Recensione

Bibliografia__________________________________________________________________________

P NPV, Joye IJ. Dietary Fibre from Whole Grains and Their Benefits on Metabolic Health. Nutrients. 2020 Oct 5;12(10):3045. doi: 10.3390/nu12103045. PMID: 33027944; 

Abstract. The consumption of whole grain products is often related to beneficial effects on consumer health. Dietary fibre is an important component present in whole grains and is believed to be (at least partially) responsible for these health benefits. The dietary fibre composition of whole grains is very distinct over different grains. Whole grains of cereals and pseudo-cereals are rich in both soluble and insoluble functional dietary fibre that can be largely classified as e.g., cellulose, arabinoxylan, β-glucan, xyloglucan and fructan. However, even though the health benefits associated with the consumption of dietary fibre are well known to scientists, producers and consumers, the consumption of dietary fibre and whole grains around the world is substantially lower than the recommended levels. This review will discuss the types of dietary fibre commonly found in cereals and pseudo-cereals, their nutritional significance and health benefits observed in animal and human studies.

Stephen AM, Champ MM, Cloran SJ, Fleith M, van Lieshout L, Mejborn H, Burley VJ. Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health. Nutr Res Rev. 2017 Dec;30(2):149-190. doi: 10.1017/S095442241700004X. 

Abstract. Research into the analysis, physical properties and health effects of dietary fibre has continued steadily over the last 40-50 years. From the knowledge gained, countries have developed guidelines for their populations on the optimal amount of fibre to be consumed each day. Food composition tables from many countries now contain values for the dietary fibre content of foods, and, from these, combined with dietary surveys, population intakes have been determined. The present review assessed the uniformity of the analytical methods used, health claims permitted, recommendations and intakes, particularly from national surveys across Europe and around the world. It also assessed current knowledge on health effects of dietary fibre and related the impact of different fibre types on health. The overall intent was to be able to provide more detailed guidance on the types of fibre which should be consumed for good health, rather than simply a total intake figure, the current situation. Analysis of data indicated a fair degree of uniformity in the definition of dietary fibre, the method used for analysis, the recommended amount to be consumed and a growing literature on effects on digestive health and disease risk. However, national dietary survey data showed that intakes do not reach recommendations and very few countries provide guidance on the types of fibre that are preferable to achieve recommended intakes. Research gaps were identified and ideas suggested to provide information for more detailed advice to the public about specific food sources that should be consumed to achieve health benefits.

Gill SK, Rossi M, Bajka B, Whelan K. Dietary fibre in gastrointestinal health and disease. Nat Rev Gastroenterol Hepatol. 2021 Feb;18(2):101-116. doi: 10.1038/s41575-020-00375-4. 

Abstract. Epidemiological studies have consistently demonstrated the benefits of dietary fibre on gastrointestinal health through consumption of unrefined whole foods, such as wholegrains, legumes, vegetables and fruits. Mechanistic studies and clinical trials on isolated and extracted fibres have demonstrated promising regulatory effects on the gut (for example, digestion and absorption, transit time, stool formation) and microbial effects (changes in gut microbiota composition and fermentation metabolites) that have important implications for gastrointestinal disorders. In this Review, we detail the major physicochemical properties and functional characteristics of dietary fibres, the importance of dietary fibres and current evidence for their use in the management of gastrointestinal disorders. It is now well-established that the physicochemical properties of different dietary fibres (such as solubility, viscosity and fermentability) vary greatly depending on their origin and processing and are important determinants of their functional characteristics and clinical utility. Although progress in understanding these relationships has uncovered potential therapeutic opportunities for dietary fibres, many clinical questions remain unanswered such as clarity on the optimal dose, type and source of fibre required in both the management of clinical symptoms and the prevention of gastrointestinal disorders. The use of novel fibres and/or the co-administration of fibres is an additional therapeutic approach yet to be extensively investigated.

Dwyer JT, Goldin B, Gorbach S, Patterson J. Drug therapy reviews: dietary fiber and fiber supplements in the therapy of gastrointestinal disorders. Am J Hosp Pharm. 1978 Mar;35(3):278-87. 

Abstract. Dietary fiber and fiber supplements are reviewed, with particular emphasis on their sources, composition and properties; physiological actions on gastrointestinal functions; and uses in gastrointestinal disease states (functional bowel disease, diverticular disease and other conditions). Adverse effects and contraindications, and the hypothesis of diet's effect on colon cancer also are discussed. Dietary fiber supplements may relieve symptoms of constipation, spastic colon, and diverticular disease; in the two latter disorders, colonic pressure relationships are altered. It is concluded that current evidence does not support other therapeutic uses for dietary fiber sonstituents, except possibly in patients with anal fissures and hemorrhoids, which can be helped by the passage of a softer stool.

