Carbohydrates and Health

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Body fatness and fat distribution 8.156 Three cohort studies were identified that presented evidence on diets differing in dietary fibre content and body fatness and fat distribution (Johnson et al., 2008; Cheng et al., 2009; Albertson et al., 2009). One study reported grams of fibre consumed per day and anthropometric data at puberty onset and over the subsequent 4 years (Cheng et al., 2009). Another study determined dietary fibre density in the diets of UK children aged 5 and 7 years, and fatness at 9 years (Johnson et al., 2008). The third study reported the cumulative percentage of days that girls consumed cereal during childhood (between ages 11.5 and 18.6 years), and percentage body fat at 18.6 years of age (Albertson et al., 2009). It is unclear whether in this study, ‘cereal’ refers to breakfast cereals only or to total cereals. The outcomes of the studies were assessed differently: by skinfold measurements (Cheng et al., 2009), by dual-energy X-ray absorptiometry (Johnson et al., 2008) and by bioimpedance (Albertson et al., 2009). 8.157 No significant association is indicated between dietary fibre intake and body fatness in two of the studies, but one does indicate that girls who ate cereal on a greater percentage of days during childhood had a lower percentage body fat and were more likely to exhibit higher levels of physical activity (Albertson et al., 2009). Overall, none of the results support a strong relationship between dietary fibre intake and adiposity in children. Dietary fibre (g/day) and body fatness • No association • Limited evidence Outcomes where there is insufficient or inconsistent evidence 13 8.158 The tables below detail the exposures and outcomes where there are two or fewer studies that meet the inclusion criteria for the review (e.g. by study duration, publication date, health of subjects, design of intervention), or where the studies are too inconsistent, to draw a conclusion as per the grading system in Annex 2. A full description of the studies can be found in the relevant systematic reviews. Table 8.1: Insufficient evidence - cohort studies Risk factor/health outcome/measure Cardiovascular disease events Coronary events Exposure legume fibre whole grain foods bread legumes 140 13 See Annex 2 paragraph A2.21 for criteria.
Table 8.1: continued Risk factor/health outcome/measure Stroke Fibrinogen Coronary and aortic calcification Vascular function Incident hypertension Blood pressure Fasting blood lipids Fibrinogen Change in body weight Body fatness and fat distribution Type 2 diabetes mellitus Impaired glucose tolerance and altered fasting glycaemia Insulinemia and insulin resistance/sensitivity Insulin resistance Colo-rectal cancer Colon cancer Rectal Cancer Colo-rectal adenoma recurrence Exposure soluble and insoluble fibre fibre in fruit fibre in vegetables (including potatoes) fibre in cereals total cereal intake legume intake dietary fibre dietary fibre whole grains consumption dietary fibre intake total cereal intake legume intake dietary fibre dietary fibre intake breakfast cereals dietary fibre intake dietary fibre intake, total cereal intake whole grains intake dietary fibre, cereal intake whole grains intake whole legume intake dietary fibre bread legumes dietary fibre dietary fibre soluble and insoluble fibre whole grains intake soluble and insoluble fibre vegetable fibre fruit fibre legume fibre soluble and insoluble fibre cereal fibre whole grains intake vegetable fibre fruit fibre legume fibre dietary fibre 141
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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
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Sucrose (g/day) and type 2 diabetes
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Sugars-sweetened beverages (ml/day)
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sugars-sweetened and non-caloricall
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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 and 148: Total cereals Cardiovascular diseas
Page 149 and 150: Whole grains (serving/day) and hype
Page 151 and 152: increases in vegetable, fruit, and
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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 173 and 174: 9.61 All three trials demonstrate
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
Page 199 and 200: Dietary fibre 11.17 In 1991 COMA s
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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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