Carbohydrates and Health

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ackgrounds or from lower social status groups being substantially more likely to have decay in most age groups, with the differences being most clear cut among younger children (Public Health England, 2013). Extraction of carious teeth is the most common cause for hospital admission for young children in the UK (Elmer et al., 2014). Markers and measures and their related health outcomes Table 4.1: Risk factors and measures for cardio-metabolic and colo-rectal health Risk factors and measures considered Blood pressure: Blood pressure Systolic blood pressure Diastolic blood pressure Fasting blood lipid concentrations: Total cholesterol HDL-cholesterol LDL-cholesterol LDL-cholesterol: HDL-cholesterol Total cholesterol: HDL-cholesterol Non-HDL-cholesterol Triacylglycerol Non esterified fatty acids Apolipoproteins (A1 & B) Lipoprotein (a) Coronary & vascular factors: Coronary calcification Aortic calcification Carotid plaque formation Pulse wave velocity Flow mediated dilatation Vascular compliance Arterial compliance Inflammatory markers: Acute phase protein (including CRP, serum amyloid A) Cytokines (including IL-6, tumour necrosis factor-α) Adhesion molecules Clotting cascade (including clotting associated factor PAI-1, fibrinogen, factor VII) Related outcomes cardiovascular diseases and renal impairment cardiovascular diseases cardiovascular diseases cardiovascular diseases and type 2 diabetes mellitus References MacMahon et al., 1990; Whelton, 1994; Lewington et al., 2002; Bidani & Griffin, 2002; Shammas, 2007 Gordon & Rifkind, 1989; Rader et al., 2003; Lewington et al., 2007; Shammas, 2007; Brainin & Heiss, 2009; Goldberg et al., 2011; Miller et al., 2011 Wilson et al., 2001; Kelm, 2002; Witte et al., 2005; Mattace- Raso et al., 2006; Yeboah et al., 2007; Finn et al., 2010; Janner et al., 2012 Ross, 1999; Libby et al., 2002; Kolb & Mandrup-Poulsen, 2005; Basu et al., 2006; Wang et al., 2013 34
Risk factors and measures considered Body weight & body composition: Body weight BMI Fat distribution Fat free mass Total body fat Body fatness Waist circumference Hip circumference Waist to hip ratio Energy intake & eating motivation Type 2 diabetes mellitus related risk factors: Glycaemia Insulinaemia Insulin resistance Glycosylated blood proteins Colo-rectal cancer risk factors: Colo-rectal adenomas Colo-rectal function: Faecal weight Intestinal transit time Faecal moisture Faecal microbiota Faecal pH Faecal short chain fatty acid content Related outcomes hypertension, cardiovascular disease, type 2 diabetes mellitus, various cancers and dyslipidaemias overweight/ obesity type 2 diabetes mellitus and cardiovascular disease colo-rectal cancer colo-rectal function References World Cancer Research Fund & American Institute for Cancer Research, 2007; WHO, 2007b; Klop et al., 2013 Blundell JE et al., 2008; Hetherington et al., 2013 Barr et al., 2007; Shammas, 2007; Brainin & Heiss, 2009; Sarwar et al., 2010; WHO, 2011 Kinzler & Vogelstein, 1996; Leslie et al., 2002; World Cancer Research Fund & American Institute for Cancer Research, 2007 Weaver, 1988; Cummings et al., 1992; Ogawa et al., 1992; Lewis & Heaton, 1999; Björkstén et al., 2001; Kalliomaki et al., 2001; Takaishi et al., 2008; Packey & Sartor, 2009; Schwiertz et al., 2010 35
Page 1 and 2: Carbohydrates and Health 2015
Page 3 and 4: Published by TSO (The Stationery Of
Page 5 and 6: performed the systematic review on
Page 7 and 8: Colo-rectal health Children and ado
Page 9 and 10: 5 Fibre isolates 233 Psyllium 233
Page 11 and 12: Dr David Mela Prof. Angus Walls (si
Page 13 and 14: Prof. Ian Macdonald Prof. of Metab
Page 15 and 16: Summary S.1 Carbohydrates are a ma
Page 17 and 18: Sugars and sugars-sweetened foods a
Page 19 and 20: S.21 It is recommended that dietar
Page 21 and 22: 1 Introduction and methods Backgrou
Page 23 and 24: used as the primary dietary assessm
Page 25 and 26: 2.3 Carbohydrates can be classifie
Page 27 and 28: β-glucans are a heterogeneous grou
Page 29 and 30: 2.19 The amount of energy yielded
Page 31 and 32: Definitions used in different dieta
Page 33 and 34: 2.32 In the United States ‘total
Page 35 and 36: is associated with higher incidence
Page 37 and 38: 3 Dietary sources and intakes of ca
Page 39 and 40: 3.12 In adults aged 19-64 years, s
Page 41 and 42: 3.24 At a broad food category leve
Page 43 and 44: were also significant contributors.