Cronin P, Joyce SA, O'Toole PW, O'Connor EM. Dietary Fibre Modulates the Gut Microbiota. Nutrients. 2021 May 13;13(5):1655. doi: 10.3390/nu13051655. PMID: 34068353; 

Abstract. Dietary fibre has long been established as a nutritionally important, health-promoting food ingredient. Modern dietary practices have seen a significant reduction in fibre consumption compared with ancestral habits. This is related to the emergence of low-fibre "Western diets" associated with industrialised nations, and is linked to an increased prevalence of gut diseases such as inflammatory bowel disease, obesity, type II diabetes mellitus and metabolic syndrome. The characteristic metabolic parameters of these individuals include insulin resistance, high fasting and postprandial glucose, as well as high plasma cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Gut microbial signatures are also altered significantly in these cohorts, suggesting a causative link between diet, microbes and disease. Dietary fibre consumption has been hypothesised to reverse these changes through microbial fermentation and the subsequent production of short-chain fatty acids (SCFA), which improves glucose and lipid parameters in individuals who harbour diseases associated with dysfunctional metabolism. This review article examines how different types of dietary fibre can differentially alter glucose and lipid metabolism through changes in gut microbiota composition and function.

Slavin JL. Dietary fiber: classification, chemical analyses, and food sources. J Am Diet Assoc. 1987 Sep;87(9):1164-71. 

Abstract. Dietary fiber's role in the prevention and treatment of constipation has long been known, but now fiber is touted as a cure for many of the ills in Western countries. Although some data exist to relate dietary fiber intake to certain diseases, lack of agreement on what dietary fiber is and how it should be measured make interpreting the data difficult. Further, not all dietary fiber is created equal. Water-soluble fibers, such as pectin and gums, have little effect on stool weight and hence are not appropriate treatment for patients with constipation. Water-insoluble fibers, such as cellulose and hemicellulose, are most effective in aiding laxation but may also limit absorption of minerals and possibly vitamins. Wheat bran is a good source of hemicellulose; vegetables supply cellulose to the diet. Most agencies are recommending a doubling or tripling of dietary fiber intake. Typical recommendations are set at 25 to 50 grams of dietary fiber daily. Different analytical methods for dietary fiber yield conflicting fiber values, and dietary fiber values do not exist for many foods, making fiber recommendations controversial and difficult to achieve. Fiber in the diet should ideally be increased by the consumption of unrefined breads and cereals and more fruits and vegetables. Vegetarians routinely consume 40 to 50 gm dietary fiber daily without ill effect. Fiber supplements may be appropriate for some patients, but the composition of the fiber should be known and be appropriate for the disease being treated. Before fiber supplements are marketed, clinical trials should be conducted to support the use of the supplements in the prevention and treatment of disease.

McCleary BV. Dietary fibre analysis. Proc Nutr Soc. 2003 Feb;62(1):3-9. doi: 10.1079/PNS2002204. 

Abstract. The 'gold standard' method for the measurement of total dietary fibre is that of the Association of Official Analytical Chemists (2000; method 985.29). This procedure has been modified to allow measurement of soluble and insoluble dietary fibre, and buffers employed have been improved. However, the recognition of the fact that non-digestible oligosaccharides and resistant starch also behave physiologically as dietary fibre has necessitated a re-examination of the definition of dietary fibre, and in turn, a re-evaluation of the dietary fibre methods of the Association of Official Analytical Chemists. With this realisation, the American Association of Cereal Chemists appointed a scientific review committee and charged it with the task of reviewing and, if necessary, updating the definition of dietary fibre. It organised various workshops and accepted comments from interested parties worldwide through an interactive website. More recently, the (US) Food and Nutrition Board of the Institute of Health, National Academy of Sciences, under the oversight of the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, assembled a panel to develop a proposed definition(s) of dietary fibre. Various elements of these definitions were in agreement, but not all. What was clear from both reviews is that there is an immediate need to re-evaluate the methods that are used for dietary fibre measurement and to make appropriate changes where required, and to find new methods to fill gaps. In this presentation, the 'state of the art' in measurement of total dietary fibre and dietary fibre components will be described and discussed, together with suggestions for future research.