Julie Miller Jones

CODEX-aligned dietary fiber definitions help to bridge the ‘fiber gap’

A comprehensive dietary fiber (DF) definition was adopted by the CODEX Alimentarius Commission (CAC) (1) to reflect the current state of knowledge about DF, (2) to recognize that all substances that behave like fiber regardless of how they are produced can be named as DF if they show physiological benefits, and (3) to promote international harmonization for food labeling and food composition tables. This review gives the history and evolution of the state of DF knowledge as looked at by refinements in DF methods and definitions subsequent to the launch of the DF hypothesis. The refinements parallel both interventional and epidemiological research leading to better understanding of the role of DF in contributing to the numerous physiological benefits imparted by all the various digestion resistant carbohydrates. A comparison of the CODEX definition (including its footnote that authorizes the inclusion of polymers with DP 3–9) and approved CODEX Type 1 methods with other existing definitions and methods will point out differences and emphasize the importance of adoption of CODEX-aligned definitions by all jurisdictions. Such harmonization enables comparison of nutrition research, recommendations, food composition tables and nutrition labels the world over. A case will be made that fibers are analogous to vitamins, in that they vary in structure, function and amount needed, but each when present in the right amount contributes to optimal health. Since the intake of DF is significantly below recommended levels throughout the world, the recognition that ‘all fibers fit’ is an important strategy in bridging the ‘fiber gap’ by enfranchising and encouraging greater intake of foods with inherent and added DF. Fortifying foods with added DF makes it easier to increase intakes while maintaining calories at recommended levels.

Whole grain health claims in the USA and other efforts to increase whole-grain consumption

In response to the 1990 Nutrition Labeling and Education Act, the Food and Drug Administration approved seven health claims that addressed the relationship between broad food categories and risk of certain chronic diseases. These claims are based on scientific consensus that includes epidemiological, animal and clinical research. The Food and Drug Administration also established a process to petition for new health claims that address substance-disease relationships supported by adequate scientific and specific regulatory requirements. The whole grain-cancer and heart disease authoritative statement health claim approved in July 1999 followed a completely different process mandated by the Food and Drug Administration Modernization Act of 1997. It is based on an authoritative statement made by a government body that represents scientific consensus and is supported by other scientific agencies and organizations. The scientific basis for the claim published in Diet and Health reflects a comprehensive and deliberative review of epidemiological, animal and human studies by the National Academy of Sciences Committee on Diet and Health. Health claims used on whole grain products can attract the attention of health-conscious consumers and are important tools in communicating health messages. However, the US public consumes substantially fewer whole-grain servings than recommended by US dietary guidance. Reasons given by consumers for not purchasing wholegrain foods include colour, price, softness, texture, moisture content and taste. Developing tastier value-added wholegrain foods along with simple coordinated messages from industry, the scientific community, public health experts and government will help consumers identify, purchase and consume more wholegrain products.

The definition of dietary fiber - discussions at the Ninth Vahouny Fiber Symposium: building scientific agreement

A definition for dietary fiber was adopted in June 2009 by the Codex Alimentarius Commission based on the recommendation for endorsement of the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) in November 2008. The definition listed three categories of carbohydrate polymers that are not hydrolyzed by the endogenous enzymes in the small intestine of humans. However, the definition left the inclusion of carbohydrates with degrees of polymerization (DP) in the range of 3 and 9 to the discretion of national authorities and left the ‘physiological effect(s) of benefit to health’ as undefined. The ILSI Europe and ILSI North Americas committees on dietary carbohydrates organized a forum at the Ninth Vahouny Fiber Symposium in 2010 to discuss these implementation issues with the objective of building scientific consensus on how to resolve them. The results of this session are encouraging and indicated that the scientific community agrees on maintaining a worldwide consensus regarding the inclusion of non-digestible carbohydrates with ≥DP3 as dietary fiber and on a core, non-exhaustive list of beneficial physiological effects that dietary fibers have. These results are consistent with previous worldwide agreements.

