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Natalie Maglich

HUN 3230

Advanced Nutrition Science 1

Dr. Arikawa

Position of the American Dietetic Association: Health Implications of Dietary Fiber

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It is the position of The American Dietetic Association that the public should consume
adequate amounts of dietary fiber from a variety of plant foods ( Journal 1716).1
The American Dietetic Association states that populations should consume additional
dietary fiber from a variety of plant based foods, which will lead to less chronic disease in
individuals.1 Studies recently have proven that not just the solubility of the fiber is important,
but properties such as fermentability and viscosity are important parameters of fiber as well.
These high fiber diets provide fecal bulk, are more filling, and have been connected to lowering
body weight in individuals. Healthy children and adults can meet this daily fiber requirement
by adding a variety of foods to their diet.1 The major points the Position of the American
Dietetic Association focuss on in this article include:
Sources of fibers
Benefits of sufficient fiber intake
Clinical uses of dietary fiber
Fibers affecting mineral absorption,
bone mineral content, and bone structure
How a healthy fiber intake can effect
Cardiovascular disease, gastrointestinal health
and disease, weight control, and diabetes.
Potential negative effects of dietary fiber
Sources of fibers include dietary fibers, functional fibers and total fiber.1 Dietary fibers
would describe the non-digestible carbohydrates and lignin that are intact in plants, whereas
functional fibers are nondigestable carbohydrates that can benefit the human body. Total fiber
is the sum of the dietary and functional fiber. High fiber foods such as whole grains, legumes,
fruits and vegetables should be included when consuming a high fiber diet. Oat bran, barley
bran, and psyllium are mostly soluble fibers, which can be attributed to lowering blood lipid
levels in individuals. Wheat bran and other insoluble fibers have been associated with laxation
as well.1
Benefits of adequate fiber intake in individuals can include a decrease in cardiovascular
disease, improved gastrointestinal health, weight control, and beneficial to patients with
diabetes.1 A high-fiber diet from whole foods may lower blood pressure, improve serum levels,
and reduce inflammation. Increased stool weight is another benefit that is caused by the
presence of the fiber, the water absorption of the fiber, and by fermentation of fiber, which then
increases the bacteria of the stool. This process promotes normal laxation every day for
individuals who have problems with bowel function. Weight reduction may be affected by
consuming around 20-27g/day from whole foods. In patients with diabetes, studies were
conducted that compared a low fiber diet and it concluded that if an individual consumes a diet
with 30-50g of fiber per day it may produce lower serum glucose levels in patients with
diabetes.1
Other roles for fiber that can contribute to a persons improved health include fiber
affect on mineral absorption, bone mineral content, and bone structure.1 Dietary fiber has also
been linked to increasing calcium absorption in adolescents and post-menopausal women.
Lastly, excess fiber intake has potentially negative side effects that include reduced absorption
of vitamins, minerals, proteins, and energy. Diarrhea is also another side effect of excess fiber
intake.1
The American Dietetic Association states that based on current data, consuming dietary
fiber from whole foods and supplements could have some benefits such as weight loss and
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other health benefits.1 They suggest that fiber intakes of 20 to 27g/day from whole foods can
have favorable outcomes to overweight individuals. Three mechanisms by which fiber can act
as a physiological obstacle with energy intake include: fiber can displace available energy and
nutrients from the diet, fiber can increase chewing which promotes more saliva and gastric
juices leading to expansion of the stomach causing a feeling of fullness. Lastly, fiber reduces
the absorption efficiency of the small intestine. In the studies collected the average
effectiveness of increasing fiber intake by 14g per day resulted in a 10% decrease in energy
intake, and a weight loss of 1.9kg at 3.8 months from beginning of the change. In addition, they
also saw an increase of effectiveness in fiber in obese patients. The study concluded that they
believed increasing the populations intake of fiber to 25g to 30g/day would be beneficial in
reducing the prevalence of obesity.1 This review paper demonstrates the importance of
adequate intake of fiber and its benefits on prevention of chronic disease. Similarly, in an
article written in the Journal of Human Nutrition and Dietetics present a study that has some
similar supporting arguments about adequate intake of fiber and weight control.
In a study published in the Journal of Human Nutrition and Dietetics, Tonsad, Malik,
and Haddad conducted a study on high-fiber bean-rich diet versus a low-carbohydrate diet for
obesity. In this study they compared a diet that was high in beans, which increased dietary fiber
to promote weight loss, with a low carbohydrate diet in a randomized control trial. According
to this study they suggest that even though weight loss tends to be more effective with low-
carbohydrate diets than low-fat diets in short term, differences seem to even out after 1-2
years.3 Low-fat diets have been used extensively as treatment for obesity, however low-fat diets
have not been shown to prevent chronic disease. This study monitored approximately 178
randomized subjects, and were set up with a registered dietician who educated participants with
instructional material on their diets. Subjects in the high fiber group added one serving of beans
to one meal a day. It was gradually increased to one serving with each meal 3 times a day.
Individuals in the low-carbohydrate group began reducing their intake of carbohydrates at the
same time. After 16 weeks both groups decreased their weight, BMI, waist and hip
circumferences, and blood pressure. Those who consumed the high fiber diet significantly
