Carbohydrates and Health

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Polyols and dental caries incidence in both the mixed and permanent dentition • Effect • Moderate evidence • The direction of the effect demonstrates that use of chewing gum containing polyols in comparison with not using a chewing gum is beneficial to oral health The effect is biologically relevant Outcomes where there is insufficient or inconsistent evidence 14 9.79 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 9.1: Insufficient evidence - randomised controlled trials Risk factor/health outcome/measure Apolipoproteins LDL-cholesterol:HDL-cholesterol ratio Apolipoproteins Body weight change Eating motivation Insulin resistance Glycaemia Insulin levels Exposure non-digestible oligosaccharides non-digestible oligosaccharides non-digestible oligosaccharides resistant starch non-digestible oligosaccharides non-digestible oligosaccharides non-digestible oligosaccharides and inulin Faecal short chain fatty acid RS 4 Faecal bacteria in children non-digestible oligosaccharides Faecal pH RS 4 Mineral absorption resistant starch Intestinal transit time Constipation Diarrhoea Adenoma recurrence Magnesium absorption Caries in the deciduous dentition Caries in the mixed and permanent dentition polyols polydextrose polyols polydextrose non-digestible oligosaccharides resistant starch non-digestible oligosaccharides polyols polyol containing confectionery 164 14 See Annex 2 paragraph A2.21 for criteria.
Table 9.2: Inconsistent evidence - randomised controlled trials Measure Eating motivation Exposure non-digestible oligosaccharides Summary and Conclusions 9.80 This assessment is based on randomised controlled trials investigating the relationship between supplements of resistant starch, oligosaccharide or inulin and cardio-metabolic and colo-rectal outcomes. There were no prospective cohort studies investigating the relationship between oligosaccharides and the relevant health/disease outcomes. There was no relevant evidence, which met the inclusion criteria for this report, identified on non-digestible oligosaccharides, inulin or resistant starch intake in relation to oral health outcomes. 9.81 Nearly all the trials investigating non-digestible oligosaccharides supplemented subjects’ diets with arabinoxylan-oligosaccharide, fructo-oligosaccharide, galactooligosaccharide or inulin. The data are too limited to draw conclusions on other non-digestible oligosaccharides that may be found naturally in foods or are produced using industrial processes. The non-digestible oligosaccharides and inulin used in trials often differ in their degree of polymerisation, but it is unclear from the data whether these differences have an impact on the outcomes investigated. The doses required for some of the observed effects may vary depending on the specific oligosaccharide preparation. Different enzymatic preparations can result in different molecular structures which may affect functionality. 9.82 Randomised controlled trials that supplemented subjects’ diets with nondigestible oligosaccharides or inulin indicate a beneficial effect on fasting LDLcholesterol concentration, but no effect is indicated on fasting total cholesterol, HDL-cholesterol or triacylglycerol concentration. Trials indicate no effect of non-digestible oligosaccharide supplementation on fasting glucose, fasting insulin concentration or energy intake. The trials do indicate that non-digestible oligosaccharides cause an increase in faecal weight and effect faecal bacterial content, including increases in the content of Bifidobacterium spp., but have no effect on faecal short chain fatty acid content. Trials indicate that non-digestible oligosaccharides or inulin supplementation increases the fractional absorption of calcium in children and adolescents, but not in adults. 9.83 Randomised controlled trials that supplemented subjects’ diets with resistant starch indicate no effect of resistant starch on energy intake. Resistant starch supplementation (types 1, 2 and 3 analysed together) is shown to cause an increase in faecal weight, has no effect on faecal bacterial content, but modifies faecal short chain fatty acid content, with an increase in the concentration or proportion of butyrate and a lowering of pH. A limited number of trials indicate little effect of resistant starch type 4 on these faecal parameters. 9.84 The supplement doses of resistant starch, non-digestible oligosaccharide or inulin at which the effects described above become apparent is above levels currently consumed in typical diets in the UK, but recent and future developments of novel 165
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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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6.53 No meta-analyses have been con
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foods. Five of these adjusted their
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Table 6.1: continued Risk factor/he
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that met the inclusion criteria. As
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7 Starch and starch-rich foods 7.1
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7.11 No association was found betwe
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were combined into a meta-analysis
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7.25 Findings from prospective coh
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2011; Park et al., 2011; Wallstrom
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Hays et al., 2006). The data were i
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Dietary fibre and fasting insulin c
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2007; Schatzkin et al., 2007; Wakai
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Page 129 and 130: Fruit fibre (g/day) and coronary ev
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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 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: 9.76 Of the five trials that inves
Page 181 and 182: 10 Glycaemic index and glycaemic lo
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Page 185 and 186: 10.18 No significant effect of GI i
Page 187 and 188: Glycaemic index (unit/day) and fast
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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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Page 203 and 204: Figure 11.4: Risk of type 2 diabete
Page 205 and 206: 12 Overall summary and conclusions
Page 207 and 208: permanent dentitions. There is a la
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Page 215 and 216: ANNEX 1 Cardio-metabolic, colo-rect
Page 217 and 218: frequency and age. For oral cancer,
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Page 223 and 224: Commentary on the evidence on fruct
Page 225 and 226: A3.9 There are few data from trial
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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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Carbohydrates and Health

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