Dietary Fibre Intake and the 10-Year Incidence of Tinnitus in Older Adults

Tinnitus is the phantom perception of sound in the ears or head that increases in prevalence as age increases. With strong evidence supporting the benefits of dietary fibre for vascular health and hearing loss, intake of dietary fibre may also have a role in the prevention of tinnitus symptoms. This longitudinal study aims to determine the association between the intake of dietary fibre and other carbohydrate nutrition variables including glycaemic index (GI), glycaemic load (GL) and total carbohydrate intakes, and incident tinnitus over 10 years. Of the 1730 participants (aged ≥50 years) from the Blue Mountains Hearing Study with complete baseline data on tinnitus symptoms and carbohydrate intakes, 536 (31%) cases of tinnitus were identified and excluded from further incidence analysis. Dietary data were collected using a validated semi-quantitative food frequency questionnaire to determine intakes of total dietary fibre and fibre contributions from cereals, vegetables, and fruit. A purpose-built database based on Australian GI values was used to calculate mean GI. Lower versus higher intakes of fruit fibre (≤3.6 g/day vs. >3.6 g/day) and cereal fibre (≤4.2 g/day vs. >4.2 g/day) were significantly associated with a 65% (HR = 1.65; 95% CI: 1.15–2.36) and 54% (HR = 1.54; 95% CI: 1.07–2.22) increased risk of developing tinnitus over 10 years, respectively. Associations between intake of other carbohydrate nutrients and incident tinnitus were mostly non-significant. In summary, our study showed modest associations between intake of dietary fibre and incident tinnitus. The protective effects of fibre, particularly insoluble fibre, could underlie observed associations by reducing the risk of tinnitus via vascular risk factors such as cardiovascular disease. Further longitudinal studies evaluating different types and sources of fibre and tinnitus risk are needed to confirm our study findings.

Inadequate Intake of Dietary Fibre in Adolescents, Adults, and Elderlies: Results of Slovenian Representative SI. Menu Study

Dietary fibre has proven to promote healthy body mass and reduce the risk of non-communicable diseases. To date, in Slovenia, there were only a few outdated studies of dietary fibre intake; therefore, we explored the dietary fibre intake using food consumption data collected in the SI.Menu project. Following the EU Menu methodology, data were collected on representative samples of adolescents, adults, and elderlies using a general questionnaire, a food propensity questionnaire, and two 24 h recalls. The results indicate that the intake of dietary fibre in Slovenia is lower than recommended. The proportion of the population with inadequate fibre intakes (<30 g/day) was 90.6% in adolescents, 89.6% in adults, and 89.3% in elderlies, while mean daily fibre intakes were 19.5, 20.9, and 22.4 g, respectively. Significant determinants for inadequate dietary fibre intake were sex in adolescents and adults, and body mass index in adults. The main food groups contributing to dietary fibre intake were bread and other grain products, vegetables and fruits, with significant differences between population groups. Contribution of fruits and vegetables to mean daily dietary fibre intake was highest in elderlies (11.6 g), followed by adults (10.6 g) and adolescents (8.5 g). Public health strategies, such as food reformulation, promoting whole-meal alternatives, consuming whole foods of plant origin, and careful planning of school meals could beneficially contribute to the overall dietary fibre intake in the population.

Dietary Fibre Intake in Relation to Asthma, Rhinitis and Lung Function Impairment—A Systematic Review of Observational Studies

A high intake of dietary fibre has been associated with a reduced risk of several chronic diseases. This study aimed to review the current evidence on dietary fibre in relation to asthma, rhinitis and lung function impairment. Electronic databases were searched in June 2021 for studies on the association between dietary fibre and asthma, rhinitis, chronic obstructive pulmonary disease (COPD) and lung function. Observational studies with cross-sectional, case–control or prospective designs were included. Studies on animals, case studies and intervention studies were excluded. The quality of the evidence from individual studies was evaluated using the RoB-NObs tool. The World Cancer Research Fund criteria were used to grade the strength of the evidence. Twenty studies were included in this systematic review, of which ten were cohort studies, eight cross-sectional and two case–control studies. Fibre intake during pregnancy or childhood was examined in three studies, while seventeen studies examined the intake during adulthood. There was probable evidence for an inverse association between dietary fibre and COPD and suggestive evidence for a positive association with lung function. However, the evidence regarding asthma and rhinitis was limited and inconsistent. Further research is needed on dietary fibre intake and asthma, rhinitis and lung function among adults and children.

