Carbohydrates and Health

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publications presented data on the same study (Steffen et al., 2003; Nettleton et al., 2008) and the data from the former were used in a meta-analysis. One study only presented results for individual sources of whole grains, which were in broad agreement with the results from the meta-analysis (Drogan et al., 2007). One cohort study was subsequently identified in the update search (Nilsson et al., 2012) (Cardio-metabolic review, cardiovascular disease chapter; Update search). 8.128 An association is indicated between higher consumption of whole grains and a reduced incidence of cardiovascular disease (RR 0.95, 95% CI 0.92, 0.97 for each 0.5 serving/day; p
Whole grains (serving/day) and hypertension • Association • Limited evidence • The direction of the association indicates higher whole grains consumption is beneficial to health • The association is biologically relevant Blood pressure 8.133 Three randomised controlled trials were identified that presented evidence on whole grains intake in relation to blood pressure, all of which were included in the meta-analyses for systolic and diastolic blood pressure (Davy et al., 2002b; Howard et al., 2006b; Andersson et al., 2007; Tinker et al., 2008). Two publications presented data from the same trial (Howard et al., 2006b; Tinker et al., 2008), and the data from Howard et al. (2006b) were used in the meta-analysis. Two trials were subsequently identified in the update search (Brownlee et al., 2010; Tighe et al., 2010) (Cardio-metabolic review, incident hypertension and blood pressure chapter; Update search). All trials compared whole grain diets to refined grain control diets. 8.134 No significant effect is demonstrated for whole grains consumption on systolic blood pressure (0.2 mmHg, 95% CI -1.6, 2.0; p=0.85). Of the trials identified in the update search one reports no significant effect (Brownlee et al., 2010), and the other reports higher whole grains consumption to reduce systolic blood pressure (Tighe et al., 2010). 8.135 No significant effect is demonstrated for whole grains consumption on diastolic blood pressure (-0.3 mmHg, 95% CI -0.9, 0.4; p=0.43). The two trials identified in the update search report no significant effect of whole grains consumption on diastolic blood pressure. 8.136 One trial, contributes 92% to the pooled estimate for systolic blood pressure and 97% for diastolic blood pressure (Howard et al., 2006b). This trial elicited a very small increase in whole grains consumption (less than one serving per day) and also resulted in weight loss differences between experimental groups. Whole grains and systolic and diastolic blood pressure • No effect • Moderate evidence Fasting blood lipids 8.137 Five randomised controlled trials were identified that presented evidence on whole grains intake in relation to total cholesterol, LDL-cholesterol, HDL-cholesterol and triacylglycerol concentration, all of which were included in a meta-analysis (Saltzman et al., 2001; Davy et al., 2002a; Howard et al., 2006b; Andersson et al., 2007; Kim et al., 2008). One study did not report data on LDL-cholesterol (Kim et al., 2008). Two trials were subsequently identified in the update search (Tighe et al., 2010; Brownlee et al., 2010) (Cardio-metabolic review, hyperlipidaemias and 135
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Carbohydrates and Health 2015
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Published by TSO (The Stationery Of
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performed the systematic review on
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Colo-rectal health Children and ado
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5 Fibre isolates 233 Psyllium 233
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Dr David Mela Prof. Angus Walls (si
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Prof. Ian Macdonald Prof. of Metab
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Summary S.1 Carbohydrates are a ma
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Sugars and sugars-sweetened foods a
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S.21 It is recommended that dietar
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1 Introduction and methods Backgrou
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used as the primary dietary assessm
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2.3 Carbohydrates can be classifie
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β-glucans are a heterogeneous grou
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2.19 The amount of energy yielded
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Definitions used in different dieta
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2.32 In the United States ‘total
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is associated with higher incidence
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3 Dietary sources and intakes of ca
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3.12 In adults aged 19-64 years, s
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3.24 At a broad food category leve
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were also significant contributors.
