Health benefits of dietary fiber.

Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements.

[1]  James W. Anderson,et al.  Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. , 1999, The American journal of clinical nutrition.

[2]  E. Rimm,et al.  Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. , 1996, Circulation.

[3]  N. Betts,et al.  The 'age+5' rule: comparisons of dietary fiber intake among 4- to 10-year-old children. , 1998, Journal of the American Dietetic Association.

[4]  Katherine M Flegal,et al.  Prevalence and trends in overweight among US children and adolescents, 1999-2000. , 2002, JAMA.

[5]  D. Mozaffarian,et al.  Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals. , 2003, JAMA.

[6]  W. Willett,et al.  Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. , 2005, JAMA.

[7]  M. Sugano,et al.  Dietary effect of guar gum and its partially hydrolyzed product on the lipid metabolism and immune function of Sprague-Dawley rats. , 1999, Bioscience, biotechnology, and biochemistry.

[8]  S. Beske,et al.  Oat consumption does not affect resting casual and ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage I hypertension. , 2002, The Journal of nutrition.

[9]  James W. Anderson.  Dietary Fiber and Associated Phytochemicals in Prevention and Reversal of Diabetes , 2009 .

[10]  T. Nicklas,et al.  Impact of dietary fat and fiber intake on nutrient intake of adolescents. , 2000, Pediatrics.

[11]  W. Haskell,et al.  Role of water-soluble dietary fiber in the management of elevated plasma cholesterol in healthy subjects. , 1992, The American journal of cardiology.

[12]  V. Loening-Baucke,et al.  Increased Prevalence of Obesity in Children With Functional Constipation Evaluated in an Academic Medical Center , 2005, Pediatrics.

[13]  W. Willett,et al.  Calcium, vitamin D, dairy products, and risk of colorectal cancer in the Cancer Prevention Study II Nutrition Cohort (United States) , 2003, Cancer Causes & Control.

[14]  L. Egede,et al.  Epidemiology of type 2 diabetes: focus on ethnic minorities. , 2005, The Medical clinics of North America.

[15]  M. Thun,et al.  A prospective study of whole grains, fruits, vegetables and colon cancer risk , 2003, Cancer Causes & Control.

[16]  G. Sturniolo,et al.  [Irritable bowel syndrome]. , 1988, Giornale di clinica medica.

[17]  J. Slavin,et al.  Partially hydrolyzed guar gum: clinical nutrition uses. , 2003, Nutrition.

[18]  K. Gould,et al.  Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial , 1990, The Lancet.

[19]  James W. Anderson,et al.  Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. , 2000, The American journal of clinical nutrition.

[20]  E. Wynder,et al.  A new recommendation for dietary fiber in childhood. , 1995, Pediatrics.

[21]  Judith Wylie-Rosett,et al.  Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee , 2006, Circulation.

[22]  P. Trumbo,et al.  Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. , 2002, Journal of the American Dietetic Association.

[23]  E. Harju,et al.  Long term effects of guar gum on lipid metabolism after carotid endarterectomy , 1995, BMJ.

[24]  C. Williams,et al.  Childhood diet, overweight, and CVD risk factors: the Healthy Start project. , 2008, Preventive cardiology.

[25]  J. Dwyer,et al.  Dietary fiber and progression of atherosclerosis: the Los Angeles Atherosclerosis Study. , 2003, The American journal of clinical nutrition.

[26]  D. Grobbee,et al.  Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. , 2005, Archives of internal medicine.

[27]  M. Rodríguez-Moran,et al.  Lipid- and glucose-lowering efficacy of Plantago Psyllium in type II diabetes. , 1998, Journal of diabetes and its complications.

[28]  J. Tuomilehto,et al.  Long term effects of guar gum on metabolic control, serum cholesterol and blood pressure levels in type 2 (non-insulin-dependent) diabetic patients with high blood pressure. , 1984, Annals of clinical research.

[29]  Judith Wylie-Rosett,et al.  Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. , 2004, The American journal of clinical nutrition.

[30]  F. Guarner.  Studies with inulin-type fructans on intestinal infections, permeability, and inflammation. , 2007, The Journal of nutrition.

