High Fiber Diet and Serum Lipids Research Paper

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High Fiber Diet and Serum Lipids

The study reported herein addresses the question of "What affect does a high fiber diet have on serum lipids in adults?"

The significance of this study is the additional information that will be added to the already existing base of knowledge in this area of study and the synthesis of the information and research on serum lipids and high fiber diet outcomes.

The study reported is a retrospective chart review on patients that have been on a high fiber diet for a period of 12 weeks. Serum lipids were drawn at the beginning of the diet and at 12 weeks to see if there was a change in the serum lipids. Expectations in this study are to witness a decrease in serum lipids of patients in the study who were on a high fiber diet.

Review of the Literature

A high fiber diet is one in which fiber intake is increased to 25 to 40 grams per day because this amount of fiber intake per day has been linked to "reduced risk of many chronic diseases, including cancer, heart disease, certain gastrointestinal conditions, and perhaps even obesity." (The Institute for Optimum Nutrition, 2009) Both soluble and insoluble fibers are included in a high fiber diet. Soluble fibers are those found in beans, oats and fruits while insoluble fiber is found in "vegetables, whole grains and fruit skins." (The Institute for Optimum Nutrition, 2009)

The work of Ballesteros, et al. (2001) entitled: "Dietary Fiber and Lifestyle Influence Serum Lipids in Free Living Adult Men" reported in the Journal of Nutrition reports a study in with the objective of determining the effective of dietary fiber consumption and lifestyle on serum lipids in adult men with non-restricted diet and physical activity. The study involved two groups of 19 men who are reported to have been classified as high and low fiber groups stated at 48 grams per day and 27 grams per day respectively. It is reported that for a seven-day period "Anthropometry, food frequency, daily weighed intakes and physical activity were done for a seven-day period. Fasting blood was collected and serum was analyzed for triglycerides, total cholesterol and lipoprotein cholesterol fractions." (Ballesteros, et al., 2001) The findings of the study are stated to show:

"total cholesterol was negatively associated with physical activity, total dietary fiber and P/S ratio (r = -0.52; p < 0.001, r = -0.44; p < 0.01, r = -0.51, p < 0.001). LDL-C was also correlated negatively with total dietary fiber and P/S ratio (r = -0.34, p < 0.03; r = -0.53, p < 0.01). It was also positively associated with dietary cholesterol and body weight (r = 0.34, p < 0.03; r = 0.31, p < 0.05). Serum triglycerides had an inverse association with total dietary fiber and physical activity (r = -0.30; p < 0.05; r = -0.45, p < 0.004). After controlling for energy intake, total fat, saturated fat, dietary cholesterol, physical activity and body mass index, LDL-C/HDL-C, and TC/HDL-C, remained significantly associated with dietary fiber (r = -0.34; p < 0.05 and r = -0.38; p < 0.02, respectively)." (Ballesteros, et al., 2001)

The study is stated to prove that in free living men that "there is an association between fiber intake and favorable lipid status..." (Ballesteros, et al., 2001) It is reported that consumption of dietary fiber, specifically the soluble type such as pectics and guar gum can results "in a decrease of serum cholesterol levels in healthy and hyperlipidemic subjects." (Ballesteros, et al., 2001)

The work of David Jenkins, et al. (1993) entitled: "Effect on Blood Lipids of Very High Intakes of Fiber in Diets Low in Saturated Fat and Cholesterol" reported that it is known that soluble fiber in the diet "can lower blood lipids. Jenkins et al. reports a study in which the effects of a diet very high in fiber from fruits and vegetables was tested. Jenkins et al. (2001) reports that the levels of intake were those "...which had originally inspired the dietary fiber hypothesis related to colon cancer and heart disease prevention and also may have been eaten early in human evolution." It is reported specifically that 10 volunteers in good health took 3 metabolic diets for a period of two weeks." (Jenkins, et al., 2001)

The diets were comprised by "...high-vegetable, fruit, and nut (very-high-fiber, 55 g/1,000 kcal); starch-based containing cereals and legumes (early agricultural diet); or low-fat (contemporary therapeutic diet). All diets were intended to be weight-maintaining (mean intake, 2,577 kcal/d). Compared with the starch-based and low-fat diets, the high-fiber vegetable diet resulted in the largest reduction in low-density lipoprotein (LDL) cholesterol (33% ± 4%, P < .001) and the greatest fecal bile acid output (1.13 ± 0.30 g/d, P = .002), fecal bulk (906 ± 130 g/d, P < .001), and fecal short-chain fatty acid outputs (78 ± 13 mmol/d, P < .001). Nevertheless, due to the increase in fecal bulk, the actual concentrations of fecal bile acids were lowest on the vegetable diet (1.2 mg/g wet weight, P = .002)." (Jenkins, et al., 2001)