decreased atherogenic lipids versus the low-carbohydrate diet, which did not. Patients with the
low carb diet tended to have a lower BMI and waist circumference, whereas patients on high
fiber had lowered LDL cholesterol and total cholesterol over the 16 weeks. This article
concluded that the weight lost seen in the low-carbohydrate diet was similar to that of the high-
fiber diet. After 52 weeks it was recorded that the weight loss in the low-carb diet was retained
better than that of the high fiber diet, but total cholesterol was lower in this group.3
In comparing this article to that of the position of the American Dietetic Association, it
does agree with the position statement The public should consume adequate amounts of
dietary fiber from a variety of plant based foods, which could then have benefits of reduced
chance of chronic disease.1 The Journal of Human Nutrition and Dietetics does compare their
high-fiber diet to that of a low-carbohydrate diet, which shows that there was not much
difference in weight loss amongst the groups. However, in addition to weight loss, the high-
fiber diet lowered LDL cholesterol and total cholesterol, which is very important for prevention
of cardiovascular disease. Therefor, this study further supports the position of the academy on
dietary fiber.
Alternative Medicine Review conducted an additional study on the effect of a novel
viscous polysaccharide along with lifestyle changes on short-term weight loss and associated
risk factors in overweight and obese adults. This research study provides evidence that an
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added viscous fiber polysaccharide along with lifestyle changes had a beneficial effect on
weight control. According to this article, viscous soluble fiber has been shown to promote
satiety, which will give a sense of being full and then cause a person to eat less amounts of food
and improve the ability to lose weight.2
In this study a total of 29 sedentary women and men participated in a clinical weight
loss program. In addition, each patient took PolyGlycoplex (PGX), which is a highly viscous
polysaccharide.2 The patients took 5g of this dietary fiber 3 times a day with each meal.
Individuals who had type 2 diabetes, using tobacco, employing prescription or non-prescription
weight-loss medications, using weight-loss programs, pregnant, or lactating, or who had a BMI
less than 25 kg/m^2 or greater then 36 kg/m^2 were not accepted into the program. Each
participant was evaluated every two weeks for his or her height, weight, and wait-hip
measurements. Each patient was given directions for healthy eating, weight loss, and exercise.
The recommended for food were focused on portion control and including foods such as
vegetables, fruits, whole grains, legumes, lean protein and choosing lower fat options.2
During the 14-weeks of the PGX use there was a significant reduction in weight loss for
the entire group.2 Men lost an average of 8.30+-2.79 kg, while the women lost 5.14+-3.49 kg
over the 14-week period. The subjects lipid levels showed a significant decrease of 19.26
percent and 25.51 percent in plasma total and LDL-cholesterol values. The participants also has
a 6.96 percent decrease in fasting glucose, a 12.05 percent decline in glucose on the two-hour
glucose tolerance test, and a 27.76 percent reduction in fasting insulin levels. A report was also
given to the participants at the end of the study and 97.7 percent of the patients noted that they
had a curb in appetite and food cravings while participating in this study.2
These results are significant and agree with the position of the American Dietetic
Associations position paper. All three of these articles support the position statement that the
public should consume an adequate amount of dietary fiber from plant-based foods to prevent
chronic disease and control weight. The first article discusses and compares the benefits of a
high-fiber bean-rich diet versus a low-carbohydrate diet and how they can be effective for
weight loss. The article also discussed how this high-fiber diet had positive and favorable
results on LDL cholesterol levels. In the second article they also recorded results of patients
BMI and cholesterol levels decreasing. This difference between this study and the first study is
that they used a dietary fiber supplement in addition to placing their study group on an exercise
regime.
In conclusion, this high-fiber diet combined with weight-loss could be a very promising
diet for patients who are overweight and have cardiovascular disease. Even though these
articles focused on the correlation between weight and fiber intake, they also presented with
lowering levels of cholesterol, which could potentially reduce chronic disease in the United
States. With the rising epidemic of obesity and cardiovascular disease, making sure that the
population can get the adequate amount of dietary fiber daily is something that is feasible and
should be emphasized in nutritional community outreach. Although not just fiber can help
control weight, along with a healthy balanced diet and exercise these studies show promising
conclusions that should be further researched for future generations and for decreasing chronic
disease in the country.
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References

1. Gorman, Bowman C. Position of The American Dietetic Association: Health

implications of dietary fiber. Journal of the American Dietetic Association.
2008;108(10):1716-1731. doi:10.1016/0002-8223(93)92252-s.

2. Lyon MR, Reichart RG. The Effect of a Novel Polysaccharide Blend (PGX micro-
granules) on Short- Term Weight Loss and Other Laboratory Parameters in Overweight
and Obese Adults: an Observational Retrospective Analysis. http://isrctnorg/>.
2010;15(1):68-75. doi:10.1186/isrctn50749194.
3. Tonstad S, Malik N, Haddad E. A high-fibre bean-rich diet versus a low-carbohydrate diet
for obesity. Journal of Human Nutrition and Dietetics J Hum Nutr Diet. 2014;27:109-
116. doi:10.1111/jhn.12118. Gorman MA, Bowman C. Position of The American
Dietetic Association: Health implications of dietary fiber. Journal of the American
Dietetic Association. 2008;108(10):1716-1731. doi:10.1016/0002-8223(93)92252-s.