are foods from the low GI category. There was a significant reduction in the hemoglobin A(1c) level at week 12 for patients in the lowest GI/GL quartile (Δ  =  -0.7 ± 0.1%) compared with those in the highest GI/GL quartile (Δ  =  -0.1 ± 0.2%).

    CONCLUSIONS: These results demonstrate the ability of low GI dietary advice to improve the dietary quality of Asian patients with T2DM.
    Matched MeSH terms: Dietary Fiber/administration & dosage
  11. Hatami M, Taib MN, Jamaluddin R, Saad HA, Djazayery A, Chamari M, et al.
    Appetite, 2014 Nov;82:194-201.
    PMID: 25068789 DOI: 10.1016/j.appet.2014.07.026
    This study investigated the determinants of overweight/obesity in adolescents. A cross-sectional survey was carried out on 1157 adolescents. Weight and height were measured. Information on socio-economic status (SES), dietary intakes, physical activity, and sedentary behaviours were collected by a self-administered questionnaire. Binary and multivariate binary logistic regressions were used to obtain the relationships and odds-ratios, respectively. The prevalence of overweight and obesity was higher among adolescents in low- or high-income families, adolescents whose mothers worked out of home, adolescents whose parents were both overweight, adolescents who watched a lot of TV or had excessive energy intake, adolescents with lower physical activity or lower intake of dietary fibre, those who skipped breakfast ≥ 4 times per week, and those with low and high fat intake. However, multiple logistic regression analysis showed that only energy intake was associated with increased odds and vegetables and fibre intake were associated with a reduction in the odds of being overweight (all p<0.05). Adolescents from middle SES showed a lower risk of overweight/obesity than low and high SES due to better dietary intakes and less sedentary behaviours. Therefore, in overweight/obesity prevention programs, adolescents with determined risk factors from families with low and high SES should receive attention.
    Matched MeSH terms: Dietary Fiber/administration & dosage
  12. Kamarul Zaman M, Chin KF, Rai V, Majid HA
    World J Gastroenterol, 2015 May 7;21(17):5372-81.
    PMID: 25954112 DOI: 10.3748/wjg.v21.i17.5372
    To investigate fiber and prebiotic supplementation of enteral nutrition (EN) for diarrhea, fecal microbiota and short-chain fatty acids (SCFAs).
    Matched MeSH terms: Dietary Fiber/administration & dosage*
  13. Shyam S, Arshad F, Abdul Ghani R, Wahab NA, Safii NS, Nisak MY, et al.
    Nutr J, 2013 May 24;12:68.
    PMID: 23705645 DOI: 10.1186/1475-2891-12-68
    BACKGROUND: Gestational Diabetes Mellitus (GDM) increases risks for type 2 diabetes and weight management is recommended to reduce the risk. Conventional dietary recommendations (energy-restricted, low fat) have limited success in women with previous GDM. The effect of lowering Glycaemic Index (GI) in managing glycaemic variables and body weight in women post-GDM is unknown.

    OBJECTIVE: To evaluate the effects of conventional dietary recommendations administered with and without additional low-GI education, in the management of glucose tolerance and body weight in Asian women with previous GDM.

    METHOD: Seventy seven Asian, non-diabetic women with previous GDM, between 20- 40y were randomised into Conventional healthy dietary recommendation (CHDR) and low GI (LGI) groups. CHDR received conventional dietary recommendations only (energy restricted, low in fat and refined sugars, high-fibre). LGI group received advice on lowering GI in addition. Fasting and 2-h post-load blood glucose after 75 g oral glucose tolerance test (2HPP) were measured at baseline and 6 months after intervention. Anthropometry and dietary intake were assessed at baseline, three and six months after intervention. The study is registered at the Malaysian National Medical Research Register (NMRR) with Research ID: 5183.