Jenkins et al. (2001) report that the maximum lipid reductions "...occurred within 1 week. Urinary mevalonic acid excretion increased (P = .036) on the high-vegetable diet reflecting large fecal steroid losses. We conclude that very high-vegetable fiber intakes reduce risk factors for cardiovascular disease and possibly colon cancer. Vegetable and fruit fibers therefore warrant further detailed investigation."

The work of Tymchuk, Tessler and Barnard (2000) entitled: "Changes in Sex Hormone-Binding Globulin, Insulin, and Serum Lipids in Postmenopausal Women on a Low-Fat, High-Fiber Diet Combined with Exercise" reports that playing a role in breast cancer development are factors including fat and fiber "possibly mediated by changes in estradiol. The study was reported as having been designed for the purpose of measuring "the effects of a low-fat, high-fiber diet, combined with regular aerobic exercise, on the levels of SHBG, insulin and serum lipids in postmenopausal women with or without hormone replacement therapy (HRT). " (Tymchuk, Tessler and Barnard, 2000)

The report states that the study involved "...two groups of postmenopausal women, 11 on HRT and 11 not on HRT, underwent a low-fat (10% fat calories), high-fiber (65-70 g/day) diet-and-exercise intervention for three weeks. Serum SHBG, insulin, and lipids were measured before and after the regimen." (Tymchuk, Tessler and Barnard, 2000)

Following the intervention it is reported that SHBG levels "...were significantly increased for the women on HRT (44.5 ± 3.4 vs. 62 ± 6.4 nmol/l) and the women not on HRT (32.1 ± 4.6 vs. 45.5 ± 6.1 nmol/l, both changes p < 0.01). Also after the intervention, insulin levels were significantly reduced for the women on HRT (196 ± 44.4 vs. 119.8 ± 28.7 pmol/l) and the women not on HRT (144.2 ± 17.9 vs. 115.5 ± 20.8 pmol/l, both changes p < 0.01). Body mass index and total cholesterol were significantly reduced for both groups of women (all changes p < 0.01)." (Tymchuk, Tessler and Barnard, 2000)

It was reported in June 2002 in the Nutrition Research Newsletter article entitled: "Dietary Fiber Health Claims and Serum Lipids -- Cardiovascular Disease" that the U.S. Food and Drug Administration (FDA) "has approved health claims for two viscous fibers, psyllium (1.78 g/serving) and oat beta-glucan (0.74 g/serving), on the assumption that four servings per day would reduce cardiovascular disease risk. In addition, national agencies concerned with cardiovascular health have for the first time recommended viscous fiber intake." (Nutrition Research Newsletter, 2002) It is reported that researchers in Canada tested "the effects of psyllium and beta-glucan intake, in the amounts approved by the FDA for a fiber health claim, on serum lipid risk factors for cardiovascular disease." (Nutrition Research Newsletter, 2002)

The study included 68 hyperlipidemic subjects who were assigned to "received either a test (high-fiber) and a control low-fat, or low-cholesterol diet for one month each in a randomized crossover study." (Nutrition Research Newsletter, 2002) it is reported that the individuals in the study were educated "and then instructed to follow the guidelines of the National Cholesterol Education Program Step II diet..." (Nutrition Research Newsletter, 2002)

It is reported that the high fiber diet was inclusive of four daily servings of food that contained beta-glucan or psyllium with eight grams per day of more soluble fiber than similar foods that were unsupplemented in the control diet. It is reported that "fasting blood samples and blood pressure readings were obtained at baseline and weeks 2 and 4 and the weight of subjects was monitored on a weekly basis. Each of the diets "had high and similar palatability scores and satiety scores. Compared with the control diet, the high fiber diet significantly reduced total cholesterol, total:HDL cholesterol, and LDL:HDL cholesterol. There was a non-significant reduction in apolipoprotein B:A-I." (Nutrition Research Newsletter, 2002)

Application of the Framingham cardiovascular disease risk equation to the data is stated to have "...confirmed a reduction in risk of 4.2-1.4%. Systolic and diastolic blood pressures were reduced after both diets. No significant… [END OF PREVIEW]

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