[31]  W. Sheu,et al.  Konjac Supplement Alleviated Hypercholesterolemia and Hyperglycemia in Type 2 Diabetic Subjects—A Randomized Double-Blind Trial , 2003, Journal of the American College of Nutrition.

[32]  Julie R Jones,et al.  Dietary reference intakes: implications for fiber labeling and consumption: a summary of the International Life Sciences Institute North America Fiber Workshop, June 1-2, 2004, Washington, DC. , 2006, Nutrition reviews.

[33]  K. Walker,et al.  Arabinoxylan fiber, a byproduct of wheat flour processing, reduces the postprandial glucose response in normoglycemic subjects. , 2000, The American journal of clinical nutrition.

[34]  its Panel on Folate,et al.  FOOD AND NUTRITION BOARD , 1998 .

[35]  A. Dyer,et al.  Major Risk Factors as Antecedents of Fatal and Nonfatal Coronary Heart Disease Events , 2003 .

[36]  A. Tjønneland,et al.  Intake of fruit and vegetables and the risk of ischemic stroke in a cohort of Danish men and women. , 2003, The American journal of clinical nutrition.

[37]  Paul Knekt,et al.  Whole-grain and fiber intake and the incidence of type 2 diabetes. , 2003, The American journal of clinical nutrition.

[38]  Michael Proschan,et al.  Effects of Comprehensive Lifestyle Modification on Diet, Weight, Physical Fitness, and Blood Pressure Control: 18-Month Results of a Randomized Trial , 2006, Annals of Internal Medicine.

[39]  Arshag D Mooradian,et al.  Nutrition principles and recommendations in diabetes. , 2004, Diabetes care.

[40]  J. I. Rader,et al.  Historical perspective as a guide for identifying and developing applicable methods for dietary fiber. , 2005, Journal of AOAC International.

[41]  S. Grundy,et al.  Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. , 2003, Mayo Clinic proceedings.

[42]  L. Simons,et al.  Long-term treatment of hypercholesterolaemia with a new palatable formulation of guar gum. , 1982, Atherosclerosis.

[43]  J. Eriksson,et al.  High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study , 2006, Diabetologia.

[44]  D. Puder,et al.  Soluble fiber enhances the hypocholesterolemic effect of the step I diet in childhood. , 1995, Journal of the American College of Nutrition.

[45]  J. Goldblum,et al.  An oral supplement enriched with fish oil, soluble fiber, and antioxidants for corticosteroid sparing in ulcerative colitis: a randomized, controlled trial. , 2005, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[46]  V. Solfrizzi,et al.  Role of Olive Oil and Monounsaturated Fatty Acids in Mitochondrial Oxidative Stress and Aging , 2006 .

[47]  Smits Bj.  The irritable bowel syndrome. , 1974 .

[48]  W C Willett,et al.  Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. , 1998, Circulation.

[49]  R. E. Miller,et al.  Oat-bran intake selectively lowers serum low-density lipoprotein cholesterol concentrations of hypercholesterolemic men. , 1981, The American journal of clinical nutrition.

[50]  J. Anderson,et al.  Plant fiber and blood pressure. , 1983, Annals of internal medicine.

[51]  D. Kritchevsky,et al.  Dietary fiber in human nutrition , 1975 .

[52]  Dodson Pm,et al.  Long-term follow-up of the treatment of essential hypertension with a high-fibre, low-fat and low-sodium dietary regimen. , 1985 .

[53]  P. Elwood,et al.  EFFECTS OF CHANGES IN FAT, FISH, AND FIBRE INTAKES ON DEATH AND MYOCARDIAL REINFARCTION: DIET AND REINFARCTION TRIAL (DART) , 1989, The Lancet.

[54]  J. Keenan,et al.  Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. , 2002, The Journal of family practice.

[55]  J. Cummings.  The Effect of Dietary Fiber on Fecal Weight and Composition , 2001 .

[56]  James W. Anderson,et al.  Propionate Inhibits Hepatocyte Lipid Synthesis , 1990, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[57]  H. El‐Serag,et al.  Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers , 2004, Gut.

[58]  J. Florholmen,et al.  Experiences with three different fiber supplements in weight reduction. , 2005, Medical science monitor : international medical journal of experimental and clinical research.

