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Phillips2013 Dietary Fibrea Chemical Category or Health Ingredient PDF
Phillips2013 Dietary Fibrea Chemical Category or Health Ingredient PDF
Phillips2013 Dietary Fibrea Chemical Category or Health Ingredient PDF
www.elsevier.com/locate/bcdf
Glyn O. Phillipsa,b,n
a
Glyn O. Phillips Hydrocolloids Research Centre, Glyndŵr University, Wrexham, LL11 2AW Wales, UK
b
Phillips Hydrocolloids Research Ltd., 45 Old Bond Street, London W1S 4AQ, UK
Article history: Consideration is given to the extent to which the definition of a dietary fibre should relate to
Received 4 May 2012 its chemical nature or to its physiological action. Whereas a dietary fibre needs to fulfil the
Received in revised form necessary condition of forming short-chain fatty acid in the colon, any specific health claim
28 December 2012 must be independently verified. Clarification is also required when interchangeable or
overlapping terms are used such as dietary fibre, prebiotic, and probiotic. For biomaterials
Keywords: which show biological activity, the extent to which the whole material provides the
Dietary fibre bioactivity relative to contribution of specific components needs to be determined. Despite
Polysaccharide the acceptance of an international definition of dietary fibre by Codex, individual countries
Short-chain fatty acids and regions tend also to adopt additional requirements. A dilemma could also arise if a
Prebiotic decision based on national health research is used to by-pass the cumbersome international
EFSA
Health claim
Contents
n
Correspondence address: Glyn O. Phillips Hydrocolloids Research Centre, Glyndŵr University, Wrexham, LL11 2AW Wales, UK.
Tel.: þ44 2920 843298; fax: þ44 2920 843145.
E-mail address: phillipsglyn@aol.com
2212-6198/$ - see front matter & 2013 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.bcdf.2012.12.001
4 Bioactive Carbohydrates and Dietary Fibre 1 (2013) 3 –9
Dietary fibre: They report that prebiotics were being examined for anti
pathogenic effects (such as inhibiting adhesion of pathogenic
improves laxation or regularity by increasing stool bulk; organisms to the gut mucosa), and also being developed to
reduces blood total and/or LDL cholesterol levels; decrease faecal transit time, lower cholesterol and the glycae
reduces post-prandial blood glucose and/or insulin levels; and mic response, improve bone health, lower daily energy (fat)
provides energy-yielding metabolites through colonic intake, relieve symptom of inflammatory bowel disease, and
fermentation. attempt to lower colon cancer rates. The report draws atten
tion to the dilemma already noted in this paper that many of
Before use in Canada a novel dietary fibre without a history the same effects are being promoted for ‘‘dietary fibres’’,
of food use must prove its safely and a demonstrable physio- which raises the question of if and how prebiotics can be
logical effect must be established. Thus, there is a need to differentiated from, or are they the same as, dietary fibres?
conform to individual country’s regulations, which could be The FAO meeting put forward a definition for ‘‘prebiotics’’,
somewhat different to the basic requirements of Codex. namely: ‘‘A prebiotic is a non-viable food component that
confers a health benefit on the host associated with modula-
tion of the microbiota’’. To make things even more confusing
3. Overlapping definitions they concluded also ‘‘A prebiotic can be a fibre but a fibre need
not be a prebiotic’’. Therefore there must be a method to
What then is the term ‘‘dietary fibre’’ intended to do? Is it distinguish and decide what qualities constitute a prebiotic,
designed to identify a specific category of carbohydrate which which raises practical and regulatory difficulties. The require-
immediately conveys the impression that it will impart a health ments which they identify are set out in Annex 1a and Fig. b1.
benefit by acting physiologically in a particular manner? If it can
be shown that it is not metabolised in the stomach but passes
into the colon where it is bacterially fermented to give short- 5. The position of probiotics
chain fatty acids, is this sufficient to promote it as a healthy food?
