Jenni Lappi

Dietary fiber type reflects physiological functionality: comparison of grain fiber, inulin, and polydextrose

Dietary fiber is a nutritional concept based not on physiological functions but on defined chemical and physical properties. Recent definitions of dietary fiber differentiate inherent plant cell wall-associated fiber from isolated or synthetic fiber. For the latter to be defined as fiber, beneficial physiological effects should be demonstrated, such as laxative effects, fermentability, attenuation of blood cholesterol levels, or postprandial glucose response. Grain fibers are a major natural source of dietary fiber worldwide, while inulin, a soluble indigestible fructose polymer isolated from chicory, and polydextrose, a synthetic indigestible glucose polymer, have more simple structures. Inulin and polydextrose show many of the same functionalities of grain fiber in the large intestine, in that they are fermentable, bifidogenic, and laxative. The reported effects on postprandial blood glucose and fasting cholesterol levels have been modest, but grain fibers also show variable effects. New biomarkers are needed to link the physiological functions of specific fibers with long-term health benefits.

Gut Microbiota Signatures Predict Host and Microbiota Responses to Dietary Interventions in Obese Individuals

Background Interactions between the diet and intestinal microbiota play a role in health and disease, including obesity and related metabolic complications. There is great interest to use dietary means to manipulate the microbiota to promote health. Currently, the impact of dietary change on the microbiota and the host metabolism is poorly predictable and highly individual. We propose that the responsiveness of the gut microbiota may depend on its composition, and associate with metabolic changes in the host. Methodology Our study involved three independent cohorts of obese adults (n = 78) from Belgium, Finland, and Britain, participating in different dietary interventions aiming to improve metabolic health. We used a phylogenetic microarray for comprehensive fecal microbiota analysis at baseline and after the intervention. Blood cholesterol, insulin and inflammation markers were analyzed as indicators of host response. The data were divided into four training set – test set pairs; each intervention acted both as a part of a training set and as an independent test set. We used linear models to predict the responsiveness of the microbiota and the host, and logistic regression to predict responder vs. non-responder status, or increase vs. decrease of the health parameters. Principal Findings Our models, based on the abundance of several, mainly Firmicute species at baseline, predicted the responsiveness of the microbiota (AUC  =  0.77–1; predicted vs. observed correlation  =  0.67–0.88). Many of the predictive taxa showed a non-linear relationship with the responsiveness. The microbiota response associated with the change in serum cholesterol levels with an AUC of 0.96, highlighting the involvement of the intestinal microbiota in metabolic health. Conclusion This proof-of-principle study introduces the first potential microbial biomarkers for dietary responsiveness in obese individuals with impaired metabolic health, and reveals the potential of microbiota signatures for personalized nutrition.

Intake of Whole-Grain and Fiber-Rich Rye Bread Versus Refined Wheat Bread Does Not Differentiate Intestinal Microbiota Composition in Finnish Adults with Metabolic Syndrome

Whole-grain (WG) foods rich in indigestible carbohydrates are thought to modulate the composition of the intestinal microbiota. We investigated in a randomized, parallel, 2-arm 12-wk intervention whether consumption of WG and fiber-rich rye breads compared with refined wheat breads affected the microbiota composition in Finnish individuals aged 60 ± 6 y with metabolic syndrome. Fecal samples from 51 participants (25 males, 26 females) before and after the intervention were processed for the microbiota analysis using a phylogenetic microarray and quantitative polymerase chain reactions targeting the 16S rRNA gene. The intake of whole grains calculated from food records was higher in the group consuming rye breads (75 g) than in that consuming refined wheat breads (4 g; P < 0.001), confirmed by fasting plasma alkylrecorsinol concentrations, a biomarker of whole grain intake. The intestinal microbiota composition did not significantly differ between the groups after the intervention. However, we detected a 37% decrease of Bacteroidetes (P < 0.05) in parallel to a 53% decrease in the alkylrecorsinol concentration (P < 0.001) in the group consuming refined wheat breads. In this group, the abundance of bacteria related to Bacteroides vulgatus, B. plebeius, and Prevotella tannerae decreased, whereas that of bacteria related to Collinsella and members of the Clostridium clusters IV and XI increased. In a multivariate regression analysis, the abundance of Bacteroides spp. was best explained by different fat compounds among dietary variables, whereas the main sugar-converting butyrate-producers were mostly associated with the intake of whole- and refined-grain bread and fiber. Our results indicate that the quality of grains has a minor effect on the intestinal microbiota composition in participants with metabolic syndrome and suggest that the dietary influence on the microbiota involves other dietary components such as fat.