The Importance of Promoting a Whole Grain Foods Message

Despite mention in the Dietary Guidelines for Healthy Americans and in Healthy People 2010, the lack of a coordinated campaign promoting whole grain foods and their health benefits may be contributing to low consumption. Fiber consumption in the U.S. likewise falls below recommended levels, in part, as a result of suboptimal intake of whole grain foods. Research findings suggest that whole grain is related to reduced disease risk, and that whole grain foods have relevant biological activity in humans. This necessitates a call to action to help Americans increase whole grain consumption as a strategy for health. The establishment of a whole grain coalition could promote increased consumption by developing consumer messages; partnering with health professionals; advocating whole grains to government agencies; seeking funding for scientific research and market research; and educating consumers, as well as health professionals, food manufacturers and millers, about the value and benefit of whole grains.

Functionality of Sugars in Foods and Health

Overweight and obesity are global health problems that affect more than 1.9 billion adults who are overweight, and of these 600 million are obese. In the United States, these problems affect 60% of the population. Critical to these statistics is the association with increased risk of cardiovascular disease, type 2 diabetes, and metabolic syndrome among other noncommunicable diseases. Many factors, including sugars, have been charged as potential causes. However, obesity and overweight and their attendant health problems continue to increase despite the fact that there is a decline in the consumption of sugars. Sugars vary in their types and structure. From a food science perspective, sugars present an array of attributes that extend beyond taste, flavor, color, and texture to aspects such as structure and shelf-life of foods. From a public health perspective, there is considerable controversy about the effect of sugar relative to satiety, digestion, and noncommunicable diseases. This comprehensive overview from experts in food science, nutrition and health, sensory science, and biochemistry describes the technical and functional roles of sugar in food production, provides a balanced evidence-based assessment of the literature and addresses many prevalent health issues commonly ascribed to sugar by the media, consumer groups, international scientific organizations, and policy makers. The preponderance of the evidence indicates that sugar as such does not contribute to adverse health outcomes when consumed under isocaloric conditions. The evidence generally indicates, as noted by the 2010 Dietary Guidelines Advisory Committee, that sugar, like any other caloric macronutrient, such as protein and fat, when consumed in excess leads to conditions such as obesity and related comorbidities. More recently, the 2015-2020 Dietary Guidelines for Americans recommended limiting dietary sugar to 10% of total energy in an effort to reduced the risk of these noncommunicable diseases.

Identifying Practical Solutions to Meet America’s Fiber Needs: Proceedings from the Food & Fiber Summit

Fiber continues to be singled out as a nutrient of public health concern. Adequate intakes of fiber are associated with reduced risk for cardiovascular disease, cancer, diabetes, certain gastrointestinal disorders and obesity. Despite ongoing efforts to promote adequate fiber through increased vegetable, fruit and whole-grain intakes, average fiber consumption has remained flat at approximately half of the recommended daily amounts. Research indicates that consumers report increasingly attempting to add fiber-containing foods, but there is confusion around fiber in whole grains. The persistent and alarmingly low intakes of fiber prompted the “Food & Fiber Summit,” which assembled nutrition researchers, educators and communicators to explore fiber’s role in public health, current fiber consumption trends and consumer awareness data with the objective of generating opportunities and solutions to help close the fiber gap. The summit outcomes highlight the need to address consumer confusion and improve the understanding of sources of fiber, to recognize the benefits of various types of fibers and to influence future dietary guidance to provide prominence and clarity around meeting daily fiber recommendations through a variety of foods and fiber types. Potential opportunities to increase fiber intake were identified, with emphasis on meal occasions and food categories that offer practical solutions for closing the fiber gap.

Becoming proactive with the whole-grains message

Whole-grain foods have always been considered a healthy part of the diet. Only recently have epidemiologic and other data shown that whole grains have a role in preventing cardiovascular disease, diabetes, some types of cancer, and even obesity. What nearly all consumers and most health professionals fail to realize is that whole grains deliver as many if not more phytochemicals and antioxidants than do fruits and vegetables. Healthy People 2010 (DHHS) recommends 3 servings of whole grains per day. Because the average intake in the United States is less than 1 serving per day, health professionals must mount an active campaign to help consumers better understand the important health benefits of whole grains and work to increase their intake in the diet.