It is important to recognise that nutritional functions can Another well publicised intervention in the ‘‘healthy food’’
overlap for carbohydrates which have, for good practical reasons, category are the ‘‘Probiotics’’ (Steven et al., 2002) which seek to
been given a label which points to some physical, chemical or ensure balanced microflora by introducing directly ‘‘colonic
metabolic characteristic. For example the terms ‘‘dietary fibres’’, foods’’ which claim to add to the amount of bacteria in the colon
‘‘non-starch polysaccharides’’ and ‘‘prebiotics’’ can be applied to termed ‘‘beneficial’’ so that they dominate over the potentially
the same polysaccharide. The subject has suffered from being harmful bacteria. It remains a controversial subject but the
fragmented with chemical and biological observations often concept is helpful in the overall dietary fibre context since it
being presented in unrelated contexts. Usually the physiology stimulates research into the importance of microbial flora. The
aspects have taken preference over the functional material value to health of these probiotic products now on the market
component’s specific characteristics. For example the definition: remains unproven. Stephen, Henry, Marks, and Short (2002)
‘A prebiotic is a non-digestible food ingredient that beneficially affects identifies the following physiological role of microbial flora:
the host by selectively stimulating the growth and/or activity of one of a
limited number of bacteria in the colon, and thus improves host health’ fermentation and salvation of energy from nutrients
(Gibson, Probert, Van Loo, Rastall, & Roberfroid, 2004). However, which are partly or totally resistant to digestion in the
‘‘dietary fibre’’ and ‘‘non-starch polysaccharides can act in the upper gastrointestinal tract (stomach and small intestine);
same way. The terms do not represent a single chemical help in the absorption of vitamins and minerals;
category, but each might well represent a health benefit. Their establishment of a barrier to protect the organism from
independent use could have a useful function. Short chain undesirable microbial invasion; and
polysaccharide production in the human colon influences the production of acetate, propionate and butyrate, the short
fuel energy availability from the substrate, could control move- chain fatty acids that play key roles as modulators of cell
ment of water out of the colon lumen, play an important role in turnover and cell differentiation in the colonic mucosa
maintaining mucosal integrity and possibly influence the inci- and which act also as regulators of the metabolism in
dence of small bowel cancer and lower serum cholesterol etc. systemic tissues like the liver or even the muscle.
(Cummings & Macfarlane, 1991).
Materials which influence the behaviour of the microbial
4. Dietary fibre and prebiotics population of the colon, therefore, have a basic health
interest. There is reason then to find a chemical definition
An FAO Report (2007) stated that the market for prebiotics in which when used directly implies that short chain fatty acids
food is growing rapidly and at that time there are over 400 are produced when passing into the colon. That could be the
prebiotic food products and more than 20 companies produ- reason why historically there seems to have been a desire to
cing oligosaccharides and fibres used as ‘‘prebiotics’’. A Frost encompass both concepts when defining dietary fibre: ‘‘Intrin-
& Sullivan review on The World Prebiotic Ingredient Market sic cell wall polysaccharides’’ to give the chemical pedigree and
(http://www.ubic-consulting.com/template/fs/The-World-Pre ‘‘indigestibility in the small intestine’’ to convey a physiological
biotic-Ingredient-Market.pdf) reported that the European pre advantage (Englyst & Liu, 2007; Englyst, 2007). In any event a
biotics market in 2007 was worth 87 million euro, and claimed health effect needs to be proved rather than implied
predicted that it would reach 179.7 million euro by 2010. by reference to the broad definitions.
6 Bioactive Carbohydrates and Dietary Fibre 1 (2013) 3 –9
Consideration too needs to be given to the influence of the emulsification capability, gel formation etc of carbohydrate and
physical nature of the dietary carbohydrate on the physiolo- protein hydrocolloids, the structure-function relationships are
gical behaviour. Jenkins et al. (1978) showed that viscosity considered paramount and have been well studied. Likewise this
of the diet had an important action on the glucose responses is now the challenge for bioactive polysaccharides, where it has
of non-starch polysaccharides. already been shown that conformation of a polysaccharide such
as lentinan has been shown to control its biological action.
been established between the consumption of acacia gum and main- In this respect they quote the EFSA definition of dietary fibre as all non-
tenance of normal blood cholesterol concentrations.’’ digestible carbohydrates plus lignin that comprises:
Further separate claims for acacia gums were also sub-
mitted for decreasing potentially pathogenic gastro-intestinal
microorganisms (ID 758), changes in short chain fatty acid non-starch polysaccharides—cellulose, hemicelluloses,
(SCFA) production and pH in the gastro-intestinal tract (ID pectins, hydrocolloids (gums, mucilages, beta-glucans);
759), changes in bowel function (ID 759), reduction of gastro- resistant oligosaccharides—fructo-oligosaccharides (FOS),
intestinal discomfort (ID 759), maintenance of faecal nitrogen galacto-oligosaccharides (GOS), other oligosaccharides that
content and/or normal blood urea concentrations (ID 840, 1975), resist digestion (with three or more monomeric units);
and maintenance of normal blood LDL–cholesterol concentra- resistant starch—physically enclosed starch, some types
tions (ID 841) pursuant to Article 13(1) of Regulation (EC) no. 1924/ of raw starch granules, retrograded amylose, chemically
20061. All were rejected by the EFSA panel usually because the and/or physically modified starches; and
cause and effects had not been established. lignin naturally associated with dietary fibre polysaccharides.