ASSOCIATION BETWEEN KNOWLEDGE, ATTITUDE, AND PRACTICE ABOUT DIETARY FIBRE INTAKE AND TYPE 2 DIABETES AMONG RURAL PEOPLE IN TERENGGANU, MALAYSIA

Awareness of the dietary fibre intake (DF) and its importance in prevention and management of type 2 diabetes mellitus (T2DM) among rural people is seldom reported in Malaysia. This study aimed to determine the knowledge, attitude, and practice (KAP) of DF intake and their association with type 2 diabetes mellitus (T2DM) among rural people in Terengganu, Malaysia. A community-based cross-sectional study was carried out among the households in Kampung Jati, Kuala Nerus, Terengganu, Malaysia from 29th December 2019 until 20th February 2020. The village has 524 houses, the data was collected from all available and eligible subjects in each household by completed socio-demographic, validated KAP on DF intake questionnaire, as well as a 24-hour dietary recall using a self-administered questionnaire. In our study of 396 respondents, 208 (52.5%) were men. The mean age of participants was 37.85 (15.13). Most of the subjects were Malay 384 (97.0%), employed 207 (52.3%) and 274 (69.2%) attained high level of education (from tertiary school level). However, only 170 (42.9%) had a high family income which was of >RM 3860 per month. Out of 396 respondents, 157 (39.6%) of them had family history of diabetes mellitus. Respondents had moderate knowledge (39.1%), positive attitude (88.1%) and good practice (59.3%) scores towards DF intake. Among the respondents, only 39.1% of total respondents knew the nationally recommended amount of daily fibre intake which is of 20-30 grams per day. With multivariable analysis using multiple logistic regression, the analysis results revealed that age (adjusted OR: 1.11, 95% CI: 1.08, 1.15; p <0.001), having family history of T2DM (adjusted OR: 6.81, 95% CI: 2.75, 16.84; p <0.001) and having total attitude scores (adjusted OR: 0.84, 95% CI: 0.76, 0.93; p <0.001) were found to be adjusted significant associated factors of T2DM among the respondents after controlling confounders. Public health authorities should raise awareness on health benefit of consuming dietary fibre to promote an increase in consumption which can help in prevention and management of chronic diseases among rural population of Malaysia.

Food and Nutrient Intakes of Nova Scotian Children in Home and Childcare Environments

Purpose: To describe the energy (E), sodium, saturated fat, sugar, and fibre intakes of a sample of children attending regulated childcare (RCC) in Nova Scotia. Methods: Nutrient analyses from 79 food records were compiled and grouped by intakes in and outside of RCC, age, sex, location of the RCC (urban or rural), and nutrient intake data. Descriptive statistics and independent t tests were conducted. Results: Mean E and macronutrients were within recommended ranges and, for days attending RCC, 45%E was consumed in RCC. Saturated fat intake was 12%E on average. Mean sodium intake exceeded or approached the tolerable upper limit for 3-year olds (1726 mg/day) and 4–5-year olds (1770 mg/day), respectively. Total sugar was 27%E intake and significantly more sugar was consumed outside RCC and by boys compared to girls. Mean daily dietary fibre intake was below recommended levels (15 g/day). Conclusions: On average dietary intakes of children exceeded recommendations for sodium, saturated fat, and sugar with higher intakes outside RCC. The foods provided by RCC have a positive influence on children’s intakes, but given the pervasiveness of sugar and sodium in the food environment and the challenges of feeding children, support is needed for both RCC and families to encourage healthy eating behaviours for positive growth and development.