[59]  P. Kris-Etherton,et al.  Recent discoveries in inclusive food-based approaches and dietary patterns for reduction in risk for cardiovascular disease , 2002, Current opinion in lipidology.

[60]  E. Rimm,et al.  Prospective study of diet and the risk of duodenal ulcer in men. , 1997, American journal of epidemiology.

[61]  James W. Anderson,et al.  Carbohydrate and Fiber Recommendations for Individuals with Diabetes: A Quantitative Assessment and Meta-Analysis of the Evidence , 2004, Journal of the American College of Nutrition.

[62]  A. Schatzkin,et al.  Dietary fiber and whole-grain consumption in relation to colorectal cancer in the NIH-AARP Diet and Health Study. , 2007, The American journal of clinical nutrition.

[63]  K. Ward,et al.  Long-term Effects of High-carbohydrate, High-fiber Diets on Glucose and Lipid Metabolism: A Preliminary Report on Patients with Diabetes , 1978, Diabetes Care.

[64]  E. Rimm,et al.  Dietary fiber reduces peripheral arterial disease risk in men. , 2003, The Journal of nutrition.

[65]  C. Field,et al.  The immune-enhancing effects of dietary fibres and prebiotics , 2002, British Journal of Nutrition.

[66]  C. Loria,et al.  Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988-91. , 1994, Advance data.

[67]  A. Prentice,et al.  Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. , 2002, The American journal of clinical nutrition.

[68]  U. Smith,et al.  Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. , 1992, The American journal of clinical nutrition.

[69]  M. S. Butt,et al.  Guar Gum: A Miracle Therapy for Hypercholesterolemia, Hyperglycemia and Obesity , 2007, Critical reviews in food science and nutrition.

[70]  M. Roberfroid,et al.  Introducing inulin-type fructans , 2005, British Journal of Nutrition.

[71]  L. F. Burroughs,et al.  DEPLETION AND DISRUPTION OF DIETARY FIBRE EFFECTS ON SATIETY, PLASMA-GLUCOSE, AND SERUM-INSULIN , 1977, The Lancet.

[72]  W. Willett,et al.  Long-Term Intake of Dietary Fiber and Decreased Risk of Cholecystectomy in Women , 2004, American Journal of Gastroenterology.

[73]  James W. Anderson,et al.  Importance of Weight Management in Type 2 Diabetes: Review with Meta-analysis of Clinical Studies , 2003, Journal of the American College of Nutrition.

[74]  R. Snow,et al.  Review of the Evidence. , 1964, Science.

[75]  P. Wilson,et al.  Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. , 2004, Diabetes care.

[76]  Y. Ho,et al.  Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids , 2000, Diseases of the colon and rectum.

[77]  J. Hankin,et al.  Fiber intake and risk of adenocarcinomas of the esophagus and stomach , 2007, Cancer Causes & Control.

[78]  M. Krotkiewski.  Effect of guar gum on the arterial blood pressure. , 2009, Acta medica Scandinavica.

[79]  S. Bertrais,et al.  Dietary fiber intake and risk factors for cardiovascular disease in French adults. , 2005, The American journal of clinical nutrition.

[80]  R. Kleinman,et al.  Pediatric Nutrition Handbook , 2003 .

[81]  S. Gropper,et al.  The therapeutic effect of fiber in treating obesity. , 1987, Journal of the American College of Nutrition.

[82]  G. Veereman.  Pediatric applications of inulin and oligofructose. , 2007, The Journal of nutrition.

[83]  D. Maslen,et al.  Constipation in the Elderly , 1994, Journal of the American Geriatrics Society.

[84]  A. Dyer,et al.  Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. , 2003, JAMA.

[85]  J. H. Lee,et al.  Consumption of Whole Grain and Legume Powder Reduces Insulin Demand, Lipid Peroxidation, and Plasma Homocysteine Concentrations in Patients With Coronary Artery Disease: Randomized Controlled Clinical Trial , 2001, Arteriosclerosis, thrombosis, and vascular biology.

[86]  James W. Anderson,et al.  Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia. , 2000, The American journal of clinical nutrition.