ILSI Brazil International Workshop on Functional Foods: a narrative review of the scientific evidence in the area of carbohydrates, microbiome, and health

To stimulate discussion around the topic of ‘carbohydrates’ and health, the Brazilian branch of the International Life Sciences Institute held the 11th International Functional Foods Workshop (1–2 December 2011) in which consolidated knowledge and recent scientific advances specific to the relationship between carbohydrates and health were presented. As part of this meeting, several key points related to dietary fiber, glycemic response, fructose, and impacts on satiety, cognition, mood, and gut microbiota were realized: 1) there is a need for global harmonization of a science-based fiber definition; 2) low-glycemic index foods can be used to modulate the postprandial glycemic response and may affect diabetes and cardiovascular outcomes; 3) carbohydrate type may influence satiety and satiation; glycemic load and glycemic index show links to memory, mood, and concentration; 4) validated biomarkers are needed to demonstrate the known prebiotic effect of carbohydrates; 5) negative effects of fructose are not evident when human data are systematically reviewed; 6) new research indicates that diet strongly influences the microbiome; and 7) there is mounting evidence that the intestinal microbiota has the ability to impact the gut–brain axis. Overall, there is much promise for development of functional foods that impact the microbiome and other factors relevant to health, including glycemic response (glycemic index/glycemic load), satiety, mood, cognition, and weight management.

Grain Foods and Health: A Primer for Clinicians

Abstract Preventing many chronic diseases in North America requires substantial changes in dietary habits. Achieving a better balance of grain-based foods through the inclusion of whole grains is one scientifically supported dietary recommendation. Epidemiological and other types of research continue to document health benefits for diverse populations who have adequate intakes of both folic acid-fortified grain foods and whole grains. Folic acid fortification of grains is associated with reduced incidence of neural tube and other birth defects and may be related to decreased risk of other chronic disease. Whole grain intake is associated with reduced risk of chronic disease. Specifically, there is a decreased risk of obesity, coronary heart disease, hypertension, stroke, metabolic syndrome, type 2 diabetes, and some cancers observed among the highest whole grain eaters compared with those eating little or no whole grains. Nationally promulgated dietary recommendations such as those in the US Dietary Guidelines or by health promotion organizations such as the American Heart Association have incorporated the science on whole grains, recommending that consumers increase their whole grain intake. The US Dietary Guidelines state that consumers select half of the recommended bread and cereal servings as whole grain. Thus, the recommendations recognize the importance of adequate folic acid intake from refined, fortified grains to reduce the risk of birth defects and other disorders and to reflect the existing science on whole grains. The association between whole grains and decreased chronic disease is not surprising because whole grains are a source of vitamins, minerals, fatty acids, antioxidants, and other phytochemicals and dietary fiber. Each of these components can act singly or in tandem to contribute to specific health-maintaining and disease-preventing mechanisms. Health professionals should be aware of these benefits and advocate these dietary strategies to help prevent chronic disease and to improve overall health.

Nutritional Impacts of Different Whole Grain Milling Techniques: A Review of Milling Practices and Existing Data

The majority of whole grain flour is produced using modern milling techniques, usually with steel rollers, in which a batch of grain is separated into multiple millstreams, sifted, and recombined. In some cases constituent millstreams are purchased and combined by a supplier or end user to achieve a reconstituted whole grain flour or meal with desired functional, safety, and nutritional properties. In a very small number of cases whole grain flours are stone-ground, with the grain kernels crushed between rotating stones. Data comparing single-stream milling and multiple-stream milling with recombination do not show any strong advantage for either milling method. The separation of millstreams, in fact, allows highly labile brans and germs to undergo a stabilization treatment to make them less susceptible to rancidity—the net result of which is greater safety, stability, and nutrient retention. Data comparing use of stones and steel rollers in milling, in most cases, show improved nutrient and dietary fiber retention and greater protein availability in grains such as barley when steel-roller mills are used. The AACCI Whole Grains Working Group supports increasing whole grain intake through the use of intact whole grains and grains milled with stones and steel rollers in single-stream milling, multiple-stream milling where streams are recombined at the mill, and multiple-stream milling in which whole grains are responsibly reconstituted.