There is no disagreement about whether acacia gum is a
dietary fibre, and there is published information about its
physiological behaviour within the functions for which the ‘‘Can we then promote such materials as healthy foods?’’
claims were made. Whereas the practitioners in the acacia field Buttriss and Stokes (2008), presumably giving the views of
have for a considerable time quoted these health claims by the British Nutrition Foundation states that ‘‘People who eat
referring to published data, EFSA has now ruled that they will fibre-rich diets tend to have a reduced risk of certain cancers,
not allow a definite health claim to be made. Many probiotic coronary heart disease (CHD) and obesity. Fibre can help to reduce
products came to the same fate at the hands of EFSA. Other the energy density of foods owing to its bulking effect and can
hydrocolloids dietary fibres have fared better than acacia gum. promote satiety’’. Is this becoming close to advancing a health
The following health claims have been accepted: claim? The UK government’s Scientific Advisory Committee
on Nutrition (SACN) 2008 has reviewed the role of dietary
carbohydrate in colorectal health (including colorectal can-
Arabinoxylan Blood glucose EFSA journal
cer, irritable bowel syndrome and constipation),dietary car-
(from wheat level 2011;9(6):2205
bohydrate and metabolic health[including insulin resistance,
germ)
glycaemic index (GI) and obesity. The data presented is
Chitosan Blood cholesterol 2011;9(6)2214
extremely useful since it comprehensively reviews the scien-
level
tific literature dealing with the relationship between dietary
Konjac Blood cholesterol 2009;7(9):1258
fibre and disease. It is a vast reservoir of detailed information
level
which can prove an invaluable data base for researchers.
HPMC Blood cholesterol 2010;8(10)1739
Each area needs an independent assessment before dietary
and glucose levels
fibre–specific disease relationships can be identified.
Pectin Blood cholesterol 2010;8(10)1747
Recently this has been undertaken for the relationship of
and glucose levels
dietary fibre with colorectal cancer (Aune et al., 2011). The
Resistant starch Blood glucose 2011;9(4):2022
authors searched PubMed and several other databases for
relevant studies up to December 2010. The results were carefully
statistically evaluated. The question which the study aimed to
answer was ‘‘Does a high intake of dietary fibre or whole grains
There is need, therefore, for each particular dietary fibre to be reduce the risk of developing colorectal cancer?’’ The British
evaluated individually and the specific health benefit proven Medical Journal considered this to be a landmark study and an
before a commercial product can be offered. Consequently, there associated Editorial deserves consideration. They point to a
is a dilemma between a desire to harness the health giving lesson which all associated with this subject need to take heed
properties of dietary fibre by giving healthy food to the public of. Whereas food items rich in dietary fibre have been considered
and the legally permissible claims which can be made in relation since 1988 to prevent colorectal cancer, randomised trial study-
to the material. Indeed the very process that is intended to ing dietary fibre have not supported the association. Classical
protect the public may perversely prove an obstacle to this. It is nutritional epidemiology has consistently found that when a
certainly not permissible to demonstrate or infer to the produc- food item is related to decreased incidence of disease and the
tion of short chain fatty acid production and point then to some biological effect is attributed to a single component, when this
of the proven benefits of these materials. That is not to say that component is tested randomly the results are not what was
there is not expert encouragement in this regard. Buttriss and expected. The message is that researchers should study the
Stokes (2008) from the British Nutrition Foundation, London, UK dietary source and not only one specific component. Aune and
(2008) have provided authoritative information about the rela- colleagues have done this and showed that a high intake of fibre
tionship between dietary fibre and health. They acknowledge from cereals and consumption of wholegrain foods is signifi-
that ‘‘many studies have found that people on diets high in fibre have cantly associated with a reduced risk of colorectal cancer
reduced risks of certain diseases such as cancers, coronary heart disease, whereas no preventative effects can be seen with other sources
obesity and possibly diabetes’’. They also support the point pre- of dietary fibre. It is the whole grain and not the fibre component
viously made ‘‘that reconciling chemical definitions for fibre with alone that has the beneficial effects. It is not understood why
definitions that reflect physiological effects remains a major challenge.’’ fibre from grains is associate with decreased risk when fibre
8 Bioactive Carbohydrates and Dietary Fibre 1 (2013) 3 –9
from fruit, for example, is not. The biological mechanisms to internationally by Codex and in Europe by the European
account for this behaviour need to be further studied. Union, there remains some ambivalence to what extend the
chemical definition and the physiological action should be
given prominence. Conversion in the colon to short-chain
8. Medical intervention or regulation? fatty acids is a necessary pre-requisite if the material is to be
considered a dietary fibre. While this might provide a health
There is thus a clear need to balance medical experience of aura to the product, it cannot be inferred that a specific health
the benefits of dietary fibre with the international–national benefit can be claimed. The route to a commercial product
regulatory requirements, which are often slow and ineffec- bearing a specific health claim could require unequivocal
tive in their execution. The perceived benefit of dietary fibre biological, physiological and clinical evidence coupled with
in chronic renal disease is a case in point. An important sound chemical characterisation of the test material. When a
recent evaluation brings into sharp focus how early dietary natural product is shown to exhibit bioactivity and the
intervention could assist the 16 million US adults with individual components responsible are tracked down, the
chronic kidney disease (CKD) which is believe to be an experience with whole grain foods needs to be built into the
independent risk factor for cardiovascular disease. investigation to assess the relative merits of the whole
Raj Krishnamurthy et al. (2012) analysed data from 14,543 material in relation to the component parts. Formulating a
participants in the National Health and Nutrition Examina- healthy diet, in the final resort, should adopt a common sense
tion Survey III. For each 10-g/day increase in total fibre intake, approach based on the emerging information on dietary fibre.
