Carbohydrates and Health

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EFSA (2009) Review of labelling reference intake values for selected nutritional elements. EFSA Journal 1008, 1-14. EFSA (2010a) Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre. EFSA Journal 8, 1462. EFSA (2010b) Scientific Opinion on the substantiation of a health claim related to whole grain (ID 831, 832, 833, 1126, 1268, 1269, 1270, 1271, 1431) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 8, 1766. EFSA (2015) Scientific Opinion on the safety of the proposed extension of use of erythritol (E 968) as a food additive. EFSA Journal 13, 4033. El Aidi H, Bronkhorst EM, Huysmans MCDN & Truin GJ (2011) Multifactorial Analysis of Factors Associated with the Incidence and Progression of Erosive Tooth Wear. Caries Res 45, 303-312. Elia M & Cummings JH (2007) Physiological aspects of energy metabolism and gastrointestinal effects of carbohydrates. Eur J Clin Nutr 61, S40-S74. Ells LJ, Seal CJ, Kettlitz B, Bal W & Mathers JC (2005) Postprandial glycaemic, lipaemic and haemostatic responses to ingestion of rapidly and slowly digested starches in healthy young women. British Journal of Nutrition 94, 948-955. Elmer TB, Langford JW & Morris AJ (2014) An alternative marker for the effectiveness of water fluoridation: hospital extraction rates for dental decay, a two-region study. Br Dent J 216, E10. Englyst HN, Kingman SM & Cummings JH (1992) Classification and measurement of nutritionally important starch fractions. European Journal of Clinical Nutrition 46, S33-S50. Englyst HN, Quigley ME & Hudson GJ (1994) Determination of dietary fibre as non- starch polysaccharides with gas-liquid chromatographic, high-performance liquid chromatographic or spectrophotometric measurement of constituent sugars. Analyst 119, 1497-1509. Englyst KN, Liu S & Englyst HN (2007) Nutritional characterization and measurement of dietary carbohydrates. European Journal of Clinical Nutrition 61, S19-S39. Ericson U, Sonestedt E, Gullberg B, Hellstrand S, Hindy G, Wirfalt E & Orho-Melander M (2013) High intakes of protein and processed meat associate with increased incidence of type 2 diabetes. Br J Nutr 109, 1143-1153. Eshak ES, Iso H, Date C, Kikuchi S, Watanabe Y, Wada Y, Wakai K, Tamakoshi A & JACC JACC (2010) Dietary fiber intake is associated with reduced risk of mortality from cardiovascular disease among Japanese men and women. Journal of Nutrition 140, 1445-1453. Eshak ES, Iso H, Mizoue T, Inoue M, Noda M & Tsugane S (2013) Soft drink, 100% fruit juice, and vegetable juice intakes and risk of diabetes mellitus. Clin Nutr 32, 300-308. 320
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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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metabolic review, cardiovascular di
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Fruit fibre (g/day) and coronary ev
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(Salmeron et al., 1997a; Salmeron e
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Faecal weight and intestinal transi
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Coronary events 8.76 Eight cohort s
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Oat bran and β-glucans and fasting
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Oat bran and β-glucans and fasting
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al., 2008). The data on dietary int
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observes an increase in bowel movem
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Cereal fibre (g/day) and colo-recta
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Total cereals Cardiovascular diseas
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Whole grains (serving/day) and hype
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increases in vegetable, fruit, and
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8.150 Due to variation between the
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Table 8.1: continued Risk factor/he
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Table 8.3: Inconsistent evidence Ri
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9 Non-digestible oligosaccharides,
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Forcheron & Beylot, 2007). One tria
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trial administers 21g/day inulin co
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coffee (Walton et al., 2010). All t
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Arabinoxylan-oligosaccharides 9.33
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9.42 An effect of raw resistant sta
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1999c) or retrograde resistant star
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9.61 All three trials demonstrate
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Non-digestible oligosaccharide (fru
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9.76 Of the five trials that inves
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Table 9.2: Inconsistent evidence -
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10 Glycaemic index and glycaemic lo
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Stroke 10.10 Three cohort studies w
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10.18 No significant effect of GI i
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Glycaemic index (unit/day) and fast
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10.38 No significant effect is demo
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health review (Greenwood et al., 20
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Table 10.1: Insufficient evidence -
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11 Dietary recommendations 11.1 T
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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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Page 283 and 284: Table 3.13b: Total quantities consu
Page 289 and 290: Table 3.16: continued Aged 1.5 year
Page 295 and 296: Table 3.19b: Top 20 contributors to
Page 297 and 298: Table 3.19d: Top 20 contributors to
Page 299 and 300: Table 3.20a: Top 20 contributors to
Page 301 and 302: Table 3.20c: Top 20 contributors to
Page 303 and 304: Table 3.20e: Top 20 contributors to
Page 305 and 306: Table 3.21b: Top 20 contributors to
Page 307 and 308: Table 3.21d: Top 20 contributors to
Page 309 and 310: Table 3.22a: Top 20 contributors to
Page 311 and 312: Table 3.22c: Top 20 contributors to
Page 313 and 314: Table 3.22e: Top 20 contributors to
Page 315 and 316: A9.1 The meta-analysis was perform
Page 317 and 318: A9.3 The difference in sugars inta
Page 319 and 320: References Abete I, Parra D & Marti
Page 321 and 322: Asayama K, Thijs L, Brguljan-Hitij
Page 323 and 324: Beiswanger BB, Boneta AE, Jau MS, K
Page 325 and 326: Bouhnik Y, Flourie B, Riottot M, Bi
Page 327 and 328: Campain AC, Morgan MV, Evans RW, Ug
Page 329 and 330: COMA (1991) Dietary Reference Value
Page 331 and 332: Davy BM, Melby CL, Beske SD, Ho RC,
Page 333: Due A, Toubro S, Skov AR & Astrup A
Page 337 and 338: Francois IE, Lescroart O, Veraverbe
Page 339 and 340: Grasten SM, Juntunen KS, Poutanen K
Page 341 and 342: Health and Social Care Information
Page 343 and 344: Howarth NC, Murphy SP, Wilkens LR,
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Page 351 and 352: Levine RS, Nugent ZJ, Rudolf MC & S
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Page 365 and 366: Ross R (1999) Atherosclerosis--an i
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