[87]  James W. Anderson,et al.  Hypocholesterolemic effects of different bulk-forming hydrophilic fibers as adjuncts to dietary therapy in mild to moderate hypercholesterolemia. , 1991, Archives of internal medicine.

[88]  P. Suter.  Carbohydrates and dietary fiber. , 2013, Handbook of experimental pharmacology.

[89]  B. Larijani,et al.  Psyllium decreased serum glucose and glycosylated hemoglobin significantly in diabetic outpatients. , 2005, Journal of ethnopharmacology.

[90]  F. Guarner.  Prebiotics in inflammatory bowel diseases , 2007, British Journal of Nutrition.

[91]  F. Rank,et al.  PRIMARY PREVENTION OF CORONARY HEART DISEASE IN WOMEN THROUGH DIET AND LIFESTYLE , 2000 .

[92]  J. Garssen,et al.  Immune-modulatory effects and potential working mechanisms of orally applied nondigestible carbohydrates. , 2007, Critical reviews in immunology.

[93]  W. Aldoori.  The protective role of dietary fiber in diverticular disease. , 1997, Advances in experimental medicine and biology.

[94]  Mark A Pereira,et al.  Effect of whole grains on insulin sensitivity in overweight hyperinsulinemic adults. , 2002, The American journal of clinical nutrition.

[95]  P. O’Connor,et al.  Do whole-grain oat cereals reduce the need for antihypertensive medications and improve blood pressure control? , 2002, The Journal of family practice.

[96]  D. Couper,et al.  Dietary fiber intake and glycemic index and incidence of diabetes in African-American and white adults: the ARIC study. , 2002, Diabetes care.

[97]  B. Rosner,et al.  Cholesterol-lowering effects of dietary fiber: a meta-analysis. , 1999, The American journal of clinical nutrition.

[98]  P. Whelton,et al.  Oats and buckwheat intakes and cardiovascular disease risk factors in an ethnic minority of China. , 1995, The American journal of clinical nutrition.

[99]  E. Giannini,et al.  Role of partially hydrolyzed guar gum in the treatment of irritable bowel syndrome. , 2006, Nutrition.

[100]  J. Anderson,et al.  Metabolic effects of high-carbohydrate, high-fiber diets for insulin-dependent diabetic individuals. , 1991, The American journal of clinical nutrition.

[101]  Adrian P Mander,et al.  Energy-dense, low-fiber, high-fat dietary pattern is associated with increased fatness in childhood. , 2008, The American journal of clinical nutrition.

[102]  Lawrence A Leiter,et al.  Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. , 2000, Diabetes care.

[103]  M. Roberfroid.  Inulin-type fructans: functional food ingredients. , 2004, The Journal of nutrition.

[104]  P. Dodson,et al.  Long-term follow-up of the treatment of essential hypertension with a high-fibre, low-fat and low-sodium dietary regimen. , 1985, Human nutrition. Clinical nutrition.

[105]  M. Morais,et al.  Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. , 1999, Journal of pediatric gastroenterology and nutrition.

[106]  F. Guarner.  Inulin and oligofructose: impact on intestinal diseases and disorders , 2005, British Journal of Nutrition.

[107]  L. Dieleman,et al.  Probiotics and prebiotics in chronic inflammatory bowel diseases. , 2006, World journal of gastroenterology.

[108]  R. Krauss.  Low-Fat Dietary Pattern and Risk of Invasive Breast Cancer: The Women's Health Initiative Randomized Controlled Dietary Modification Trial , 2006, Current atherosclerosis reports.

[109]  H. J. Mcclung,et al.  Constipation and dietary fiber intake in children. , 1995, Pediatrics.

[110]  A. Taneja,et al.  Effect of incorporation of isabgol husk in a low fibre diet on faecal excretion and serum levels of lipids in adolescent girls. , 1989, European Journal of Clinical Nutrition.

[111]  T. Hatch.  Encopresis and constipation in children. , 1988, Pediatric clinics of North America.

[112]  J. Tuomilehto,et al.  Long term treatment of severe hypercholesterolaemia with guar gum. , 1988, Atherosclerosis.

[113]  James W. Anderson,et al.  Meta-analysis of the effects of soy protein intake on serum lipids. , 1995, The New England journal of medicine.