the odds of elevated serum C-reactive protein levels were
decreased by 11% and 38%, in those without and with kidney
disease, respectively. Dietary total fibre intake was not sig- Annex 1a. FAO recommended method how to
nificantly associated with mortality in those without but was evaluate and substantiate that a product is a
inversely related to mortality in those with kidney disease. prebiotic
Thus, their evidence indicated that a high dietary total fibre
intake is associated with lower risk of inflammation and 1. Product specification/characteristics of the prebiotic
mortality in kidney disease The component to which the claim of being prebiotic is
A commentary on these results (Evenepoel & Meijers, 2012) attributed, must be characterised for any given product.
provides support for possible intervention regimes arising from This includes:
these findings. They conclude that the harmful effects of CKD source, origin;
are exacerbated by dietary protein and reversed by dietary fiber. Purity;
They further comment that ‘‘in the overall study population, it was chemical composition and structure; and
found that high fiber intake was associated with lower inflammation. vehicle, concentration and amount in which it is to be
Although this association was found both in non-CKD and in CKD delivered to the host.
patients, it was significantly stronger in CKD patients. Only in the 2. Functionality
subgroup of patients with CKD, dietary fiber intake was also associated At a minimum, there needs to be evidence of a correlation
with mortality risk. Each 10-g/ d increase in intake was associated with between the measurable physiological outcomes and
a hazard ratio of 0.83 (total fiber), 0.77 (insoluble fiber), and 0.67 modulation of the microbiota at a specific site (primarily
(soluble fiber) for overall mortality. This large population-based obser- the gastrointestinal tract, but potentially also other sites
vational study thus suggests that the presence of CKD is a potent such as vagina and skin). Need to correlate a specific
modifier of the beneficial effects of dietary fiber intake’’. function at a specific site with the physiological effect and
In contrast to dietary fibre, dietary protein promotes pro- its associated timeframe.
teolytic fermentation, increases the nutritional acid load, and Within a study, the target variable should change in a
is associated with poor outcomes in CKD. This potentially statistically significant way and the change should be
explains why a ‘‘Mediterranean ‘‘diet protects against cardio- biologically meaningful for the target group consistent
vascular disease whereas a ‘‘Western’’ diet (characterised by a with the claim to be supported.
high intake of processed meat, red meat, butter, high-fat dairy Substantiation of a claim should be based on studies
products, and refined grains) confers an increased risk. with the final product type, tested in the target host.
However, another conclusion of the commentary is ‘‘Prebiotics A suitably sized randomized control trial (compared to
are an attractive alternative to dietary fiber.’’ Thus after most placebo or a standard control substance) is required,
constructive observations the authors add a semantic confusion preferably with a second independent study.
to a major health observation and recommendation. Never- Examples of physiological outcomes due to administration
theless, their overall conclusion is positive and clear ‘‘In conclu- of prebiotics could be: satiety (measured towards carbohy-
sion, the study of Krishnamurthy et al adds to a growing body of drates, fats, total energy intake); endocrine mechanisms
evidence that dietary fiber has important health-promoting properties’’. regulating food intake and energy usage in the body;
effects on absorption of nutrients (e.g. calcium, magne-
sium, trace elements, protein); reduced incidence or
9. Conclusion duration of infection; blood lipid and classic endocrine
parameters; bowel movement and regularity; markers for
Despite the fact that a definition of dietary fibre, mainly based cancer risk; changes in innate and acquired immunity
on a chemical designation, has been legally accepted that are evidence of a health benefit.
Bioactive Carbohydrates and Dietary Fibre 1 (2013) 3 –9 9