Effects of rye and whole wheat versus refined cereal foods on metabolic risk factors: A randomised controlled two-centre intervention study

BACKGROUND & AIMS Intervention studies investigating the effects of wholegrain intake on glucose and insulin metabolism have provided conflicting results. Aim of this study was the evaluation of glucose and insulin metabolism in response to long-term consumption of rye and whole wheat compared with a diet containing the same amount of refined cereal foods, in individuals with metabolic syndrome from two European locations (Kuopio-Finland/Naples-Italy). METHODS 146 individuals of both genders, age range 40-65 years with metabolic syndrome, were recruited to this study with parallel groups. After a 2-4 week run-in period, participants were assigned to a diet based on wholegrain (wholegrain group) or on refined cereal products (control group), each one for a duration of 12 weeks. Peripheral insulin sensitivity, assessed by FSIGT, lipids and inflammatory markers were measured before and at the end of intervention. RESULTS 61 participants in the control group and 62 in the wholegrain group completed the dietary intervention. Compliance to the two diets was good. At the end of the intervention, insulin sensitivity indices and secretion (SI, QUICKI, DI, dAIRG) and lipids and inflammatory markers did not change significantly in the wholegrain and control groups as compared with baseline and no differences between the two groups were observed. CONCLUSIONS Wholegrain cereal foods consumption compared with refined cereals for 12 weeks did not affect peripheral insulin sensitivity. The study was registered with ClinicalTrials.gov identifier NCT00945854.

Systematic Review and Meta-Analysis of Human Studies to Support a Quantitative Recommendation for Whole Grain Intake in Relation to Type 2 Diabetes.

Background Due to the increasing evidence of their health benefits, whole grains are recommended for consumption worldwide. Such recommendations are, however, rarely quantitative. Our aim was to perform a quantitative evaluation of the relationship between whole grain consumption and the occurrence of type 2 diabetes (T2D) to support a recommendation on the daily consumption of whole grains. Methods and Findings We conducted a systematic review by searching three bibliographic databases. We included human studies addressing the relationship between whole grain consumption and T2D occurrence, and providing quantitative information on daily intake of whole grains. A dose-response meta-regression analysis between whole grain intake and T2D occurrence was performed, using a hierarchical mixed least square linear regression model. Eight observational studies were included (all but one prospective), with a total of 15,573 cases of T2D among 316,051 participants. Quantitative meta-regression demonstrated a significant linear inverse relationship between whole grain intake and T2D occurrence (P<0.0001), with an overall absolute reduction of 0.3% in the T2D rate for each additional 10 g of whole grain ingredient consumed daily. The association persisted when adjusted on sex, age, country, study design, follow up duration, and mode of report of whole grain intakes (as foods or ingredients). Conclusions The meta-regression model made it possible to estimate the decrease in T2D risk corresponding to various changes in whole grain intakes, and the results contribute to setting up quantitative recommendations. For instance, consuming three servings of whole grain foods (45 g of whole grain ingredients) daily would induce a 20% relative reduction in the T2D risk as compared to consuming a half serving (7.5 g of whole grain ingredients). These results should be considered for future recommendations, by considering the actual whole grain intake of the concerned populations. The systematic review protocol was published on the PROSPERO register (CRD42013006925).

The Postprandial Plasma Rye Fingerprint Includes Benzoxazinoid-Derived Phenylacetamide Sulfates

The bioavailability of whole-grain rye-derived phytochemicals has not yet been comprehensively characterized, and different baking and manufacturing processes can modulate the phytochemical composition of breads and other rye products. The aim of our study was to find key differences in the phytochemical profile of plasma after the consumption of 3 breads containing rye bran when compared with a plain white wheat bread control. Plasma metabolite profiles of 12 healthy middle-aged men and women were analyzed using LC quadrupole time-of-flight mass spectrometry metabolomics analysis while fasting and at 60 min, 120 min, 240 min, and 24 h after consuming a meal that contained either 100% whole-grain sourdough rye bread or white wheat bread enriched with native unprocessed rye bran or bioprocessed rye bran. White wheat bread was used as the control. The meals were served in random order after a 12-h overnight fast, with at least 3 d between each occasion. Two sulfonated phenylacetamides, hydroxy-N-(2-hydroxyphenyl) acetamide and N-(2-hydroxyphenyl) acetamide, potentially derived from the benzoxazinoid metabolites, were among the most discriminant postprandial plasma biomarkers distinguishing intake of breads containing whole-meal rye or rye bran from the control white wheat bread. Furthermore, subsequent metabolite profiling analysis of the consumed breads indicated that different bioprocessing/baking techniques involving exposure to microbial metabolism (e.g., sourdough fermentation) have a central role in modulating the phytochemical content of the whole-grain and bran-rich breads.

The quality of school lunch consumed reflects overall eating patterns in 11-16-year-old schoolchildren in Finland.

OBJECTIVE To explore how the quality of school lunch consumed reflected overall eating patterns in school-aged children. DESIGN Children filled in an Internet-based questionnaire about their eating patterns. The children were then divided into balanced and imbalanced school lunch eaters on the basis of their responses in the questionnaire. A balanced school lunch consisted of, by the definition used in the present study, a main dish, salad and bread. SETTING Eleven primary schools and one middle school in eastern Finland. SUBJECTS A total of 531 schoolchildren (247 boys and 284 girls) aged 11-16 years. RESULTS The school lunch was balanced in 46·5% of children. Eating a balanced school lunch was associated with overall healthier eating patterns outside school. Children who ate a balanced school lunch had more regular meal times and consumed healthier snacks. They ate fruit or berries and vegetables, dairy products and wholegrain foods more often, consumed fewer salty snacks, pizzas, meat pies and drank fewer soft drinks and energy drinks. Their eating patterns at home were also healthier, with vegetables being offered at every family dinner and fruit being offered daily, whereas soft drinks were offered seldom. CONCLUSIONS The choices made by children in their school lunch reflect the overall eating patterns among school-aged children. Eating a balanced school lunch is associated with more regular meal patterns, the availability of healthier foods at home and an overall healthier diet, suggesting that healthy eating patterns are learnt at home.