Association between Dietary Fibre Intake and Colorectal Adenoma: A Systematic Review and Meta-Analysis

PubMed/Medline, Excerpta Medica dataBASE (EMBASE) and Scopus were searched in January 2021 in order to retrieve evidence assessing the association between dietary fibre intake and the risk of colorectal adenoma in adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the reporting of results. Only primary observational studies were included. Publication bias was estimated through the Egger’s test and the visual inspection of the funnel plot. Heterogeneity between studies was calculated with I2 statistics. The search strategy identified 683 papers, 21 of which were included in our meta-analysis. Having evaluated a total of 157,725 subjects, the results suggest a protective effect of dietary fibre intake against colorectal adenoma. Effect Size (ES) was [0.71 (95% CI = 0.68–0.75), p = 0.000)]. Moderate statistical heterogeneity (Chi2 = 61.68, df = 23, I2 = 62.71%, p = 0.000) was found. Findings show a statistically significant (p = 0.000) and robust association between a higher intake of dietary fibre and a lower risk of colorectal adenoma, considering both the prevalent and incident risk. Moreover, the meta-regression analysis showed a borderline significant negative linear correlation between the amount of dietary fibre intake and colorectal adenoma. Lastly, we performed a subgroup analysis by sex, showing a higher protective effect for men.

The Low-Carbohydrate Diet: Short-Term Metabolic Efficacy Versus Longer-Term Limitations

Background: Diets have been a central component of lifestyle modification for decades. The Low-Carbohydrate Diet (LCD), originally conceived as a treatment strategy for intractable epilepsy (due to its association with ketogenesis), became popular in the 1970s and since then has risen to prominence as a weight loss strategy. Objective: To explore the efficacy, limitations and potential safety concerns of the LCD. Data Sources: We performed a narrative review, based on relevant articles written in English from a Pubmed search, using the terms ‘low carbohydrate diet and metabolic health’. Results: Evidence supports the efficacy of the LCD in the short-term (up to 6-months) for reduction in fat mass and remission of Type 2 Diabetes Mellitus (T2D). However, the longer-term efficacy of the LCD is disappointing, with diminishment of weight loss potential and metabolic benefits of the LCD beyond 6-months of its adoption. Furthermore, practical limitations of the LCD include the associated restriction of food choices that restrict the acceptability of the LCD for the individual, particularly over the longer term. There are also safety concerns of the LCD that stem from nutritional imbalances (with a relative excess of dietary fat and protein intake with associated dyslipidaemia and increased risk of insulin resistance and T2D development) and ketotic effects. Finally, the LCD often results in a reduction in dietary fibre intake, with potentially serious adverse consequences for overall health and the gut microbiota. Conclusions: Although widely adopted, the LCD usually has short-lived metabolic benefits, with limited efficacy and practicality over the longer term. Dietary modification needs tailoring to the individual, with careful a priori assessments of food preferences to ensure acceptability and adherence over the longer term, with avoidance of dietary imbalances and optimization of dietary fibre intake (primarily from plant-based fruit and vegetables), and with a posteriori assessments of the highly individual responses to the LCD. Finally, we need to change our view of diets from simply an excipient for weight loss to an essential component of a healthy lifestyle.

Dietary Fibre Intake Is Associated with Serum Levels of Uraemic Toxins in Children with Chronic Kidney Disease

Imbalanced colonic microbial metabolism plays a pivotal role in generating protein-bound uraemic toxins (PBUTs), which accumulate with deteriorating kidney function and contribute to the uraemic burden of children with chronic kidney disease (CKD). Dietary choices impact the gut microbiome and metabolism. The aim of this study was to investigate the relation between dietary fibre and gut-derived PBUTs in paediatric CKD. Sixty-one (44 male) CKD children (9 ± 5 years) were prospectively followed for two years. Dietary fibre intake was evaluated by either 24-h recalls (73%) or 3-day food records (27%) at the same time of blood sampling for assessment of total and free serum levels of different PBUTs using liquid chromatography. We used linear mixed models to assess associations between fibre intake and PBUT levels. We found an inverse association between increase in fibre consumption (g/day) and serum concentrations of free indoxyl sulfate (−3.1% (−5.9%; −0.3%) (p = 0.035)), free p-cresyl sulfate (−2.5% (−4.7%; −0.3%) (p = 0.034)), total indole acetic acid (IAA) (−1.6% (−3.0%; −0.3%) (p = 0.020)), free IAA (−6.6% (−9.3%; −3.7%) (p < 0.001)), total serum p-cresyl glucuronide (pCG) (−3.0% (−5.6%; −0.5%) (p = 0.021)) and free pCG levels (−3.3% (−5.8%; −0.8%) (p = 0.010)). The observed associations between dietary fibre intake and the investigated PBUTs highlight potential benefits of fibre intake for the paediatric CKD population. The present observational findings should inform and guide adaptations of dietary prescriptions in children with CKD.