    RESULTS: After 6 months, significant reductions in body weight, BMI and waist-to-hip ratio were observed only in LGI group (P<0.05). Mean BMI changes were significantly different between groups (LGI vs. CHDR: -0.6 vs. 0 kg/m2, P= 0.03). More subjects achieved weight loss ≥5% in LGI compared to CHDR group (33% vs. 8%, P=0.01). Changes in 2HPP were significantly different between groups (LGI vs. CHDR: median (IQR): -0.2(2.8) vs. +0.8 (2.0) mmol/L, P=0.025). Subjects with baseline fasting insulin≥2 μIU/ml had greater 2HPP reductions in LGI group compared to those in the CHDR group (-1.9±0.42 vs. +1.31±1.4 mmol/L, P<0.001). After 6 months, LGI group diets showed significantly lower GI (57±5 vs. 64±6, P<0.001), GL (122±33 vs. 142±35, P=0.04) and higher fibre content (17±4 vs.13±4 g, P<0.001). Caloric intakes were comparable between groups.

    CONCLUSION: In women post-GDM, lowering GI of healthy diets resulted in significant improvements in glucose tolerance and body weight reduction as compared to conventional low-fat diets with similar energy prescription.

    Matched MeSH terms: Dietary Fiber/administration & dosage
  14. Kadir NAAA, Azlan A, Abas F, Ismail IS
    Nutrients, 2020 Nov 14;12(11).
    PMID: 33202660 DOI: 10.3390/nu12113511
    A source of functional food can be utilized from a source that might otherwise be considered waste. This study investigates the hypocholesterolemic effect of defatted dabai pulp (DDP) from supercritical carbon dioxide extraction and the metabolic alterations associated with the therapeutic effects of DDP using 1H NMR urinary metabolomic analysis. Male-specific pathogen-free Sprague-Dawley rats were fed with a high cholesterol diet for 30 days to induce hypercholesterolemia. Later, the rats were administered with a 2% DDP treatment diet for another 30 days. Supplementation with the 2% DDP treatment diet significantly reduced the level of total cholesterol (TC), triglyceride, low-density lipoprotein (LDL), and inflammatory markers (C-reactive protein (CRP), interleukin 6 (IL6) and tumour necrosis factor-α (α-TNF)) and significantly increased the level of antioxidant profile (total antioxidant status (TAS), superoxide dismutase (SOD), glutathione peroxide (GPX), and catalase (CAT)) compared with the positive control group (PG) group (p < 0.05). The presence of high dietary fibre (28.73 ± 1.82 g/100 g) and phenolic compounds (syringic acid, 4-hydroxybenzoic acid and gallic acid) are potential factors contributing to the beneficial effect. Assessment of 1H NMR urinary metabolomics revealed that supplementation of 2% of DDP can partially recover the dysfunction in the metabolism induced by hypercholesterolemia via choline metabolism. 1H-NMR-based metabolomic analysis of urine from hypercholesterolemic rats in this study uncovered the therapeutic effect of DDP to combat hypercholesterolemia.
    Matched MeSH terms: Dietary Fiber/administration & dosage
  15. Mazlyn MM, Nagarajah LH, Fatimah A, Norimah AK, Goh KL
    Malays J Nutr, 2013 Apr;19(1):53-64.
    PMID: 24800384 MyJurnal
    Diet and lifestyle modification is commonly used in constipation management. As there is a dearth of studies on this topic in Malaysia, we aim to elucidate the relations between stool patterns, dietary intake and physical activity levels among adults with functional constipation.
    Matched MeSH terms: Dietary Fiber/administration & dosage
  16. Daud NM, Ismail NA, Thomas EL, Fitzpatrick JA, Bell JD, Swann JR, et al.
    Obesity (Silver Spring), 2014 Jun;22(6):1430-8.
    PMID: 24715424 DOI: 10.1002/oby.20754
    OBJECTIVE: To investigate the effect of nutrient stimulation of gut hormones by oligofructose supplementation on appetite, energy intake (EI), body weight (BW) and adiposity in overweight and obese volunteers.

    METHODS: In a parallel, single-blind and placebo-controlled study, 22 healthy overweight and obese volunteers were randomly allocated to receive 30 g day(-1) oligofructose or cellulose for 6 weeks following a 2-week run-in. Subjective appetite and side effect scores, breath hydrogen, serum short chain fatty acids (SCFAs), plasma gut hormones, glucose and insulin concentrations, EI, BW and adiposity were quantified at baseline and post-supplementation.