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4.5 Obesity occurs when energy int
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loose stools with fast transit thro
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Risk factors and measures considere
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important in trials assessing effec
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5.18 Two cohort studies were identi
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Higher carbohydrate, average protei
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Fasting blood lipids 5.32 Fifty ei
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evidence of an effect of higher car
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Higher carbohydrate, average protei
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to exclude confounding by concomita
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Fasting LDL-cholesterol 5.57 Twenty
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Fasting LDL-cholesterol:HDL-cholest
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Carbohydrate diets and C-reactive p
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not be included in a meta-analysis
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Phillips et al., 2008; Due et al.,
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concomitant weight loss on fasting
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5.105 Due to variation between the
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carbohydrates was less than 5% betw
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5.121 The heterogeneity is above t
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Higher carbohydrate and lower fat d
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5.138 No significant association is
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Table 5.2: Insufficient evidence -
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5.151 The trials do provide eviden
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6.7 No significant association is o
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al., 2006), which left an insuffici
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Sugars and energy intake • Effect
Page 97 and 98: Sucrose (g/day) and type 2 diabetes
Page 99 and 100: Sugars-sweetened beverages (ml/day)
Page 101 and 102: sugars-sweetened and non-caloricall
Page 103 and 104: 6.53 No meta-analyses have been con
Page 105 and 106: foods. Five of these adjusted their
Page 107 and 108: Table 6.1: continued Risk factor/he
Page 109 and 110: that met the inclusion criteria. As
Page 111 and 112: 7 Starch and starch-rich foods 7.1
Page 113 and 114: 7.11 No association was found betwe
Page 115 and 116: were combined into a meta-analysis
Page 117 and 118: 7.25 Findings from prospective coh
Page 119 and 120: 2011; Park et al., 2011; Wallstrom
Page 121 and 122: Hays et al., 2006). The data were i
Page 123 and 124: Dietary fibre and fasting insulin c
Page 125 and 126: 2007; Schatzkin et al., 2007; Wakai
Page 127 and 128: metabolic review, cardiovascular di
Page 129 and 130: Fruit fibre (g/day) and coronary ev
Page 131 and 132: (Salmeron et al., 1997a; Salmeron e
Page 133 and 134: Faecal weight and intestinal transi
Page 135 and 136: Coronary events 8.76 Eight cohort s
Page 137 and 138: Oat bran and β-glucans and fasting
Page 139 and 140: Oat bran and β-glucans and fasting
Page 141 and 142: al., 2008). The data on dietary int
Page 143 and 144: observes an increase in bowel movem
Page 145 and 146: Cereal fibre (g/day) and colo-recta
Page 147: Total cereals Cardiovascular diseas
Page 151 and 152: increases in vegetable, fruit, and
Page 153 and 154: 8.150 Due to variation between the
Page 155 and 156: Table 8.1: continued Risk factor/he
Page 157 and 158: Table 8.3: Inconsistent evidence Ri
Page 159 and 160: 9 Non-digestible oligosaccharides,
Page 161 and 162: Forcheron & Beylot, 2007). One tria
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Page 165 and 166: coffee (Walton et al., 2010). All t
Page 167 and 168: Arabinoxylan-oligosaccharides 9.33
Page 169 and 170: 9.42 An effect of raw resistant sta
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Page 175 and 176: Non-digestible oligosaccharide (fru
Page 177 and 178: 9.76 Of the five trials that inves
Page 179 and 180: Table 9.2: Inconsistent evidence -
Page 181 and 182: 10 Glycaemic index and glycaemic lo
Page 183 and 184: Stroke 10.10 Three cohort studies w
Page 185 and 186: 10.18 No significant effect of GI i
Page 187 and 188: Glycaemic index (unit/day) and fast
Page 189 and 190: 10.38 No significant effect is demo
Page 191 and 192: health review (Greenwood et al., 20
Page 193 and 194: Table 10.1: Insufficient evidence -
Page 195 and 196: 11 Dietary recommendations 11.1 T
Page 197 and 198: energy compensation (degree of volu
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Dietary fibre 11.17 In 1991 COMA s
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with any adverse effects on growth
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Figure 11.4: Risk of type 2 diabete
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12 Overall summary and conclusions
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permanent dentitions. There is a la
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supplements on recurrence of colo-r
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• With the proposed reduction in
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sweet spreads, fruit juice, confect
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ANNEX 1 Cardio-metabolic, colo-rect
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frequency and age. For oral cancer,
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framework for the evaluation of evi
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• Whether the effect or associati
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Commentary on the evidence on fruct
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A3.9 There are few data from trial
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mechanism may have been acting for
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Table A4.1: Prospective cohort stud
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Randomised controlled trials A4.14
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Table A4.3: continued Study Trial d
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Table A4.3: continued Study Trial d
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TableA4.4: Risk of bias assessment
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TableA4.5: Results from prospective
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likely to progress in subjects who
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Table A4.6: continued Study Interve
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A4.37 The effect of one litre a day
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Fibre isolates ANNEX 5 A5.1 Prospe
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Constipation A5.9 Four randomised c
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Isolated gums and gelling agent sup
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a meta-analysis. Overall, the trial
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Mixed isolated gums and gelling age
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Risk factor/health outcome/measure
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IL-6 Interleukin 6 J Joule kcal Kil
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A7.4 Higher birth weight is associ
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A7.17 One cohort study observed tha
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Carbohydrate intake (% energy) and
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Summary and conclusions A7.31 This
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P P er er c c ent ent Top tw Top tw
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Table 3.2: Average daily intake of
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Table 3.13b: Total quantities consu
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Table 3.16: continued Aged 1.5 year
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Table 3.19b: Top 20 contributors to
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Table 3.19d: Top 20 contributors to
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Table 3.20a: Top 20 contributors to
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Table 3.20c: Top 20 contributors to
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Table 3.20e: Top 20 contributors to
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Table 3.21b: Top 20 contributors to
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Table 3.21d: Top 20 contributors to
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Table 3.22a: Top 20 contributors to
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Table 3.22c: Top 20 contributors to
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Table 3.22e: Top 20 contributors to
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A9.1 The meta-analysis was perform
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A9.3 The difference in sugars inta
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References Abete I, Parra D & Marti
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Asayama K, Thijs L, Brguljan-Hitij
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Beiswanger BB, Boneta AE, Jau MS, K
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Campain AC, Morgan MV, Evans RW, Ug
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COMA (1991) Dietary Reference Value
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Davy BM, Melby CL, Beske SD, Ho RC,
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Due A, Toubro S, Skov AR & Astrup A
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Esrey KL, Joseph L & Grover SA (199
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