[114]  E. Harju.  Guar gum benefits duodenal ulcer patients by decreasing gastric acidity and rate of emptying of gastric contents 60 to 120 minutes postprandially. , 1984, The American surgeon.

[115]  C. Koebnick,et al.  Arabinoxylan consumption decreases postprandial serum glucose, serum insulin and plasma total ghrelin response in subjects with impaired glucose tolerance , 2007, European Journal of Clinical Nutrition.

[116]  A. Folsom,et al.  Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. , 2003, The American journal of clinical nutrition.

[117]  Patrice D Cani,et al.  A place for dietary fibre in the management of the metabolic syndrome , 2005, Current opinion in clinical nutrition and metabolic care.

[118]  C. Koebnick,et al.  Cereal fiber improves whole-body insulin sensitivity in overweight and obese women. , 2006, Diabetes care.

[119]  Walter C Willett,et al.  Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women. , 2004, The American journal of clinical nutrition.

[120]  L. Niskanen,et al.  High-fiber rye bread and insulin secretion and sensitivity in healthy postmenopausal women. , 2003, The American journal of clinical nutrition.

[121]  G. Block,et al.  Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. , 1992, Nutrition and cancer.

[122]  James W. Anderson,et al.  Nutraceuticals, Glycemic Health and Type 2 Diabetes , 2008 .

[123]  James W. Anderson.  Whole grains and coronary heart disease: the whole kernel of truth. , 2004, The American journal of clinical nutrition.

[124]  C. Scarpignato,et al.  Management of Colonic Diverticular Disease , 2006, Digestion.

[125]  J. Manson,et al.  Whole grain consumption and risk of ischemic stroke in women: A prospective study. , 2000, JAMA.

[126]  C. Melby,et al.  The effect of fiber-rich carbohydrates on features of Syndrome X. , 2003, Journal of the American Dietetic Association.

[127]  C. Sacerdote,et al.  Dietary magnesium and fiber intakes and inflammatory and metabolic indicators in middle-aged subjects from a population-based cohort. , 2006, The American journal of clinical nutrition.

[128]  its Panel on Folate,et al.  STANDING COMMITTEE ON THE SCIENTIFIC EVALUATION OF DIETARY REFERENCE INTAKES , 1998 .

[129]  M. Ryan-Harshman,et al.  How diet and lifestyle affect duodenal ulcers. Review of the evidence. , 2004, Canadian family physician Medecin de famille canadien.

[130]  P. Whorwell,et al.  Double blind study of ispaghula in irritable bowel syndrome. , 1987, Gut.

[131]  J. Manson,et al.  Whole- and refined-grain intakes and the risk of hypertension in women. , 2007, The American journal of clinical nutrition.

[132]  C. L. Williams,et al.  Plant stanol ester and bran fiber in childhood: effects on lipids, stool weight and stool frequency in preschool children. , 1999, Journal of the American College of Nutrition.

[133]  P. Whelton,et al.  Effect of dietary fiber intake on blood pressure: a meta-analysis of randomized, controlled clinical trials , 2005, Journal of hypertension.

[134]  D. Burkitt,et al.  Refined Carbohydrate Foods and Disease: Some Implications of Dietary Fibre , 1975, Diabetes.

[135]  B. Watzl,et al.  Inulin, oligofructose and immunomodulation , 2005, British Journal of Nutrition.

[136]  M. Medow,et al.  Treatment of type IIa hyperlipidemia in childhood by a simplified American Heart Association diet and fiber supplementation. , 1990, American journal of diseases of children.

[137]  E. Rimm,et al.  Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. , 1996, JAMA.

[138]  G. Costamagna,et al.  Review article: uncomplicated diverticular disease of the colon , 2006, Alimentary pharmacology & therapeutics.

[139]  Maurice E. Shils,et al.  Modern Nutrition in Health and Disease , 1965, Diabetes.

[140]  J. Manson,et al.  Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. , 1999, JAMA.

[141]  J. Manson,et al.  Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. , 1999, The American journal of clinical nutrition.

[142]  F. Ingelfinger.  The Handbook of Nonprescription drugs. , 1977, The New England journal of medicine.