    RESULTS: Oligofructose increased breath hydrogen (P 

    Matched MeSH terms: Dietary Fiber/administration & dosage
  17. Sabatino A, Regolisti G, Karupaiah T, Sahathevan S, Sadu Singh BK, Khor BH, et al.
    Clin Nutr, 2017 06;36(3):663-671.
    PMID: 27371993 DOI: 10.1016/j.clnu.2016.06.007
    BACKGROUND & AIMS: Protein-Energy Wasting (PEW) is the depletion of protein/energy stores observed in the most advanced stages of Chronic Kidney Disease (CKD). PEW is highly prevalent among patients on chronic dialysis, and is associated with adverse clinical outcomes, high morbidity/mortality rates and increased healthcare costs. This narrative review was aimed at exploring the pathophysiology of PEW in end-stage renal disease (ESRD) on hemodialysis. The main aspects of nutritional status evaluation, intervention and monitoring in this clinical setting were described, as well as the current approaches for the prevention and treatment of ESRD-related PEW.

    METHODS: An exhaustive literature search was performed, in order to identify the relevant studies describing the epidemiology, pathogenesis, nutritional intervention and outcome of PEW in ESRD on hemodialysis.

    RESULTS AND CONCLUSION: The pathogenesis of PEW is multifactorial. Loss of appetite, reduced intake of nutrients and altered lean body mass anabolism/catabolism play a key role. Nutritional approach to PEW should be based on a careful and periodic assessment of nutritional status and on timely dietary counseling. When protein and energy intakes are reduced, nutritional supplementation by means of specific oral formulations administered during the hemodialysis session may be the first-step intervention, and represents a valid nutritional approach to PEW prevention and treatment since it is easy, effective and safe. Omega-3 fatty acids and fibers, now included in commercially available preparations for renal patients, could lend relevant added value to macronutrient supplementation. When oral supplementation fails, intradialytic parenteral nutrition can be implemented in selected patients.

    Matched MeSH terms: Dietary Fiber/administration & dosage
  18. Jankovic N, Geelen A, Streppel MT, de Groot LC, Kiefte-de Jong JC, Orfanos P, et al.
    Am J Clin Nutr, 2015 Oct;102(4):745-56.
    PMID: 26354545 DOI: 10.3945/ajcn.114.095117
    BACKGROUND: Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly.

    OBJECTIVE: The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged ≥60 y.

    DESIGN: We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model.

    RESULTS: During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I(2) = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I(2) = not applicable).

    CONCLUSION: Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.

    Matched MeSH terms: Dietary Fiber/administration & dosage
  19. Appannah G, Pot GK, Huang RC, Oddy WH, Beilin LJ, Mori TA, et al.
    Nutr Metab Cardiovasc Dis, 2015 Jul;25(7):643-50.
    PMID: 26026208 DOI: 10.1016/j.numecd.2015.04.007
    BACKGROUND AND AIMS: Energy dense, high fat, low fibre diets may contribute to obesity in young people, however their relationships with other cardiometabolic risk factors are unclear. We examined associations between an 'energy-dense, high-fat and low-fibre' dietary pattern (DP) and cardiometabolic risk factors, and the tracking of this DP in adolescence.

    METHODS AND RESULTS: Data was sourced from participants in the Western Australian Pregnancy (Raine) Cohort Study. At 14 and 17 y, dietary intake, anthropometric and biochemical data were measured and z-scores for an 'energy dense, high fat and low fibre' DP were estimated using reduced rank regression (RRR). Associations between DP z-scores and cardiometabolic risk factors were examined using regression models. Tracking of DP z-scores was assessed using Pearson's correlation coefficient. A 1 SD unit increase in DP z-score between 14 and 17 y was associated with a 20% greater odds of high metabolic risk (95% CI: 1.01, 1.41) and a 0.04 mmol/L higher fasting glucose in boys (95% CI: 0.01, 0.08); a 28% greater odds of a high-waist circumference (95% CI: 1.00, 1.63) in girls. An increase of 3% and 4% was observed for insulin and HOMA (95% CI: 1%, 7%), respectively, in boys and girls, for every 1 SD increase in DP z-score and independently of BMI. The DP showed moderate tracking between 14 and 17 y of age (r = 0.51 for boys, r = 0.45 for girls).

    CONCLUSION: An 'energy dense, high fat, low fibre' DP is positively associated with cardiometabolic risk factors and tends to persist throughout adolescence.

    Matched MeSH terms: Dietary Fiber/administration & dosage
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