Do Large Intestinal Events Explain the Protective Effects of Whole Grain Foods Against Type 2 Diabetes

Consumption of whole grain foods has been associated with decreased risk of type 2 diabetes. Insulin sensitivity and inflammation are key mechanisms in the development of type 2 diabetes, but the cause of the protective effects of whole grains is not known. In this review, we search for evidence to support the hypothesis of a link between whole grains, large intestinal events, and peripheral inflammation. Due to the unique structure and composition of the grain fiber complex, fermentation in the large intestine is probably an important mediator of the effects of whole grains. Fermentation of grain fiber takes place throughout the large intestine affecting beneficially the composition of gut microbiota, hence decreasing the permeability of gut barrier. Improved gut barrier function reduces leaking of endotoxic bacterial lipopolysaccharides (LPS) into the circulation. Lower concentration of LPS in blood seems to alleviate peripheral inflammation. Fermentation of grain fiber also leads to continuous supply and absorption of metabolites such as short chain fatty acids and ferulic acid derivatives which may have anti-inflammatory effects. These phenomena, mainly based on in vitro and animal studies, are associated with fermentation of grain fiber and improve insulin sensitivity, which over time may decrease the risk of type 2 diabetes. To test these mechanisms, more well-designed human studies are needed.

Comparison of postprandial phenolic acid excretions and glucose responses after ingestion of breads with bioprocessed or native rye bran

Rye bran contains a high amount of phenolic acids with potential health promoting effects. However, due to binding to dietary fibre, the phenolic acids are poorly absorbed in human body. We used bioprocessing with enzymes and yeast to release phenolic acids from the fibre complex and studied the effect of bioprocessing on absorption of phenolic acids in healthy humans. White wheat breads fortified with bioprocessed or native rye bran, and wholegrain rye bread and white wheat bread as controls were served to 15 subjects in a randomized order in the cross-over design. Urine was collected at the basal state and over 24 hours in four-, eight-, and twelve-hour periods and analyzed for phenolic acids and their metabolites with gas chromatography. A total of six blood samples were taken over four hours to study the effect of the bread ingestion on postprandial glucose and insulin responses. Bioprocessing of rye bran increased the proportion of free ferulic acid (FA) and soluble arabinoxylan in the bread. Ingestion of the white wheat bread fortified with bioprocessed rye bran increased (p < 0.001) urinary excretion of FA particularly during the first four hours, indicating increased absorption of FA from the small intestine. The postprandial glucose and insulin responses were similar between these breads. Bioprocessing of rye bran did not affect excretion of benzoic, phenylpropionic, and phenylacetic acid metabolites. As a conclusion, bioprocessed rye bran as compared with native rye bran increased absorption of FA from the small intestine, but did not improve postprandial glucose and insulin responses.

Postprandial glucose metabolism and SCFA after consuming wholegrain rye bread and wheat bread enriched with bioprocessed rye bran in individuals with mild gastrointestinal symptoms

BackgroundRye bread benefits glucose metabolism. It is unknown whether the same effect is achieved by rye bran-enriched wheat bread. We tested whether white wheat bread enriched with bioprocessed rye bran (BRB + WW) and sourdough wholegrain rye bread (WGR) have similar effects on glucose metabolism and plasma level of short chain fatty acids (SCFAs).MethodsTwenty-one (12 women) of 23 recruited subjects completed an intervention with a four-week run-in and two four-week test periods in cross-over design. White wheat bread (WW; 3% fibre) was consumed during the run-in, and WGR and BRB + WW (10% fibre) during the test periods. A meal test providing 51/33/11 E % from carbohydrates/fat/protein was conducted at the end of each period. Fasting and postprandial plasma samples were analysed for glucose, insulin, and SCFA.ResultsGlucose and insulin responses and plasma concentrations of SCFAs to the meal test were similar between the WGR and BRB + WW periods. When compared to the WW period, postprandial insulin concentration at 120 min was lower (p = 0.023) and the first-phase insulin secretion improved (p = 0.033) only after the WGR period, whereas postprandial concentrations of butyrate (p < 0.05) and propionate (p = 0.009) at 30 min increased during both rye bread periods.ConclusionsBeneficial effects of WGR over white wheat bread on glucose and SCFA production were confirmed. The enrichment of the white wheat bread with bioprocessed rye bran (BRB + WW) yielded similar but not as pronounced effects than WGR when compared to WW alone. Postprandially measured glucose metabolism and concentrations of SCFAs provided additional information along with fasting measurements.