Page 45 and 46: 4.5 Obesity occurs when energy int
Page 47: loose stools with fast transit thro
Page 51 and 52: important in trials assessing effec
Page 53 and 54: 5.18 Two cohort studies were identi
Page 55 and 56: Higher carbohydrate, average protei
Page 57 and 58: Fasting blood lipids 5.32 Fifty ei
Page 59 and 60: evidence of an effect of higher car
Page 61 and 62: Higher carbohydrate, average protei
Page 63 and 64: to exclude confounding by concomita
Page 65 and 66: Fasting LDL-cholesterol 5.57 Twenty
Page 67 and 68: Fasting LDL-cholesterol:HDL-cholest
Page 69 and 70: Carbohydrate diets and C-reactive p
Page 71 and 72: not be included in a meta-analysis
Page 73 and 74: Phillips et al., 2008; Due et al.,
Page 75 and 76: concomitant weight loss on fasting
Page 77 and 78: 5.105 Due to variation between the
Page 79 and 80: carbohydrates was less than 5% betw
Page 81 and 82: 5.121 The heterogeneity is above t
Page 83 and 84: Higher carbohydrate and lower fat d
Page 85 and 86: 5.138 No significant association is
Page 87 and 88: Table 5.2: Insufficient evidence -
Page 89 and 90: 5.151 The trials do provide eviden
Page 91 and 92: 6.7 No significant association is o
Page 93 and 94: al., 2006), which left an insuffici
Page 95 and 96: 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
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6.53 No meta-analyses have been con
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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
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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
Page 117 and 118:
7.25 Findings from prospective coh
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2011; Park et al., 2011; Wallstrom
Page 121 and 122:
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
Page 127 and 128:
metabolic review, cardiovascular di
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Fruit fibre (g/day) and coronary ev
Page 131 and 132:
(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
Page 175 and 176:
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
Page 193 and 194:
Table 10.1: Insufficient evidence -
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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
Page 201 and 202:
with any adverse effects on growth
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Figure 11.4: Risk of type 2 diabete
Page 205 and 206:
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
Page 213 and 214:
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
Page 227 and 228:
mechanism may have been acting for
Page 229 and 230:
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
Page 235 and 236:
Table A4.3: continued Study Trial d
Page 237 and 238:
TableA4.4: Risk of bias assessment
Page 239 and 240:
TableA4.5: Results from prospective
Page 241 and 242:
likely to progress in subjects who
Page 243 and 244:
Table A4.6: continued Study Interve
Page 245 and 246:
A4.37 The effect of one litre a day
Page 247 and 248:
Fibre isolates ANNEX 5 A5.1 Prospe
Page 249 and 250:
Constipation A5.9 Four randomised c
Page 251 and 252:
Isolated gums and gelling agent sup
Page 253 and 254:
a meta-analysis. Overall, the trial
Page 255 and 256:
Mixed isolated gums and gelling age
Page 257 and 258:
Risk factor/health outcome/measure
Page 259 and 260:
IL-6 Interleukin 6 J Joule kcal Kil
Page 261 and 262:
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
Page 267 and 268:
Summary and conclusions A7.31 This
Page 269 and 270:
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 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Table 3.13b: Total quantities consu
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Page 287 and 288:
Page 289 and 290:
Table 3.16: continued Aged 1.5 year
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Page 293 and 294:
Page 295 and 296:
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
Page 301 and 302:
Table 3.20c: Top 20 contributors to
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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
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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
Page 319 and 320:
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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Bouhnik Y, Flourie B, Riottot M, Bi
Page 327 and 328:
Campain AC, Morgan MV, Evans RW, Ug
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COMA (1991) Dietary Reference Value
Page 331 and 332:
Davy BM, Melby CL, Beske SD, Ho RC,
Page 333 and 334:
Due A, Toubro S, Skov AR & Astrup A
Page 335 and 336:
Esrey KL, Joseph L & Grover SA (199
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Francois IE, Lescroart O, Veraverbe
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Grasten SM, Juntunen KS, Poutanen K
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Health and Social Care Information
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Howarth NC, Murphy SP, Wilkens LR,
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Jenkins DJ, Vuksan V, Kendall CW, W
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Keogh JB, Brinkworth GD, Noakes M,
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Kvaavik E, Andersen LF & Klepp KI (
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Levine RS, Nugent ZJ, Rudolf MC & S
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Livesey G (2003) Health potential o
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Marteau P, Flourie B, Cherbut C, Co
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Miller M, Stone NJ, Ballantyne C, e
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Pasman W, Wils D, Saniez MH & Kardi
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Pitts NB, Chestnutt IG, Evans D, Wh
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Ross R (1999) Atherosclerosis--an i
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Sarwar N, Gao P, Seshasai SR, et al
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Sharman MJ, Gomez AL, Kraemer WJ &
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Sorensen LB, Vasilaras TH, Astrup A
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Tuohy KM, Kolida S, Lustenberger AM
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Vester Boler BM, Serao MC, Bauer LL
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West NX, Hughes JA, Parker D, Weave
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Wycherley TP, Brinkworth GD, Keogh
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